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Its recommendation is based on studies that signal mitochondrial dysfunction as part of the pathogenesis of CVS.98,99 Patients with migraine show reduced mitochondrial respiratory complex function, which most likely is present in CVS as well, albeit there are no studies confirming that assumption.100 Coenzyme Q10 (Co-Q10) is a natural hydrophobic compound derived from steroids that acts as an electron transporter between complex 1 or 2 and complex 3 of the mitochondrial respiratory chain

Along with medication, a healthy diet and exercise should be followed, as lifestyle changes make long-term weight loss possible (Mozaffarian et al

The paper synthesises existing research and adds gene expression analysis but does not generate new patient data