Fatigue. In many disorders, patients experience fatigue, even extreme fatigue, e.g., heart failure patients, chronic fatigue syndrome and fibromyalgia patients, multiple sclerosis patients, post-treatment Lyme disease syndrome patients, etc.

Dr. William V Judy

Today’s author is Dr. William Judy, founder and president of the SIBR Research Institute, where he has conducted studies of the effect of CoQ10 supplementation on fatigue in chronic heart failure and chronic fatigue syndrome patients.

The chronic fatigue may well be associated with cellular energy depletion and impaired mitochondrial function [Mantle 2022].

  • Research studies have implicated mitochondrial dysfunction in the development of chronic fatigue syndrome and fibromyalgia and in the resulting fatigue [Mantle 2022].
  • The outcomes of randomized controlled clinical trials have shown that CoQ10 supplementation significantly improves symptoms in chronic fatigue syndrome and fibromyalgia patients [Mantle 2022].
  • A 2019 systematic review of CoQ10 supplementation studies has shown significant benefits of CoQ10 supplementation on fatigue following exercise, statin intake, the development of multiple sclerosis, and the development of end-stage heart failure [Mehrabani 2019].
  • Supplemental CoQ10 has been shown to significantly improve plasma and skeletal muscle CoQ10 levels, exercise tolerance, and exercise recovery time in chronic fatigue patients. The response is not rapid. It takes months of supplementation to allow mitochondria regeneration and the improvement in exercise tolerance. If the supplementation of CoQ10 is stopped, then the chronic fatigue will slowly return [Judy 2018a, 2018b].

Coenzyme Q10, Inflammation, and Fatigue

Mantle et al [2022] make the point that that inflammation, which involves the release of pro-inflammatory cytokines, is not a wholly negative process in the body. Inflammation is the body’s normal response to infection or injury; it is essential for tissue healing.

Inflammation – in the form of chronic systemic inflammation – occurs when the initial immune response to infection or injury does not resolve itself without releasing the so-called cytokine storm, which is the uncontrolled release of pro-inflammatory cytokines that cause tissue injury.

  • Chronic systemic inflammation promotes fatigue through its effect on the brain and nervous system, the immune system, and the mitochondria in tissue cells.
  • Coenzyme Q10 is known to play a role mediating this pro-inflammatory process [Mantle 2021].
  • The outcomes of randomized controlled clinical studies have shown significant reductions in various circulatory inflammatory bio-markers following supplementation with Coenzyme Q10 in patients diagnosed with cardiovascular disease, non-alcoholic fatty liver disease, and polycystic ovary syndrome.

Coenzyme Q10, Oxidative Stress, and Fatigue

Insider's guide To Coenzyme Q10

In Dr. Judy’s book The Insider’s Guide to Coenzyme Q10, he reviews the effects of CoQ10 supplementation on cardiovascular disease, chronic fatigue syndrome, and exercise and performance. The book is available from amazon.com.

Oxidative stress (an abundance of harmful free radicals in relation to protective antioxidants) causes damage to healthy cells and the mitochondria inside the cells, thus impairing cellular energy production and leading to fatigue [Lee 2018].

  • Numerous randomized controlled clinical trials have demonstrated the statistically (and clinically) significant benefit of CoQ10 supplementation on oxidative stress parameters in such fatigue-related disorders as heart disease, multiple sclerosis, non-alcoholic fatty liver disease, and type II diabetes [Mantle 2022].
  • CoQ10 supplementation is associated with significant reduction of oxidative stress and should, therefore, also be capable of reducing the fatigue associated with oxidative stress [Mantle 2022].

Coenzyme Q10, Mitochondrial Dysfunction, and Fatigue

CoQ10 supplements are safe and well-tolerated. Coenzyme Q10 supplementation has been described as an indirect positive influence on the strength of the contraction of the heart muscle; CoQ10 supplementation is associated with the restoration of energy production in the mitochondria, leading to improved heart muscle cell performance [Mortensen 2014a].

Conclusions: Coenzyme Q10 to Fight Against Fatigue

CoQ10 supplementation is a key component against fatigue in three important ways [Mantle 2022]:

  • Sufficient Coenzyme Q10 is needed for the process of cellular energy generation within the mitochondria.
  • Coenzyme Q10 is a lipid-soluble antioxidant that protects cellular and sub-cellular membranes from free-radical-induced oxidative damage.
  • Coenzyme Q10 protects against the tissue damaging effects of poorly regulated inflammation.

CoQ10 supplements are safe, effective, and affordable. However, not all CoQ10 supplements are equally well absorbed and available to the cells and tissues. Buying an inexpensive CoQ10 product could be a waste of money if the Coenzyme Q10 it contains is poorly formulated and poorly absorbed.


Judy WV. Coenzyme Q10: The Substance That Powers Life: An Insider’s Guide. Ny Videnskab, 2018a. ISBN: 978-87-7776-186-7. Book available from amazon.com.

Judy WV. Influence of CoQ10 supplementation on plasma and tissue CoQ10 levels and exercise tolerance. Presented at the International Coenzyme Q10 Association meeting, New York, 2018b.

Lee JS, Kim HG, Lee DS, Son CG. Oxidative Stress is a Convincing Contributor to Idiopathic Chronic Fatigue. Sci Rep. 2018;8(1):12890.

Mantle D, Turton N, Hargreaves IP. Lyme disease: a role for Coenzyme Q10 supplementation? Antioxidants. 2022;11:667. https://doi.org/10.3390/antiox11040667.

Mantle D, Heaton RA, Hargreaves IP. Coenzyme Q10 and immune function: an overview. Antioxidants. 2021;10:759.

Mehrabani S, Askari G, Miraghajani M, Tavakoly R, Arab A. Effect of Coenzyme Q10 supplementation on fatigue: A systematic review of interventional studies. Complement Ther Med. 2019 Apr;43:181-187.

Mortensen SA, Mortensen AL. The mitochondria in heart failure: a target for Coenzyme Q10 therapy? Clin Pharmacol Ther. 2014a Dec;96(6):645-7.

Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP. 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. 2014b 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 April 2022