I have been posting on how the lack of proteases (pancreatic enzymes that break down proteins) would lead to CFS. The posts can be found on the threads: "The difference between MS and ME" and "What causes Sjogren's syndrome". In the previous posts, we identified the lack of carnitine in CFS and showed how this lack would lead to mitochondrial dysfunction. We traced this lack of carnitine directly back to an inability to break down dietary proteins. We also traced low vitamin D, low iron, dysautonomia, low dopamine, spinal cord changes, lack of vitamin B12, the connection to hypothyroidism and low adrenal function, primary biliary cirrhosis, the connection to Sjogren's, dysregulated calcium, low magnesium (which we showed was linked to the mitral valve prolapse often found in CFS), lack of tryptophan, explained chemical sensitivity, the connection to bacteria and viruses, Restless Legs Syndrome, peripheral neuropathy, lack of phenylalanine, dysregulated tumor necrosis factor (cytokine), the depression, insomnia, confusion, anxiety, brain fog, fatigue, low zinc, the spinal fluid study findings, and white matter lesions directly back to these missing protease. In addition to carnitine, another critical component necessary for proper function of the mitochondria is Coenzyme Q10 (CoQ10). It acts as an essential cofactor to produce ATP (adenosine triphosphate), which is the currency of energy in the body. To produce ATP, mitochondria need certain essential raw nutrients, such as carnitine and CoQ10. CoQ10 also functions as an antioxidant. A recent study found that plasma CoQ10 was significantly lower in CFS patients. ("Coenzyme Q10 Deficiency in ME/CFS" by Michael Maes, et al.) It stated, "Up to 44.8% of patients with ME/CFS had values beneath the lowest plasma CoQ10 value detected in the normal controls.." CoQ10 is a fat-soluble compound synthesized by the body and also consumed in the diet. A report from Iowa State University lists beef, chicken, pork, and fish as the foods with the highest levels of CoQ10.In a normal person, CoQ10 can be synthesized, but it requires the presence of one of two amino acids we have found lacking in CFS, phenylalanine and tyrosine. The Linus Pauling Institute at Oregon State University states, "The biosythesis of coenzyme Q10 involves three major steps: 1) synthesis of the benzoquinone structure from either TYROSINE OR PHENYLALANINE." Tyrosine is derived from phenylalanine and phenylalanine is found in high protein foods. Without the ability to break down high protein foods, you would not have the necessary amino acids to produce CoQ10.