Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome?

Abstract

Chronic fatigue syndrome (CFS) is a chronic and extremely debilitating illness characterized by prolonged fatigue and multiple symptoms with unknown cause, diagnostic test, or universally effective treatment. Inflammation, oxidative stress, mitochondrial dysfunction, and CoQ10 deficiency have been well documented in CFS. We conducted an 8-week, randomized, double-blind placebo-controlled trial to evaluate the benefits of oral CoQ10 (200 mg/day) plus NADH (20 mg/day) supplementation on fatigue and biochemical parameters in 73 Spanish CFS patients. This study was registered in ClinicalTrials.gov (NCT02063126). A significant improvement of fatigue showing a reduction in fatigue impact scale total score (p<0.05) was reported in treated group versus placebo. In addition, a recovery of the biochemical parameters was also reported. NAD+/NADH (p<0.001), CoQ10 (p<0.05), ATP (p<0.05), and citrate synthase (p<0.05) were significantly higher, and lipoperoxides (p<0.05) were significantly lower in blood mononuclear cells of the treated group. These observations lead to the hypothesis that the oral CoQ10 plus NADH supplementation could confer potential therapeutic benefits on fatigue and biochemical parameters in CFS. Larger sample trials are warranted to confirm these findings.

Figures

FIG. 1.

Flow diagram showing the distribution of the participants from initial assessment to analysis of study data. Details are given according to the Consolidated Standards of Reporting Trials (CONSORT) statement for reporting randomized controlled trials.

FIG. 2.

NAD+/NADH content in blood mononuclear cells (BMCs) from chronic fatigue syndrome (CFS) patients at baseline and after 8 weeks of treatment. (A) NAD+ levels, (B) NADH levels, and (C) NAD+/NADH ratio were measured as noted in the Notes section. Data represent the mean±SD of duplicate separate assays. *p<0.001 significant differences between before and after 8 weeks of treatment.

FIG. 3.

Coenzyme Q10 levels in BMCs from CFS patients were measured by high-performance liquid chromatography, as described in the Notes section. Data represent the mean±SD of three separate experiments. ***p<0.05 significant differences between before and after 8 weeks of treatment.

FIG. 4.

Intracellular ATP and mitochondrial citrate synthase in BMCs from CFS patients were measured, as described in the Notes section. (A) ATP content and (B) specific activity of mitochondrial citrate synthase were performed, as described in Notes section. Data represent the mean±SD of three separate experiments. ***p<0.05 significant differences between before and after 8 weeks of treatment.

FIG. 5.

Lipid peroxidation levels in BMCs from CFS patients were measured by TBARS assay, as described in the Notes section. Data represent the mean±SD of three separate experiments. ***p<0.05 significant differences between before and after 8 weeks of treatment.