Reprinted with the kind permission of Celeste Cooper .
“Coenzyme Q10 is a natural compound produced by the body… On a cellular chemistry level, this antioxidant helps convert food into energy.” – Cooper and Miller, 2010 
CoQ10, also known as ubiquinone, is a fat-soluble supplement that is believed to help with many things from heart failure to cancer. But, for this post we will focus on how it might help fibromyalgia, ME/CFS (chronic fatigue syndrome), migraine, and related symptoms.
Effects of CoQ10 on Gene Expression and Human Cell Signaling
CoQ10 affects expression of genes in mice , and gene expression in human cell signaling, metabolism and transport . It is thought that the effects of CoQ10 supplementation  may be due to this property.
The Mitochondria and CoQ10
“In order to understand how CoQ10 works, it is first necessary to understand mitochondria. Imagine that each cell in your body is a car. Mitochondria are the engines – or energy producers – in each cell that make your “car” run. It is the job of the mitochondria to supply this energy in the form of adenosine triphosphate (ATP). This is where CoQ10 comes in. To continue the car analogy, it is the oil that enables the engine to work. [It] is the catalyst that makes it possible for the mitochondria to produce ATP, the molecule upon which all cellular functions in the body depend.” – Karen Lee Richards, ProHealth 
Coenzyme Q10 is essential to the functioning of the cells in our body, and deficiency has been related to several serious health consequences. This does not mean it comes without precautions and side effects , or drug interactions . So, if you decide to try it, please make sure your doctor and pharmacist have a complete list of all your medications and all the over-the-counter supplements and remedies you use.
Could CoQ10 Help Fibromyalgia and ME/CFS?
One study on mitochondrial dysfunction shows that CoQ10 could help. Interestingly, in this study  IL-8 (a proinflammatory cytokine) was elevated. This was also found in another study  relating neuroinflammation to heart rate variability (an autonomic effect) in fibromyalgia. This begs the question,
with autonomic nervous system involvement?”
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“It is argued that mitochondrial dysfunctions, e.g. lowered ATP production, may play a role in the onset of ME/CFS symptoms, e.g. fatigue and post-exertional malaise, and may explain in part the central metabolic abnormalities observed in ME/CFS, e.g. glucose hypometabolism and cerebral hypoperfusion.” (Morris and Maes, 2014 .) Though further trials are suggested, it was found in another study  that CoQ10 along with NADH, might be beneficial in treating ME/CFS. The results of another study  showed “lowered levels of CoQ10 play a role in the pathophysiology of ME/CFS and that symptoms, such as fatigue, and autonomic and neurocognitive symptoms may be caused by CoQ10 depletion.”
Mitchondria, CoQ10 and Migraine
In a literature review published in the journal Headache (Markley, 2012), it was concluded, “Arising from these extensive neurophysiological studies, the treatment of metabolic encephalomyopathies with pharmacological doses of riboflavin and coenzyme Q10 has shown positive benefits. The same treatment has now been applied to migraine, adding clinical support to the theory that migraine is a mitochondrial disorder.”
According to a HealthCentral Clinician , CoQ10 is showing promise for preventing migraine. Research was presented at an American Headache Society meeting, showing 300 mg per day to be effective. It is also reported that gel capsules are absorbed and utilized best by the body.
As with all supplements, CoQ10 is not regulated by the FDA, so please check the manufacturers safety and purity standards. You can check to make sure it is USP verified .
Coenzyme Q10 should not be taken on an empty stomach because it will reduce absorption. It is absorbed best when taken with foods that have fat, such as olive oil (a healthy choice) because it is fat-soluble. Taking it in smaller doses several times a day will help maintain the level circulating in your body and provide the greatest benefit.
While CoQ10 is relatively safe, as we age, so does our metabolism and our production of CoQ10. What is a recommended dose for one person might not be so for another, that’s why having the guidance of your physician is important. If you experience common side effects, talk it over with your doctor, it could be you need to start with a lower dose.
Editor’s comment: In order to produce cellular energy, the body must convert the ubiquinone form of CoQ10 to ubiquinol. It is the ubiquinol that carries electrons through the mitochondria and produces energy. As we age or when we have a chronic illnesses, our ability to convert CoQ10 to ubiquinol diminishes. Therefore, many experts recommend that anyone over 25 take their CoQ10 in the form of ubiquinol rather than ubiquinone.
About the author: Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body, Wounded Spirit, Balancing the See Saw of Chronic Pain, Fall Devotions  devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection  (coauthor, Jeff Miller PhD) She is a fibromyalgia expert for Dr. Oz, et al., at Sharecare.com , and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy . You can read more educational information and about her books on her website, TheseThree.com .