Coenzyme Q10 benefits Gulf War veterans

Between 1/4 and 1/3 of the men and women who served in the first Gulf War continue to suffer from a variety of symptoms caused by environmental exposure.

Can a daily Coenzyme Q10 supplement help to alleviate the multi-symptom medical and psychological problems afflicting one-fourth or more of the veterans of the first Gulf War?

That was the research question that Dr. Beatrice Golomb, M.D. and Ph.D., together with colleagues in the Departments of Medicine and Family and Preventive Medicine at the University of California in San Diego, set out to investigate (1).

Well over 100,000 veterans, possibly almost 200,000 veterans, of the Gulf War in 1990-1991 continue to suffer from a collection of symptoms associated with their participation in the desert warfare.  As Dr. Golomb says in her article in the journal Neural Computation, the symptoms and the problems of the veterans have not resolved themselves with the passage of time.

Gulf War Illness symptoms and the importance of Q10
It is the chronic presence of a collection of symptoms that characterizes the syndrome that is known as Gulf War Illness.  What are some of the common symptoms?  They include problems with fatigue and sleep, cognition, mood, pain, muscle function, digestion, breathing, and skin irritation.

These and other symptoms, a total of 20 different symptoms in all, remain after doctors and researchers have controlled for such possible causes as post-traumatic stress disorder and psychiatric illness.

Environmental exposure, in particular exposure to inhibitors of acetyl-cholinesterase, seems to be at blame for the Gulf War Illness.  Acetyl-cholinesterase is an enzyme that helps to stop the excitation of a nerve after an impulse has been transmitted.  Dr. Golomb points out that the toxicity of exposure to the acetyl-cholinesterase inhibitors is strongly linked to oxidative stress and to mitochondrial dysfunction, and that realization made her and the members of her team think that Q10 could have a beneficial effect on Gulf War Illness.

Coenzyme Q10 the primary antioxidant in the human body
Dr. Golomb cites extensive research – her reference list is one of the most impressive that I have seen – demonstrating that Q10 is the primary lipophilic antioxidant in the body and that Q10 has been shown, in research studies, to alleviate such symptoms as fatigue, muscle pain and weakness, cognitive problems, neuropathy problems, exercise intolerance, headaches, and quality of life issues.  All of these problems are known to be affecting many Gulf War veterans today.

Coenzyme Q10’s vital role in cellular energy production
Moreover, Coenzyme Q10, in its ubiquinone form, plays a vital role in the production of energy at the level of the cells.  Brain activity, in general, and neural computation, in particular, are very demanding of energy.  Dr. Golomb and her team of researchers reasoned that the use of a well-absorbed Q10 supplement could be of benefit to the brain, which is such a big consumer of energy in the body.

Coenzyme Q10 and the Gulf War Illness study participants
The Golomb study itself was set up to meet all the criteria of a gold standard clinical trial.  There was a comparison of the outcomes in the placebo group with the outcomes in the Q10 treatment groups.  The participants were randomized to the placebo group and to the two Q10 treatment groups, which received either 100 mg Q10 daily or 300 mg Q10 daily.  The study was set up as a double-blind study.  Neither the researchers nor the patients knew who was getting what.

The researchers enrolled 46 veterans living in southern California who met the Kansas and Centers for Disease Control criteria for a diagnosis of Gulf War Illness. Both males and females were represented in the sample.

The researchers chose the Q10 supplement that they used based on data showing the following attributes.  They wanted a Q10 supplement with a record of excellent quality control, with an absence of any ingredients that might have adverse cellular effects, with documented evidence of an ability to reduce malondialdehyde, which is a marker of oxidative stress, and with documented evidence of high bioavailability of the Q10.  They wanted a preparation using soft-gel capsules with the Q10 in an oil solution.

The manufacturer of the Q10 soft gelatin capsules also provided placebo capsules that were identical in size and appearance to the Q10 capsules.  The Q10 preparation chosen by the researchers and used in the study was the same preparation that was used in the Q-symbio clinical trial with chronic heart failure patients and in the KiSel-10 clinical trial with healthy elderly men and women.

Coenzyme Q10 and the Gulf War Illness study methodology
There were four treatment phases lasting 3.5 months +/- 0.5 months each.  During and throughout two of the four phases of the study, all of the participants received placebo capsules exclusively, which both provided placebo control outcomes and served as a washout phase between Q10 treatment phases.

In the Q10 treatment phases, the participants received either 100 mg Q10 or 300 mg Q10 daily.

The expectation, based on an earlier study by Singh et al, was that 300 mg Q10 taken as 100 mg at three times during the day would yield higher blood levels of Q10 than would a one-time-a-day dose of 100 mg of Q10 (2).

Outcomes of the Q10 and Gulf War Illness study
The primary outcome in the study was General Self-Rated Health.  On this outcome, Q10 supplement resulted in a statistically significant improvement among the men in the sample (men made up 85% of the total sample) but not in the total sample.

In the total sample, women included, Q10 supplementation gave a statistically significant improvement in physical function, which was assessed by Summary Performance Scores.

Moreover, in the total sample, the direction of change in 19 of the 20 tested symptoms was positive with the daily administration of 100 mg of Q10.

With the 300 mg daily administration of Q10, there were significant positive improvements in several of the symptoms.

Changes in Coenzyme Q10 blood levels and study outcomes
As Dr. Golomb has indicated, the important thing to note is whether increases in Q10 levels in blood correlate positively with improvements in General Self-Rated Health, in improvements in Summary Performance Scores, and in reductions in the severity of the symptoms of Gulf War Illness.

In the total sample, the correlation between Q10 blood level and improvements in Summary Performance Scores was statistically significant,

The relationship of Q10 blood levels to improvements in General Self-Rated Health was nearly significant.

Moreover, the daily administration of 300 mg of Q10 was more instrumental in establishing the positive relationships between Q10 blood levels and health and performance outcomes than the 100 mg daily administration of Q10 was.

The relationships between Q10 blood levels and positive study outcomes tend to support the supposition that there is a true causal effect from Q10 supplementation.

Coenzyme Q10 and oxidative stress and mitochondrial dysfunction
Extrapolating from the results of the study, which was done with a small sample and which needs to be replicated, we can say to ourselves that the study done by Dr. Golomb and her colleagues seems to be evidence that supplementation with a properly formulated and well-absorbed Q10 preparation can help to reduce oxidative stress and mitochondrial dysfunction.

Bottom line
Gulf War veterans are not the only people who are exposed to environmental and stress factors that lead to oxidative stress and, eventually, mitochondrial dysfunction.  If you are 40-45 years of age or older, if you are taking statins, if you are working or exercising strenuously, you should be thinking seriously about taking a well-absorbed Coenzyme Q10 supplement.

Sources:

1. Golomb, B.  CoQ10 and gulf war illness.  Neural Computation 2014 Nov; Vol. 26 (11), pp. 2594-651
2. Singh, R. B.,Niaz, M. A., Sindberg, C. D.,Moesgaard, S.,& Littarru, G. P. (2005). Effect of oral coenzyme Q10 dosages on serum Q10 and MDA levels among healthy men. Paper presented at the International Coenzyme Q10AssociationMeeting Abstracts, Los Angeles.