CoQ10 (short for Coenzyme Q10) is an essential element for many daily functions and is required by every single cell in the body. As an antioxidant that protects cells from the effects of aging, CoQ10 has been used in medical practices for decades, especially for treating heart problems.
Although the body creates Coenzyme Q10, it doesn’t always do so consistently. Lack of CoQ10, or CoQ10 deficiency, is most commonly associated with the damaging effects of oxidative stress (also called free radical damage). (1) CoQ10 deficiency is now believed to be associated with conditions like declining cognition, diabetes, cancer, fibromyalgia, heart disease and muscle conditions. (2)
In fact, CoQ10’s antioxidative capacity is what makes it one of the most popular anti-aging supplements in the world, and why it may be a great addition to an integrative health program. Is CoQ10 right for you?
What Is CoQ10?
The name may not sound very natural, but CoQ10 is in fact an essential nutrient that works like an antioxidant in the body. In its active form, it’s called ubiquinone or ubiquinol. CoQ10 is present in the human body in the highest levels in the heart, liver, kidneys and pancreas. It’s stored in the mitochondria of your cells, often called the cells’ “powerhouse,” which is why it’s involved in energy production.
What is CoQ10 good for? It’s synthesized within the body naturally and used for important functions, such as supplying cells with energy, transporting electrons and regulating blood pressure levels. As a “coenzyme,” CoQ10 also helps other enzymes to work properly. The reason it’s not considered a “vitamin” is because all animals, including humans, can make small amounts of coenzymes on their own, even without the help of food. While the human body make some CoQ10, CoQ10 supplements are also available in various forms — including capsules, tablets and by IV — for people who have low levels and can benefit from more.
How CoQ10 Works:
- To sustain enough energy to perform bodily functions, inside our cells, tiny organelles called mitochondria take fat and other nutrients and turn them into useable sources of energy. This conversion process requires the presence of CoQ10.
- Coenzyme Q10 is not only necessary for producing cellular energy, but also for defending cells from damage caused by harmful free radicals.
- Coenzyme Q10 can exist in three different oxidation states, and the ability in some forms to accept and donate electrons is a critical feature in its biochemical functions that cancel out free radical damage.
- As a powerful antioxidant, Coenzyme Q10 can increase absorption of other essential nutrients. It’s been shown that it helps recycle vitamin C and vitamin E, further maximizing the effects of vitamins and antioxidants that are already at work in the body.
Should I Take a CoQ10 Supplement?
It’s a fair question — if your body already contains and produces CoQ10 on its own, is there a reason you should take it in supplement form, too? Although the body has the ability to make some CoQ10 on its own, CoQ10 production naturally declines as we age — just when we need our cells to help defend us most.
According to research compiled by Oregon State University, natural synthesis of CoQ10, plus dietary intake, appears to provide sufficient amounts to help prevent a CoQ10 deficiency in healthy people — however, the body produces less CoQ10 as someone gets older, and if they struggle with certain health conditions, such as heart disease. (3)
Some contributing factors to CoQ10 deficiency/low levels, besides aging and genetic defects, are believed to include:
- Having chronic diseases
- High levels of oxidative stress
- Nutritional deficiencies in B vitamins
- Mitochondrial diseases
- Taking statin drugs
As mentioned above, the natural ability to convert CoQ10 into its active form called ubiquinol declines during the aging process. This decline is most apparent in people over the age of 40, particularly those taking statin drugs. It’s also been found that people with diabetes, cancer and congestive heart failure tend to have decreased plasma levels of coenzyme Q10, although the age-related drop in CoQ10 levels isn’t medically defined as a “deficiency.”
Rarely, a person may suffer from “primary coenzyme Q10 deficiency,” which is a genetic defect that stops the body from properly synthesizing this compound. For these individuals, supplement with CoQ10 is typically needed to help reverse the brain and muscle-related symptoms of primary CoQ10 deficiency.
