Coenzyme Q10 for Fatigue
For everyday tiredness, coenzyme Q10 has not been shown to work: high-quality evidence and major health authorities do not support it as an energy or anti-fatigue supplement. A narrow, confounded signal exists only in specific conditions like ME/CFS, which does not justify general use.
Why this grade7-layer evidence engine
The strongest signals are condition-specific and shaky, not general. The most-cited positive trial in chronic fatigue syndrome (Castro-Marrero 2021, PMID 34444817, n=207) tested CoQ10 combined with NADH, so any benefit cannot be attributed to CoQ10 alone, and it was industry-funded. A 2022 meta-analysis (Tsai, PMID 36091835, 13 RCTs, n=1126) found only a small-to-moderate effect (Hedges' g -0.40) across a grab-bag of unrelated populations with substantial heterogeneity. A post-viral fatigue review (PMID 10779395) rested on open-label, underpowered data.
For the most rigorously studied scenario, exercise, the result is a biomarker-symptom dissociation. A 2024 meta-analysis (Sangsefidi, PMID 38479900, 28 RCTs, n=830) showed CoQ10 lowers muscle-damage and oxidative-stress markers (CK, LDH, MDA) but did NOT improve physical performance or subjective fatigue. Examine.com grades CoQ10 'D' for general fatigue.
Regulators and clinics reinforce the counter-evidence grade. The EU's EFSA rejected CoQ10 energy-metabolism claims, finding no established cause-and-effect relationship; the US FDA treats disease claims as unapproved 'new drugs'; and UK NICE guidance recommends only riboflavin, not CoQ10. Harvard Health states plainly it 'has not been shown to boost your energy,' and no professional society endorses it for fatigue. Hence a Tier D, counter-evidence verdict.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.44
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (2 篇 > 0 negative)
- tier_strict_requirement_check — | C→D 因 scope.conflation_risk=true 且 L11 獨評較低 (B7-2 tier cap)
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status