Gulf War Illness, Fibromyalgia, ME/CFS and Long COVID Overlap Common Symptoms and Underlying Biological Mechanisms ... , 2025, Mantle

[Dolphin]

https://www.preprints.org/manuscript/202508.1805/v1

Gulf War Illness, Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Overlap Common Symptoms and Underlying Biological Mechanisms: Implications for Future Therapeutic Strategies​

David Mantle*,†,Joan Carles Domingo†

,Beatrice A. Golomb,Jesus Castro-Marrero;*


† These authors contributed equally to this work.

Abstract​

Although Gulf War illness (GWI), fibromyalgia (FM), myalgic encephalitis/chronic fatigue syndrome (ME/CFS), and long COVID have distinct origins, in this article, we have reviewed evidence that these disorders comprise a group of so-called low-energy associated syndromes with common symptoms and underlying pathology.

In particular, evidence for mitochondrial dysfunction, oxidative stress, inflammation, immune dysregulation, neuroendocrine dysfunction, disrupted brain-gut-microbiome axis, apoptosis/ferroptosis, and telomere shortening as common features in the pathogenesis of these disorders has been identified.

Given the role of coenzyme Q10 (CoQ10) in promoting normal mitochondrial function, as an antioxidant, antiinflammatory, and antiapoptotic and antiferroptotic agent, there is a rationale for supplementary CoQ10 in the management of these disorders.

The reported benefits of supplementary CoQ10 administration in GWI, FM, ME/CFS, and long COVID have been reviewed; the potential benefit of supplementary CoQ10 in reducing telomere shortening and improving the efficiency of stem cell transfer relevant has also been identified a promising therapeutic strategy in these conditions.

Keywords:​

Gulf war illness
;
myalgic encephalomyelitis/chronic fatigue syndrome
;
fibromyalgia
;
long COVID
;
coenzyme Q10
;
mitochondrial dysfunction
;
oxidative stress
;
apoptosis/ferroptosis
;
neuroinflammation
;
immune dysregulation

 

[forestglip]

Now published:

Gulf War Illness, Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Overlap in Common Symptoms and Underlying Biological Mechanisms: Implications for Future Therapeutic Strategies

David Mantle, Joan Carles Domingo, Beatrice Alexandra Golomb, Jesús Castro-Marrero

[Line breaks added]

Abstract
Although Gulf War Illness (GWI), fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID have distinct origins, in this article we have reviewed evidence that these disorders comprise a group of so-called low-energy associated disorders with overlapping common symptoms underlying pathology. In particular, evidence for mitochondrial dysfunction, oxidative stress, inflammation, immune dysregulation, neuroendocrine dysfunction, disrupted brain–gut-microbiome axis, apoptosis/ferroptosis and telomere shortening as common features in the pathogenesis of these disorders has been identified.

Given the role of coenzyme Q10 (CoQ10) in promoting normal mitochondrial function, as an antioxidant, antiinflammatory and antiapoptotic and antiferroptotic agent, there is a rationale for supplementary CoQ10 in the management of these disorders. The reported benefits of supplementary CoQ10 administration in GWI, FM, ME/CFS and long COVID have been reviewed; the potential benefit of supplementary CoQ10 in reducing telomere shortening and improving the efficiency of stem cell transfer relevant has also been identified as promising therapeutic strategies in these disorders.

This review advances beyond previous systematic reviews and consensus statements on overlapping similar symptoms and underlying biological pathomechanisms in these complex disorders.

Web | PDF | International Journal of Molecular Sciences | Open Access

 

[forestglip]

In GWI, supplementary CoQ10 improved physical function and self-reported health, as well as fatigue, pain and muscle strength [176].

Unpublished trial of CoQ10 in GWI where it doesn't appear to help:

The registration for Nancy Klimas's CoQ10 phase III trial for gulf war illness shows that the study was completed in 2020, and they subsequently added the results to that page.

The differences mostly seem modest and aren't consistent across outcomes (e.g. SF-36 - more improvement in CoQ10 group, but brief visual memory test - more improvement in placebo). No p values reported.

Does anyone know if this was published? If it's a null result, it's good that they at least posted the numbers on the registration page, but currently if you search for "CoQ10 gulf war" in PubMed, the only trial listed is the 2014 RCT posted above, which might make doctors overconfident in this supplement's usefulness.