Can Coenzyme Q10 help in fatigue management?
A recent systematic review published in 2019, which assessed 16 interventional studies has ascertained the effect of coenzyme Q10 (CoQ10) supplementation on fatigue status and 10 studies showed CoQ10 supplementation significantly reduced fatigue status1.
Fatigue is a very common ailment encountered by every individual at some point in their life that exacerbates with physical or mental activity and subsides with adequate rest1. However, chronic fatigue syndrome is the prolonged fatigue with associated symptoms (headaches, muscles or joint pain, recurrent sore throat, tender lymph nodes, impaired sleep, memory and cognition, and worsening exhaustion after physical or mental activity) lasting at least 6 months after exclusion of other fatigue-related etiologies and persists despite adequate rest2.
Stress as a result of the inability to cope with life’s demands often goes hand in hand with fatigue. Apart from sharing some of the common signs such as impaired memory and sleep, poor performance, anxiety, depression and muscular pain; it acts as an important precursor to chronic fatigue syndrome3. Therefore, stress management helps in alleviating the severity of fatigue symptoms and burden of the disease; thus, promoting fatigue management and quality of life4,5.
There have been different pharmacological and non-pharmacological interventions for the management of chronic fatigue as well as stress. Pharmacological interventions range from non-steroidal anti-inflammatory drugs (ibuprofen, naproxen), narcotics (tramadol, morphine, codeine), antidepressants (nortriptyline, doxepin, bupropion, mirtazapine, fluoxetine, sertraline), anticonvulsants (gabapentin, pregabalin) to antiviral and immunomodulatory drugs (rintatolimod, interferons, immunoglobulins, rituximab, corticosteroids, hormones)6.
Non-pharmacological interventions include adaptive pacing therapy, graded exercise therapy, sleep hygiene, physical therapy, acupuncture, massage, transcutaneous electrical nerve stimulation, yoga, biofeedback, mindfulness-based stress reduction techniques, coping skills training, cognitive behavioral therapy and dietary management. Recently, the interest in nutritional supplements, such as vitamin D, vitamin B12, magnesium, essential fatty acids, acetyl-L-carnitine, antioxidants (vitamin E, vitamin C, alpha-lipoic acid), reduced form of NADH and CoQ10 has increased among healthcare professionals and researchers 6,7.
CoQ10 or ubiquinone is one such nutritional supplement with antioxidative properties that has a significant role in mitochondrial energy metabolism8. Its deficiency results in reduced tolerance to physical activity and fatigue and its supplementation have been associated with increased exercise performance and anti-fatigue effects9.
The recent article published by Mehrabani et al.1 reviewed 16 studies conducted between 2004 and 2016, which included participants from various countries of both genders between 13-69 years of age with different health conditions. Among them, 10 studies showed positive effects of CoQ10 supplementation on fatigue in healthy, fibromyalgia, statin-associated myopathy and other fatigue-related diseases (multiple sclerosis, end-stage heart failure). Researchers saw the greatest benefit of CoQ10 supplementation of 300 mg/day and 200 mg/day for 3 months in patients with fibromyalgia and statin-induced fatigue, respectively. In healthy participants, researchers saw a significant reduction in physical fatigue in groups receiving 300 mg/day CoQ10 for 8 days.
Although Mehrabani and colleagues concluded that CoQ10 could be an effective supplement in fatigue management; there is still a need for further high-quality clinical trials, which could establish a firm link of CoQ10 supplementation in alleviating fatigue, to support the use of CoQ10 as a definitive alternative therapy for fatigue.
- Mehrabani S, Askari G, Miraghajani M, Tavakoly R, Arab A. Effect of coenzyme Q10 supplementation on fatigue: A systematic review of interventional studies. Complementary Therapies in Medicine. 2019;43:181-187.
- Bjorklund G, Dadar M, Pen JJ, Chirumbolo S, Aaseth J. Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach. Biomedicine and Pharmacotherapy. 2019;109:1000-1007.
- Danielsson M, Heimerson I, Lundberg U, Perski A, Stefansson C, Akerstedt T. Psychosocial stress and health problems: Health in Sweden: The National Public Health Report 2012. Chapter 6. Scandinavian Journal of Public Health. 2012;40(9 Suppl):121-134.
- Lattie EG, Antoni MH, Fletcher MA, Czaja S, Perdomo D, Sala A, Nair S, Fu SH, Penedo FJ, Klimas N. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Symptom Severity: Stress Management Skills are Related to Lower Illness Burden. Fatigue. 2013;1(4):10.
- Lopes-Júnior LC, Bomfim EO, Nascimento LC, Nunes MDR, Pereira-da-Silva G, Lima RAG. Non-pharmacological interventions to manage fatigue and psychological stress in children and adolescents with cancer: an integrative review. European Journal of Cancer Care. 2015;25(6):921–935.
- Castro-Marrero J, Sáez-Francàs N, Santillo D, Alegre J. Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome. British Journal of Pharmacology. 2017;174(5):345–369.
- Rowe PC, Underhill RA, Friedman KJ, Gurwitt A, Medow MS, Schwartz MS, Speight N, Stewart JM, Vallings R, Rowe KS. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer. Frontiers in Pediatrics. 2017;5:121.
- Crane FL. Biochemical functions of coenzyme Q10. Journal of the American College of Nutrition. 2001;20(6):591–598.
- Littarru GP, Tiano L. Clinical aspects of coenzyme Q10: an update. Nutrition. 2010;26(3):250–254.