1. Sustains Natural Energy
CoQ10 plays a role in “mitochondrial ATP synthesis,” which is the conversion of raw energy from foods (carbohydrates and fats) into the form of energy that our cells use called adenosine triphosphate (ATP). This conversion process requires the presence of coenzyme Q in the inner mitochondrial membrane. One of its roles is to accept electrons during fatty acid and glucose metabolism and then transfer them to electron acceptors. (4)
The process of making ATP is crucial to every cell in the human body and also allows messages to be sent between cells. To maintain energy (down to the cellular level), ATP synthesis is vital, and it needs CoQ10 to do its job. (5)
CoQ10 may even improve specific fatigue related to exercise. Three separate double-blind, placebo-controlled studies in humans have shown improvements in exercise-related fatigue when supplemented with CoQ10 (at dosages between 100–300 milligrams per day). (6, 7, 8)
2. Reduces Free Radical Damage
Oxidative damage (or free radical damage) of cell structures plays an important role in the functional declines that accompany aging and cause disease. As both a water- and fat-soluble antioxidant, CoQ10 has been found to inhibit lipid peroxidation, which occurs when cell membranes and low-density lipoproteins are exposed to oxidizing conditions that enter from outside the body. (9)
In fact, when LDL is oxidized, CoQ10 is one of the first antioxidants used to help offset the effects. Within mitochondria, coenzyme Q10 has been found to protect membrane proteins and DNA from the oxidative damage that accompanies lipid peroxidation and neutralize free radicals directly that contribute to nearly all age-related diseases (heart disease, cancer, diabetes, neurological disease, etc.). (10, 11)
One way this might be especially effective is found in a research study that discovered CoQ10 may help protect from some oxidative stress caused by insulin resistance and related to diabetes. (12) Results on mixed on its effects on blood sugar, however.
3. Can Improve Heart Health and Offset Effects of Statin Drugs
Although experts feel that additional well-controlled clinical trials are still needed to prove its effects, CoQ10 has strong potential for prevention and treatment of heart ailments by improving cellular bioenergetics, acting as an antioxidant and boosting free radical-scavenging abilities.
What we do know is that CoQ10 supplementation may be useful for those taking statins, since it can lower side effects that they often cause. Statins are used to reduce an enzyme in the liver that not only decreases the production of cholesterol, but also further lowers the natural production of CoQ10.
It’s possible that CoQ10 can interact with lipid lowering medications that inhibit the activity of HMG-CoA reductase, a critical enzyme in both cholesterol and coenzyme Q10 biosynthesis. A supplement of CoQ10 is often recommended to restore natural levels to their optimum and counter the effects of statin drugs, including muscle pain. (13)
However, some evidence conflicts — a 2007 review found that evidence was lacking to officially recommend CoQ10 supplementation for patients with statins, although it did recognize that there aren’t any “known risks.” (14) Ultimately, this review recognized the need for better-designed trials and did not actually contradict the possible benefit of CoQ10 to offset statin side effects.
This isn’t the only way CoQ10 can support the heart and circulatory system, though. Does CoQ10 improve circulation? Yes — and it may be able to increase blood flow and improve exercise performance and capacity for people who have suffered heart failure (15, 16, 17)
Does CoQ10 lower blood pressure? Study results have been mixed overall when it comes to its effects on hypertension. According to the National Institutes of Health, “The small amount of evidence currently available suggests that CoQ10 probably doesn’t have a meaningful effect on blood pressure.” However, a 2002 review published in the Journal of Cardiovascular Nursing states: (18)
[CoQ10] has potential for use in prevention and treatment of cardiovascular disease, particularly hypertension (high blood pressure), hyperlipidemia, coronary artery disease, and heart failure… Further clinical trials are warranted, but because of its low toxicity it may be appropriate to recommend coenzyme Q10 to select patients as an adjunct to conventional treatment.
4. Slows Down Effects of Aging
Mitochondrial ATP synthesis is an important function for maintaining a fast metabolism, strength of muscles, strong bones, youthful skin and healthy tissue, and abnormal mitochondrial can cause issues. Tissue levels of coenzyme Q10 have been reported to decline with age, and this is believed to contribute to declines in energy metabolism and degeneration of organs, such as the liver and heart, and skeletal muscle.
Although supplementing with CoQ10 has not been shown to increase the life span of animals that have been tested with it, researchers believe it can slow down the age-related increase in DNA damage that naturally affect us all. Possible anti-aging benefits of consuming more CoQ10 include:
- Protection of the heart against stress-related aging (19)
- Protection of skeletal muscle genetic structure to keep those muscles strong, minimizing bone and joint injury risk (20)
- Improved fertility during your 40s by the reversal of egg degradation and increased production of ATP (21)
- Increased activity of antioxidants catalase and glutathione to protect cell membranes throughout the body from free radical damage (22, 23)
- Reduced UV skin damage (topical cream form) (24)
5. Helps Maintain Optimal pH Levels
Within cells, CoQ10 helps transport proteins across membranes and separate certain digestive enzymes from the rest of the cell, which helps maintain optimal pH. It’s believed that diseases develop more easily in environments that have to work harder to maintain proper pH levels. (25, 26) This, in addition to its major antioxidant capacity, may be one reason that cancer risk may be associated with CoQ10 levels.
