A new HFME paper is available: CoQ10 (ubiquinol), L carnitine, D ribose and
This paper looks at questions such as: Why are these three supplements (plus
magnesium) so important for heart health? What is the appropriate dosage of
each of these supplements? How well tolerated are these supplements in M.E.?
Which drugs dangerously deplete the body of CoQ10?
This paper/page also includes a summarised practical paper for patients.
(Severely affected patients may prefer to read just this summarised paper.)
(As you can see, the focus on nutritional, herbal and orthomolecular
medicine continues this month, as it will for several more months, before
the more 'usual' service is once more resumed. As I'm sure many of you will
understand, it is far easier to write on a single topic exclusively for a
time, with M.E.)
CoQ10 (ubiquinol), L carnitine, D ribose and M.E. by Jodi Bassett July 2010
Metabolic cardiologist Dr Stephen T. Sinatra considers coenzyme Q10 (CoQ10),
L carnitine, D ribose and magnesium the 'awesome foursome' of cardiovascular
Dr Sinatra explains that while 1 + 1 will always equal 2 in mathematics, in
metabolic cardiology and nutritional medicine, when you are talking about
substances that are synergistic with each other such as the 'awesome
foursome', 1 + 1 might equal 5 or even 10. In other words, the benefits of
taking more than one of these substances at a time may far outweigh the
benefits seen from taking any of them alone.
The heart and the brain are especially rich in mitochondria. This makes them
especially vulnerable to mitochondrial damage and the resulting decrease in
energy output. Both the brain and the heart (with its extraordinary non-stop
work) need an enormous amount of energy.
Dr Sinatra explains that,
It's all about ATP (adenosine triphosphate). Hearts, skeletal muscles and
every other tissue in our bodies have an absolute need for ATP as their
primary energy currency. Cells and tissues will cease to function if they
are not provided with a constant and stable supply of energy. Both the total
pool of energy substrates (ATP) in the cell and the cell's ability to
recycle these compounds are fundamental to healthy energy metabolism and
When hearts are stressed by disease, energy substrates, called purines, wash
out of the cell and the total pool of cellular energy becomes severely
depleted. Disease also disrupts the heart's ability to recycle its remaining
energy through the oxidative phosphorylation mechanisms. The combination of
energy pool depletion and metabolic dysfunction contributes to the severity
of the disease and impacts the physiological health of the heart. The same
is true for skeletal muscles that are stressed through disease or
CoQ10 and L carnitine are major players in the energy recycling metabolic
pathways. D ribose is the only compound used by the body to replenish
depleted energy stores and rebuild energy pools. Magnesium is a vital
mineral used by the enzymes that make energy synthesis and recycling
Or as Dr Sinatra explains; D ribose fills the tank, CoQ10 and L carnitine
helps convert this fuel to energy (helps the engine run properly) and
magnesium is the glue that holds it all together.
CoQ10 is an enzyme that occurs naturally in the mitochondria of every cell
in your body. It plays a key part in metabolizing energy from food. CoQ10
was first isolated in 1957. Since then, scientists have studied its effects
on a wide variety of illnesses and conditions.
CoQ10 plays an important role in stabilising cell membranes.
CoQ10 is essential in directly supporting ATP recycling in the mitochondria
of the cells. This is especially important for tissues that use a lot of
energy, such as the heart and the brain.
Dr Sinatra explains that CoQ10 helps any type of cardiomyopathy, congestive
or even hypertropic. It impacts on both systolic and diastolic dysfunction,
improving quality of life...
To read on or view a reference list for this paper, see:
Important notes on using the HFME's treatment information - Summary. Please
read this information before starting any new treatment
. For the best results, an individualised nutrition and supplementation plan
should be created in partnership with a qualified holistic practitioner.
Ideally, this practitioner would also be the patient's doctor. The
information on HFME should be used only as an additional source of
information, as a starting point for the patient's own research efforts and
for discussions with their own practitioner.
