Various Studies and Case Reports Suggest that CoQ10 (Coenzyme Q10) May be Helpful in Treating Fibromyalgia
By Heike Lück-Knobloch
Fibromyalgia is a chronic pain syndrome of unknown origin. It affects an estimated two to four per cent of the general adult population in Western countries. More women are affected by it than men. So far, the disease could not be clearly diagnosed with imaging techniques or blood tests, etc.
To date, the diagnosis is primarily based on 18 special pressure pain points (tender points) at the junctions between muscles and tendons. If a certain amount of pressure causes pain in at least 11 of these 18 tender points, it is a clear sign of fibromyalgia. Pain in various parts of the body (above and below the waist, on the trunk) that lasts longer than three months is also a characteristic symptom.
However, researchers in Würzburg have recently made an important discovery. They used three specific test procedures (including skin biopsies) to examine specific nerve fibres (small fibres) located right under the surface of the skin in affected people. In all three tests, the patients showed clear signs of damage to the small nerve fibres. It demonstrated that fibromyalgia patients actually suffer from neuropathic pain. Moreover, it provides the first objectively measurable criterion that doctors can use to guide their diagnosis (1).
Fibromyalgia patients complain of a variety of symptoms, in particular: stinging pain, joint stiffness, migraines, toothache, complete exhaustion, concentration and sleep disorders, gastrointestinal problems (irritable bowel syndrome), painful urination, hypersensitive mucous membranes, psychosomatic heart problems or difficulty breathing, ringing in the ears, hypersensitivity to smells, noise and light, chills as well as depressive moods. Often they feel muscle soreness throughout their entire body. Emotional stress and sleep deficit usually make the symptoms worse.
Treatment primarily focuses on influencing the patient’s altered perception of pain, especially with targeted exercise (physical therapy), individually adapted endurance and strength training, activating psychotherapy (cognitive behavioural therapy), medication (analgesics, opioids, cannabinoids, or even temporarily with certain low-dose antidepressants) as well as relaxation techniques (yoga, Tai Chi).
In some cases, inpatient treatment in a psychosomatic clinic that specialises in fibromyalgia over several weeks is recommended. Partial inpatient treatment options may also prove useful if outpatient treatment does not deliver the desired results.
Previous studies (2, 3) already suggested that increased oxidative stress and mitochondrial dysfunction could play a particularly relevant role in the pathophysiology of the disease.
Various recent studies and case reports (4–9) indicate that CoQ10 (ubiquinone) may be beneficial. These findings are supported by the fact that fibromyalgia patients usually have significantly low CoQ10 plasma levels, suggesting that the disease is most likely associated with a coenzyme deficit.
In the studies, supplementation with CoQ10 (100 to 800 mg daily) for 3 to 9 months led to an increase in coenzyme Q10 levels, improved cholesterol metabolism and alleviated symptoms such as chronic fatigue.
Researchers at the University of Seville, Spain, recently conducted a randomised, double-blind, placebo-controlled study, in which 20 fibromyalgia patients received 300 mg of CoQ10 daily over a period of 40 days. Compared to the placebo group, the pain, general fatigue, morning tiredness as well as the number of tender points decreased significantly in the verum group (10).
CoQ10 (for example, contained in Q10 Bio-Qinon® Gold, Pharma Nord) is important for mitochondrial energy metabolism (ATP production, respiratory chain), membrane stabilisation and the immune system. The lipophilic antioxidant also regenerates vitamin E and reduces LDL oxidation.
Various medicines can impair Q10 metabolism, for example statins, acid blockers, antibiotics, tricyclic antidepressants, antihypertensives, chemotherapeutics, antidiabetics and antihistamines (11).
According to one study, even muscle aches caused by statins decreased statistically significantly in 28 patients after taking CoQ10 for six months (12).
Author: Heike Lück-Knobloch
Registered German naturopath, non-medical practitioner
Am Pohlacker 19
40885 Ratingen, Germany
Email: Heike_lueck@gmx.de
Studies and references:
(1) Nurcan Üҫeyler et al., Small fibers in fibromyalgia syndrome, doi:10.1093/brain/awto53.
(2) Cordero MD et al., Mitochondrial dysfunction and mitophagy activation in blood mononuclear cells of fibromyalgia patients: implications in the pathogenesis of the disease. Arthritis Res Ther. 2010;12(1):R17.
(3) Cordero MD et al., Coenzyme Q10 distribution in blood is altered in patients with fibromyalgia. Clin. Biochem. 2009 May;42(7-8):732-5.
(4) Miyamae T et al., Increased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation. Redox Rep. 2013;18(1):12-9.
(5) Alcocer-Gómez E et al., Effect of coenzyme Q10 evaluated by 1990 and 2010 ACR Diagnostic Criteria for Fibromyalgia and SCL-90-R: Four case reports and literature review. Nutrition. 2013 Nov-Dec;29(11-12):1422-5.
(6) Cordero MD et al., 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.
(7) Cordero MD et al., Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q10 effect on clinical improvement. PloS One. 2012;7(4):e35677.
Abdullah M et al., Mitochondrial myopathy presenting as fibromyalgia: a case report. J Med Case Rep. 2012 Feb 10;6(1):55.
(8) Cordero MD et al., Coenzyme Q(10): a novel therapeutic approach for Fibromyalgia? case series with 5 patients. Mitochondrion. 2011 Jul;11(4):623-5.
(9) Lister RE. An open, pilot study to evaluate the potential benefits of coenzyme Q10 combined with Ginkgo biloba extract in fibromyalgia syndrome. J Int Med Res. 2002 Mar-Apr;30(2):195-9.
(10) Cordero MD et al., Can coenzyme q10 improve clinical and molecular parameters in
fibromyalgia? Antioxid Redox Signal. 2013 Oct 20;19(12):1356-61.
(11) Suzy Cohen. Drug Muggers. Which medications are robbing your body of essential nutrients and natural ways to restore them. Rodale Books New York ISBN 978-1-60529-415-5 Page 123-131 (2011).
(12) Zlatohlavek L. et al., The effect of coenzyme Q10 in statin myopathy. Neuro Endocrinology Letters 2012; 33 Suppl. 2:98-101.
other sources:
Dr Tilman Hassenstein, Fibromyalgie: Hinweis auf Ursache gefunden (Fibromyalgia: Clue to cause discovered), NDR television broadcast: Rounds, broadcast date: 01/10/2013;
Uwe Gröber, Mikronährstoffe in der Orthomolekularen Medizin (Micronutrients in Orthomolecular Medicine), 2002 Wissenschaftl. Verlagsges. mbH, Stuttgart;