Coenzyme Q10

Coenzyme Q10: What is it?

• Coenzyme Q10 (CoQ10) is a naturally occurring quinone that is found in many aerobic organisms such as bacteria and mammals.

• It functions primarily to aid in energy production, augment the immune system, and combat oxidative damage in the body.

• It is found in abundance in tissues with significant metabolic activity such as the heart, lungs, liver, kidneys, spleen, pancreas, and adrenal glands.

• It is typically sourced through oily fish such as tuna and salmon, organ meats, and whole grains; however, it can also be supplemented in the form of oral tablets, capsules, and sprays.

How does it work in the body?

• In mitochondria, CoQ10 functions primarily as a cofactor in the electron transport chain during the formation of adenosine triphosphate (ATP) for cellular energy.

• It is also found on cell membranes and transport lipoproteins such as LDL and HDL where it functions as an antioxidant to combat oxidative damage.

• CoQ10 exists in the body in two forms: Ubiquinone (oxidized form) or Ubiquinol (reduced form). Most of its antioxidant properties are carried out in its Ubiquinol form, and it does so by neutralizing free radicals and reactive oxygen species.

What is it used for?

• Supplementation with CoQ10 is typically used to improve its deficiency as well as diseases related to mitochondrial dysfunction and oxidative stress such as fibromyalgia, diabetes, chronic fatigue syndrome, and heart diseases. It can also be used for performance enhancement and to prevent adverse effects of statins.

Evidence for and against:

• CoQ10 deficiency: Deficiency can lead to symptoms such as weakness, fatigue, seizures, encephalopathy, and nephrotic syndrome. Oral CoQ10 supplementation has been shown to reduce these symptoms and reverse the progression of some.

• Mitochondrial encephalomyopathy (MELAS): Studies show that CoQ10 supplementation can improve symptoms of mitochondrial dysfunction such as nerve dysfunction, muscle weakness, tremors, cramps, and muscle stiffness.

• Heart disease: Studies show that CoQ10 supplementation has significant benefits for heart health.

• CoQ10 was shown to reduce heart wall thickness, regulate heart rate, improve heart function, and quality of life in patients with hypertrophic cardiomyopathy.

• In heart failure studies inclusive of 420 and 639 participants, oral CoQ10 supplementation was shown to reduce mortality, hospitalizations, and significant complications from heart failure.

• Another study also found that supplementation reduced heart failure mortality but that it did not improve heart function or symptoms.

• Vascular health: CoQ10 was shown to increase nitric oxide levels through its antioxidant effects leading to improved blood vessel dilation and increased circulation.

• Blood pressure: Many studies inclusive of over 280 participants show that CoQ10 supplementation reduces systolic and diastolic blood pressure.

  • Other studies suggest that supplementation with 200 mg/day for 12 weeks had no effect on blood pressure.

• Inflammation: A systematic review found that CoQ10 supplementation significantly reduced inflammatory markers such as TNF-α but had no effect on CRP and IL-6.

• Diabetes mellitus: 400 mg of CoQ10 daily was shown to reduce nerve damage and improved nerve function in diabetic mice.

  • CoQ10 also has been shown to protect organs such as the kidneys and heart from elevated blood sugar levels. A meta-analysis also showed that low doses of CoQ10 (<200 mg) reduced blood sugar levels when given for 12 weeks or less.

• Migraines: CoQ10 supplementation has been shown to reduce migraine duration, frequency, and severity.

• Fibromyalgia: Patients with fibromyalgia have been shown to have reduced and dysfunctional CoQ10, supplementation has been shown to improve headache, depression, and fatigue symptoms associated with this disorder.

• Multiple sclerosis: 500 mg/day of CoQ10 has been shown to improve fatigue and depression associated with multiple sclerosis.

Dosage:

• 100–300 mg of CoQ10 twice daily has proven to be effective for most of its usages.

• It has been shown to be safe and well tolerated at dosages up to 1200 mg daily.

Precautions/side effects:

• Studies show that CoQ10 does not cause serious harmful effects in humans, but mild side effects may include diarrhea, nausea, loss of appetite, headache, or rash. It is metabolized by the liver and eliminated through bile so people with liver or biliary pathology may be at a higher risk of experiencing these side effects due to poor elimination from the body.

Interactions:

• Warfarin: CoQ10 has structural similarity to procoagulant Vitamin K so may reduce Warfarin's effect.

• Blood pressure: CoQ10 has been shown to lower blood pressure so should be taken with caution by those taking antihypertensives.

• Blood sugar: CoQ10 has been shown to lower blood-glucose levels so should be taken with caution by those taking glucose-lowering medications.

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