Featured article | February 2026
Mitochondrial Support in the Treatment of Chronic Fatigue Syndrome: A Case Report
Ross, C., & Logan, A. C. (2000). Journal of Orthomolecular Medicine, 15(1), 15–17.
This case report examines the use of targeted mitochondrial support nutrients in a patient with Chronic Fatigue Syndrome (CFS).
The authors chose L-carnitine, NADH, and coenzyme Q10 (CoQ10) as therapeutic interventions, based on earlier reports of mitochondrial abnormalities and low carnitine levels observed in some individuals with CFS.
Discussed in this article:
-
Clinical Context
-
CFS is defined by fatigue lasting six months or longer, accompanied by symptoms such as unrefreshing sleep, muscle pain, cognitive complaints, and post-exertional malaise.
-
With CFS, routine laboratory results are often normal, although research has identified physiological differences between patients and healthy controls, including mitochondrial changes.
-
- Mitochondrial Mechanisms
- Structural mitochondrial abnormalities have been reported in CFS. As well, post-viral fatigue, including degeneration, swelling, and altered mitochondrial fibre characteristics have been reported.
- Carnitine transports long-chain fatty acids into mitochondria and helps regulate the CoA:acyl CoA ratio within the cell. Lower serum acylcarnitine and carnitine levels have been observed in some individuals with CFS.
- NADH supports mitochondrial ATP production by donating electrons within the electron transport chain. Prior studies suggest oral NADH improve fatigue and cognitive symptoms in some patients.
- CoQ10 functions as an electron carrier in oxidative phosphorylation and plays a central role in mitochondrial energy production.
- Clinical Observations in the Case
- A 31-year-old male with viral-onset CFS received L-carnitine, NADH, and CoQ10. After six weeks, he reported reduced muscle aches, less post-exertional fatigue, and improved concentration.
- No adverse effects were reported, and the patient chose to continue treatment.
Dosing Information:
- L-Carnitine: 500 mg twice daily with meals
- NADH: 2.5 mg three times daily before meals
- CoQ10: 100 mg twice daily
- Route: Oral
- Safety: No adverse effects were noted.
“The treatment plan was initiated to address one area of research where nutritional support may be of benefit. The results in this case were positive and demonstrate the need for further research into supplementation which can improve mitochondrial activity.”
