Low energy syndrome disorders include chronic fatigue syndrome, fibromyalgia, long COVID, and Gulf War illness. These disorders have different origins. However, they have overlapping common symptoms related to an underlying similar pathology. In all four low energy syndrome disorders, there is evidence for mitochondrial dysfunction, oxidative stress, inflammation, and immune system dysregulation [Mantle 2025].

Low energy woman at laptop

CoQ10 supplements can treat a group of low energy disorders with common symptoms and common underlying pathology.

Coenzyme Q10 is known to play a role in the promotion of normal mitochondrial function. CoQ10 also functions as a lipid-soluble antioxidant and as an anti-inflammatory agent. Accordingly, there is a rationale for CoQ10 supplementation in the management of low energy syndrome disorders. In a 2025 review, Mantle et al have reported the benefits of CoQ10 administration to patients with chronic fatigue syndrome, fibromyalgia, long COVID, and Gulf War illness.

Low Energy Syndrome Disorders

In all four conditions, clinical evaluation is difficult. There are no clear objective case criteria or specific biomarkers. At present, there are no known cures for these disorders. Treatment focuses on managing symptoms and improving quality of life [Mantle 2025]:

  • Acupuncture
  • Cognitive-behavioral therapy
  • Graded exercise therapy
  • Tai-Chi
  • Yoga

Anxiety and depression may accompany low energy syndrome disorders. As a result, some antidepressants may be used.

Some symptoms do seem to be present in all four disorders [Mantle 2025]:

  • Fatigue and post-exertional tiredness
  • Damage to nerves of the autonomic nervous system
  • Cognitive impairment
  • Unrefreshing sleep
  • Muscle and joint pain
Chronic Fatigue Syndrome

Also known as Myalgic Encephalomyelitis, chronic fatigue syndrome is characterized by post-exertional tiredness, unrefreshing sleep, cognitive dysfunction, and autonomic nervous system dysfunction [Mantle 2025].

Fibromyalgia

Historically, fibromyalgia has been difficult to diagnose. It is identified by widespread pain and tender points, fatigue, and cognitive dysfunction.

Long COVID

Long COVID illness is a longer-term consequence of an acute SARS-CoV-2 infection. Long COVID patients typically show symptoms such as brain fog, fatigue, and general malaise lasting more than four weeks. In some ways, long COVID resembles chronic fatigue syndrome [Mantle 2025].

Gulf War Illness

Gulf War illness affects veterans of the 1990–91 Gulf War. It involves fatigue, pain, and cognitive issues. Gulf War illness symptoms are linked to both environmental exposure and genetic susceptibility [Mantle 2025].

CoQ10 and Low Energy Syndrome Disorders

Mantle et al [2025] point out that there are no health-authority-approved effective treatments for the low energy syndrome disorders beyond four medications currently available for treating fibromyalgia:

  • Cyclobenzaprine
  • Duloxetine
  • Milnacipran
  • Pregabalin

Chief among the shared symptoms of the low energy syndrome disorders are the following:

  • Faster rate of telomere shortening
  • Immune system dysregulation
  • Mitochondrial dysfunction
  • Oxidative stress
  • Systemic inflammation
CoQ10 and Chronic Fatigue Syndrome

Somewhat more studies have shown that CoQ10 supplementation reduces fatigue and improves the quality of life in individuals with chronic fatigue syndrome. In a consensus report, the European network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (the EUROMENE consortium) has suggested CoQ10 supplementation for the reduction of fatigue, pain, and cognitive dysfunction in chronic fatigue syndrome patients [Mantle 2025].

CoQ10 and Fibromyalgia

Mantle et al point out that fibromyalgia patients are known to have depleted levels of circulating and tissue CoQ10: typically 40–50% of normal levels. A randomized controlled clinical trial has shown that daily CoQ10 supplementation reduced fatigue and pain in fibromyalgia patients. The CoQ10 supplementation was also associated with improved mitochondrial ATP energy generation. The dosage and duration in the study were 300 mg/day of CoQ10 for 40 days [Cordero 2013].

CoQ10 and Long COVID

There have been mixed results from clinical studies of CoQ10 supplementation in COVID-19 patients and long COVID patients. An observational study reduced levels of fatigue in patients supplemented with 200 mg of CoQ10 and 200 mg of alpha-lipoic acid per day for 2 months, as compared with patients who received placebo [Mantle 2025].

On the other hand, a randomized controlled intervention study enrolling long COVID patients failed to show any significant benefits of supplementation with 500 mg of CoQ10 per day for six weeks [Mantle 2025].

More clinical research is needed.

CoQ10 and Gulf War Illness

A 2014 clinical study has shown that CoQ10 supplementation of Gulf War illness veterans improved fatigue, pain, muscle strength, and physical function, compared with placebo [Golomb 2014].

CoQ10 and Telomere Attrition
Prof Urban Alehagen lecturing

Prof. Urban Alehagen was the lead researcher on the KiSel-10 study of CoQ10 and selenium supplementation of elderly individuals who had low circulating levels of both substances.

More rapid telomere shortening seems to be common to all four low energy syndrome disorders. In a KiSel-10 sub-study, researchers found that combined supplementation with CoQ10 and selenium with CoQ10 resulted in less telomere shortening compared to placebo. The researchers also observed a correlation between longer telomeres and reduced cardiovascular mortality [Opstad 2022].

Conclusion: CoQ10 and Low Energy Syndrome Disorders

Low energy syndrome disorders have overlapping common symptoms and underlying biological mechanisms.

In low energy syndrome disorders, there is evidence of mitochondrial dysfunction, oxidative stress, inflammation, immune dysregulation, and telomere shortening.

There is a rationale for the use of CoQ10 supplementation in the management of low energy syndrome disorders.

Sources

Cordero MD et al. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q10 effect on clinical improvement. PLoS One. 2012;7(4):e35677.

Golomb BA et al. Coenzyme Q10 benefits symptoms in Gulf War veterans: results of a randomized double-blind study. Neural Comput. 2014 Nov;26(11):2594-651.

Mantle D et al. Gulf War illness, fibromyalgia, myalgic encephalomyelitis / chronic fatigue syndrome and long COVID overlap in common symptoms and underlying biological mechanisms: implications for future therapeutic strategies. Int. J. Mol. Sci. 2025, 26, 9044.

Opstad TB et al. Selenium and Coenzyme Q10 intervention prevents telomere attrition, with association to reduced cardiovascular mortality-sub-study of a randomized clinical trial. Nutrients. 2022 Aug 15;14(16):3346.

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