Permission to repost from Prof. G CoQ10 nutriceutical for fatgue and depression Would I recommend Coenzyme Q10? #MSBlog #MSResearch "This placebo-controlled study below tantalizingly shows that Coenzyme Q10, a nutriceutical, improves MS-related negative symptoms of fatigue and depression. What is Coenzyme Q10? It is an oil-soluble, vitamin-like substance that is present in most cells, primarily in the mitochondria. It is a component of the so called electron transport chain and participates in respiration, generating energy in the form of ATP. 95% of the body’s energy is generated in this way. Coenzyme Q10 functions in the electron transport chain as an antioxidant, protecting the mitochondrion and cell from damage from reactive oxygen species. Oxidation, or oxidative damage, is believed to play a role in neurodegeneraton. Therefore, Coenzyme Q10 has been hypothesised to be a general neuroprotectant and is used to treat other neurodegenerative disorders, for example the mitochondrial cytopathies. Should all MSers now take Coenzyme Q10? No. This study provides the necessary evidence that it may work in MS symptoms and therefore larger trials of Coenzyme Q10 in MS are required." "Coenzyme Q10 is potentially neuroprotective, therefore any study testing it as a neuroprotectant in MS will need to be seriously considered. I would recommend adding it on top of an anti-inflammatory drug that controls so called upstream adaptive immune responses, i.e. autoimmunity. How we design and test add-on therapies is an unresolved issue. We are currently trying a novel approaches using spinal fluid neurofilament levels in SPMS and OCT (optical coherence tomography) in acute optic neuritis. The International Progressive MS Alliance is looking at the issue of progressive MS trials; let's hope something good comes out of this. We have submitted a preliminary application to explore the length-dependent axonal and asynchronous progressive MS hypotheses. Both of these have implications for progressive MS trial design." Epub: Sanoobar et al. Coenzyme Q10 as a treatment for fatigue and depression in multiple sclerosis patients: A double blind randomized clinical trial. Nutr Neurosci. 2015 Jan. Objectives: MS is the chronic inflammatory and demyelinating disorder of central nervous system which is accompanied with disability and negative life style changes such as fatigue and depression. Aim: The aim of this study is to investigate the effect of coenzyme Q10 (CoQ10) supplementation on fatigue and depression in MSers. Methods: We performed a randomized, double-blinded, placebo-controlled trial to determine the effect of CoQ10 supplement (500 mg/day) vs. placebo for 12 weeks. Fatigue symptoms were quantified by means of fatigue severity scale (FSS) and the Beck depression inventory (BDI) was used to assess depressive symptoms. Results: A significant decrease of FSS was observed in CoQ10 group during the intervention (P = 0.001) and significant increase of FSS change was observed within placebo group (P = 0.001). Repeated measure analysis of variance showed a significant time-by-treatment interaction for FSS (baseline 41.5 ± 15.6 vs. endpoint P < 0.001) and BDI (baseline 17.8 ± 12.2 vs. endpoint 20.4 ± 11.4; P < 0.001), indicating significant decrease of FSS and BDI in CoQ10 group compared to placebo group. Conclusion: Our study suggests that CoQ10 supplementation (500 mg/day) can improve fatigue and depression in patients with multiple sclerosis. Reactions: Posted by Gavin Giovannoni at 07:30 8 comments: AnonymousWednesday, February 04, 2015 8:44:00 am Are you saying that MSers shouldn't take it yet because there may be safety concerns or issues about combining it with other therapies? If not, what is the reason? Is it available over the counter? Fatigue is not one of my symptoms, so I would have no reason to try it, but I know MSers who will try anything to alleviate the fatigue that is ruining their lives. Wednesday, February 04, 2015 8:46:00 am All this time wasted for more studies why should we wait for more studies Wednesday, February 04, 2015 10:51:00 am Also doesn't this boost the immune system, which in turn will cause the whole disease process (if immune system related) to go into overdrive? AnonWednesday, February 04, 2015 11:23:00 am You can get supplements like these, my dad takes a lot of supplements like this with the aim of supporting his mitochondrial function for his chronic fatigue syndrome. He was almost bed bound for 14 years but now is out working all day on the farm and able to go to drinks parties (used to be impossible when fatigue made standing up, following a conversation etc incredibly difficult). He has changed other things too, so its not definitely because of these supplements that he's got better, but he has been improving since having them. His doctor has done a lot of work on the role of mitochondria in CFS and has developed an “ATP profile” blood test, as described in this paper: Chronic fatigue syndrome and mitochondrial dysfunction, Sarah Myhill et al, 2009, Journal of International Clinical Experimental Medicine. (Available in pubmed/online for free I think) In this study they compared mild, moderate and severe patients with healthy controls. The tests they performed on the blood were designed to assess: 1) fraction of the ATP is available for energy supply. 2) the ADP to ATP recycling efficiency (this makes more energy available as needed). 3) efficiency for the transfer of ATP from the mitochondria into the cytosol (where it can be used in cellular processes as needed). The authors found that different patients differed from controls in different aspects of the test, concluded that the ATP profile test is a diagnostic tool to "differentiate patients who have fatigue and other symptoms as a result of energy wastage by stress and psychological factors from those who have insufficient energy due to cellular respiration dysfunction". Based on the findings of these ATP profile tests, patients can be recommended supplements, to try to support the functions (yes - sold by one of the test developers- read the 'About My Practise' part of her website where she explains the 'economics' of her practice). I haven't looked into this in detail but the author states on her website that "The second aspect of the test measures the efficiency with which ATP is made from ADP. If this is abnormal then this could be as a result of magnesium deficiency, of low levels of Co-enzyme Q10, low levels of vitamin B3 (NAD) or of acetyl L-carnitine." I wonder whether people with MS would have different ATP Profile Test results to healthy controls, whether it there would be a difference between MS people with and without fatigue, and whether this test could prove useful for management of fatigue in MS? What do you think ProfG/MouseDoctor? Wednesday, February 04, 2015 3:31:00 pm My Mum has been taking enzymes (not Q10) for a longer time when she had unexplained headaches and the docs thought of a brain tumor etc. nobody could help and nobody could find the cause but after taking the enzymes for a year or so the headaches (very strong ones like your skull exploding) stopped never to return. I took enzymes when I first got diagnosed and during that period I was well with no new lesions - can't tell what it was but it could explain a lot. Wednesday, February 04, 2015 3:52:00 pm At some point you have to take an educated guess at what might help prevent neurodegeneration. It is clear by most researchers that mitochondrial dysfunction is a culprit in disease progression so what investigations has been undertaken to a dress this? CoQ10 has a lot of data behind it but if you are waiting for gold standard trials it may be too late: http://www.ncbi.nlm.nih.gov/pubmed/24621064 MouseDoctor2Wednesday, February 04, 2015 4:15:00 pm Mitochondrial dysfunction is an area which we (and others) are looking at. Watch this space.