The discussion about some of the papers I have looked at is not reassuring.
Castro-Marrero et al
47,
48 assessed clinical outcomes after supplementation with reduced nicotinamide adenine dinucleotide (NADH) and CoQ10 in ME/CFS. Castro-Marrero et al
47 also claimed a direct improvement in mitochondrial function by finding a statistically significant increase in ATP levels and NAD+/NADH ratio in the intervention group. It is not clear if positive effects are due to CoQ10 alone or due to the combination of additional NADH, especially as treatment with NADH or CoQ10 alone had shown no changes in fatigue scores in previous studies.
53,
54
For example work in 2015 by the Castro-Marrero team on CoQ10 is discussed here;
CoQ10 - Coenzyme Q10
(A more recent study by the same team further illustrates the problems with their studies -
Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related QoL in ... ME/CFS, 2021, Castro-Marrero et al.)
MitoQ is a supplement developed by Otago University researchers - they are friends of Warren Tate, and he and his team have been trying to show that MitoQ can be helpful in ME/CFS. This study does report on the Mendus study which had a blinded investigation and an unblinded one. The blinded investigation found that MitoQ did not help ME/CFS symptoms at all, while in the unblinded investigation it appeared to. The authors here suggest that issues with the lack of confirmation of diagnosis and inability to confirm compliance with the dosage might have caused problems. That's potentially true, but there was not even a glimmer of a suggestion of a result in the blinded investigation.
Johnson and Grant
55 performed a randomised controlled trial of MitoQ versus placebo in participants with ME/CFS conducted online via a website. Fifty one participants with ME/CFS were sent either MitoQ or placebo in the mail. No statistically significant improvement occurred. There were several limitations and potential biases to this study including a lack of ability to confirm the diagnosis, the usage of self-reported data and an inability to confirm compliance with the study. By contrast, another group of participants who took MitoQ without a matching placebo group, by purchasing the supplement themselves, found significant results and a reduction in clinical symptoms. So far, this online study is the only published study investigating MitoQ for ME/CFS.
I think this paper is useful as a list of relevant papers, but the analysis of them needed to be stronger.
This conclusion just is not warranted on the studies done to date.
On the basis of the research done with ME/CFS patients, we propose that MitoQ may alleviate the effects of the cytokine storm and restore the function of exhausted T cells through improving mitochondrial function, in ‘long haul’ or chronically ill SARS-CoV-2 patients as well.
I really want the Otago team to be producing great work - Warren Tate is a lovely man who has been a strong supporter of people with ME/CFS, has run the ME/CFS research programme on a shoestring for a long time and who keeps bringing young researchers into the field. And these are New Zealand researchers. But this paper does not show the necessary level of skepticism about the evidence base for CoQ10 and MitoQ as treatments for ME/CFS.
I know of a lot of people with ME/CFS who are spending money they can't afford in order to take MitoQ in the hope that it is doing something. The ongoing promotion of MitoQ by the Otago team is causing harm if the supplement doesn't really help. Rather than letting the possibility of a treatment drag on, it would be relatively easy to organise a blinded trial of MitoQ here in New Zealand. People could have their GPs confirm that they have an ME/CFS diagnosis, the MitoQ company could supply the tablets. There are people who could help organise a trial.
(Sorry, have made an edit to recognise that this paper could not have included results from the Castro-Marrero 2021 paper.)