. The best results are achieved by following a comprehensive nutrition and
supplementation plan, rather than only taking a small number of supplements.
. As much reading as possible should be done before starting any new
treatment Read all of the information about the treatment available on
HFME in full and, if possible, some of the items in the relevant extra
recommended reading sections as well. Read as much and as widely as you can.
The information on general M.E. treatment on the HFME website is best
read together with one or more (or all) of the following books: The
Vita-Nutrient Solution, Orthomolecular Medicine for Everyone: Megavitamin
Therapeutics for Families and Physicians, Fire your Doctor: How to be
Independently Healthy and The Optimum Nutrition Bible (and also perhaps one
of the books on vitamin C). Borrowing or buying these books and combining
the information in them with the information on the HFME site (or book) is
. Before starting any new treatment the patient should: (a) make sure they
are aware of all the cautions relating to using it safely, such as whether
it must be taken with food or not, with other related supplements or in
divided doses, (b) check that it is compatible with all current medications
(and supplements) being taken, (c) check that it is safe for any other
conditions they may have (such as diabetes or kidney problems), and (d)
discuss it with their doctor or qualified holistic practitioner (if at all
. Any new supplement should be started at a low dose and the dose should
only be raised gradually. If you are sensitive to supplements, start at
minuscule dose: perhaps 1/10th of the normal dose or less, or a few crumbs
of a crushed tablet taken once a week. Try only one new treatment at a time,
if possible. (Simultaneously starting 3 or 4 or more of the treatments
listed in 'A quick start guide to treating and improving M.E.' may cause
. It should not be assumed that 'natural' means safe. Vitamins, minerals,
enzymes and herbs etc. taken at medicinal doses can have drug-like effects
and can potentially cause significant relapse or worsening of some symptoms.
Reading as much as you can about each treatment and starting very slowly are
important with EVERY treatment.
. Taking supplements is not a replacement for eating well, getting enough
rest and avoiding overexertion, having good sleep habits, limiting emotional
stress and avoiding toxic chemical exposures. There is little point in
giving the body the substances it needs to try to heal itself while at the
same time causing more damage in other ways.
. The treatments mentioned here are certainly not miracle cures for
long-term M.E., and no promises can be made about outcomes.
Promises of easy cures in many books and articles should be treated
with the contempt that they deserve! Many of these contemptible false
promises are made on the false assumption that 'CFS' means M.E., made in
many general books and articles on health, nutrition and vitamins. Some
diseases misdiagnosed as 'CFS' may well be easily treated and cured, but
this has no relevance to M.E. patients any more than it does to MS patients.
Particular treatments will not necessarily give particular outcomes.
The aim here is to give your body its best possible chance to at least
partly heal itself by giving it some of the basic tools and materials it
needs to heal itself. No specific level of improvement can or should be
guaranteed, with any treatment.
. HFME's collation of information on M.E. treatment is and will always be a
work in progress, as with any guide to treatment. M.E. patients and M.E.
experts are always invited and encouraged to submit any additional
information or comments they may have. It is recommended that readers
periodically check the HFME site for updates.
Disclaimer: HFME does not dispense medical advice or recommend treatment,
and assumes no responsibility for treatments undertaken by visitors to the
site. It is a resource providing information for education, research and
advocacy only. In no way does reading this site replace the need for an
evaluation of your entire health history from a physician. Please consult
your own health-care provider regarding any medical issues relating to the
diagnosis or treatment of any medical condition.
The full paper (properly formatted) is available here:
If you would like to link to this page, please do so using the link above
only. If you'd like to download a Word or PDF version of this text, please
click on the above link or use the links below:
The Hummingbirds' Foundation
for Myalgic Encephalomyelitis:
"Both carnitine and CoQ10 promote energy to cardiac muscle cells. It is
important to note that this action is physiological and is not similar to
the pharmacological effects of drugs that affect the heart rate and
contractibility of the heart." Dr Sinatra in 'The Sinatra Solution'