INGREDIENTS & RESEARCH

Coenzyme Q10

BACKGROUND

Ingredient Type: Substance to supplement the diet, Metabolite, Vitamin-like substance 

Also Known As: Vitamin Q10, CQ10, CoQ10, Ubiquinone

Coenzyme Q10 is essential for energy production and is found in every cell within the body.  Coenzyme Q10 is a substance that helps convert food into energy.   It is so important to all body cells that it is produced naturally by the body as well as taken from nature.  Natural sources include meat, poultry, fish, soybeans, and nuts.  CoQ10 works as an antioxidant to protect membranes from damage by reactive molecules known as free radicals.  It’s also used inside every cell as a necessary compound for converting sugar and fats into energy (1).

CoQ10 exists in several forms including ubiquinol and ubiquinone.  Ubiquinol is the active form and is the form used in most supplements (1).  Because CoQ10 is fat soluble it is best absorbed when taken in an oil-based soft gel rather than tablets (3). 

 

TRADITIONAL USES

  • Taken after a heart attach to prevent subsequent heart attacks and chest pain
  • To reduce high blood pressure
  • To reduce high cholesterol
  • To help with symptoms of diabetes
  • To help heal heart damage 

 

WHAT DOES SCIENCE TELL US?

According to a review in Molecular Syndromology in July 2014, scientific evidence to date indicates that CoQ10 supplementation may help relieve fatigue and stiffness caused by fibromyalgia in patients who are CoQ10 deficient.  The same review shows that it may also improve nerve function in diabetics and help protect nerves in people with Parkinson's disease.

A study in the January 2015 issue of Nutritional Neuroscience also reported that CoQ10 supplementation improved symptoms of depression and helped alleviate fatigue in patients with multiple sclerosis.

Other studies have supported the following benefits to CoQ10 supplementation: 

After a Heart Attack: One clinical study found that people who took daily CoQ10 supplements within 3 days of a heart attack were less likely to have subsequent heart attacks and chest pain.  They were also less likely to die of heart disease than those who did not take the supplements (2).

Heart failure (HF): There is evidence that CoQ10 may help treat heart failure when combined with conventional medications.  People who have congestive heart failure, where the heart is not able to pump blood as well as it should also have low levels of CoQ10.  Heart failure can cause blood to pool in parts of the body, such as the lungs and legs.  It can also cause shortness of breath.  Several clinical studies suggest that CoQ10 supplements help reduce swelling in the legs; reduce fluid in the lungs, making breathing easier; and increase exercise capacity in people with heart failure.  Not all studies are positive, however, and some found no effect.  Using CoQ10 for heart failure remains controversial (2).                       

High Blood Pressure: Several clinical studies involving small numbers of people suggest that CoQ10 may lower blood pressure.  However, it may take 4 to 12 weeks to see any change.  In one analysis, after reviewing 12 clinical studies, researchers concluded that CoQ10 has the potential to lower systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by 10 mm Hg, without significant side effects (2).                            

High Cholesterol: People with high cholesterol tend to have lower levels of CoQ10, so CoQ10 has been proposed as a treatment for high cholesterol, but scientific studies are lacking.  Taking CoQ10 supplements might bring levels back to normal.  Some studies also show that CoQ10 may reduce the muscle pain associated with statin treatment (2).            

Diabetes: CoQ10 supplements may improve heart health and blood sugar, and help manage high blood pressure in people with diabetes.  Preliminary studies found that CoQ10 improves blood sugar control, but subsequent studies have shown no effect.                                                             

Heart Damage Caused by Chemotherapy: Several clinical studies suggest that CoQ10 may help prevent heart damage caused by certain chemotherapy drugs, adriamycin, or other athracycline medications. More studies are needed (2).  

Heart surgery: Clinical research indicates that introducing CoQ10 prior to heart surgery, including bypass surgery and heart transplantation, can reduce damage caused by free radicals, strengthen heart function, and lower the incidence of irregular heartbeat (arrhythmias) during the recovery phase.  It is important to remember, however, that people should not take any supplements before surgery unless they have approval from their health care provider (2).                   

Gum (Periodontal) disease: Gum disease is a common problem that causes swelling, bleeding, pain, and redness of the gums.  Clinical studies show that people with gum disease tend to have low levels of CoQ10 in their gums.  A few studies with small numbers of people found that CoQ10 supplements led to faster healing and tissue repair, but more research is needed (2). 

 

SAFETY

Supplements can help boost CoQ10 levels, which decline due to age and health conditions such as diabetes, cancer and heart disease.  While supplemental CoQ10 is safe for most people, it should not be mixed with some medications unless your physician gives the go-ahead.

CoQ10 may interfere with the effectiveness of blood-thinning medications such as warfarin.  It could also amplify the impact of medications used to lower blood pressure, which might cause an unhealthy drop in your blood pressure.

