Increasing ATP production in the treatment of chronic fatigue

The causes of chronic fatigue syndrome (CFS) are complex and not entirely well understood, but one thing is certain: its effects are frustrating and debilitating

Characterised by insurmountable fatigue that lasts for 6 months or longer and can’t be attributed to another medical condition, CFS causes a host of life-disrupting symptoms.

These can include muscle pain, difficulty sleeping (or sleeping too much), and cognitive problems. Many people with CFS experience a worsening of symptoms with exercise.

One possible explanation for the poor exercise tolerance and fatigue associated with CFS is mitochondrial failure and specifically a reduced rate of adenosine-5-triphosphate (ATP) synthesis.

Two supplements, coenzyme Q10 (CoQ10) and nicotinamide adenine dinucleotide (NADH), have been shown in previous studies to increase cellular ATP production. These antioxidants traditionally have been used for cardiovascular health. But some research has shown that they may be helpful in fighting CFS as well.

In a study whose results were published in the journal Clinical Nutrition in 2016, researchers aimed to determine how CoQ10 and NADH affected cardiovascular function, as well as fatigue, pain and sleep disturbances, in people with CFS.

The randomised, placebo-controlled, double-blind trial included 80 CFS patients who received either CoQ10 plus NADH or placebo twice daily for 8 weeks.

Patients randomised to the CoQ10 plus NADH group received four enteric-coated tablets daily consisting of active ingredients (50mg of CoQ10 and 5mg of NADH) and excipients (20mg of phosphatidylserine and 40mg of vitamin C). To measure cardiovascular function, the researchers measured maximum heart rate during a cycle ergometer test.

At week 8, those in the treatment group experienced a significant reduction in maximum heart rate during exercise compared to baseline (p=0.022). In addition, fatigue was reduced in the treatment group compared to placebo (p=0.03) at all time points. However, pain and sleep did not improve. The treatment was well tolerated.

This study suggests CoQ10 plus NADH may help increase energy levels in those with CFS, while also promoting cardiovascular health.