Fibromyalgia is a condition that pertains to a malfunction in the hypothalamus, a section of the brain located just above the pituitary. This can greatly affect the entire body. In addition to being a prominent piece of the nervous system the hypothalamus is charged with the regulation of hormones that interact with the entire body.
Causes of fibromyalgia may not necessarily be triggered in the hypothalamus. A number of factors that can contribute to this condition include malfunctioning mitochondria, hormonal deficiencies and/or imbalances, viral infections, neurotoxins, coagulation, and CoQ10 (Coenzyme Q10) deficiency. In order to treat fibromyalgia, it is important to take appropriate action. A multi-system approach, which targets each problem area individually rather than a large singular condition, is recognized as the best course of treatment. That being said, research has shown that vitamin D and CoQ10 supplementation is highly beneficial in assisting those suffering from fibromyalgia.
What is Vitamin D?
Vitamin D is unique – it’s the only vitamin that is also a hormone in its active form. Therefore Vitamin D3 (cholecalciferol) is actually considered a pro-hormone. Made by cholesterol in response to sun exposure, it is stored in the liver and then converted to its active form (calciatrol) by the kidneys. Once in its hormone form, it is in charge of making various enzymes, hormones, and neurotransmitters. Vitamin D plays a major role in bone health, calcium homeostasis, and immune system regulation, just to name a few.
Vitamin D and Fibromyalgia
Recent studies have shown that vitamin D supplementation may help relieve symptoms in fibromyalgia patients with low vitamin D levels. The study, which was reported on in the journal PAIN in early 2014, looked at the role of vitamin D supplementation in fibromyalgia patients, and assessed whether raising the levels of levels of 25-hydroxy Vitamin D in patients would reduce their level of pain.
The randomized, controlled trial focused on getting the patients to a level between 32 and 48ng/ml for 20 weeks via oral supplements. The levels were reassessed at 5, 13 weeks, 25 weeks, and 24 weeks after supplementation was discontinued.
The researchers found that even after supplementation was stopped, the patients experienced a significant reduction in their perceived level of pain. Between weeks 1 and 25 of supplementation, the group being treated had significant improvement in pain, while the placebo group had no improvement. The group being treated also scored better on a questionnaire assessing morning fatigue.
What is Coenzyme Q10 (CoQ10)?
CoQ10 is an antioxidant that can be found in every cell in the body. Cells utilize this antioxidant for individual cell growth and maintenance. In addition to promoting healthy cells it also assists in energy production for the body. As an antioxidant, CoQ10 acts as one of many literal bodyguards defending against harmful molecules, such as free radicals, which can cause significant issues for the body including damaged DNA and cell membranes.
Coenzymes, such as CoQ10, assist with metabolic actions such as deconstructing and breaking down food in order to convert it into usable energy in the form of adenosine triphosphate (ATP). Additionally, CoQ10 is a proenzyme, meaning that it is converted by the body into an active working enzyme. Through utilization of vitamin B6, the body synthesizes this enzyme. Therefore, if the body has insufficient vitamin B6 available you may become, or already be, CoQ10 deficient.
There are two primary forms in which CoQ10 can be found. They are ubiquinol, the active form of the antioxidant, and ubiquinone, the oxidized form that is partially converted by the body into active ubiquinol. Both are commonly found in numerous supplements but the active form has greater antioxidant efficiency than the oxidized form.
CoQ10 and Fibromyalgia
Research shows that CoQ10 can alleviate symptoms such as: hyperglesia (pain associated with fibromyalgia), depression, fatigue, and exercise intolerance. Those treated with CoQ10 showed improvement in these areas due to its influence on oxidative and nitrosative stress. It is notable that many of those diagnosed with fibromyalgia have also been diagnosed as CoQ10 deficient. This deficiency is commonly accompanied by increased inflammation.
Inflammation is considered one, if not the primary, factor in the pain associated with fibromyalgia. Increased levels of inflammatory cytokine TNF-alpha, prominently seen when levels of CoQ10 are low, is recognized as contributing to the inflammation and pain commonly seen among fibromyalgia patients. Through supplemental provision of CoQ10, patients experienced stabilized levels of TNF-alpha and therefore improved quality of life through reduced pain. Because CoQ10 is responsible for regulation of inflammatory genes such as TNF-alpha and NF-kappaB, returning it to appropriate levels can have significant positive effects. In addition, with restored levels, patients recovered AMPK gene expression. This is notable because AMPK enzymes functionally decide whether mitochondria consume or produce energy.
