CoQ10 and Chronic FatigueSyndrome

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http://www.prohealth.com/me-cfs/library/showArticle.cfm?libid=16337

Dr. Myhill on Coenzyme Q10 in Chronic Fatigue Syndrome

(ME/CFS)

ProHealth.com

by Myhill, MD

June 22, 2011

Dr. Myhill is a UK-based physician and clinical

nutritionist with a special interest in the treatment of fatigue and ME/CFS. Pioneering

research led by Dr. Myhill suggests that the cells' energy generating

mitochondria are dysfunctional in ME/CFS patients. The phenomenon was measured

directly by Acumen Lab in the UK, and the report (“Chronic Fatigue

Syndrome and Mitochondrial Dysfunction,”) by Dr. Myhill, Dr.

McLaren-, and Dr. Norman Booth, was published in January 2009 by the International

Journal of Clinical and Experimental Medicine

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Chronic fatigue syndrome is a symptom of mitochondrial failure, resulting in

poor production of ATP (adenosine triphosphate), which is the currency of

energy in the body.

To produce ATP, mitochondria need certain essential raw materials, namely

Coenzyme Q10 (CoQ10), D-ribose, L-carnitine, magnesium and vitamin B-3.

In a normal healthy person, CoQ10 can be synthesized, but it requires the amino

acid tyrosine, at least eight vitamins, and several trace elements. The

vitamins include folic acid, vitamin C, B-12, B-6 and B-5.

Synthesis of CoQ10 is inhibited by environmental toxins and chronic disease.

I am coming to the view that many of my CFS patients are metabolically

“dyslexic” - that is to say, even when all the raw materials are

available, they cannot make their own CoQ10 in sufficient amounts, and

therefore levels need to be measured and supplemented.

Indeed a recent study showed a close correlation between levels of CoQ10 and

severity of CFS. (“Coenzyme

Q10 Deficiency in ME/CFS” by Maes, et al.)

Blood Levels of Coenzyme Q10

Certainly when I check blood levels, it is very common to find very low levels

of CoQ10. CoQ10 is the most important antioxidant in the mitochondria, and

since it is the rate at which mitochondria fail that determines the normal

ageing process, it may well be that CoQ10 is a vital anti-ageing molecule!

I also see CoQ10 as an acquired metabolic dyslexia with age - as we age we get

less good at making certain key molecules, and CoQ10 is one.

The normal range in blood given by Biolab Medical Unit (www.biolab.co.uk)

is 0.55 - 2.0 mmol/L (millimoles per liter). This is equivalent to 0.637 - 2.3

ug/ml (micrograms per milliliter). However, Coenzyme Q10 has been widely used

in the treatment of heart failure, which we now know is what happens in

patients with severe chronic fatigue syndrome.

There have been a great many studies done looking at Coenzyme Q10 levels in

heart disease, and although the optimal dose of CoQ10 is not known for every

pathological situation, most researchers now agree that blood levels of 2.5

ug/ml and preferably 3.5 ug/ml are required to have a positive impact on

severely diseased hearts.

Clearly not all patients I see with chronic fatigue syndrome have severely

diseased hearts, but my view is that we should be aiming for a level above the

Biolab Unit's 2.00 mmol/L.

How Much CoQ10 to Take

The question is, how much CoQ10 should be given to supplement levels? Again,

the dose of CoQ10 in order to achieve a response has been worked out for

cardiac patients and this varies from 200 mg to 600 mg daily.

It is important that a hydro [water]-soluble form of Coenzyme Q10 be used in

order to ensure good absorption.

The absorption of CoQ10 can be improved if it is taken with a fatty or oily

meal. Or you could empty a capsule into a teaspoon of olive oil before

swallowing the lot.

(In the UK, it is possible for CoQ10 to be prescribed on National Health

Service Prescription. CoQ10 is not in the British National Formulary, but it

has not been blacklisted in capsule form, so can be prescribed if your GP is

willing to help.)

I am estimating that the following doses of CoQ10 will be required:

CoQ10 Blood levels 1.5 - 2.0 umol/l

100 mg CoQ10

CoQ10 Blood levels 1.0 - 1.5 umol/l

200 mg CoQ10 (split the dose: 100 mg twice a day)

CoQ10 Blood levels 0.5 - 1.0 umol/l

300 mg CoQ10 (split the dose: 100 mg 3 times a day)

CoQ10 Blood levels less than 0.5 umol/l

400 mg CoQ10 (split the dose: 200 mg am, 100 mg lunch, 100 mg evening)

Once a therapeutic effect has been achieved, then it should be possible to

reduce the dose to a lower maintenance dose, but a blood test may be required

to re-check that levels are adequate.

CoQ10 can be expected to work best in conjunction with:

• Magnesium,

• D-ribose,

• Acetyl L-carnitine (also available through eating red meat,

especially mutton, lamb, beef and pork - but to get 2 grams you need to eat

about a pound of meat a day!)

• And NAD (the conenzyme nicotinamide adenine dinucleotide).

Levels can be measured, but most people need 500 mg of NAD daily.

It may take up to 30 days to get blood levels up to a good level and therefore

start to see clinical response. Most studies of use of CoQ10 in heart disease

assess patients at three months. I would also expect to see improvements in

heart related symptoms such as chest pain, dysrhythmias, exercise tolerance,

shortness of breath and mitral valve disease.

There are virtually no side effects.

- Myhill, MD

Test Information

For information on the Acumen/Biolab Mitochondrial Function Profile (includes a

CoQ10 test) in the UK, click here.

And for overseas ME/CFS patients, click

here.

[For more information on CoQ10 see " Coenzyme

Q10 - The Energy Maker, " by Lee s.]

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* This article is reproduced with kind permission from Dr.

Myhill’s educational website (DrMyhill.co.uk)®

Myhill Limited, Registered in England and Wales: Reg. No. 4545198.

Note: This information has not been reviewed by the FDA. It is for general

information purposes only; is not meant to replace the personal attention of a

medical doctor; and is not intended to prevent, diagnose, treat or cure any

condition, illness or disease. It is very important that you make no change in

your healthcare plan or health support regimen without researching and

discussing it in collaboration with your professional healthcare team.

[Guest guest]

You need to take much more than the Recommended Daily Dose - A

doctor told me that my husband needed 300mgs CoQ10 and 350mgs Niacin (vitamin

B3), and I think that is a good recommendation.

Luv - Sheila

Sheila this

is very interesting and something I will show to my father who has heart

disease.

My doctor says I have post viral fatigue, but I dont have heart problems. Does

anyone know how much COq10 should I take?

Love Debbie