Chronic fatigue syndrome: Researchers at the Vall d’Hebron University Hospital in Barcelona, Spain, have shown that daily combined CoQ10 and selenium supplementation can alleviate the symptoms of chronic fatigue syndrome and may also address the underlying issues of mitochondrial dysfunction, oxidative stress, and systemic inflammation [Castro-Marrero 2022].

Woman at computer

Myalgic encephalomyelitis/chronic fatigue syndrome is debilitating illness that affects millions of people. Its cause is not known. Its symptoms are persistent fatigue, muscle and joint pain, concentration difficulties, depression, and mood swings. There is no known cure.

This is indeed good news as it offers hope to millions of chronic fatigue syndrome sufferers for whom there is no standard medical treatment available.

Who Took the Coenzyme Q10 and Selenium Supplements?

The Barcelona researchers administered the combined CoQ10 and selenium supplements to 27 women diagnosed with mild to moderate chronic fatigue syndrome. The women’s average was 47 years. The women’s body mass indexes indicated that the women were not overweight or obese [Castro-Marrero 2022].

Which CoQ10 and Selenium Supplements Gave Health Benefits?

The study participants took the following supplements daily for eight weeks:

When Did They Take the CoQ10 and Selenium Supplements?

Thirty minutes before breakfast and again thirty minutes before lunch, the study participants took two 100-mg capsules of the Coenzyme Q10, equaling a total of 400 mg of Coenzyme Q10 each day. Divided doses give a better absorption than single doses do.

Thirty minutes before breakfast, the study participants took a 200-mcg selenium yeast tablet.

Why Did the Researchers Use a Combination Treatment?

No doubt the Barcelona researchers were influenced by the results of similar combined supplementation of healthy elderly citizens in the KiSel-10 Study in Sweden. In that study, the study participants had an average age of 78 years but were still able to live on their own.

They took 2 times 100 mg of Coenzyme Q10 and 200 mcg of selenium daily for four years. At the conclusion of the study, the study participants who had taken the combined CoQ10 and selenium treatment had significantly reduced risk of death from cardiovascular disease and significantly improved heart function compared to study participants who had taken matching placebos [Alehagen 2013].

Follow-up of the study participants for an additional eight years beyond the cessation of the four-year supplementation period showed that the risk of death from cardiovascular disease was still significantly reduced in the active treatment group [Alehagen 2018].

Prof. Urban Alehagen and the Swedish research team conducted sub-analyses of the KiSel-10 Study data that showed that the beneficial health effects of the combined treatment were positively associated with reductions in the levels of blood biomarkers of oxidative stress, systemic inflammation, and fibrosis [Alehagen 2018].

How Did the Combined CoQ10 and Selenium Treatment Work?

The data from the Barcelona study show that the combined CoQ10 and selenium treatment had the following beneficial effects on the chronic fatigue syndrome patients:

  • Significantly reduced the severity of overall fatigue
  • Significantly improved the overall quality of life
  • Significantly increased total antioxidant capacity
  • Significantly reduced the level of malondialdehyde, a blood biomarker for oxidative stress

Dr. Castro-Marrero and the Barcelona researchers concluded that the combined treatment had alleviated the symptoms of persistent fatigue and poor quality of life by exerting a modulating effect on the extent of oxidative stress and inflammation in the chronic fatigue syndrome patients [Castro-Marrero 2022].

Dr. William Judy

In the book The Insider’s Guide to Coenzyme Q10, Dr. William V. Judy describes a study of chronic fatigue patients in which CoQ10 supplementation was associated with an increase in exercise time and a decrease in recovery time [Judy 1993, 1998]. The book is available on ISBN: 978-87-7776-186-7.

They hypothesized that long-term supplementation with a combination of Coenzyme Q10 and selenium may have a beneficial synergistic effect on chronic fatigue syndrome patients [Castro-Marrero 2022].

Coenzyme Q10 and Selenium – A Special Interrelationship

Prof. Urban Alehagen and Prof. Jan Aaseth have posited that there exists a special interrelationship between Coenzyme Q10 and selenium such that selenium deficiency can affect the ability of the cells to achieve optimal concentrations of Coenzyme Q10 and such that the cells are dependent on adequate levels of Coenzyme Q10 to realize optimal function of selenoproteins [Alehagen & Aaseth 2015].

Conclusion: Chronic Fatigue Syndrome Combined Therapy

There seems to be an advantage to using Coenzyme Q10 and selenium together, particularly in patient populations that have low levels of both substances, e.g., chronic fatigue syndrome patients, heart failure and ischemic heart disease patients, elderly citizens living in selenium-poor regions.


Alehagen U, Johansson P, Björnstedt M, Rosén A, Dahlström U. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Int J Cardiol. 2013 Sep 1;167(5):1860-6.
Alehagen U, Aaseth J. Selenium and coenzyme Q10 interrelationship in cardiovascular diseases–A clinician’s point of view. J Trace Elem Med Biol. 2015;31:157-62.

Alehagen U, Aaseth J, Alexander J, Johansson P. Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly. PLoS One. 2018 Apr 11;13(4):e0193120.

Castro-Marrero J, Domingo JC, Cordobilla B, Ferrer R, Giralt M, Sanmartín-Sentañes R, Alegre-Martín J. Does Coenzyme Q10 plus selenium supplementation ameliorate clinical outcomes by modulating oxidative stress and inflammation in individuals with myalgic encephalomyelitis/chronic fatigue syndrome? Antioxid Redox Signal. 2022 Apr;36(10-12):729-739.

Judy WV & Folkers K. Management of chronic fatigue syndrome patients with CoQ10. 8th Intl Symp Biomed and Clin Aspects of CoQ. 1993:55.

Judy WV, Stogsdill WW, & Folkers K. (1998). Dose related effectiveness of Coenzyme Q10 in the treatment of chronic fatigue. Boston: 1st Conf. Of the Intl. Coenzyme Q10 Assn. 86.

Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014 Dec;2(6):641-9.

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

15 September 2022