Mitochondrial dysfunction is a significant instigator of inflammation among fibromyalgia patients and is capable of being significantly detrimental when coupled with reactive oxygen species. These issues can manifest as cellular death, tissue damage, and organ dysfunction. Increased levels of reactive oxygen species correlates with reduced levels of CoQ10, which can lead to greater mitochondrial dysfunction. With supplementation of CoQ10 fibromyalgia patients decreased inflammatory markers such as dysfunctional mitochondria and TNF-alpha. Other benefits, specifically for those with dysfunctional mitochondria, included decreased muscle pain and greater migraine resiliency.
When acting as an antioxidant it is observed that CoQ10 in conjunction with vitamin E acts synergistically and more effectively as a combatant against free radicals. Without protection of such antioxidants, as stated previously, free radicals can cause significant bodily disruption by attacking DNA and cell membranes.
Researchers implemented a study with the intent of measuring the impact of CoQ10 supplementation in adults with fibromyalgia. This study, detailed in the Journal of Antioxidants and Redox Signaling, was conducted by prescribing the test group specific dosage of CoQ10 to be taken daily for a 40-day period. This trial resulted in the patients experiencing reduced pain, lessened fatigue, eased morning stiffness, and decreased bodily tenderness. These improvements were followed with inflammation recovery, improved antioxidant enzymes and increased mitochondrial regeneration. Studies such as these have led researchers to agree that supplementation of CoQ10 could be an effective and powerful tool in fibromyalgia treatment and therapy.
Supplementation to Alleviate Fibromyalgia Pain
Supplementation of vitamin D and CoQ10 is available without a prescription and is well documented as being a safe supplement. These supplements have been recommended in the treatment of conditions such as fibromyalgia for a notable time. However, as with any supplement, it is highly recommended to speak with your physician before moving forward. As stated previously, every case of fibromyalgia is complex and unique to each individual and should be treated using the multi-system approach.
At Holtorf Medical Group, our physicians are trained to utilize cutting-edge testing and innovative treatments to uncover and address the underlying cause of fibromyalgia. If you are experiencing symptoms of fibromyalgia, but aren’t getting the treatment you need, call us at 877-508-1177 to see how we can help you!
1. Kent Holtorf, MD. “A Confounding Condition.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/A_Confounding_Condition.pdf
2. Kent Holtorf, MD. “Chronic Fatigue Syndrome and Fibromyalgia; Now Treatable Diseases.” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Chronic_Fatigue_syndrome_and_Fibromyalgia_now_treatable_diseases.pdf
3. Wepner, et. al. “Effects of vitamin D on patients with fibromyalgia syndrome: A randomized placebo-controlled trial.” PAIN. February 2014 (Vol. 155, Issue 2, Pages 261-268).
4. Karras S et. al. “Vitamin D in Fibromyalgia: A Causative or Confounding Biological Interplay?” Nutrients. 2016 Jun 4;8(6).
5. Turner MK, Hooten WM, Schmidt JE, et al. “Prevalence and Clinical Correlates of Vitamin D Inadequacy among Patients with Chronic Pain.” Pain Journal. 2008 Nov;9(8):979-84.
6. Cordero MD, Alcocer-Gomez E, Culic O, et al. ” NLRP3 inflammasome is activatedin fibromyalgia: the effect of coenzyme Q10. “ Antioxidants and redox signaling. 2014 Mar 10;20(8):1169-80.
7. Cordro MD, Cotan D, del-Pozo-Martin Y, et al. ” Oral coenzyme Q10 supplementation improves clinical symptoms and recovers pathologic alterationsin blood mononuclear cells in a fibromyalgia patient.” Nutrition. 2012 Nov-Dec;28(11-12):1200-3.
8. Morris G, Anderson G, Berk M, Maes M. “Coenzyme Q10 depletion in medical and neuropsychiatric disorders: potential repercussions and therapeutic implications.” Molecular neurobiology. 2013 Dec;48(3):883-903.