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While its precise etiology remains unclear, growing evidence implicates oxidative stress and mitochondrial dysfunction as key contributors to its pathophysiology ( Oxidative stress results from an imbalance between reactive oxygen species (ROS) production and antioxidant defenses, leading to cellular damage, lipid peroxidation, mitochondrial dysfunction, and neuroinflammationall of which may exacerbate pain sensitization and fatigue in FM ( Mitochondrial dysfunction in Redox imbalance is marked by decreased CoQ10 levels, reduced mitochondrial DNA content, and impaired electron transport chain activity, leading to excessive ROS production and decreased ATP synthesis

Take 2-4 hours prior to exercise

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L-Carnitine plus cilostazol versus cilostazol alone for the treatment of claudication in patients with peripheral artery disease: a multicenter, randomized, double-blind, placebo-controlled trial