Increasing impact of chemotherapy drugs and protect from side effects: Supplementing with CoQ10 during cancer treatment may help to increase the cancer-killing potential of these medications (like doxorubicin and daunorubicin). There is also evidence that CoQ10 can protect the heart from DNA damage that can sometimes occur from high doses of chemotherapy medications. (27)
May slow or reverse spread of breast cancer in high-risk patients: A 1994 study followed 32 breast cancer patients (ranging from 32-81 years old) classified as “high-risk,” due to the way their cancer had spread to lymph nodes. Each patient was given nutritional antioxidants, essential fatty acids and 90 milligrams per day of CoQ10. Not only did no patients die over the study period of 18 months, although, statistically, four were expected to pass away from their disease, no patient worsened during this period, all reported quality of life improvements and six patients went into partial remission. (28) Two of the patients in partial remission were then given more Coenzyme Q10 (300 milligrams each day), both of whom went into totally remission, showing complete absences of previous tumors and tumor tissue (one after two months, the other after three months). (29)
Could help prevent colon cancer: One research study discovered CoQ10 significantly lowered oxidative stress in the colon that leads to colon cancer. (30) While this still needs to be replicated in humans, it suggests a preventative potential of CoQ10 for those at risk for colon cancer.
Might play a role in the prevention of cervical cancer: Low levels of CoQ10 are seen in patients with cervical cancer, although it’s not clear why. It’s possible that supplementing with CoQ10 might lower the risk of developing cervical cancer in women who are diagnosed with precancer cervical lesions, but this still requires a lot more study before we can be sure. (31)
May improve survival rate in end-stage cancers: A pilot study over nine years followed 41 patients with various primary cancers that had advanced to stage four and were given CoQ10 supplements plus an additional antioxidant mixture. Of the patients followed, the median time of survival was 17 months, five months longer than expected overall. In total, 76 percent of the patients survived longer than expected on average, with little to no side effects noted from the treatment. (32)
These studies are far from hard proof, but they are encouraging beginnings to the thought that CoQ10 supplementation may help improve risk factors and even survival with certain cancers.
6. May Protect Cognitive Health
In those with cognitive impairments, such as Parkinson’s disease, increased oxidative stress in a part of the brain called the substantia nigra is thought to contribute to symptoms. CoQ10 has been shown to offset decreases in activity of mitochondrial electron transport chains that affect nerve channels and brain function, and studies show that people with cognitive disorders tend to have reduced levels of CoQ10 in their blood. (33)
Several studies have investigated the effects of CoQ10 in individuals with Parkinson’s disease. One randomized, placebo-controlled trial that evaluated the efficacy of 300, 600 or 1,200 milligrams a day given to 80 people with early Parkinson’s disease found that supplementation was well-tolerated and associated with slower deterioration of cognitive functions compared to the placebo. Other trials have shown that around 360 milligrams a day taken for four weeks moderately benefited Parkinson’s disease patients. (34)
Other evidence suggests contrary outcomes for Parkinson’s, though. Two studies, one in mid-stage Parkinson’s and the other in early-stage, found no significant improvement or slowing of the disease resulting from treatment of CoQ10, leading to the cancellation of a planned clinical trial due to the assumption that Coenzyme Q10 would be unlikely to be effective over placebo. (35, 36, 37)
Some preliminary studies have found positive outcomes in lab and research studies, and a few small human clinical trials, for CoQ10 to treat some of the cognitive decline in other neurological diseases, including progressive supranuclear palsy (PSP), Huntington’s disease, amytrophic lateral sclerosis (ALS) and Friedreich’s ataxia. (38, 39)
Regarding the most well-known neurodegenerative disease, Alzheimer’s disease, there have been little to no human trials conducted using CoQ10. However, research studies have found modestly positive results, making Coenzyme Q10 a possible addition to an Alzheimer’s diet and supplementation plan. (40, 41)
7. Could Improve Male Infertility
- Improves sperm motility (movement)
- Increases fertilization rates
- Boosts sperm count
- Improves sperm morphology (size/form)
- Increases antioxidants in seminal plasma
- Aids in treatment of asthenozoospermia (diagnostically low sperm motility)
- Improves symptoms of Peyronie’s disease (a serious male infertility disease)
8. Treats Symptoms of Fibromyalgia
Multiple clinical trials and case reports have found that CoQ10 may be a powerful natural method of treating fibromyalgia symptoms. In adults, the dosage was typically 300 milligrams per day, while one study on juvenile fibromyalgia focused on a 100 milligram dose.
