Mark Borigini M.D.

Overcoming Pain

Chronic Pain

A Cue In on Coenzyme Q10

It carries with it the enigma of, and the hope for, fibromyalgia and fatigue.

Posted Oct 01, 2016

We see it advertised on television.  Costco always seems to feature a coupon for one of the brands under which it is sold.

It is coenzyme Q10 (CoQ10).

And its benefit appears to carry with it the enigma of the condition it has lately been touted as benefiting: fibromyalgia.

Now, the pathophysiological mechanisms of fibromyalgia remain, for the most part, difficult to identify; and current drug therapies demonstrate limited effectiveness—at least in the opinion of many patients. However, the identification of a CoQ10 deficiency as possibly playing a role in the pathophysiology of fibromyalgia has led to researchers investigating the effect of CoQ10 supplementation.

The results of one such study, a randomized, double-blind, placebo-controlled trial to evaluate clinical and gene expression effects of 40 days of CoQ10 supplementation (300 mg/day) on 20 fibromyalgia patients, was reported in the October, 2013, issue of “Antioxidants & Redox Signaling.”   An important clinical improvement was noted:  a prominent reduction in generalized pain, fatigue, and morning tiredness, as well as an important reduction in the pain visual scale and a reduction in tender points. The authors of the article conclude that the results indicate that CoQ10 may have a potential therapeutic effect in fibromyalgia.  The study was small, and the duration short; but the results hold out hope for this agent—or at least for the worthiness of further study of CoQ10.     

Another study, again published in 2013, this time in the journal “Redox Report,”  found that plasma levels of ubiquinol (the reduced form of CoQ10) were significantly decreased and the ratio of ubiquinone (oxidized CoQ10) to total CoQ10  was significantly increased in children suffering from fibromyalgia compared to the healthy controls. This, say the Japanese researchers, suggests that fibromyalgia is associated with CoQ10 deficiency and increased oxidative stress.

The children were then supplemented with 100 mg daily of ubiquinol. After 12 weeks of supplementation, there were significant improvements in chronic fatigue scores, increases in overall CoQ10 levels, and decreases in levels of ubiquinone. Results, say the researchers, suggest that CoQ10 status may be impaired in subjects with juvenile fibromyalgia, and as such supplementation may be of benefit.

To reiterate, we still need more and larger studies to know for sure what role CoQ10 plays in fibromyalgia, how safe and effective treatment is, and whether drugs that target CoQ10 levels would be more effective than supplementation.

For now, supplementation is available, assuming you and your healthcare provider decide to use it; but at a significant monetary cost—even with that Costco coupon.

On the other hand, it is not difficult to increase the amount of CoQ10 in your diet. It is found in:

  • beef
  • chicken
  • eggs
  • oily fish such as sardines, mackerel, herring, and trout
  • organ meats such as liver, kidney, and heart
  • soybean and canola oil
  • peanuts
  • pistachio nuts
  • sesame seeds
  • broccoli
  • cauliflower
  • oranges
  • strawberries

A last thought:  If CoQ10 is indeed found so widely in the foods we eat, does the diet of fibromyalgia patients contribute to a relative deficiency?  Or is their oxidative load so great as to cause a deficiency, no matter the robustness of the diet?

One thing can be agreed upon:  There remains a knowledge deficit regarding the role of CoQ10 in chronic pain syndromes such as fibromyalgia.