Coenzyme Q10 Supplementation Alleviates Chronic Fatigue

Fatigue. Chronic fatigue. Can CoQ10 supplementation make a difference against fatigue, lethargy, tiredness?

Dr. William V. Judy (1938-2022), president of the SIBR Research Institute, managed clinical trials of CoQ10 treatment for patients with heart failure, chronic fatigue syndrome, and prostate cancer. Dr. Judy advocated for the use of CoQ10 supplementation with patients with low-energy syndromes.

The pooled data from 13 randomized controlled trials enrolling 1,126 study participants has shown that Coenzyme Q10, as compared with placebo, significantly reduces fatigue scores [Tsai 2022].

• The beneficial treatment effects of the CoQ10 supplementation were consistent in both healthy and diseased study participants.
• Increases in the daily dose of Coenzyme Q10 and in the duration of the CoQ10 treatment were both positively associated with greater fatigue reduction.
• There was only one adverse (gastrointestinal) event in the 602 study participants who had taken the CoQ10 supplements.

The authors of the 2022 meta-analysis concluded that Coenzyme Q10 is an effective and safe supplement for reducing fatigue symptoms [Tsai 2022].

How Does Coenzyme Q10 Relieve Fatigue?

There are several factors involved in chronic fatigue. There is evidence that CoQ10 supplementation addresses some of these factors, e.g., mitochondrial dysfunction, oxidative stress, chronic systemic inflammation [Tsai 2022].

• Mitochondrial dysfunction: The mitochondria – bean-shaped organelles in the cells – have several key functions in cell metabolism. The most important function is the generation of cellular ATP energy. Coenzyme Q10 is a key component in the mitochondrial electron transfer chain, which drives the process of cellular energy production [Hidalgo-Gutiérrez 2021].
• Oxidative stress: Coenzyme Q10 is a lipid-soluble antioxidant that works to inhibit oxidation of lipid-containing structures such as cellular membranes and lipoproteins. CoQ10 supplementation may also provide protection against oxidative damage to neurons, which is a factor in persistent fatigue [Aaseth 2021]. A 2020 meta-analysis of 19 clinical studies has shown that CoQ10 supplementation can reduce the levels of  blood bio-markers of oxidative stress [Sangsefidi 2020].
• Chronic systemic inflammation: Fatigue is one part of the response to chronic inflammation [Omdal 2020]. A 2017 meta-analysis of 17 clinical studies showed that CoQ10 supplementation has significant lowering effects on the C-RP, IL-6, and TNF-α blood bio-markers of inflammation [Fan 2017].

In the landmark KiSel-10 study, Professor Urban Alehagen showed that combined Coenzyme Q10 and selenium supplementation improved heart function and reduced the levels of blood bio-markers for oxidative stress and inflammation.

The Safety of CoQ10 Supplementation

Coenzyme Q10 has a well-documented safety level of up to 1,200 mg/day per person [Hidaka 2008].

Pharmacokinetic studies indicate that CoQ10 supplementation does not affect the biosynthesis of endogenous Coenzyme Q10 and that Coenzyme Q10 does not accumulate in the plasma or the tissues after the cessation of
supplementation (Bhagavan and Chopra 2007].

Conclusion: Coenzyme Q10 Has a Fatigue Alleviating Effect

Tsai et al [2022] have shown that CoQ10 supplementation does have a fatigue alleviating effect and that the effect increases with increased daily dosage and with longer treatment duration.

There remains the question of whether the formulation and the bioavailability of the CoQ10 supplement plays a role in its fatigue reducing effect.

The formulation of the CoQ10 supplement is the decisive factor in the absorption and bioavailability of the substance: the manufacturer’s failure to solve the problem of CoQ10 crystal dissolution to single CoQ10 molecules can reduce bioavailability by 75% [Mantle & Dybring 2020].

Note: The human body cannot absorb CoQ10 crystals. It can absorb only single CoQ10 molecules.

Consequently, it is important to buy a CoQ10 supplement that has been formulated with the proper mix of carrier oils and that has been prepared using precise heating and cooling procedures [Lopez-Lluch 2019].

Buying a CoQ10 product without documented absorption and bioavailability will likely be a waste of money. Moreover, there is good reason to think that a well-formulated ubiquinone CoQ10 supplement will supply the body with significant quantities of the ubiquinol form of Coenzyme Q10 in the blood plasma and lipoproteins [Mantle & Dybring 2020].

Sources

Aaseth J, Alexander J, Alehagen U. Coenzyme Q10 supplementation – In ageing and disease. Mech Ageing Dev. 2021 Jul;197:111521.

Bhagavan HN, Chopra RK. Plasma coenzyme Q10 response to oral ingestion of coenzyme Q10 formulations. Mitochondrion. 2007 Jun;7 Suppl:S78-88.

Fan L, Feng Y, Chen GC, Qin LQ, Fu CL, Chen LH. Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2017 May;119:128-136.

Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K. Safety assessment of coenzyme Q10 (CoQ10). Biofactors. 2008;32(1-4):199-208.

Hidalgo-Gutiérrez A, González-García P, Díaz-Casado ME, Barriocanal-Casado E, López-Herrador S, Quinzii CM, López LC. Metabolic targets of Coenzyme Q10 in mitochondria. Antioxidants (Basel). 2021 Mar 26;10(4):520.

López-Lluch G, Del Pozo-Cruz J, Sánchez-Cuesta A, Cortés-Rodríguez AB, Navas P. Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition. 2019 Jan;57:133-140.

D, Dybring A. Bioavailability of Coenzyme Q10: An Overview of the Absorption Process and Subsequent Metabolism. Antioxidants (Basel). 2020 May 5;9(5):386.

Omdal R. The biological basis of chronic fatigue: neuroinflammation and innate immunity. Curr Opin Neurol. 2020 Jun;33(3):391-396.

Sangsefidi, Z. S., Yaghoubi, F., Hajiahmadi, S., and Hosseinzadeh, M. The effect of Coenzyme Q10 supplementation on oxidative stress: a systematic review and meta-analysis of randomized controlled clinical trials. Food Sci. Nutr. 2020;8:1766–1776.

Tsai IC, Hsu CW, Chang CH, Tseng PT, Chang KV. Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Pharmacol. 2022 Aug 24;13:883251.

The information presented in this review article is not intended as medical advice and should not be used as such.

30 November 2022