A recent review by researchers in the UK and Spain explores mitochondrial dysfunction and its link with post-viral syndromes including ME/CFS, long COVID and fibromyalgia. Acknowledging that there are currently no FDA-approved pharmacological therapies for these conditions, the authors focus on the potential of supplementation with coenzyme Q10 (CoQ10).
Often referred to as the powerhouses of the cell, mitochondria play a crucial role in generating energy for the body’s needs. The review mentions that there have been reports in the scientific literature identifying a link between mitochondrial dysfunction and low-grade systemic inflammation in post-viral conditions, and that both elements have been implicated in the perpetuation of symptoms.
CoQ10 is a natural antioxidant present in mitochondrial membranes that helps protect cells from oxidative stress-induced damage. In their review, the authors highlight studies in which supplementation with CoQ10 has led to symptomatic relief of fatigue and pain in individuals with fibromyalgia. However, CoQ10 supplementation in individuals with COVID-19 or long COVID has produced mixed results.
And regarding ME/CFS, one randomised controlled trial involved more than 200 individuals with ME/CFS who received CoQ10 alongside NADH supplementation, and reported significant improvements in fatigue perception. However, a smaller trial supplementing CoQ10 alone demonstrated improvements in other symptoms but not in fatigue.
Whilst the research findings overall seem to be inconsistent across post-viral syndromes, the paper does suggest that there are still avenues to explore in relation to CoQ10 intervention studies and mitochondrial dysfunction. These include: “whether the bioavailability of CoQ10 could be improved through the use of alternative administration routes (e.g. intravenous, intraperitoneal, intramuscular, etc.); whether supplemental CoQ10 is able to cross the blood–brain barrier; and how CoQ10 is transported into and within cells”.
It should be noted, as acknowledged in the paper, that one of the authors is a medical adviser to Pharma Nord UK, a manufacturer of dietary supplements. Additionally, whilst the papers cited show that mitochondrial dysfunction has been explored in relation to the stated conditions, evidence is often inconsistent across papers or findings need validation. It is also worth noting that in its review of research related to dietary supplementation (including CoQ10) for the NICE 2021 guideline for ME/CFS, NICE concluded that there is not enough evidence to recommend dietary supplementation for ME/CFS.
Given the nature of ME/CFS, mitochondrial dysfunction remains a research focus. Currently, ME Research UK is funding research led by Prof. Jo Nijs exploring the links between mitochondrial function and the autonomic nervous system in ME/CFS.