The exact aetiology and pathogenesis of fibromyalgia is yet to be elucidated but appears to involve mitochondrial dysfunction and oxidative stress. Coenzyme Q10 (CoQ10) is an essential cofactor in mitochondrial oxidative phosphorylation, producing energy in the form of ATP. CoQ10 also acts as a strong antioxidant. CoQ10 deficiency has been observed in patients with fibromyalgia and supplementation has previously shown to improve clinical symptoms.
Serotonin is an important neurotransmitter for both mood and pain modulation, with abnormal serotonin metabolism and transmission possibly contributing to fibromyalgia symptoms including altered pain perception, disturbed sleep, fatigue, poor cognition and lowered mood. A recent clinical trial sought to investigate the effects of CoQ10 supplementation on serotonin levels and depressive symptoms in patients with fibromyalgia.
Twenty patients diagnosed with fibromyalgia in accordance with the American College of Rheumatology criteria were randomised to receive either 300mg of CoQ10 (100mg three times a day) or placebo for 40 days. CoQ10 and serotonin levels were evaluated pre and post treatment, as were depression scores according to the Beck Depression Inventory (BDI) scale.
Before treatment, fibromyalgia patients had higher levels of depression and significantly reduced CoQ10 and serotonin levels compared to healthy controls.
At the completion of the trial, patients receiving CoQ10 supplementation experienced an improvement in depressive symptoms and significantly increased CoQ10 and serotonin levels, compared to placebo.
The results support the use of CoQ10 for the reduction of depressive symptoms in fibromyalgia patients, and for the restoration of CoQ10 levels. CoQ10 may produce these beneficial effects by affecting serotonin content, transmission and function, and improving mitochondrial dysfunction and oxidative stress.
- Cordero MD, Cotán D, del-Pozo-Martín Y, et al. Oral coenzyme Q10 supplementation improves clinical symptoms and recovers pathologic alterations in blood mononuclear cells in a fibromyalgia patient. Nutrition 2012;28(11-12):1200-1203. [Abstract]
- Cordero MD, Santos-García R, Bermejo-Jover D, et al. Coenzyme Q10 in salivary cells correlate with blood cells in fibromyalgia: improvement in clinical and biochemical parameter after oral treatment. Clin Biochem 2012;45(6):509-511. [Abstract]
- Alcocer-Gómez E, Sánchez-Alcázar JA, Cordero MD. Coenzyme q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients: results of a small clinical trial. J Clin Psychopharmacol 2014;34(2):277-278. [Full text]