Long COVID, fibromyalgia, chronic fatigue syndrome, and Gulf War Illness are low energy syndrome disorders. They have different origins. However, they also have overlapping common symptoms that help to explain the underlying pathology [Mantle 2025].

Woman with low energy

Fatigue, low energy, unrefreshing sleep all characterize the low energy syndrome disorders. CoQ10 supplementation may enhance mitochondrial function and ATP energy generation.

In a 2025 review article, Dr. David Mantle and his co-authors identify the evidence for common features in the four different disorders. Of particular interest is the authors’ focus on mitochondrial dysfunction, oxidative stress, and chronic inflammation as factors in the development of these disorders.

The vitamin-like substance Coenzyme Q10 promotes normal mitochondrial function. CoQ10 also functions as an antioxidant and as an anti-inflammatory agent. Accordingly, Mantle et al see a rationale for CoQ10 supplementation in the treatment and management of these disorders. They have reviewed the existing clinical studies.

Overlapping Symptoms in Low Energy Syndrome Disorders

In their 2025 review article, Mantle et al have identified the common symptoms shared by the four disorders.

  • Fatigue and post-exertional malaise
  • Dysregulation of the autonomic nervous system
  • Cognitive dysfunction and impairment
  • Unrefreshing sleep
  • Joint pain and muscle aches

Common Biological Mechanisms in the Four Low Energy Syndrome Disorders

Mitochondrial Dysfunction

Lagging mitochondrial cellular energy production is associated with low energy syndrome disorders. In these disorders, mitochondrial dysfunction and impaired ATP generation may be an underlying contributor to the fatigue and muscle weakness [Mantle 2025].

Oxidative Stress and Systemic Inflammation

In the low energy syndrome disorders, it is typical to find blood biomarkers indicating a increased oxidative stress and/or elevated levels of inflammation [Mantle 2025].

CoQ10 Supplementation and Low Energy Syndrome Disorders

Mantle et al summarize the clinical evidence that CoQ10 supplementation can have beneficial effects in Long COVID, fibromyalgia, chronic fatigue syndrome and Gulf War illness. The CoQ10 supplementation is associated with improved mitochondrial function, reduced levels of oxidative stress and inflammation, and, with less telomere shortening [Mantle 2025].

In a 2012 clinical trial enrolling fibromyalgia patients, Cordero et al showed that CoQ10 supplementation was associated with significant improvements in ATP levels [Cordero 2012].

Conclusion: CoQ10 and Low Energy Syndrome Disorders

The low energy syndrome disorders have different origins. However, they have many of the same underlying biological mechanisms.

Mitochondrial dysfunction, increased oxidative stress, and elevated inflammation characterize the low energy syndrome disorders.

Supplementary Coenzyme Q10 improves mitochondrial function, reduces oxidative stress, and decreases chronic inflammation.

The absorption and bioavailability of commercially available CoQ10 supplements depend upon how well the supplement is formulation.

It is important to buy a CoQ10 supplement that has well documented absorption and bioavailability.

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.

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 Sep 17;26(18):9044.

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