Does Coenzyme Q10 Plus Selenium Supplementation Ameliorate Clinical Outcomes by Modulating Oxidative Stress and Inflammation in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a neuroinflammatory, multifaceted chronic disorder of unknown cause. Accumulating data indicate a link between a redox imbalance, mitochondrial dysfunction, and inflammation status in ME/CFS. Coenzyme Q10 (CoQ10) and selenium as effective antioxidant and anti-inflammatory agents have shown potential clinical implications in chronic diseases; however, their therapeutic benefits in ME/CFS remain elusive. This open-label exploratory study aimed to evaluate the effectiveness of combined CoQ10 plus selenium supplementation on clinical features and circulating biomarkers in ME/CFS. Twenty-seven ME/CFS patients received an oral combination of 400 mg of CoQ10 and 200 μg of selenium daily for 8 weeks. The primary endpoint was patient-reported changes in outcome measures from baseline to 8 weeks' postintervention. Secondary endpoint included changes in circulating biomarkers from baseline to each participant. After an 8-week intervention, a significant improvement was found for overall fatigue severity (p = 0.021) and global quality of life (p = 0.002), while there was no significant effect on the sleep disturbances (p = 0.480) among participants. After 8 week's intervention, there was significantly increased total antioxidant capacity, and there were reduced lipoperoxide levels from the participants (p < 0.0001 for both). Circulating cytokine levels decreased significantly (p < 0.01 for all), but with no significant changes in the C-reactive protein, FGF21, and NT-proBNP biomarkers after supplementation. Based on these findings, we hypothesized that long-term supplementation of combined CoQ10 and selenium may indicate a potentially beneficial synergistic effect in ME/CFS. Antioxid. Redox Signal. 36, 729-739.

Keywords: biomarkers; cardiovascular health; chronic fatigue syndrome; coenzyme Q10; inflammation; myalgic encephalomyelitis; redox status; selenium.

Conflict of interest statement

No competing financial interests exist.

Figures

Color images are available online.

FIG. 1.

Overview of clinical trial protocol illustrating the experimental design of the participants. Oral 400 mg CoQ10 plus 200 μg selenium per day was supplemented to each participant over 8 weeks of intervention. CoQ10, coenzyme Q10. Color images are available online.

FIG. 2.

Reduction of oxidative stress status after CoQ10 and selenium supplementation among participants. Representative box plot diagram showing statistically significant differences of TAC (expressed as μM of copper-reducing equivalents) and lipid peroxidation levels (assessed by TBARS assay) (A, B) after 8 weeks' intervention from baseline. Each dot represents a single participant (n = 27). Data are expressed as mean ± SEM of duplicates and are representative of two independent experiments. The box extends from the 25th to 75th percentiles, the line represents the mean, and the whiskers show the minimum and maximum. p-Values versus baseline were calculated using the Wilcoxon signed-rank test. SEM, standard error of the mean; TAC, total antioxidant capacity; TBARS, thiobarbituric acid-reacting substances. Color images are available online.

FIG. 3.

Decreased inflammatory profile after CoQ10 plus selenium supplementation in the study participants. (A–E) The circulating levels of inflammatory cytokines and C-reactive protein (F) at baseline and after 8-week CoQ10 plus selenium administration in participants as described in the Notes section. Each dot represents a single participant (n = 27). Values are shown as mean ± SEM of duplicates and are representative of two independent experiments. The box extends from the 25th to 75th percentiles, the line represents the mean, and the whiskers show the minimum and maximum. p-Values versus baseline were calculated using the Wilcoxon signed-rank test. Color images are available online.

FIG. 4.

Biomarkers of cardiovascular risk do not change during the intervention in the participants. Representative box plots showing no statistically significant differences of circulating FGF21 and NT-proBNP levels (A, B) between baseline and 8 weeks of intervention. Each dot represents a single participant (n = 27). Values are expressed as mean ± SEM of duplicates and are representative of two independent experiments. The box extends from the 25th to 75th percentiles, the line represents the mean, and the whiskers show the minimum and maximum. p-Values versus baseline were calculated using the Wilcoxon signed-rank test. FGF21, fibroblast growth factor 21; NT-proBNP, N-terminal prohormone of brain natriuretic peptide. Color images are available online.