Role of mitochondria, oxidative stress & the response to antioxidants in ME/CFS: A possible approach to SARS-CoV-2 ‘long-haulers’? (Wood et al., 2021)

Pyrrhus

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From the team of Warren Tate who, I am obligated to say, comes from New Zealand:

Role of mitochondria, oxidative stress & the response to antioxidants in ME/CFS: A possible approach to SARS-CoV-2 ‘long-haulers’? (Wood et al., 2021)
https://www.sciencedirect.com/science/article/pii/S2095882X20300839

Excerpt:
Wood et al 2021 said:
A significant number of SARS-CoV-2 (COVID-19) pandemic patients have developed chronic symptoms lasting weeks or months which are very similar to those described for myalgic encephalomyelitis/chronic fatigue syndrome.

This study reviews the current literature and understanding of the role that mitochondria, oxidative stress and antioxidants may play in the understanding of the pathophysiology and treatment of chronic fatigue. It describes what is known about the dysfunctional pathways which can develop in mitochondria and their relationship to chronic fatigue.

It also reviews what is known about oxidative stress and how this can be related to the pathophysiology of fatigue, as well as examining the potential for specific therapy directed at mitochondria for the treatment of chronic fatigue in the form of antioxidants. This study identifies areas which require urgent, further research in order to fully elucidate the clinical and therapeutic potential of these approaches.
 
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I was only going to read a little bit, but it's well-written so I ended up reading the whole review.

I tried ubiquinol, which was mentioned. The review said much higher doses of CoQ10 may be necessary for its concentration in the brain to increase. Maybe my lack of response was due to not sticking to it for long.

I didn't respond to ATP either. The review mentioned D-ribose, which I think is similar, and I've never tried it. It's kind of expensive for a supplement IIRC, and it seemed like an expensive sugar to me at the time.

The review mentions lipid peroxidation and that reducing oxidative stress can be beneficial. My CRP and reverse-T3 were at the low end of normal, and my blood sugar is normal. Issues of this nature are certainly likely to cause CFS, make it worse, and prevent healing, but some people with CFS don't have them. They are likely primarily those with ME/mostly neurological chronic fatigue.

The review didn't mention thiamine, which is used to treat hereditary mitochondrial disease and reduces lactate production. It has a form that crosses the blood brain barrier easily, TTFD, that's used to treat neurological diseases by certain neurologists. Some people with ME/CFS and dysautonomia say it's very effective.

There could be a lack of certain nutrients like CoQ10 or thiamine in the CNS in ME, and there could be more global problems in CFS, like mitochondrial damage and reduced transkelotase (enzyme form of thiamine) which would make the diseases look similar. The inconsistency regarding CoQ10's benefits mentioned by the review possibly reflects a difference in pathology.

Another overlap is that functional CNS problems, and mitochondrial problems, are both difficult to test for, poorly understood, and often dismissed by doctors.

I think focusing on mitochondrial disease in CFS research is good. I think the post-exertional immune responses, like elevated antibodies in CFS are due to damage (maybe oxidative stress) from improper mitochondrial function, and that PEM in ME is a specifically neuroinflammatory response due to damage from insufficient nutrition, like from lack of cerebral blood flow which is common in OI.
 

Wishful

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To me, the conclusion is: "the hypothesis sounds really good, but all the trials of theoretical treatments don't show significant results."

Maybe my lack of response was due to not sticking to it for long.
Me too. :) Of course CoQ10 is the treatment for ME, but I just didn't take enough of it for long enough, and maybe I wasn't getting enough of an unmentioned but vital cofactor, and maybe Mars was thumbing his nose at Aquarius, or some other reason why reality wasn't matching theory ... but the theory is sound! :rolleyes:
 

leokitten

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I tried ubiquinol, which was mentioned. The review said much higher doses of CoQ10 may be necessary for its concentration in the brain to increase. Maybe my lack of response was due to not sticking to it for long.
Also because ubiquinol is really expensive to take the high doses you need per day. It costs $20-30 for a bottle of 200 mg 60 softgels. If you take six a day it lasts you 10 days you would have to spend $60-90 a month!
 

Pyrrhus

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Thanks for your thoughtful review, @barabara !

I tried ubiquinol, which was mentioned. The review said much higher doses of CoQ10 may be necessary for its concentration in the brain to increase. Maybe my lack of response was due to not sticking to it for long.

I didn't respond to ATP either. The review mentioned D-ribose, which I think is similar, and I've never tried it. It's kind of expensive for a supplement IIRC, and it seemed like an expensive sugar to me at the time.
I'm one of those people who get very large, very noticeable, and rather immediate increases in energy from very small doses of CoQ10 or Ribose. Unfortunately, I also get significant deterioration in sleep quality from both of those, so the long-term effect of either one for me is decidedly negative.

However, I don't know how many other people in the community experience the same response that I get. I suspect a rather small percentage.
 
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