Background
Fatigue, a symptom impacting both healthy and diseased populations, is prevalent in chronic conditions like fibromyalgia, chronic fatigue syndrome, and multiple sclerosis. Coenzyme Q10 (CoQ10), a lipid-soluble antioxidant crucial in mitochondrial energy production, has been proposed as a potential treatment for fatigue due to its role in reducing oxidative stress and improving mitochondrial function. This study conducted a systematic review and meta-analysis of 13 randomized controlled trials (RCTs) involving 1,126 participants to evaluate the efficacy of CoQ10 in reducing fatigue symptoms.
Methods
- Inclusion Criteria: Trials involving human participants, CoQ10 supplementation compared to placebo, and quantitative fatigue assessments.
- Data Sources: PubMed, Embase, Cochrane CENTRAL, Web of Science, and ClinicalTrials.gov.
- Statistical Approach: A random-effects model was employed to analyze pooled effect sizes (Hedges’ g) and assess the impact of daily CoQ10 dose and treatment duration using meta-regression.
Key Findings
Primary Outcome – Fatigue Reduction
- Across all 13 trials, CoQ10 supplementation significantly reduced fatigue scores compared to placebo (Hedges’ g = -0.398, 95% CI = -0.641 to -0.155, p = 0.001).
- Subgroup analysis showed a greater effect in participants with fatigue-associated diseases (Hedges’ g = -0.433, p = 0.005) compared to healthy participants (Hedges’ g = -0.351, p = 0.089).
Impact of CoQ10 Dose and Duration
- Fatigue reduction correlated positively with higher daily CoQ10 doses (coefficient = -0.0017 per mg, p < 0.001) and longer treatment durations (coefficient = -0.0042 per day, p = 0.007).
CoQ10 Formulations
- Trials using pure CoQ10 demonstrated significant fatigue reduction (Hedges’ g = -0.552, p = 0.001), whereas CoQ10 compounds (e.g., combined with NADH) showed trivial effects (Hedges’ g = -0.028, p = 0.781). The lower efficacy in compounds was attributed to lower CoQ10 doses.
Safety
- Among 602 participants receiving CoQ10, only one adverse event (gastrointestinal upset) was reported, indicating a high safety profile.
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Discussion
The meta-analysis confirmed that CoQ10 supplementation effectively reduces fatigue, particularly in individuals with chronic conditions. Key mechanisms include its role in mitochondrial energy production and its ability to mitigate oxidative stress and inflammation. The results highlighted that:
- Higher doses (300-500 mg/day) and longer durations (>3 months) amplify the fatigue-reducing effects.
- CoQ10-only formulations were more effective than compound formulations, likely due to differences in bioavailability and dosage.
Conclusion
CoQ10 is a safe and effective intervention for reducing fatigue, especially in populations with chronic conditions. Higher doses and extended treatment durations enhance its efficacy, making it a promising therapeutic option for managing fatigue. Future research should explore the long-term effects and optimal formulations for sustained benefits.
For full details, refer to the original article: https://pmc.ncbi.nlm.nih.gov/articles/PMC9449413/