Fibromyalgia woman

Fibromyalgia patients have low Coenzyme Q10 levels and low serotonin levels.  Studies done in the Faculty of Medicine at the University of Sevilla, Spain, show that Coenzyme Q10 supplements can restore both Coenzyme Q10 and serotonin levels and can improve the symptoms of depression. Other studies show that Coenzyme Q10 supplementation can inhibit the inflammatory process and reduce oxidative stress damage.

Can we make a convincing argument for fibromyalgia patients to take a daily Coenzyme Q10 nutritional supplement?  If so, what is the basis for the argument?

Fibromyalgia is a complex disorder.  It causes pain, joint stiffness, debilitating fatigue, and difficulty thinking and remembering.  Its cause is not known; its treatment is uncertain.  It affects as many as five million Americans above the age of 18 years.  It affects many more women than men.

Coenzyme Q10 status and fibromyalgia
The first thing to know is that fibromyalgia is associated with low plasma Coenzyme Q10 levels [Garrido-Maraver 2014].

Coenzyme Q10 is a known and essential co-factor in the cellular process of energy production.  Coenzyme Q10 supplementation has also been seen to decrease the levels of some biological markers for inflammation [Cordero 2013].  These two functions — energy production and reduction of inflammation —  constitute the basis of the claim for Coenzyme Q10 supplementation of fibromyalgia patients.

Moreover, research has shown that the distribution of Coenzyme Q10 is altered in the blood components of fibromyalgia patients as compared with normal healthy individuals [Cordero 2009].  Some research results indicate that there is increased oxidative stress associated with fibromyalgia [Cordero 2009].

Coenzyme Q10 and oxidative stress
It may be possible to trace this association between oxidative stress and fibromyalgia back to a deficiency or maldistribution of Coenzyme Q10 in the cells and tissues of fibromyalgia patients.  Dr. Cordero et al have demonstrated higher levels of harmful free radical production and higher levels of oxidative stress markers in the plasma of fibromyalgia patients as compared with healthy control subjects [Cordero 2009].

Independent research results show that Coenzyme Q10 supplementation is associated positively with reductions in the levels of some bio-markers of oxidative stress [Alehagen 2015].

Dr. Castro-Marrero and a team of researchers have shown significantly decreased blood Coenzyme Q10 concentrations and significantly increased levels of lipid peroxidation in both fibromyalgia and chronic fatigue syndrome patients, compared to controls.  These findings indicate that both fibromyalgia and chronic fatigue syndrome patients suffer from oxidative stress-induced damage [Castro-Marrero 2013].

Coenzyme Q10 and inflammasome activation
Inflammation is a protective response of the body’s immune system to harmful pathogens and toxins.  Inflammasomes are components of the innate immune system.  Inflammasomes are responsible for activating inflammatory processes.

Research has shown a definite association between Coenzyme Q10 deficiency, on the one hand, and the activation of pro-inflammatory markers and increased serum levels of pro-inflammatory cytokines , on the other hand [Cordero 2014].

In a placebo-controlled study, Dr. Cordero et al have shown the following interesting associations:

  • NLRP3 inflammasome activity is associated with the development of fibromyalgia.
  • Supplementation with Coenzyme Q10 is associated with inhibition of NLRP3 inflammasome activity.
  • Supplementation with Coenzyme Q10 is associated with reduced interleukin IL-1β and IL-18 serum levels [Cordero 2014].

The researchers’ results suggest that supplementation with Coenzyme Q10 might well be a useful therapeutic intervention for use with fibromyalgia patients.

Coenzyme Q10 and fatigue
The Fibromyalgia Impact Questionnaire (FIQ) is a test designed to measure various aspects of the physical functioning of women diagnosed with fibromyalgia.  Among the sub-scales of the test are such items as subjective physical well-being, ability to go to work, ability to do one’s job, pain, fatigue, ability to rest, stiffness, anxiety, and depression [Fibromyalgia 2017].

In a randomized, double-blinded, placebo-controlled trial, Dr. Cordero and his colleagues tested the effect of 40 days of Coenzyme Q10 supplementation (300 milligrams/day) on fibromyalgia patients.  The supplementation with Coenzyme Q10 was associated with significant improvement as compared with the placebo supplementation:

  • reduction in FIQ test scores
  • reduction in pain
  • reduction in fatigue
  • reduction in morning tiredness [Cordero 2013]

In a separate study in which fibromyalgia patients were supplemented with 300 milligrams of Coenzyme Q10 for three months, Dr. Cordero and his fellow researchers found an improvement in clinical symptoms and in the previously low blood Coenzyme Q10 levels [Cordero 2012].

