Coenzyme Q10 to Alleviate Fatigue

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.

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Coenzyme Q10 for Longevity

Interesting statistics regarding life expectancy and longevity in the United States:

  • Individuals with no chronic conditions by age 67 years can expect to live another 22.6 years on average.
  • Individuals aged 67 years with 5 chronic conditions can expect to live 7.7 fewer additional years, on average.
  • Individuals aged 67 years with 10 or more chronic conditions can expect to live 17.6 fewer additional years, on average.
Human cells
Our cells’ production of Coenzyme Q10 declines as we get older and older. We need adequate Coenzyme Q10 in our cells to produce ATP energy, to protect against harmful free radicals, and to modulate inflammation.

These are some of the outcomes of a retrospective cohort study done by researchers at the Johns Hopkins University Bloomberg School of Public Health using the data from 1,372,272 Medicare fee-for-service beneficiaries who were 67 and older [DuGoff 2014].

When the researchers talk about chronic conditions (also called co-morbidities), they are referring to such conditions as cancer, cardiovascular disease, diabetes, hypertension, kidney disease, liver disease, and neurodegenerative diseases, among others.

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The Instability of Ubiquinol, Part 2 – Dog Studies

The results from large dog studies done by SIBR Research show that orally administered ubiquinol is mostly converted to the ubiquinone form of Coenzyme Q10 by the time it reaches the small intestines [Judy 2021 Part 2].

Dr Judy in the lab
Coenzyme Q10 is an essential bio-nutrient, especially important as we get older. It is a redox molecule with an oxidized state called ubiquinone and a reduced state called ubiquinol. Both are bio-active states. Ubiquinone supplements are more stable and much more tested than ubiquinol supplements. Ubiquinol by nature of being an electron donor is relatively quick to be oxidized to ubiquinone.

In the small intestines, it is then absorbed primarily as ubiquinone. Once it enters the lymph, it is increasingly converted back to ubiquinol.

By the time it leaves the lymph to enter the blood circulation, it is approximately 96 % ubiquinol again.

These findings beg the question: why buy a ubiquinol supplement when the ubiquinol will probably be converted to the ubiquinone form of Coenzyme Q10 prior to absorption?

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The Instability of Ubiquinol Supplements – Lab Studies

At SIBR Research, we have long been concerned about misleading claims for ubiquinol supplements on the Web. It seems that there is a lack of understanding of the processes influencing the absorption and subsequent metabolism of ubiquinol. Moreover, this misunderstanding seems to have been exacerbated by some manufacturers’ incorrect claims regarding the bioavailability of their ubiquinol supplements [Mantle & Dybring 2020].

Dr William V Judy
SIBR Research studies show that the ubiquinol in supplements is very likely to be converted to ubiquinone in the small intestines, to be absorbed as ubiquinone, and then to be converted back to ubiquinol in the lymph.

Basic Information about Ubiquinone and Ubiquinol

  • Ubiquinol is the reduced form of Coenzyme Q10; it is the antioxidant form of Coenzyme Q10.
  • Ubiquinone is the oxidized form of Coenzyme Q10. It is essential for the process of ATP energy generation.

Note: Both forms of Coenzyme Q10 are bio-active forms.

Ubiquinone More Stable than Ubiquinol in Supplements

Ubiquinol molecules are electron donors. Thus, they are inherently unstable. They are constantly looking to give up two electrons. It is this property that first made us wonder whether the ubiquinol in supplements actually gets absorbed as ubiquinol or gets converted to ubiquinone before being absorbed.

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