CoQ10 and nicotinamide adenine dinucleotide may aid chronic fatigue syndrome in women

In a pilot eight-week, randomized, controlled, double-blind trial on 80 women with chronic fatigue syndrome, researchers found​ that supplementation of coenzyme Q10 with nicotinamide adenine dinucleotide (NAD) was able to reduce maximum heart rate more than a placebo.

The researchers are building on an earlier study, which suggested that “there is a mitochondrial failure which reduces the rate of adenosine-5-triphosphate (ATP) synthesis, the central agent of energy production in most chronic fatigue syndrome patients.”​

Hence, because of prior evidence that CoQ10 and NAD can increase cellular ATP production via mitochondrial oxidative phphorylation, the researchers hypothesize that supplementation with the two coenzymes “could help improve fatigue and other symptoms in chronic fatigue syndrome,”​ they wrote.

“The data regarding the effects of CoQ10 and NADH supplementation on exercise performance and cardinal symptoms in [chronic fatigue syndrome] remain limited and inconsistent,”​ they added.

“Additionally, no specific assessment of cardiovascular functioning with CoQ10 plus NAD supplementation during a stress test in [chronic fatigue syndrome] has been performed to date.”​

Selecting participants​

“Since [chronic fatigue syndrome] is more prevalent in women we preferred to study a more homogeneous and representative sample,”​ the researchers wrote. Other inclusion criteria included age (between 18 and 65 years), and a confirmed diagnosis of chronic fatigue syndrome based on the 1994 US CDC case criteria​.

A total of 80 participants who met the criteria were then randomized in a double-blind manner, divided in two groups to receive either the CoQ10 and NAD supplement or placebo (with 40 participants in each group). Participants were instructed to refrain from taking other supplements containing CoQ10, NAD, phosphatidylserine, and vitamin C throughout the period of study.

The supplement group ingested four enteric-coated tablets daily for eight weeks. The supplement tablets contained active ingredients (50 mg of CoQ10 and 5 mg of NAD) and excipients (20 mg of phosphatidylserine and 40 mg of vitamin C), donated by Vitae Natural Nutrition Corporation, who also provided some financial support for the study.

Study design​

On weeks four and eight, the participants self-reported changes in fatigue, pain, and sleep problems through questionnaires.

The patients were evaluated at baseline and at the end of the period on week eight for their predicted max heart rate functional response with an incremental cycle ergometer test. “The subjects performed a cycle ergometer test against a graded increase in workload, until exhaustion was reached,” ​the researchers wrote.

The researchers treated the reduction of maximum heart rate post exercise as an indicator for the supplement’s efficacy, as hearts of trained individuals, such as athletes, tend to beat less frequently because more blood is pumped with each beat.

Observations and results​

Based on the two analysis criteria—questionnaires on changes in feeling and maximum heart rate based on cycle test—the researchers found that the supplement group participants had a greater maximum heart rate reduction after cycling in week eight compared to the placebo group.

Based on the questionnaires, participants in the supplement group also perceived less fatigue than the placebo group, but there were no statistically significant differences for pain perception and sleep disruption between the two groups.

“In conclusion, [study] suggested that the CoQ10 plus NAD supplementation may be a safe, well tolerated and potentially useful treatment,”​ the researchers wrote, highlighting that there were no adverse effects from combining the two coenzymes together, which they claimed had not been observed before.

“Larger multicenter trials with longer term follow-up interventions in more homogenous chronic fatigue syndrome populations are warranted to assess these findings and to produce evidence-based guidelines regarding the potential benefits of antioxidant therapy in chronic fatigue syndrom and other chronic conditions,”​ they added.

A rising market​

“Coenzyme Q10 (CoQ10) and reduced nicotinamide adenine dinucleotide (NAD) are common antioxidant supplements with known cardioprotective effects which have been used for several decades as dietary supplements for general health maintenance,”​ the researchers wrote.

Though many cardiologists recommend CoQ10 for their patients, how it works is still shrouded with mystery​ to them. Nevertheless, a recent market report by Grand View Research forecasted that the CoQ10 market can pass the billion mark by 2024​.