Data published in Pharmacology indicated that a statistical reduction in fatigue was demonstrated in all trials examined by researchers, with positive results consistent among both healthy and fatigue-associated disease subgroups when these were examined separately.
In addition, further analyses found CoQ10-only supplementation led to a significant reduction in fatigue symptoms while results for CoQ10 plus a reduced form of nicotinamide adenine dinucleotide (NADH) (CoQ10 compounds) were “trivia and statistically insignificant”, compared to the placebo.
“CoQ10 was shown to statistically significantly reduce fatigue, and was maintained within sensitivity analyses,” the authors wrote.
“We found that CoQ10- only formulations were effective in relieving fatigue, in contrast to CoQ10 compounds. Moreover, an increase in the daily dose and treatment duration of CoQ10 correlated with a better reduction in fatigue.”
Temporary fatigue effects up to 45% of the general population and is common in patients with poliomyelitis and multiple sclerosis. Causation is not completely understood but experts believe mitochondrial dysfunction and pro-inflammatory status play a role.
CoQ10 is a lipid-soluble antioxidant produced by the human body and an essential component of the mitochondrial transport chain.
Study authors explained that CoQ10 inhibits oxidation of lipid-containing cellular membranes and lipoproteins and protects the peripheral and central nervous systems. Furthermore, it regulates mitochondrial respiration and has a high safety profile up to 1,200mg daily.
Evidence supports the role of coQ10 in alleviating fatigue symptoms. A trial comparing patients with depression and chronic fatigue syndrome with healthy volunteers found that CoQ10 deficiency was positively associated with fatigue, in contrast to serum CoQ10 that inversely correlated with fatigue severity.
The trials assessed in the meta-analysis included 1,126 subjects with a mean age of 49 years and 25% were male. Subject diagnoses included chronic fatigue syndrome, fibromyalgia, end-stage heart failure, obesity, breast cancer, poliomyelitis, and multiple sclerosis. Healthy individuals and healthy individuals with fatigue were also evaluated. Study durations ranged from four to 24 weeks.
Three studies examined the effects of compounds mixed with CoQ10 – including two trials on CoQ10 with a reduced form of nicotinamide adenine dinucleotide (NADH) and one within a multi-vitamin nutritional drink - and 10 studies focused on CoQ10 only.
Study authors assessed the methodological quality of trials included the meta-analysis using the Cochrane risk of bias tool for randomised trials. Fatigue measurements were standardised using Hedges’ g; a random-effects model was used to pool studies and subgroup analysis conducted, according to standard practice.
The primary aim was to evaluate fatigue scores following CoQ10 supplementation and a secondary outcome investigated treatment-associated adverse effects.
Treatment duration key
Although CoQ10 significantly reduced fatigue symptomology in the two subgroups, the fatigue-reducing effects were not significant in the subgroup treated with CoQ10-compounds, the authors state. They speculate this may be due to the lower dose used in CoQ10 compound regimes that varied from 30mg to 200mg daily, whereas intake in subgroups taking CoQ10 only ranged from 60 to 500mg daily, and four administered 300-500mg daily.
The authors noted a positive relationship between treatment duration and fatigue reduction; meta-regression analysis demonstrated that treatment duration correlated with increased fatigue reduction.
“As fatigue is a complicated disorder involving both psychological and physiological pathways, a sufficient period of intervention is needed to restore CoQ10 from chronic depletion status,” they wrote.
There was no statistically significant impact of underlying disease conditions on the association between CoQ10 use and fatigue reduction.
Among participants treated with CoQ10, only one experienced an adverse event (gastrointestinal problems).
Published online August 24, 2022: doi: 10.3389/fphar.2022.883251
‘Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials’
Authors: I-Chen Tsai, et al.