Coenzyme Q10 and headache in fibromyalgia disorder
In one study, Dr. Cordero and his colleagues used the Heachache Impact Test (HIT-6) in a study of Coenzyme Q10 supplementation of fibromyalgia patients.  The researchers’ results showed significant negative correlation between blood Coenzyme Q10 levels and headache parameters.  The oral Coenzyme Q10 supplementation was associated with a significant improvement in clinical and headache symptoms [Cordero 2012].

Coenzyme Q10 and depression in fibromyalgia patients
Dr. Alcocer-Gómez and his colleagues have demonstrated that Coenzyme Q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients [Alcocer- Gómez 2014].

Safety of Coenzyme Q10
Coenzyme Q10 supplements are well-tolerated and safe.  They are affordable.  However, there is considerable variation in the absorption and distribution of the supplemented Coenzyme Q10.  The formulation of the Coenzyme Q10 supplement is the most important factor in its absorption.

Summary: Coenzyme Q10 supplementation and fibromyalgia
There seems to be a background of oxidative stress damage and inflammation in fibromyalgia disorder.  Plasma Coenzyme Q10 levels in fibromyalgia patients are generally low.  Supplementation with Coenzyme Q10 improves the symptoms of fibromyalgia.


Alcocer-Gómez, E., Sánchez-Alcázar, J. A., & Cordero, M. D. (2014). Coenzyme q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients: results of a small clinical trial. Journal of Clinical Psychopharmacology, 34(2), 277-278.

Alehagen, U., Aaseth, J., & Johansson, P. (2015). Less increase of copeptin and MR-proADM due to intervention with selenium and coenzyme Q10 combined: Results from a 4-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Biofactors (Oxford, England), 41(6), 443-452.

Castro-Marrero, J., Cordero, M. D., Sáez-Francas, N., Jimenez-Gutierrez, C., Aguilar-Montilla, F. J., Aliste, L., & Alegre-Martin, J. (2013). Could mitochondrial dysfunction be a differentiating marker between chronic fatigue syndrome and fibromyalgia? Antioxidants & Redox Signaling, 19(15), 1855-1860.

Cordero, M. D., Alcocer-Gómez, E., Culic, O., Carrión, A. M., de Miguel, M., Díaz-Parrado, E., & Sánchez-Alcazar, J. A. (2014). NLRP3 inflammasome is activated in fibromyalgia: the effect of Coenzyme Q10. Antioxidants & Redox Signaling, 20(8), 1169-1180.

Cordero, M. D., Alcocer-Gómez, E., de Miguel, M., Culic, O., Carrión, A. M., Alvarez-Suarez, J. M., & Sánchez-Alcazar, J. A. (2013). Can Coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxidants & Redox Signaling, 19(12), 1356-1361.

Cordero, M. D., Santos-García, R., Bermejo-Jover, D., Sánchez-Domínguez, B., Jaramillo-Santos, M. R., & Bullón, P. (2012). Coenzyme Q10 in salivary cells correlate with blood cells in Fibromyalgia: improvement in clinical and biochemical parameter after oral treatment. Clinical Biochemistry, 45(6), 509-511.

Cordero, M. D., Cano-García, F. J., Alcocer-Gómez, E., De Miguel, M., & Sánchez-Alcázar, J. A. (2012). Oxidative stress correlates with headache symptoms in fibromyalgia: Coenzyme Q10 effect on clinical improvement. Plos One, 7(4), e35677. doi:10.1371/journal.pone.0035677.

Cordero, M. D., Moreno-Fernández, A. M., deMiguel, M., Bonal, P., Campa, F., Jiménez-Jiménez, L. M., & … Navas, P. (2009). Coenzyme Q10 distribution in blood is altered in patients with fibromyalgia. Clinical Biochemistry, 42(7-8), 732-735.

Fibromyalgia Impact Questionnaire (FIQ). (2017).  American College of Rheumatology. Retrieved from

Garrido-Maraver, J., Cordero, M. D., Oropesa-Avila, M., Vega, A. F., de la Mata, M., Pavon, A. D., & Sanchez-Alcazar, J. A. (2014). Clinical applications of Coenzyme Q10. Frontiers in Bioscience, 19619-633.

Disclaimer: The information presented in this article is not intended as medical advise and should not be viewed as such.