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Latest News

Energy Makers Eroding in Fibromyalgia

Posted: February 26, 2010

Six years ago, researchers showed that the muscles of fibromyalgia patients had a substantial drop in the number of mitochondria, the part of the cell known for its energy-producing abilities.1 Even the shape of the muscle mitochondria were noted to be irregular in individuals with fibromyalgia compared to age-matched healthy control subjects. As impressive as these findings were, they remained unexplained until biochemists Placido Navas, Ph.D., and Jose A Sanchez Alcazar, Ph.D., began exploring an enzyme needed by the mitochondria: Co-Enzyme-Q10 (CoQ10).2

CoQ10 is an essential enzyme for detoxifying or neutralizing nasty waste products produced by the cells. Many of these waste products are called reactive oxygen species (ROS) because they tend to react with and degrade anything they come into contact with. In fact, elevated concentrations of ROS have been found in patients with fibromyalgia and the higher levels tend to correspond to more pain.

Close to one year ago, Navas and Alcazar found that the CoQ10 content in the blood cells of fibromyalgia patients was 40 percent less than age-matched healthy control subjects. However, in the nutrient-rich liquid portion of the blood, the CoQ10 concentration for fibromyalgia patients was double that of the healthy controls. This imbalance in the distribution of CoQ10 made no sense because the ROS inside the cells was high and yet the enzyme was concentrated outside the cells (e.g., not where it was needed most).

The current study by Navas and Alcazar looks to see if problems with the mitochondria could be responsible for the imbalance in CoQ10 distribution and the elevated levels of ROS.3 The amount of ROS in the mitochondria of 20 fibromyalgia patients was substantially greater than the age-matched control group of 10 subjects. This led the researchers to determine that the origin of the ROS was from the mitochondria within the cells. Next, the cell membranes were examined and found to be damaged by the mitochondrial-produced ROS. This meant that the cells were not able to keep the CoQ10 within the cells where the enzyme was needed the most for neutralizing the ROS.

The higher than normal ROS levels inside the blood cells eventually leads to programmed destruction of the mitochondria and the recycling of their contents for use within the blood cells. This is nature's way of limiting the ROS concentration from getting so high that it could destroy the blood cell walls. However, the processes occurring in the blood cells are known to correspond with what is happening in the muscle cells, and may offer an explanation as to why the fibromyalgia patients have a substantial reduction in their number of muscle mitochondria.

While elevated ROS can lead to more tissue damage, more nerve irritation and more pain, the imbalance in CoQ10 and loss of mitochondria could be linked to other symptoms that commonly occur in fibromyalgia. A reduction in mitochondria could lead to muscle weakness, more fatigue, and less ability to tolerate physical activities without flaring with more pain and exhaustion. In fact, this can lead to a viscous cycle because you have to exercise your muscles in order to make more mitochondria.

What can you do to possibly reverse this viscous cycle? Navas and Alcazar cultured blood cells from fibromyalgia patients with CoQ10 for 24 hours and this restored the function of the mitochondria. In addition, the blood cells from one representative fibromyalgia patient was placed into a culture containing one of the following: CoQ10, vitamin E, and N-acetyl cysteine. All three are anti-oxidants that can neutralize ROS (the first two are oil-based and the latter is water-based). N-acetyl cysteine did not reduce the ROS because these reactive chemicals were only oil-soluble.

A clinical trial using oil-based CoQ10 or less expensive oil-based anti-oxidants such as vitamin E and omega-3 fatty acids (see last month's Latest News for more details) is still needed to prove that this treatment approach can significantly reduce your symptoms. While CoQ10 can be somewhat pricy, the other anti-oxidants are relatively cheap and worth trying.

  1. Sprott H, et al. Annals Rheum Dis 63:245-51, 2004.
  2. Cordero MD, et al. Clin Biochemistry 42:732-35, 2009.
  3. Cordero MD, et al. Arthritis Res Ther 12(1):R17 [Epub ahead of print] 2010.

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