Q10 supplementation reduces chronic fatigue in both healthy and diseased individuals

Q10 is a key element in the cellular energy turnover and also serves as a protective antioxidant. The human body is able to make most of its own Q10 but as we grow older, our endogenous Q10 synthesis decreases, and this is also the case with certain diseases and as a result of using specific types of medicine. A large meta-analysis has shown that Q10 supplementation is able to reduce chronic fatigue in healthy individuals as well as in people with diseases. Apparently, taking larger doses for longer periods of time works best for energy levels. It is important to choose a Q10 supplement that has the right quality and comes with documentation to ensure that the Q10 molecules are absorbed properly in the blood and reach the energy-producing powerhouses of the cells.

There has been disagreement about whether or not Q10 is able to reduce chronic fatigue, so a team of scientists decided to conduct a meta-analysis on the subject. After trawling various scientific databases, the researchers came up with 13 controlled, randomized trials (CRT) that had been published before January 2022. The studies included a total of 1,126 participants who suffered from chronic fatigue in combination with different diseases such as fibromyalgia, heart failure, overweight, breast cancer (with chemotherapy), kidney diseases, polio, and sclerosis. There were also healthy participants who were merely bothered by chronic fatigue. The participants in the different trials were supplemented with Q10 for a period between four and 24 weeks in a daily dose between 30-500 mg.
The scientists observed that Q10, when compared with placebo, significantly lowered chronic fatigue according to a commonly used effect score called “Hedge’s g”. The positive effect was observed in both healthy and diseased participants. What the scientists could also see was that the Q10 dose is determining for the effect of the supplement. Higher Q10 doses resulted in a significant effect, while this was not the case with low-dose supplementation. It is important to choose a preparation with good absorption to ensure that the active compound reaches the cells.

• Chronic fatigue is also known as CFS (chronic fatigue syndrome) and ME (myalgic encephalomyelitis)

Chronic fatigue is common among healthy people and those with disease

Chronic fatigue is an abnormal and overwhelming tiredness that can not be linked to physical or mental exhaustion or lack of sleep and rest. Up to 45% of the general population may suffer from fatigue for shorter periods of time, while 2-11 percent suffer from chronic fatigue (longer than six months). Chronic fatigue is also widespread among older people and patients suffering from various disease or people on chemotherapy or in treatment with cholesterol-lowering drugs, antihistamines, and various other medications. Chronic fatigue comes with a huge personal and socio-economic price tag.
Although chronic fatigue may be a result of different genetic and environmental factors, it looks a if dysfunctions in the cells’ energy-producing powerhouses, the so-called mitochondria, may play a role. The same is the case with chronic inflammation that is not a thing we normally feel but, nonetheless, is a condition where the body is bombarded with free radicals that can cause damage to neurons and other cells.

Patients with chronic fatigue have less Q10 in their blood

The mitochondria convert dietary fat, protein, and carbohydrate into ATP (adenosine triphosphate), which is energy concentrated in chemical form. Helped by Q10, the cells can break down ATP and release the energy trapped inside. This energy is used for e.g., muscle work, mental activity, digestion, and tissue renewal. In addition, Q10 is a powerful antioxidant that protects cells and their mitochondria against oxidative damage caused by free radicals.
It has been shown that patients suffering from chronic fatigue syndrome have lower blood levels of Q10 than healthy people do. Also, there is an inverse relation between Q10 levels in the blood and the severity of chronic fatigue in people with this condition. This can eventually affect the heart, which uses a substantial amount of Q10 to fuel its around-the-clock action.
Scientists have tried giving high doses of Q10 to patients with chronic fatigue, including those with fibromyalgia. Depending on the patients’ own Q10 levels, researchers recommend taking around 200-600 mg daily. It is vital to continue taking the Q10 supplement to optimize levels of the nutrient in the blood and in the cells because chronic fatigue can be caused by complicated dysfunctions in the mitochondrial energy turnover. What is more, Q10 is an antioxidant that protect cells against damage caused by free radicals and chronic inflammation. The scientists therefore say that it may require supplementation for a period of three months or longer. In the case of congenital mitochondrial diseases or other ailments involving mitochondrial dysfunctions, there may be a need for permanent supplementation with Q10.
The new meta-analysis is published in Frontiers in Pharmacology and supports a small but recent study (Jesus Castyro-Marreo et al.) where patients with chronic fatigue were given
400 mg of Q10 in combination with 200 micrograms of selenium. The reason for combining the two nutrients is that selenium deficiencies are rather widespread in Europe. In addition, selenium enhances Q10’s properties as an energy provider and an antioxidant.

There are two kinds of Q10

• Ubiquinone works in the mitochondrial energy turnover
• Ubiquinol serves as an antioxidant and is primarily found in the blood
• The two kinds of Q10 are constantly converted back and forth, depending on what form the body needs
• Because of the interchangeability, the quality and bioavailability of a Q10 supplement means more than what type of Q10 it contains

The absorption and quality of Q10 supplements

By nature, Q10 molecules aggregate in large crystals that do not dissolve all that easily and are therefore difficult for the digestive system to absorb. By using a special heating technique, it is possible to make a special formulation where the Q10 crystals dissolve completely at body temperature, which enables the Q10 molecules to pass through the intestinal wall and into the bloodstream. It is therefore essential to choose a product that has documented quality and bioavailability to ensure that the active ingredient reaches the cells and their mitochondria.
Ubiquinone is more stable than ubiquinol because it does not oxidize as easily. Ubiquinone is automatically converted into ubiquinol in the body in order to maintain the right balance between the two Q10 forms. It is best to take your Q10 supplement with breakfast, and because there is a cut-off point for absorption at 100 mg, high-dosed Q10 supplementation should be split up in several doses during the day, preferably with a few hours between each dosage.

References:

I-Chen Tsai et al. Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Pharmacology. 2022

Jesús Castro-Marreo et al. Does Coenzyme Q10 Plus Selenium Supplementation Ameliorate Clinical Outcomes by Modulation Oxidative Stress and Inflammation in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome? ANTIOXIDANTS & REDOX SIGNALING. 2022

Jan Aaset, Jan Alexander, Urban Alehagen. Coenzyme Q10 supplementation – In ageing and disease. Mechanisms of Ageing and Development. 2021

Illenia Cirilli et al. Role of Coenzyme Q10 in Health and Disease: an update on the last 10 years (2010-2020). Antioxidants 2021

Pernille Lund. Q10 – fra helsekost til epokegørende medicin. Ny Videnskab 2014