Articles in English published through December 2025 were considered, with additional records identified by manually screening reference lists.<h4>Results</h4>Fibromyalgia patients exhibit elevated oxidative stress markers, impaired antioxidant enzyme function and compromised Nrf2 activity correlating with disease severity, with studies reporting approximately 30-50% reductions in coenzyme Q10 levels compared with healthy controls. This evidence concerns the gene NFE2L2 and fibromyalgia.