USES IN CFS/ ME. CoQ10 is one of the most frequently used supplements for the treatment of CFS/ ME-related fatigue because of its importance in the production of adenosine triphosphate (ATP), the cellular source of energy. In addition to reducing fatigue, CoQ10 may alleviate muscle weakness and pain. It is also one of the few supplements that seems to reduce cognitive dysfunction. Its role as a free radical scavenger may lead to improvement in immune responses in patients with CFS/ ME. Although its effects as a natural antihistamine have not yet been specifically explored in CFS/ ME, patients with allergies may benefit from CoQ10.
There is also evidence that CoQ10 is deficient in CFS/ ME patients. In 2009 Maes et al measured plasma CoQ10 in 58 CFS/ ME patients. Compared to normal controls, the CFS/ ME group had values significantly below the lowest recorded levels of the control group. Patients with very low levels of CoQ10 suffered significantly more from concentration and memory disturbances. The researchers concluded that lowered levels of CoQ10 play a role in the pathophysiology of ME/ CFS and that “symptoms, such as fatigue, and autonomic and neurocognitive symptoms may be caused by CoQ10 depletion.” Their results suggested that patients with CFS/ ME would benefit from CoQ10 supplementation in order to normalize the low CoQ10 syndrome.
PROTOCOL. Nearly all CFS/ ME physicians recommend supplementation with CoQ10. CoQ10 can be taken in a single dose or divided into two doses taken at different times during the day. There is evidence that dividing the dose is more effective than taking it all at once. The normal recommended dose is between 30 and 200 mg/ day. Dr. Lapp and Dr. Klimas recommend 120 mg a day. Sublingual CoQ10, reputedly more effective against cognitive dysfunction, may be taken at higher doses. Oral CoQ10, although primarily absorbed by the digestive tract and liver, is also effective for some patients. The oral dosage varies, but is usually 25 to 50 mg/ day. It may take up to eight weeks to see effects from oral CoQ10. Because CoQ10 is fat-soluble, it should be taken with a meal that contains some kind of fat or oil.
PROS. Taken at lower doses, CoQ10 is a supplement with very few side effects. Patients report improvements in energy, stamina, light-headedness, and syncope (fainting). Dr. Lapp reports that half of his patients see improvement after taking CoQ10. A significant number of patients, particularly those with fibromyalgia, find that CoQ10 increases their energy over the course of the day.
CONS. Some patients report that CoQ10, while giving them an initial energy boost, also increases insomnia and causes jitters. Some people report, paradoxically, that CoQ10 produces exhaustion, although this effect may be more common in the acutely ill than in those with stable symptoms. CoQ10 lowers blood sugar levels, which may be problematic for patients with hypoglycemia. High doses can cause flu-like symptoms.