Fibromyalgia is a chronic pain syndrome affecting an estimated 5% of people worldwide. It is characterized by the following symptoms:
- cognitive complaints related to concentration and memory
- fatigue and a feeling of being tired much of the time
- mood issues including anxiety and depression
- muscle stiffness and soreness
- sleep disorders
What it is that triggers fibromyalgia is not known with certainty and can vary from individual to individual. Researchers hypothesize that fibromyalgia affects the ways in which the brain processes pain signals [Mayo Clinic].
Low Coenzyme Q10 associated with fibromyalgia
If we round up the usual suspects in our investigation of fibromyalgia, we end up making a connection between Coenzyme Q10 deficiency and fibromyalgia.
Fibromyalgia researchers have documented that fibromyalgia patients have deficient Coenzyme Q10 concentrations amounting to 40% – 50% or normal Coenzyme Q10 levels [Mantle 2017].
Importance of Coenzyme Q10 for fibromyalgia patients
Fibromyalgia researchers hypothesize that the following suspects are important events in the pathogenesis of fibromyalgia [Cordero]:
- mitochondrial dysfunction
- oxidative stress
Intuitively, we can see that impaired function of the mitochondria — the key organelles involved in cellular energy production — can result in the fatigue and other symptoms of fibromyalgia.
Similarly, we can see that inadequate supply of antioxidants to neutralize harmful free radicals – the cause of oxidative stress – can result in damage to all components of the cells, including the lipids, proteins, and DNA.
Patients with fibromyalgia are candidates for CoQ10 therapy
Researchers measured the blood Coenzyme Q10 levels of patients diagnosed with fibromyalgia on the basis of examinations with the following instruments:
- the Fibromyalgia Impact Questionnaire
- the visual analogue scale (pain, fatigue, and sleep)
- the Widespread Pain Index
- the symptom severity scale
- the Symptom Checklist 90 (Scl-90-R)
All fibromyalgia patients had documented Coenzyme Q10 deficiency [Alcocer-Gomez 2013].
CoQ10 supplementation and fibromyalgia
Researchers in Sevilla, Spain conducted a randomized controlled study in which fibromyalgia patients were given 300 milligrams of Coenzyme Q10 or matching placebos for 40 days. The CoQ10 supplements were given as three times 100 milligrams [Cordero 2013].
The preparation used in the Sevilla fibromyalgia study was the same preparation that was used in the better known randomized controlled trials [Mantle]:
- The Q-Symbio study of Coenzyme Q10 as adjuvant therapy for chronic heart failure patients [Mortensen]
- The KiSel-10 study of Coenzyme Q10 combined with a high-selenium yeast preparation and heart health in senior citizens [Alehagen]
- The Gulf War Illness study of Coenzyme Q10 treatment of veterans diagnosed with Gulf War Illness [Golomb]
Reduced pain and fatigue with Coenzyme Q10 supplementation
The Coenzyme Q10 therapy produced the following outcomes in the fibromyalgia patients:
- reduced the fatigue, pain, and morning tiredness experienced by fibromyalgia patients
- improved mitochondrial energy production
- reduced the levels of bio-markers for oxidative stress and inflammation [Cordero 2013].
Coenzyme Q10 improves psychopathological symptoms in fibromyalgia patients
The same preparation and the same dosage – 3 times 100 milligrams of CoQ10 daily for 40 days – improved psychopathological symptoms, including depression, in fibromyalgia patients [Alcocer-Gomez 2014, 2017].
The patients in the active treatment group had reduced levels of bio-markers for oxidative stress and inflammation and increased levels of serotonin [Alcocer-Gomez 2014, 2017].
CoQ10 supplementation and headache symptoms in fibromyalgia patients
Dr. Cordero and colleagues found decreased CoQ10 levels, antioxidant enzyme catalase levels, and ATP levels in blood mononuclear cells from fibromyalgia patients compared to normal controls [Cordero 2012].
They also found increased levels of lipid peroxidation in the blood mononuclear cells from fibromyalgia patients compared to normal controls [Cordero 2012].
They found negative correlations between both CoQ10 levels and catalase levels and headache parameters [Cordero 2012].
Moreover, oral CoQ10 supplementation was associated with significant improvement in clinical and headache symptoms [Cordero 2012].
Coenzyme supplementation of juveniles with fibromyalgia
In a separate study, researchers reported that daily supplementation with 100 milligrams of Coenzyme Q10 reduced fatigue in juveniles [Miyamae]. The CoQ10 supplementation also improved chronic fatigue scores measured on the Chalder Fatigue Scale [Miyamae].
Coenzyme Q10 is safe and well-tolerated
Dr. David Mantle reports that the safety of Coenzyme Q10 supplementation has been demonstrated in some 200 randomized controlled trials. There are no known toxic effects of Coenzyme Q10 supplementation [Mantle].
There are no reports ever of an overdose of Coenzyme Q10, which is, itself, a substance bio-synthesized in the body. Unfortunately, once humans reach adult age, their cells’ production of Coenzyme Q10 begins to decline. With increasing age, it is not possible to make up for the loss of Coenzyme Q10 endogenous production by eating more food. The only answer is to take a Coenzyme Q10 supplement with a documented bio-availability [Lopez-Lluch].
Alcocer-Gómez, E., Culic, O., Navarro-Pando, J. M., Sánchez-Alcázar, J. A., & Bullón, P. (2017). Effect of Coenzyme Q10 on Psychopathological Symptoms in Fibromyalgia Patients. CNS Neuroscience & Therapeutics, 23(2), 188–189.
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.
Alcocer-Gómez, E., Cano-García, F. J., & Cordero, M. D. (2013). Effect of coenzyme Q10 evaluated by 1990 and 2010 ACR Diagnostic Criteria for Fibromyalgia and SCL-90-R: four case reports and literature review. Nutrition (Burbank, Los Angeles County, Calif.), 29(11–12), 1422–1425.
Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). 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. International Journal of Cardiology, 167(5), 1860-1866.
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., 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.
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.
Golomb, B. CoQ10 and gulf war illness. Neural Computation 2014 Nov; Vol. 26 (11), pp. 2594-651
López-Lluch, G., Del Pozo-Cruz, J., Sánchez-Cuesta, A., Cortés-Rodríguez, A. B., & Navas, P. (2019). Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition, 57, 133–140.
Mantle, D. (2017). Fibromyalgia and Coenzyme Q10. The Fibromyalgia Magazine, 18(2): 5.
Mayo Clinic. 2018. Fibromyalgia. Patient Care and Health Information. Retrieved from https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780
Miyamae, T., Seki, M., Naga, T., Uchino, S., Asazuma, H., Yoshida, T., Yamamoto, Y. (2013). Increased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation. Redox Report: Communications in Free Radical Research, 18(1), 12–19.
Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & Littarru, G. P. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC. Heart Failure, 2(6), 641-649.
Disclaimer: The information presented in this article is not intended as medical advice and should not be viewed as such.
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