A systematic review of nutraceutical interventions for mitochondrial dysfunctions in myalgic encephalomyelitis/chronic fatigue syndrome

Abstract

Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a debilitating illness, characterised by persistent fatigue that is unrelieved by rest, in combination with a range of other disabling symptoms. There is no diagnostic test nor targeted treatment available for this illness. The pathomechanism also remains unclear. Mitochondrial dysfunctions have been considered a possible underlying pathology based on reported differences including structural and functional changes in ME/CFS patients compared to healthy controls. Due to the potential role that mitochondria may play in ME/CFS, mitochondrial-targeting nutraceutical interventions have been used to potentially assist in improving patient outcomes such as fatigue. The aim of this systematic review is to appraise literature assessing these nutraceuticals as a possible intervention for treating ME/CFS. Methods A systematic search of Pubmed, Embase, Medline (EBSCO host) and Web of Science (via Clarivate Analytics) for journal articles published between January 1995 and 10th November 2020 was conducted. Articles assessing nutraceutical interventions and ME/CFS patient outcomes were retrieved. Using specific inclusion and exclusion criteria, the list of articles was further refined. Quality was measured using the Rosendal scale. Results Nine intervention studies were included in this review. The studies investigated patient symptom severity changes such as altered fatigue levels in response to mitochondrial-targeting nutraceuticals. Improvements in fatigue levels were observed in six of the nine studies. Secondary outcomes assessed include biochemical, psychological, and quality of life parameters. Conclusion There is insufficient evidence on the effectiveness of mitochondria- targeting nutraceuticals in ME/CFS patients. Future well-designed studies are required to elucidate both the involvement of mitochondria in the pathomechanism of ME/CFS and the effect of mitochondrial-modifying agents on illness severity.

Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

“…First, CoQ10 and NADH are bioenergetic cofactors with the potential to boost mitochondrial function. Second, CoQ10 and NADH are powerful free radical scavengers that can mitigate the lipid peroxidation and DNA damage caused by oxidative stress; third, they have powerful antioxidant properties [17].…”

“…Long-chain polyunsaturated fatty acid, prostaglandin and amino acid metabolism, and inefficient ATP biosynthesis have been suggested as consequences of ME/CFS due to perturbed mitochondrial bioenergetic metabolism [13]. Due to the potential role of the mitochondria in ME/CFS, mitochondrial-targeting nutraceutical interventions have been used to assist in improving patient outcomes such as fatigue and their health-related quality of life [14], including CoQ10, NADH, and n-Acetyl-L-carnitine as part of their treatment regime [15][16][17][18]. These treatments are administered either alone or in combination with a cocktail of other nutraceutical and/or pharmaceutical-based products.…”

Effect of Melatonin Plus Zinc Supplementation on Fatigue Perception in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial

“…There is currently no treatment that modifies the natural evolution to chronicity, and thus, research efforts should focus on finding new molecules that improve the quality of life of these patients. As several nutritional deficiencies have been demonstrated in patients with ME/CFS, many attempts have been made to find therapeutic targets within natural nutritional supplements, although the results have been inconsistent [8,16].…”

Does Coenzyme Q10 Plus Selenium Supplementation Ameliorate Clinical Outcomes by Modulating Oxidative Stress and Inflammation in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

“…Possible common pathomechanisms of mitochondrial disruption (including oxidative stress, redox imbalance, and impaired ATP production) and low-grade systemic inflammation in ME/CFS have been extensively reviewed in the literature ( 15 ). The use of different supplements has been widely documented in ME/CFS either alone or in combination as cocktail, including coenzyme Q10 (CoQ10), l -carnitine, NADH, d -ribose, vitamins, magnesium, melatonin, zinc, folic acid, essential fatty acids, and N -acetyl- l -carnitine as part of their concomitant treatment regime in the attempt to ameliorate the patients' symptoms ( 12 ).…”