Maes, Michael, Mihaylova, Ivanka, Kubera, Marta et al. · Neuro endocrinology letters · 2009
This study found that people with ME/CFS have significantly lower levels of Coenzyme Q10 (CoQ10), a substance that helps cells produce energy, compared to healthy people. Nearly 45% of ME/CFS patients had CoQ10 levels below what was found in any of the healthy control group. Low CoQ10 was connected to worse fatigue, problems with heart and blood pressure regulation, and difficulty with thinking and memory.
CoQ10 deficiency may explain multiple ME/CFS symptoms and could represent a treatable contributing factor. The association with premature cardiovascular mortality in ME/CFS patients suggests CoQ10 supplementation warrants investigation as a potential intervention to prevent serious cardiac complications.
This study does not prove that CoQ10 deficiency causes ME/CFS symptoms—it only shows an association. It does not establish whether low CoQ10 is a primary pathological feature or a secondary consequence of the disease. The study cannot determine whether CoQ10 supplementation would actually improve symptoms or outcomes, as no intervention was tested.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Maes, Michael, Mihaylova, Ivanka, Kubera, Marta, Uytterhoeven, Marc, Vrydags, Nicolas, & Bosmans, Eugene (2009). Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder.. Neuro endocrinology letters. https://pubmed.ncbi.nlm.nih.gov/20010505/
BibTeX
@article{mecfsatlas-maes-2009-coenzyme-q10,
author = {Maes, Michael and Mihaylova, Ivanka and Kubera, Marta and Uytterhoeven, Marc and Vrydags, Nicolas and Bosmans, Eugene},
title = {Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder.},
journal = {Neuro endocrinology letters},
year = {2009},
note = {PubMed: 20010505},
url = {https://www.mecfsatlas.com/evidence/maes-2009-coenzyme-q10},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/maes-2009-coenzyme-q10
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