Fibromyalgia is a common chronic pain condition without a known cause and without a reliable, effective medical treatment. It has several signs and symptoms in common with chronic fatigue syndrome: fatigue, pain, weakness, a feeling of discomfort in the body, a sense of unease and/or anxiety and depression.

Woman suffering from fibromyalgia

Treatment of fibromyalgia generally involves physiotherapy, anti-convulsants, and antidepressant therapy. Adequate intake of Coenzyme Q10, magnesium, selenium, vitamin D, and vitamin B12 may be beneficial.

Mitochondrial dysfunction, oxidative stress, and inflammation have been associated with fibromyalgia.

CoQ10 supplementation may restore an underlying deficit in CoQ10 status, which has been associated with fibromyalgia, and may improve the fibromyalgia patient’s outlook by:

  • improving mitochondrial activity
  • restoring cellular antioxidant capacity
  • ameliorating inflammation

Clinical studies of CoQ10 Supplementation and Fibromyalgia

Clinical symptoms

In 2012, Cordero et al. reported a case study in which they were able to show beneficial effects of CoQ10 treatment on the clinical symptoms, blood mononuclear cells, and mitochondrial and oxidative stress markers in a woman patient diagnosed with fibromyalgia. At the level of the cells, the CoQ10 treatment restored mitochondrial dysfunction, increased the number of mitochondrial DNA, decreased oxidative stress, and increased mitochondrial bio-genesis. Their results suggest that Coenzyme Q10 could be an alternative therapeutic approach for fibromyalgia [Cordero 2012].

In 2013, Cordero et al. reported the results of a randomized controlled trial in which fibromyalgia patients were supplemented with 300 mg Coenzyme Q10 per day for 40 days. The CoQ10 treatment was associated with significant reductions of pain, fatigue, morning tiredness, inflammation, and oxidative stress. The researchers observed a corresponding increase in mitochondrial energy generation and concluded that Coenzyme Q10 is a potential therapeutic agent in fibromyalgia [Cordero 2013].

Depression symptoms

In 2014, Alcocer-Gomez et al. reported the results of a randomized controlled clinical trial in which fibromyalgia received CoQ10 supplements in soft gel capsules for 40 days (300 mg/day CoQ10 divided into 3 daily doses) or matching placebos.

First, the researchers established that the fibromyalgia patients had significantly higher levels of depression (higher Beck Depression Inventory scores) compared with healthy controls. Coenzyme Q10 and serotonin levels in platelets isolated from fibromyalgia patients were significantly reduced in respect to controls [Alcocer-Gomez 2014].

Then, they observed that the CoQ10 treatment over 40 days had the following effects:

The researchers suggested that CoQ10 deficiency affects serotonin content in platelets and, presumably, in other cells such as neurons of the central nervous system [Alcocer-Gomez 2014].

Psychopathological symptoms

In 2017, Alcocer-Gomez et al. reported that supplementation of fibromyalgia patients with Coenzyme Q10 (300 mg/day for 40 days) was associated with significantly improved psychopathological symptoms. The researchers linked the improvement to the effect of Coenzyme Q10 in reducing oxidative stress and inflammation and in increasing serotonin levels [Alcocer-Gomez 2017].

Summary and Conclusion: Coenzyme for Fibromyalgia Patients

Safety of Coenzyme Q10 Supplementation

In more than 200 clinical trials, CoQ10 supplementation has been shown to be safe and well-tolerated with no serious adverse effects; there are no known toxic effects [Hidaka 2008].

Absorption and Bio-availability of Coenzyme Q10

To be effective, the Coenzyme Q10 has to reach the blood circulation and then be transferred to the tissue cells.

Coenzyme Q10 molecules are relatively large and are lipid-soluble; thus, they are not easily absorbed. In the small intestine, the CoQ10 molecules must be absorbed in the same way as other lipid-soluble nutrients such as Vitamin E and then transported via a lipid carrier (chylomicrons) through the lymph to the blood circulation [Mantle & Dybring 2020].

Coenzyme Q10 from supplements that remains in the crystalline form cannot be absorbed. The manufacturer of the CoQ10 product must find a process that dissolves the CoQ10 crystals to single molecules and keeps them dissolved at body temperature [Mantle & Dybring 2020].

The point being that the various CoQ10 products on the shelf and available from amazon.com are not all equally absorbed. It costs money to produce a CoQ10 product with an optimal absorption and efficacy – money spent on cheap CoQ10 products is most likely money wasted.

Sources

Alcocer-Gómez E, Sánchez-Alcázar JA, Cordero MD. Coenzyme Q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients. Journal of Clinical Psychopharmacology. 2014;34(2):277-278.

Alcocer-Gómez E, Culic O, Navarro-Pando JM, Sánchez-Alcázar JA, Bullón P. Effect of Coenzyme Q10 on Psychopathological Symptoms in Fibromyalgia Patients. CNS Neurosci Ther. 2017 Feb;23(2):188-189.

Cordero MD, de Miguel M, Carmona-López I, Bonal P, Campa F, Moreno-Fernández AM. Oxidative stress and mitochondrial dysfunction in fibromyalgia. Neuro Endocrinol Lett. 2010;31(2):169-73.

Cordero MD, Cotán D, del-Pozo-Martín Y, Carrión AM, de Miguel M, Bullón P, Sánchez-Alcazar JA. Oral coenzyme Q10 supplementation improves clinical symptoms and recovers pathologic alterations in blood mononuclear cells in a fibromyalgia patient. Nutrition. 2012 Nov-Dec;28(11-12):1200-3.

Cordero MD, Alcocer-Gómez E, de Miguel M, Culic O, Carrión AM, Alvarez-Suarez JM, Bullón P, Battino M, Fernández-Rodríguez A, Sánchez-Alcazar JA. Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal. 2013 Oct 20;19(12):1356-61.

Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K. Safety assessment of coenzyme Q10 (CoQ10). Biofactors. 2008;32(1-4):199-208.

Mantle D, Dybring A. Bioavailability of Coenzyme Q10: An overview of the absorption process and subsequent metabolism. Antioxidants (Basel). 2020 May 5;9(5):386.

The information contained in this review article is not intended as medical advice and should not be used as such.

30 November 2021

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