MAES M.:July, 2009. Co-enzyme Q10 deficiency in myalgic encephalomyelitis

Frank

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Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder.

Neuro Endocrinol Lett. 2009 [in press]

Maes M, Mihaylova I, Kubera M; Uytterhoeven M, Vrydags N, Bosmans E.


Abstract

Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is a medical illness characterized by disorders in inflammatory and oxidative and nitrosative (IO&NS) pathways.

This paper examines the role of Coenzyme Q10 (CoQ10), a mitochondrial nutrient which acts as an essential cofactor for the production of ATP in mitochondria and which displays significant antioxidant activities.

Plasma CoQ10 has been assayed in 58 patients with ME/CFS and in 22 normal controls; the relationships between CoQ10 and the severity of ME/CFS as measured by means of the FibroFatigue (FF) scale were measured.

Plasma CoQ10 was significantly (p=0.00001) lower in ME/CFS patients than in normal controls.

Up to 44.8% of patients with ME/CFS had values beneath the lowest plasma CoQ10 value detected in the normal controls, i.e. 490 :g/L.

In ME/CFS, there were significant and inverse relationships between CoQ10 and the total score on the FF scale, fatigue and autonomic symptoms.

Patients

with very low CoQ10 (<390 :g/L) suffered significantly more from concentration and memory disturbances.

The results show 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.

Our results suggest that patients with ME/CFS should be treated with CoQ10 in order to treat the low CoQ10 syndrome and the IO&NS disorders.

The findings that lower CoQ10 is an independent predictor of chronic heart failure (CHF) and mortality due to CHF may explain previous reports that the mean age of ME/CFS patients dying from CHF is 25 years younger than the age of those dying from CHF in the general population.

Since statins significantly decrease plasma CoQ10, ME/CFS should be regarded as a relative contraindication for treatment with statins without CoQ10 supplementation.

Keywords:
Coenzyme Q10, chronic fatigue syndrome, inflammation, oxidative stress, mitochondria, cytokines, heart failure, coronary artery disease, mortality, statins
 

Cort

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Wow! Those look like very low COQ10 readings; that statistical significance number .000001 or whenever it was was just off the charts! Another indication of mitochondrial dysfunction. By why are the levels so low? I wonder what he thinks. I don't think anyone has measured C0Q10 levels before.

Here's some more on COQ10

Coenzyme Q10 (CoQ10) is a fat-soluble, vitamin-like, ubiquitous compound that functions as an electron carrier in the mitochondrial respiratory chain, as well as serving as an important intracellular antioxidant. CoQ10 protects phospholipids and mitochondrial membrane proteins from peroxidation and protects DNA against the oxidative damage that accompanies lipid peroxidation 1, 2, 3.
A recent study gave its participants this much COQ10:

were given nanodispersed CoQ10 (Sanomit Q10, Monopreparation, MSE, Bad Homburg, Germany) in a dose of 3 mg/kg body weight, which was taken in the morning and evening for a total of 28 days.
They described it as a lot of COQ10.

I would note that several studies have found increased lipid peroxidation in chronic fatigue syndrome.

I wonder what the optimum dose is.
 

consuegra

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co-Q

This study looks at one of the pieces. If it is true that co-Q is low, how do you measure it? LabCorp has a test, but is it any good? Biolab has a co-Q test. And what is the treatment? Co-Q is notoriously difficult to absorb - and there are two different kinds, with different explanations on how good each one is. Various researchers are working to increase absorption, but their products have not arrived yet on the seen. It would be nice to know a co-Q that works, and it would be nice to be able to measure it with confidence.

Chris
 

JanisB

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Some of us measure it indirectly through organic acids testing. Various citric acid cycle metabolites indicate a need for or sufficient CoQ 10. We use Metametrix, Genova, Great Plains....

One of the big issues with CFS is that CoQ 10 is recyled, going from the oxidized to the reduced state. Both states of the molecule are useful at different points of the cycle.

Just measuring the serum level at a single moment in time may not give an accurate view of how the body is using it.

Just a few thoughts...
 

consuegra

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co-Q and urinary metabolites

I would appreciate it if you could instruct me as to the urinary metabolites and levels that are associated with low co-Q. I am familiar especially with the Great Plains Laboratory OAT test. I have learned to read these metabolite results with the help of others, but I don't know what to look for to try to assess co-Q. Thanks.

Chris
 

Michelle

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I wonder what the optimum dose is.
LOL -- that was exactly what my question was when I read this study!

I've been taking 400mg for about a month and a half (with my Omega 3 softgels hoping that the fat will aid in absorption) and it has improved certain cognitive skills (abstract thinking) while others have seemed almost worse (forgetting to turn off the stove, bath; word finding). My strength has not improved, but I don't seem to crash as quickly. So I guess keeping me from getting worse is better than "a kick in the head" as my boyfriend would say. ;-)
 
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Hi Michelle,

How would you know whether it is the Omega oil or the Q 10 that makes you less foggy?

Omega oils (the three 3,6,9) make me clearer in the head.

Also Vit.D helps clear my head, but I guess it is different for everybody!

bettine
 

Michelle

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How would you know whether it is the Omega oil or the Q 10 that makes you less foggy?
Because I have been taking the Omega 3 fatty acides for five years prior to beginning the CoQ10 with very little impact on my cognitive skills, though it is helpful for IBS, boosting HDL, reducing inflammation, etc. I take the CoQ10 with the Omega 3s because CoQ10 is absorbed better with fat.

