By Sarah Myhill, MD
June 22, 2017
Pioneering research led by UK-based physician/clinical nutritionist Sarah Myhill, MD, demonstrates that the cells’ energy generating mitochondria are dysfunctional in ME/CFS patients. The phenomenon was measured directly at Acumen Lab by Dr. Myhill, Dr. John McLaren-Howard, and Dr. Norman Booth in 2009 (see “Chronic Fatigue Syndrome and Mitochondrial Dysfunction”). The trio then linked ME/CFS severity to level of mitochondrial ATP production in July 2012; and in Nov 2012 reported on improvements in ATP production and symptoms for severely ill patients on a two-pronged regimen of nutritional support and energy expenditure management.
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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 Michael 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.
