Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

Jesús Castro-Marrero, Maria Jose Segundo, Marcos Lacasa, Alba Martinez-Martinez, Ramon Sanmartin Sentañes, Jose Alegre-Martin, Jesús Castro-Marrero, Maria Jose Segundo, Marcos Lacasa, Alba Martinez-Martinez, Ramon Sanmartin Sentañes, Jose Alegre-Martin

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystem, and profoundly debilitating neuroimmune disease, probably of post-viral multifactorial etiology. Unfortunately, no accurate diagnostic or laboratory tests have been established, nor are any universally effective approved drugs currently available for its treatment. This study aimed to examine whether oral coenzyme Q10 and NADH (reduced form of nicotinamide adenine dinucleotide) co-supplementation could improve perceived fatigue, unrefreshing sleep, and health-related quality of life in ME/CFS patients. A 12-week prospective, randomized, double-blind, placebo-controlled trial was conducted in 207 patients with ME/CFS, who were randomly allocated to one of two groups to receive either 200 mg of CoQ10 and 20 mg of NADH (n = 104) or matching placebo (n = 103) once daily. Endpoints were simultaneously evaluated at baseline, and then reassessed at 4- and 8-week treatment visits and four weeks after treatment cessation, using validated patient-reported outcome measures. A significant reduction in cognitive fatigue perception and overall FIS-40 score (p < 0.001 and p = 0.022, respectively) and an improvement in HRQoL (health-related quality of life (SF-36)) (p < 0.05) from baseline were observed within the experimental group over time. Statistically significant differences were also shown for sleep duration at 4 weeks and habitual sleep efficiency at 8 weeks in follow-up visits from baseline within the experimental group (p = 0.018 and p = 0.038, respectively). Overall, these findings support the use of CoQ10 plus NADH supplementation as a potentially safe therapeutic option for reducing perceived cognitive fatigue and improving the health-related quality of life in ME/CFS patients. Future interventions are needed to corroborate these clinical benefits and also explore the underlying pathomechanisms of CoQ10 and NADH administration in ME/CFS.

Keywords: NADH; chronic fatigue syndrome; coenzyme Q10; mitochondria; myalgic encephalomyelitis; nonrestorative sleep; quality of life.

Conflict of interest statement

M.J.S. is an employee of Vitae Health Innovation, S.L. (Montmeló, Barcelona, Spain). As stated in the author contributions, the funders declare that they had no role in the design, execution, analysis and interpretation, and presentation of data. J.C.-M. received financial support from Vitae Health Innovation, S.L. to conduct this intervention study. The rest of the authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials (CONSORT) flow diagram illustrating the steps of screening, enrollment, assignment, and follow-up of the study participants.
Figure 2
Figure 2
Summary of the study schedule at each visit during the clinical trial.

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