Gulf War Illness, Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Overlap Common Symptoms and Underlying Biological Mechanisms: Implications for Future Therapeutic Strategies

Although Gulf War illness (GWI), fibromyalgia (FM), myalgic encephalitis/chronic fatigue syndrome (ME/CFS), and long COVID have distinct origins, in this article, we have reviewed evidence that these disorders comprise a group of so-called low-energy associated syndromes with common symptoms and underlying pathology. In particular, evidence for mitochondrial dysfunction, oxidative stress, inflammation, immune dysregulation, neuroendocrine dysfunction, disrupted brain-gut-microbiome axis, apoptosis/ferroptosis, and telomere shortening as common features in the pathogenesis of these disorders has been identified. Given the role of coenzyme Q10 (CoQ10) in promoting normal mitochondrial function, as an antioxidant, antiinflammatory, and antiapoptotic and antiferroptotic agent, there is a rationale for supplementary CoQ10 in the management of these disorders. The reported benefits of supplementary CoQ10 administration in GWI, FM, ME/CFS, and long COVID have been reviewed; the potential benefit of supplementary CoQ10 in reducing telomere shortening and improving the efficiency of stem cell transfer relevant has also been identified a promising therapeutic strategy in these conditions.