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ingestible · for chronic fatigue syndrome

CoQ10 + NADH Combination

Reviewed by the Nimbera editorial team · Last updated May 2026

A 12-week randomized, double-blind, placebo-controlled trial (n=207 ME/CFS patients) found that 200 mg CoQ10 plus 20 mg NADH daily produced a significant reduction in cognitive fatigue (FIS-40 score, p<0.001) and improvement in health-related quality of life (SF-36, p<0.05) compared to placebo (Castro-Marrero et al., Nutrients, 2021; PMID 34444817). An earlier 8-week RCT (n=73) by the same group also reported significant improvements in fatigue impact scale scores and mitochondrial biomarkers (PMID 25386668).$60-100/month

How to use

Take 200 mg of CoQ10 (ubiquinol form is better absorbed) and 20 mg of NADH together once daily, preferably with a meal containing fat to improve absorption. Use the combination consistently for at least 8-12 weeks before evaluating effect. Do not take late in the day as NADH can be stimulating and may interfere with sleep.

How it works

CoQ10 and NADH are both essential cofactors in mitochondrial electron transport; supplementing them aims to compensate for the mitochondrial dysfunction and reduced cellular ATP production documented in ME/CFS patients.

Where to buy

Health food stores (Whole Foods, Sprouts), online retailers (iHerb, Amazon, Thorne, Pure Encapsulations). Look for ubiquinol (reduced CoQ10) for better bioavailability and stabilized NADH.

Typical cost: $60-100/month

Safety notes

CoQ10 may reduce the anticoagulant effect of warfarin - monitor INR closely if you are on blood thinners. May lower blood pressure; use caution if you already take antihypertensives. NADH is stimulating and can cause insomnia, nausea, or anxiety in some people, especially at higher doses. Quality and bioavailability vary widely between brands. Not recommended during pregnancy or breastfeeding due to lack of safety data. Consult your doctor before use if you have heart disease, cancer, or are on chemotherapy.

Drug & supplement interactions

  • Always tell your doctor or pharmacist about any supplements you take.
  • Interactions can occur with prescription medications, blood thinners, and immunosuppressants.
  • Herbal remedies can affect how the body absorbs or metabolises drugs.
  • Check drugs.com interactions checker before starting.

Clinical source

Castro-Marrero et al., Nutrients 2021

This information is compiled from primary clinical literature and is for informational purposes only. It is not a substitute for professional medical advice. Read our full disclaimer.