Coenzyme Q10 levels reduced in chronic fatigue syndrome
In a recent article published in Neuroendocrinology Letters, researchers from Belgium and Poland report that plasma coenzyme Q10 levels are significantly lower in individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a chronic disease characterized by extreme fatigue and inflammatory, autonomic and neuropsychiatric symptoms.
The current study compared the plasma CoQ10 levels of 58 men and women diagnosed with ME/CFS to 22 healthy control patients. Disease symptoms and severity were evaluated through the use of the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale (FF Scale).
A significant reduction in CoQ10 levels was observed among ME/CFS patients compared with the control group. As many as 44.8 percent of these patients had levels that were less than the lowest CoQ10 value detected in healthy patients, which was 490 micrograms per liter. Increased CoQ10 levels predicted a reduction in total FF Scale scores and individual fatigue and autonomic symptoms. Levels of CoQ10 below 390 micrograms per liter were associated with a decrease in memory and concentration ability.
In their discussion of the findings, the authors remark that reduced levels of CoQ10 may decrease antioxidative protection, resulting in damage to membrane fatty acids and proteins. Coenzyme Q10 also helps protect the mitochondria, the cells' energy-producing plants, from damage caused by free radical generation. Additionally, CoQ10 has anti-inflammatory and other properties, and is involved in the mitochondria's production of energy (it has been hypothesized that most individuals with ME/CFS experience low energy due to cellular energy dysfunction).
The authors also note that fatigue and neurocognitive disorders are often an effect of statin drug use, and that statins have been shown to deplete plasma CoQ10.
"This is a first study which shows that ME/CFS is accompanied by significantly reduced plasma concentrations of CoQ10 and that lowered plasma CoQ10 is related to specific symptoms of ME/CFS, such as fatigue, autonomic and neurocognitive symptoms," the authors announce.
"Our results suggest that patients with ME/CFS would benefit from CoQ10 supplementation in order to normalize the low CoQ10 syndrome and the inflammatory and oxidative and nitrosative stress disorders," they conclude. "The finding that lower CoQ10 is an independent predictor of chronic heart failure (CHF) and mortality due to CHF may explain previous reports that the mean age of ME/CFS patients dying from CHF is 25 years younger than the age of those dying from CHF in the general population. Since statins significantly decrease plasma CoQ10, ME/CFS should be regarded as a relative contraindication for treatment with statins without CoQ10 supplementation."
Chronic fatigue syndrome (CFS), also known as chronic fatigue and immune dysfunction syndrome, is a mysterious medical condition that affects approximately 500,000 Americans (CDC 2005a). CFS is defined as a set of symptoms that include prolonged, overwhelming fatigue that begins on awakening and lasts throughout the day. The fatigue may worsen with exercise or physical activity. Other symptoms associated with CFS include mood swings, muscle spasms, pain, headache, sleep disturbances, and loss of appetite (Afari N et al 2003; Balch PA et al 2000).
Several nutrients have been suggested to be deficient in CFS patients, including B vitamins, antioxidants, vitamin C, magnesium, sodium, zinc, L-tryptophan, L-carnitine, CoQ10, and essential fatty acids. Nutritional deficiencies influence the symptoms of the syndrome as well as the recovery process (Bounous G et al 1999; Grimble RF 1994; Vecchiet J et al 2003).
Coenzyme Q10 (CoQ10) is a potent antioxidant that aids in metabolic reactions, including the process of forming adenosine triphosphate, the molecule the body uses for energy.
In one study of 20 female patients with CFS (who required bed rest following mild exercise), 80 percent were deficient in CoQ10. After three months of CoQ10 supplementation (100 mg/day), the exercise tolerance of the CFS patients more than doubled: 90 percent had reduction or disappearance of clinical symptoms, and 85 percent had decreased post-exercise fatigue (Judy W 1996).
In the University of Iowa study, CoQ10 emerged as the leading therapy for CFS, with 69 percent of patients saying it was helpful.
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