Coenzyme Q10 for Fibromyalgia
Verdict: Published
Across 7 PubMed studies, the evidence for Coenzyme Q10 in Fibromyalgia grades Tier C — weak evidence.
C 🟠 C Weak Evidence Published
Why this grade7-layer evidence engine
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Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.48
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
C · Published
Confidence
78%
Broadly consistent
Evidence level
E2
Multiple high-quality MAs (≥2 independent, consistent)
▸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 = 0.485
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (1 篇 > 0 negative)
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (7)L2 · primary research & systematic reviews
Effects of Coenzyme Q10, Tryptophan, and Magnesium Supplementation on Fatigue in Patients with Fibromyalgia - A Randomized Trial
Finding: On the PRIMARY fatigue endpoint the trial was effectively null: fatigue improved significantly in the PLACEBO arm while the CoQ10+tryptophan+magnesium arm showed only a non-significant reduction; secondary outcomes (pain intensity, sleep quality, ICAF total) did improve significantly with the supplement.
View on PubMed Coenzyme Q10 supplementation alleviates pain in pregabalin-treated fibromyalgia patients via reducing brain activity and mitochondrial dysfunction
Finding: As add-on to pregabalin, CoQ10 reduced pain, anxiety and brain activity and lowered mitochondrial oxidative stress/inflammation versus pregabalin-plus-placebo, but the trial was very small (n=11) and reported no effect-size statistics in the abstract.
View on PubMed Can coenzyme Q10 improve clinical and molecular parameters in fibromyalgia?
Finding: CoQ10 300 mg/day for 40 days significantly reduced FIQ score and pain (both p<0.001) and improved fatigue, morning tiredness, visual pain scale and tender points (p<0.01), but only p-values (no effect sizes) were reported in a small single-center sample.
View on PubMed NLRP3 inflammasome is activated in fibromyalgia: the effect of coenzyme Q10
Finding: Placebo-controlled CoQ10 reduced NLRP3 inflammasome activation and serum IL-1β and IL-18 levels, but the primary endpoints are surrogate inflammatory biomarkers rather than clinical pain/function, and the sample (same Seville group, ~20 patients) is small with no effect sizes reported.
View on PubMed Increased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation
Finding: In juvenile fibromyalgia, ubiquinol-10 supplementation raised CoQ10 status and ameliorated hypercholesterolemia and fatigue, but the endpoints are largely biochemical surrogates, the population is pediatric, and the design lacks a placebo control with a very small sample.
View on PubMed Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Finding: Across 13 RCTs (1,126 participants) CoQ10 produced a small-to-moderate significant reduction in fatigue (Hedges' g = -0.398, 95% CI -0.641 to -0.155, p=0.001) with favorable safety, but fibromyalgia patients were only a subset and heterogeneity was substantial, so this is indirect evidence for FM specifically.
View on PubMed The Use of the Coenzyme Q10 as a Food Supplement in the Management of Fibromyalgia: A Critical Review
Finding: This critical review concludes there is no sound scientific basis to regard CoQ10 as a gold-standard FM supplement: the supporting trials are small pilot studies, and prospective randomized trials with hundreds of patients per group are still required to confirm efficacy.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4a US FDA
Cautious
not generally recognized as safe and effective for the referenced uses and therefore are considered "new drugs" source↗
L4b EU EFSA
Against
a cause and effect relationship has not been established between the consumption of coenzyme Q10 and the claimed effects source↗
L4c UK NHS
Cautious
Advise people with migraine that the food supplement riboflavin (400 mg once a day) may be effective in reducing migraine frequency and intensity for some people. source↗
L4d TW TFDA / 衛福部
Cautious
訂定「食品原料輔酵素Q10 (Coenzyme Q10)之使用限制及標示規定」 source↗
L5b Mayo Clinic
Neutral
CoQ10 supplements might be beneficial for treating conditions such as congestive heart failure and preventing migraines. Most healthcare professionals think CoQ10 is safe, with few side effects... Some research suggests that CoQ10 might help ease the muscle weakness and pain that can happen when taking statins, though there isn't enough evidence to know for sure. source↗
L5e Specialty Society (condition-mapped)
Neutral
Three drugs are FDA-approved for fibromyalgia: duloxetine (Cymbalta) and milnacipran (Savella) adjust brain chemicals to ease widespread pain. Pregabalin (Lyrica) blocks overactive nerve cells... Exercise is the most effective treatment: yoga, tai chi, or other low-impact aerobic activity. Acupuncture, chiropractic and massage can help. source↗