Use CoQ10 supplements with caution if you have diabetes or nerve damage caused by HIV.  CoQ10 may make blood sugar drop too low, and it can worsen symptoms of HIV-related neuropathy, reports the NYU Langone Medical Center (2).

Interactions:

  • Chemotherapy medications: Researchers are not sure whether CoQ10's antioxidant effect might make some chemotherapy drugs less effective.  Ask your oncologist before taking antioxidants or any supplement along with chemotherapy (3).
  • Daunorubicin and doxorubicin: CoQ10 may help reduce toxic effects on the heart caused by daunorubicin (Cerubidin) and doxorubicin (Adriamycin), two chemotherapy medications that are used to treat several kinds of cancer.  Ask your oncologist before taking antioxidants or any supplement along with chemotherapy (3).   
  • Blood pressure medications: CoQ10 may work with blood pressure medications to lower blood pressure.  In a clinical study of people taking blood pressure medications, adding CoQ10 supplements allowed them to reduce the doses of these medications.  More research is needed, however.  If you take medication for high blood pressure, talk to your provider before taking CoQ10, and DO NOT stop taking your regular medication (3).         
  • Blood-thinning medications: There have been reports that CoQ10 may make medications such as warfarin (Coumadin) or clopidigrel (Plavix) less effective at thinning the blood.  If you take blood thinners, ask your provider before taking CoQ10 (3).
  • Betaxolol (Betoptic): CoQ10 supplements may reduce the heart-related side effects of betaxolol drops (Betoptic), a beta-blocker medication used to treat glaucoma, without making the medication any less effective (3).

 

REFERENCES

  1. https://www.webmd.com/heart-disease/heart-failure/tc/coenzyme-q10-topic-overview#1
  2. https://healthfully.com/cq-5055265.html?ref=Track2&utm_source=IACB2B
  3. https://www.umm.edu/health/medical/altmed/supplement/coenzyme-q10

 

