The power and pitfalls of omics part 2: epigenomics, transcriptomics and ME/CFS
Simon McGrath concludes his blog about the remarkable Prof George Davey Smith's smart ideas for understanding diseases, which may soon be applied to ME/CFS.
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Effect of Q10 plus NAD on maximum heart rate after exercise testing in CFS

Discussion in 'Latest ME/CFS Research' started by A.B., Jul 22, 2015.

  1. A.B.

    A.B. Senior Member

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    Effect of coenzyme Q10 plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome – A randomized, controlled, double-blind trial

    Background & aims
    Chronic Fatigue Syndrome (CFS) is a complex condition, characterized by severe disabling fatigue with no known cause, no established diagnostic tests, and no universally effective treatment. Several studies have proposed symptomatic treatment with coenzyme Q10 (CoQ10) and nicotinamide adenine dinucleotide (NADH) supplementation. The primary endpoint was to assess the effect of CoQ10 plus NADH supplementation on age-predicted maximum heart rate (max HR) during a cycle ergometer test. Secondary measures included fatigue, pain and sleep.

    Methods
    A proof-of-concept, 8-week, randomized, controlled, double-blind trial was conducted in 80 CFS patients assigned to receive either CoQ10 plus NADH supplementation or matching placebo twice daily. Maximum HR was evaluated at baseline and at end of the run-in period using an exercise test. Fatigue, pain and sleep were evaluated at baseline, and then reassessed at 4- and 8-weeks through self-reported questionnaires.

    Results
    The CoQ10 plus NADH group showed a significant reduction in max HR during a cycle ergometer test at week 8 versus baseline (P = 0.022). Perception of fatigue also showed a decrease through all follow-up visits in active group versus placebo (P = 0.03). However, pain and sleep did not improve in the active group. Coenzyme Q10 plus NADH was generally safe and well tolerated.

    Conclusions
    Our results suggest that CoQ10 plus NADH supplementation for 8 weeks is safe and potentially effective in reducing max HR during a cycle ergometer test and also on fatigue in CFS. Further additional larger controlled trials are needed to confirm these findings.

    http://www.sciencedirect.com/science/article/pii/S0261561415001892
     
    John Mac likes this.
  2. Sidereal

    Sidereal Senior Member

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    Subgroups, subgroups. Some here do very well on CoQ10. Personally, it makes me sick as hell.
     
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  3. Blue

    Blue

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    I got bad insomnia from just small doses of CoQ10 (taken in the morning.)
     
    Bob likes this.
  4. adreno

    adreno PR activist

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    Q10 increases nitric oxide (vasodilation), which may be good for some, bad for others. It actually increases my heart rate.
     
    Bob likes this.
  5. Bob

    Bob

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    CoQ10 and NADH both make me feel very unpleasantly over-stimulated. So they're not supplements that I can use.
     
    Last edited: Jul 22, 2015
  6. Valentijn

    Valentijn Senior Member

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    PEM was not a mandatory symptom. And I don't think they understand the difference between Exercise Intolerance and PEM. They did single CPETs at the beginning and end, but no double CPET. No way to know if the lower heart rate during maximal exercise was followed by a catastrophic crash or not.

    Not bad overall, but they need to educate themselves regarding what ME/CFS is, and take PEM fully into account.
     
    Mij and Bob like this.
  7. Valentijn

    Valentijn Senior Member

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    The decrease in maximal heart rate seems pretty tiny: from 140.1 to 136.8 in patients being treated, and from 140.3 to 138.7 in placebo controls. So less than a 2 point drop which can be potentially attributed to the treatment.

    VO2max also dropped a bit in both groups: from 19.4 in treated patients and 19.7 in placebos down to 18.6 in both groups. It's not big enough to be statistically significant, but it's the outcome I would consider to be a lot more important, and it's going in the wrong direction.
     
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  8. Gijs

    Gijs Senior Member

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    NO significant effect was found. V02max was even lower after 8 weeks. The hartrate was almost 3 beats pmn lower. Conclusion: No effect at all!
     
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  9. Dolphin

    Dolphin Senior Member

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    Yes, when one reads the full paper, nearly everything wasn't statistically different. The results were not as good as the impression given by the abstract.
     
    mon me, Bob, Valentijn and 1 other person like this.
  10. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    I found their selection criteria / grounds for elimination puzzling.

    They eliminated those with high resting heart rate or low blood pressure, but didn't do tilt tests or any other orthostatic testing. So it would seem they eliminated people with severe POTS or NMH, but not less obvious or less immediate forms.
    I don't understand the rationale.

    It also seems like these would be the people that would potentially benefit the most from something proposed to modulate heart rate. And that would potentially have the most obvious response (The people they eliminated)
     
  11. Snowdrop

    Snowdrop Rebel without a biscuit

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    The authors themselves are kindly paying for the paper to be open access.
    I don't know anything directly about the situation for ME/cfs in Spain but I gather they are somewhat ambivalent to the real ME definition.
     
  12. Misfit Toy

    Misfit Toy Senior Member

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    I took NADH for a long time. I honestly think it wears out the adrenals as it gives you energy, but definitely not a good energy, more of a wired one. Years later, I can't tolerate it at all.
     

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