Can Supplementation with NADH and CoQ10 help Patients with Chronic Fatigue Syndrome?

NADH stands for nicotinamide adenine dinucleotide (NAD) plus hydrogen (H). It is a naturally occurring coenzyme found in all living cells and plays a central role in cellular energy production. Enzymes act as catalysts—substances that facilitate chemical reactions without being consumed—while coenzymes such as NADH assist enzymes in carrying out these reactions. In healthy individuals, NADH is synthesized from vitamin B3, also known as niacin or nicotinamide.

Coenzyme Q10 (CoQ10), also known as ubiquinone, is another essential compound involved in cellular energy metabolism. The “Q” refers to its quinone chemical structure, and the “10” reflects the number of isoprene units attached to the molecule. CoQ10 is present in all eukaryotic cells and is concentrated in the mitochondria, where it plays a critical role in the electron transport chain. Cells with high energy demands—such as heart muscle cells—contain particularly high levels of CoQ10.

A double-blind, placebo-controlled study published in Clinical Nutrition (2016 Aug;35(4):826–834. doi:10.1016/j.clnu.2015.07.010) investigated whether supplementation with NADH and CoQ10 influenced symptoms in patients with chronic fatigue syndrome. The study included 80 participants, half of whom received a combination of NADH and CoQ10, while the other half received a placebo for eight weeks.

Participants were assessed at baseline, four weeks, and eight weeks using questionnaires that evaluated fatigue, pain, and sleep quality. Maximum heart rate during exercise testing was measured at the beginning and end of the study period.

Compared with the placebo group, participants receiving NADH and CoQ10 reported reduced perceived fatigue and showed a lower maximum heart rate during exercise testing at the end of the study. No significant changes were observed in pain or sleep quality in either group.

These findings suggest that targeted support of cellular energy pathways may influence fatigue perception and exercise response in individuals with chronic fatigue syndrome, although effects appeared limited to specific outcome measures. Further research is needed to better define mechanisms and clinical relevance.