Effect of [CoQ10 Plus NADH] on Fatigue Perception and Health-Related Quality of Life in Individuals with ME/CFS... (Castro-Marrero et al., 2021)

Pyrrhus

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Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial (Castro-Marrero et al., 2021)
https://www.mdpi.com/2072-6643/13/8/2658

Excerpt:
Castro-Marrero et al 2021 said:
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystem, and profoundly debilitating neuroimmune disease, probably of post-viral multifactorial etiology. Unfortunately, no accurate diagnostic or laboratory tests have been established, nor are any universally effective approved drugs currently available for its treatment.

This study aimed to examine whether oral coenzyme Q10 and NADH (reduced form of nicotinamide adenine dinucleotide) co-supplementation could improve perceived fatigue, unrefreshing sleep, and health-related quality of life in ME/CFS patients. A 12-week prospective, randomized, double-blind, placebo-controlled trial was conducted in 207 patients with ME/CFS, who were randomly allocated to one of two groups to receive either 200 mg of CoQ10 and 20 mg of NADH (n = 104) or matching placebo (n = 103) once daily. Endpoints were simultaneously evaluated at baseline, and then reassessed at 4- and 8-week treatment visits and four weeks after treatment cessation, using validated patient-reported outcome measures.

A significant reduction in cognitive fatigue perception and overall FIS-40 score (p < 0.001 and p = 0.022, respectively) and an improvement in HRQoL (health-related quality of life (SF-36)) (p < 0.05) from baseline were observed within the experimental group over time. Statistically significant differences were also shown for sleep duration at 4 weeks and habitual sleep efficiency at 8 weeks in follow-up visits from baseline within the experimental group (p = 0.018 and p = 0.038, respectively).

Overall, these findings support the use of CoQ10 plus NADH supplementation as a potentially safe therapeutic option for reducing perceived cognitive fatigue and improving the health-related quality of life in ME/CFS patients. Future interventions are needed to corroborate these clinical benefits and also explore the underlying pathomechanisms of CoQ10 and NADH administration in ME/CFS.
(spacing added for readability)


Thoughts:
  • I am quite impressed that this is a prospective, randomized, double-blind, placebo-controlled trial. Such true Randomized Controlled Trials (RCTs) are really quite rare in ME research.
  • I do wonder if 8 week follow-up is enough to evaluate the long-term use of NADH, as I know that some have reported that the effect of NADH disappears over time.
  • This may just be me, but I personally did not notice that CoQ10 was disturbing my sleep for a couple of weeks. Although I noticed an immediate energy boost from CoQ10, the negative effects on my sleep developed gradually over a couple of weeks before I noticed this negative effect and stopped the CoQ10.
 

mitoMAN

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I have used NADH orally and Q10 without any effect on fatigue or brainfog (Even tho I am Q10 deficient, tried all sorts of dosages and brands with lab bloodworks)

However daily NADH injections (IM) starting from extremly high dosages of 150mg-600mg gave me two extremly good months. Then the effect started to vanish. I had to split the injections into 50mg and later 100mg injections as otherwise I would get breathing difficulties etc as short term sideeffect.
 

Pyrrhus

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The authors also published a similar randomized, controlled, double-blind trial in 2015, although the 2015 study used objective measurements instead of patient reports:

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 (Castro-Marrero et al., 2015)
https://www.clinicalnutritionjournal.com/article/S0261-5614(15)00189-2/fulltext


Excerpt:
Castro-Marrero et al 2015 said:
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.
 

hapl808

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Max HR is an interesting objective measurement. I've found that it often correlates to how bad my fatigue or crash is at any one time. No 'exercise testing' needed, but making it to the bathroom will often spike it to 120-130, and even my baseline HR is higher than it should be.
 
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Those are some unimpressive numbers, wish I hadn’t looked. I considered not posting this, because I believe people should be allowed their placebo effect, but while the placebo effect was similar to the treatment effect neither was big enough to warrant using this stuff. Anyone want the ubiquinol I bought?
 
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Those are some unimpressive numbers, wish I hadn’t looked. I considered not posting this, because I believe people should be allowed their placebo effect, but while the placebo effect was similar to the treatment effect neither was big enough to warrant using this stuff. Anyone want the ubiquinol I bought?
Hang in there friend. I have had this syndrome for 35 years now. Still I occasionally find myself up at midnight reading forums looking for something new. Speaking from experience and reading others once chat forums came around, we all do seem to end up in the same place - a few treatments provided some relief, usually for a little while.

We can only finish strong by both supporting each other and being honest. Your reply was more the latter, and it supported my view of the findings as well. I appreciated it :).

All that said, CoQ10 helped me quite a bit for a few months. I also tried taking multi-gram daily dosages (eg 2100-3000mg) with some improved affect once the 900mg dosage stopped. My experience shows it's worth a try.
 

EtherSpin

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THis looks like good research to me. I'm going to add this suppkement to my daily regimen
my hesitation comes from the cost and also doing a couple of months of the study into MitoQ - a supp aiming to be 100X more effective version of CoQ10 and where the company fessed up that the CFS cohort had no physical or cognitive improvement on that derivative
 
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If I read an abstract that use the term “significant” without prefacing with “statistically” and doesn’t mention the magnitude of the effect it’s a big red flag. If they have done a double blind trial but not mentioned in their abstract how the treatment group fared compared to the control group, this is another red flag. At least this article was freely available and not just the abstract. You often (in the supplement industry funded trials) see abstracts like these but you have to pay for the full article, so you can’t really verify if the results were large or tiny. Sometimes though, you can still find conflict of interest iinformation which will often state that the authors work for some supplement company.