I always add one supplement/medication at a time so it is clear what's working and what isn't.
 
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dose of CoQ10

I have a coQ10 deficiency in my muscle tissue. My blood tests are always ok (on the high side) because I take CoQ10 supplements. I take Tishcon brand Chew Qs (NFI) 600mg tablets. At one point I was taking 1200mg a day, as prescribed by my physician. I can't recall my test results exactly, but I had something like 50% of the amount of CoQ that is considered normal, so we were treating it rather aggressively. I do feel a lot better and believe the CoQ10 supplements are helping.

It's interesting that they have found the deficiency in M.E. My doctor can't tell me for sure if my CoQ10 deficiency is a primary or secondary condition. I've never been diagnosed with M.E., but I do have the symptoms. I started out with a diagnosis of FMS and now we're not sure if it is FMS or a mitochondrial disease (CoQ10 deficiency - if primary, is considered a mitochondrial disease), although it is actually one of the types of mitochondrial disease that they have a successful treatment for. I've found that most doctors who treat mitochondrial disease (many of those patients have a CoQ10 deficiency) tell their patients that low doses of CoQ10 are useless. You need to start low, but increase it until you're feeling better. Most of the mito patients I talk to are taking at least 200mg or higher. Don't know if this was of much help, but generally there has not yet been a consensus on how much to take.
 

richvank

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Synthesis of Co Q10 requires methylation

Hi, all.

I just want to note that the body normally uses methylation in the pathway to produce coenzyme Q10. If there is a partial methylation cycle block, as appears to be the case in many or most PWMEs, based on at least several hundred who have had the Vitamin Diagnostics methylation pathways panel so far, this could explain the low Co Q10 status that is observed.

Note that this same explanation can explain low levels of carnitine, creatine (and creatinine), and choline in M.E, as well as several other observed abnormalities. Methylation is a very fundamental process in the metabolism, so when the methylation capacity goes down, it affects many aspects.

Best regards,

Rich
 

JanisB

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Q

I would appreciate it if you could instruct me as to the urinary metabolites and levels that are associated with low co-Q. I am familiar especially with the Great Plains Laboratory OAT test. I have learned to read these metabolite results with the help of others, but I don't know what to look for to try to assess co-Q. Thanks.

Chris
Here's what Metametrix lab says: Elevation of Hydroxymethylglutarate (HMG) can reveal a block in your body's synthesis of Co Q10. Other functionals markers such as Lactate, Succnate, Fumarat, and Malate, indicate whether your body is able to produce energy efficiently by utilizing co Q 10. "

In more detailed discussion, Lactate when high indicates need for more CoQ, unless due to alcohol consumption or lack of NAD.

In the citric acid cycle, Co Q10 controls the rate of oxidation of succinate to fumarate. Reduced CoQ10 accepts hydrogen atoms one at a time from reduced FAD.

HMG is the precursor of both cholesterol and Co Q 10. Low levels can indicate inadequate synthesis and possible deficiency.

Then it seems more complicated as it explains that low serum COQ and low urinary HMG can both indicate blocks at different points in the pathway.

Got it? Ugh, bio chem. Who thought we'd all care about any of this before ME set in?
 

kolowesi

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MargeM CoQ10 deficiency in muscle

Hi, Marge,

Sorry to hear what you are dealing with, but that's great info.

How did you find out, a muscle biopsy? My doc would never go for that, but at least someone's did!

I'm so glad you are noticing improvement. Thanks for the post.

Kelly
 

Chris

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Q10 and B12

Hi; somewhere in Freddd's great B12 stuff is a warning that in some people the addition of Q10 while taking Methylcobalamin can significantly raise blood pressure--have not noticed that myself, but worth checking out. Best, Chris
 

Victoria

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Cort,

Would be most interested in the dose etc.

After last week's stress echocardiagram which revealed a blockage in my left mitral valve (that is the valve between the upper & lower chambers of the heart) & that part of my heart muscle is not working, I finally decided to buy some CoEnzyme Q10 on Saturday.

Had read about this enzyme many months ago, but decided it was too expensive.

So when I see the cardiologist on Wednesday (who has already put my name on his list for a coronary angiogram), I will be most interested to hear HIS views.

It was Aust$99.85 for 200 x 100mg tablets - very, very expensive based on my financial resources. I'll start with the 100mg per day as the label says & see if there's any difference, before increasing.

For that amount of money, it had better show some effect. I have not been tested for any deficiency - this is purely a supplement I'm taking to check it out (because of my heart problems & to see if it makes any improvemnt overall).

Victoria
 

*GG*

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CoQ10 and blood tests

I bought some CoQ10 a couple of years ago. I toke it for a few months and then thought how do I know it is of a good quality?

So I asked my Dr to have it checked. I did a blood test and he said that I did not need to take the supplement because of the level in my blood. I did not notice any benefit from taking it.

bought it for less online. Much more expensive even at Warehouse clubs.

quit seeing the Dr becuase he was not all that knowledgable about CFIDS.
 

liverock

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I recently had the whole Mito Profile tests done by Dr Sarah Myhill which included a COQ10 test which was 1.18umol/l (0.55-2.0).

Even though this was within range she said I should increase supplementation to get to 2.5umol/l or above as this appears to help kick start the mitochondria at which point the dosage can be reduced according to clinical response.
I am now on 400mg per day which seems to have helped.