Review Mitochondrial Dysfunction and Coenzyme Q10 Supplementation in Post-Viral Fatigue Syndrome: An Overview, 2024, Mantle et al.

Mitochondrial Dysfunction and Coenzyme Q10 Supplementation in Post-Viral Fatigue Syndrome: An Overview
Mantle, David; Hargreaves, Iain Parry; Domingo, Joan Carles; Castro-Marrero, Jesus

Post-viral fatigue syndrome (PVFS) encompasses a wide range of complex neuroimmune disorders of unknown causes characterised by disabling post-exertional fatigue, myalgia and joint pain, cognitive impairments, unrefreshing sleep, autonomic dysfunction, and neuropsychiatric symptoms. It includes myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS); fibromyalgia (FM); and more recently post-COVID-19 condition (long COVID). To date, there are no definitive clinical case criteria and no FDA-approved pharmacological therapies for PVFS. Given the current lack of effective treatments, there is a need to develop novel therapeutic strategies for these disorders.

Mitochondria, the cellular organelles responsible for tissue energy production, have recently garnered attention in research into PVFS due to their crucial role in cellular bioenergetic metabolism in these conditions. The accumulating literature has identified a link between mitochondrial dysfunction and low-grade systemic inflammation in ME/CFS, FM, and long COVID.

To address this issue, this article aims to critically review the evidence relating to mitochondrial dysfunction in the pathogenesis of these disorders; in particular, it aims to evaluate the effectiveness of coenzyme Q10 supplementation on chronic fatigue and pain symptoms as a novel therapeutic strategy for the treatment of PVFS.

Link | PDF (International Journal of Molecular Sciences)

 

"Conflicts of Interest: The authors declare no conflicts of interest. Dr Mantle is medical adviser to Pharma Nord (UK) Ltd."

I hope nobody will be surprised to learn that Pharma Nord "develops, manufactures and markets dietary supplements, herbal remedies and medical drugs." including ...... CoQ10.

 

How can something tried thousands of times before be a novel treatment.

 

Also —

Eg Mitochondrial abnormalities in the postviral fatigue syndrome (1991, Acta Neuropathologica) but there may be earlier.

 

N=1; use of the reportedly more bioavailable form of CoQ10 - Ubiquinol, somewhat improves energy. ABA trials have been done many times with the same result. Dosage used varies.

This is an expensive supplement to afford, especially on a disability pension.

 

I tried Co-Q10 in or before 2014 and couldn't tolerate it.

I said on Phoenix Rising:

"I couldn't tolerate Co-Q10 even at 100 mg/day. My main adverse effects were
dizziness, hunger and difficulty controlling bowels.

Erica Verrillo's treatment guide says:

Some patients report that CoQ10, while giving them an initial energy boost, also increases insomnia and causes jitters. Some people report, paradoxically, that CoQ10 produces exhaustion, although this effect may be more common in the acutely ill than in those with stable symptoms. CoQ10 lowers blood sugar levels, which may be problematic for patients with hypoglycemia. High doses can cause flu-like symptoms.

Verrillo, Erica (2012-09-14). Chronic Fatigue Syndrome: A Treatment Guide, 2nd Edition (Kindle Location 12894). Erica Verrillo. Kindle Edition.

Examine.com seem to think it's pretty good and safe, but of course we are all different, and I seem to be more different than most in this context "

Like many things, I think it may be related to gender?

 

I had a CcQ10 RBC test (not tested in the cells) a the marker was on the lowish side. The first trial made my heart race so I stopped. A few years later I tried it again and it seemed to help, but once I increased my activity level it was back to square 1 again. After taking it for 3 months it made me feel jittery which felt more like an artificial increase in energy which is gross because you feel more active, but when you increase your activity you feel worse with PEM.

 

May I ask a stupid question? What is it Coenzyme Q10 is supposed to do?

I took an online class a while ago on mitochondria, and Coenzyme Q10 was only mentioned in connection with the electron transport chain complex in the mitochondria's membrane.

Coenzyme A however is the end product of glycolysis, and isn't it in the glycolysis where a default in ME patient's cell respiration is located?

 

Yes, but the further details with the glycolysis goes over my head. I only remember professor Tronstad in a talk described pyruvate dehydrogenase as a nearly closed valve (ETA: in ME patients).

The end result of glycolysis is coenzyme A which goes into the mitochondria and the Kreb's cycle. So my stupid question is if it's in the glycolysis a default in ME patients has been found, then why test Coenzyme Q10 supplements and not A?

 

I like nitpicks, and my understanding of this is so limited, so to keep the terms as concise as possible is absolutely for the best, so thank you for making that point. I didn't know about the problems seen as well at the electron transport chain complex in ME patients.

Either way, it will probably take more than a supplement to fix this.

Thanks for taking the time to answer