SUPPORTING RESEARCH FOR FURTHER REVIEW

  1. Aguilaniu H, Durieux J, Dillin A. Metabolism, ubiquinone synthesis, and longevity. Genes Dev. 2005;19(20):2399-406.
  2. Al-Hasso. Coenzyme Q10: a review. Hosp Pharm. 2001;36(1):51-66.
  3. Beal MF. Therapeutic effects of coenzyme Q10 in neurodegenerative diseases. Methods Enzymol. 2004;382:473-87.
  4. Belardinelli R, Mucaj A, Lacalaprice F, et al., Coenzyme Q10 and exercise training in chronic heart failure. Eur Heart J. 2006;27(22):2675-81.
  5. Berthold HK, Naini A, Di Mauro S, Hallikainen M, Gylling H, Krone W, Gouni-Berthold I. Effect of ezetimibe and/or simvastatin on coenzyme Q10 levels in plasma: a randomised trial. Drug Saf. 2006;29(8):703-12.
  6. Caso G, Kelly P, McNurlan MA, Lawson WE. Effect of coenzyme q10 on myopathyic symptoms in patients treated with statins. Am J Cardiol. 2007;99(10):1409-12.
  7. Dhanasekaran M, Ren J. The emerging role of coenzyme Q-10 in aging, neurodegeneration, cardiovascular disease, cancer and diabetes mellitus. Curr Neurovasc Res. 2005;2(5):447-59.
  8. de Bustos F, Molina JA, Jimenez-Jimenz FJ, Garcia-Redondo A, Gomez-Escalonilla C, Porta-Etessam J, et al. Serum levels of coenzyme Q10 in patients with Alzheimer's disease. J Neural Transm. 2000;107(2):233-239.
  9. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health-System Pharm. 2000;57(13):1221-1227.
  10. Hodgson JM, Watts GF, Playford DA, et al. Coenzyme Q(10) improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr. 2002;56:1137-1142.
  11. Khan M, Gross J, Haupt H, et al., A pilot clinical trial of the effects of coenzyme Q10 on chronic tinnitus aurium. Otolaryngol Head Neck Surg. 2007;136(1):72-7.
  12. Khatta M, Alexander BS, Krichten CM, Fisher ML, Freudenberger R, Robinson SW et al. The effect of conenzyme Q10 in patients with congestive heart failure. Ann Int Med. 2000;132(8):636-640.
  13. Kolahdouz Mohammadi R, Hosseinzadeh-Attar MJ, Eshraghian MR, Nakhjavani M, Khorami E, Esteghamati A. The effect of coenzyme Q10 supplementation on metabolic status of type 2 diabetic patients. Minerva Gastroenterol Dietol. 2013;59(2):231-6.
  14. Lafuente R, Gonzalez-Comadran M, Sola I, et al. Conezyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet. 2013;30(9):1147-56.
  15. Langsjoen PH, Langsjoen JO, Langsjoen AM, Lucas LA. Treatment of statin adverse effects with supplemental Coenzyme Q10 and statin drug discontinuation. Biofactors. 2005;25(1-4):147-52.
  16. Lee BJ, Tseng YF, Yen CH, Lin PT. Effects of coenzyme Q10 supplementation (300mg/day) on antioxidation and anti-inflammation in coronary artery disease patients during statins therapy: a randomized, placebo-controlled trial. Nutr J. 2013;12(1):142.
  17. Levy G, Kaufmann P, Buchsbaum R, et al., A two-stage design for a phase II clinical trial of coenzyme Q10 in ALS. Neurology. 2006;66(5):660-3.
  18. Madmani ME, Yusuf Solaiman A, Tamr Agha K, et al. Coenzyme Q10 for heart failure. Cochrane Database Syst Rev . 2014; 6:CD008684.
  19. McCarty MF. Toward practical prevention of type 2 diabetes. Med Hypotheses. 2000;54(5):786-793.
  20. Nahas R. Complementary and alternative medicine approaches to blood pressure reduction: An evidence-based review. Can Fam Physician. 2008 Nov;54(11):1529-33. Review.
  21. Ochiai A, Itagaki S, Kurokawa T, Kobayashi M, Hirano T, Iseki K. Improvement in intestinal coenzyme q10 absorption by food intake. Yakugaku Zasshi. 2007;127(8):1251-4.
  22. Ostrowski RP. Effect of coenzyme Q(10) on biochemical and morphological changes in experimental ischemia in the rat brain. Brain Res Bull. 2000;53(4):399-407.
  23. Palan PR, Connell K, Ramirez E, Inegbenijie C, Gavara RY, Ouseph JA, Mikhail MS. Effects of menopause and hormone replacement therapy on serum levels of coenzyme Q10 and other lipid-soluble antioxidants. Biofactors. 2005;25(1-4):61-6.
  24. Quinzii CM, Dimauro S, Hirano M. Human coenzyme q(10) deficiency. Neurochem Res. 2007;32(4-5):723-7.
  25. Raitakari OT, McCredie RJ, Witting P, Griffiths KA, Letter J, Sullivan D, Stocker R, Celermajer DS. Coenzyme Q improves LDL resistance to ex vivo oxidation but does not enhance endothelial function in hypercholesterolemic young adults. Free Radic Biol Med. 2000;28(7):1100-1105.
  26. Rakel D. Rakel: Integrative Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2007.
  27. Rosenfeldt FL, Haas SJ, Krum H, Hadj A, Ng K, Leong JY, Watts GF. Conenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens. 2007;21(4):297-306.
  28. Rosenfeldt F, Hilton D, Pepe S, Krum H. Systematic review of effect of coenzyme Q10 in physical exercise, hypertension and heart failure. Biofactors. 2003;18(1-4):91-100.
  29. Salles JE, Moises VA, Almeida DR, Chacra AR, Moises RS. Myocardial dysfunction in mitochondrial diabetes treated with Coenzyme Q10. Diabetes Res Clin Pract. 2006;72(1):100-3.
  30. Sander S, Coleman CI, Patel AA, Kluger J, White CM. The impact of coenzyme Q10 on systolic function in patients with chronic heart failure. J Card Fail. 2006;12(6):464-72.
  31. Shults CW, Haas R. Clinical trials of coenzyme Q10 in neurological disorders. Biofactors. 2005;25(1-4):117-26.
  32. Shults CW. Therapeutic role of coenzyme Q(10) in Parkinson's disease. Pharmacol Ther. 2005;107(1):120-30.
  33. Singh U, Devaraj S, Jialal I. Coenzyme Q10 supplementation and heart failure. Nutr Rev. 2007;65(6 Pt 1):286-93.
  34. Spigset O. Reduced effect of warfarin caused by ubidecarenone. Lancet. 1994;344:1372-1373.
  35. Torkos S. Drug-nutrient interactions: A focus on cholesterol-lowering agents. Int J Integrative Med. 2000;2(3):9-13.
  36. Watson PS, Scalia GM, Galbraith A, et al. Lack of effect of coenzyme Q on left ventricular function in patients with congestive heart failure. J Am Coll Cardiol. 1999;33:1549-1552.
  37. Weant KA, Smith KM. The role of coenzyme Q10 in heart failure. Ann Pharmacother. 2005;39(9):1522-6.
  38. Witte KK, Clark AL, Cleland JG. Chronic heart failure and micronutrients. J Am Coll Cardiol. 2001;37(7):1765-1774.

See the Mayo Clinic entry for coenzyme Q10, the National Center for Complementary and Integrative Health entry for coenzyme Q10, the Michigan Medicine Health Library entry for coenzyme Q10, the Examine.com entry for coenzyme Q10, or the RXList entry for coenzyme Q-10 for more information.