Improvements include reduction of overall pain symptoms, less headaches, reduction of fatigue/tiredness, restored mitochondrial function, reduced oxidative stress and improvement in cholesterol markers (in the juvenile study). (49, 50, 51, 52, 53)
Coenzyme Q10 is found naturally in our diets from foods, including fish, liver, kidney and the germs of whole grain. The richest natural sources of dietary coenzyme Q10 are meat, poultry and fish, but vegetarian options, such as beans, nuts, some vegetables, eggs and dairy products, are also helpful for increasing your intake. (54)
My recommendation for the very best foods for supplying CoQ10 include:
- Grass-fed beef
- Free-range chicken
- Rainbow trout
- Sesame seeds
- Pistachio nuts
- Cage-free eggs
Currently, there is no specific dietary intake recommendation for CoQ10 established from the Institute of Medicine or other agencies. Because it’s a fat-soluble antioxidant, it’s most easily absorbed when consumed with a small amount of healthy fats (just like vitamins E and A). Although it can be obtained from certain foods, foods tend to only supply low doses, which is exactly why many experts recommend supplementing if you’re older or have a condition that may benefit from CoQ10 supplementation.
Symptoms of deficiency have not been widely reported or studied in much detail in the general population. It’s estimated that the average person’s diet contributes around 25 percent of total CoQ10. The best way to obtain enough is to eat a varied, nutrient-dense diet, PLUS to consider supplementing if it makes sense for your individual situation.
Supplements and Dosage Recommendations
COQ10 is found in such low quantities in most foods that even a healthy diet might be an impractical way to meet the daily recommended dosages. Taking a daily, high-quality CoQ10 supplement in capsule form (which helps with easier absorption into the bloodstream) can close the bridge between this gap.
CoQ10 Supplement Dosage:
Dosage sizes of CoQ10 supplements range anywhere from 50–1,200 milligrams per day. Most supplements fall in the 100–200 milligram range. (55)
Depending on the condition studies attempt to treat, the CoQ10 dosage recommendations can range from 90 milligrams up to 1,200 milligrams. This larger dose has typically been used only to study the neurological benefits of CoQ10 — most successful studies use between 100–300 milligrams.
How much do CoQ10 supplements typically cost, and how can you find a trustworthy brand?
The cost of taking 100 milligrams ranges from 8 cents to over $3, depending on the specific brand and strength.
What’s important, and makes a big difference in terms of the benefits you’ll get from taking CoQ10 supplements, is that the concentration is actually equal to the amount listed. Some products use fillers or enhancers and may even supply less of a dosage than the manufacturer claims.
Look for products with reviews, certifications ensuring the listed dosage is correct and as minimal preservatives or fillers as possible, along with supplements that possess the right CoQ10 concentrations.
When should you take CoQ10, morning or night?
While it can be taken any time that is most convenient, it’s best to take CoQ10 with a meal containing fat, since it’s fat soluble. If you take a CoQ10 dosage that exceeds 100 mg per day, it’s best to split doses into two or three smaller servings, which will help with absorption.
There’s some evidence that taking CoQ10 at night may help with the body’s ability to use it, so a good option is taking it with dinner. However some people report having difficulty falling asleep if they take CoQ10 close to bed time, so this comes down to individual preference.
Risks and Side Effects
Although it’s considered to be very safe overall and has been used in the medical field for many years, CoQ10 side effects may still affect some people. Potential CoQ10 side effects can include: (55)
- Upper abdominal pain
- Loss of appetite
- Light sensitivity
Read the dosage labels on your coenzyme Q10 supplements, and stick to them unless instructed otherwise by your healthcare professional.
If you’re pregnant or breast-feeding, it’s probably best not to take CoQ10 supplements, since it’s not clear whether or not they’re safe in these cases.
Coenzyme Q10 supplements can decrease the anticoagulant efficacy of statins like warfarin and other common cholesterol-lowering medications (such as those known as HMG-CoA reductase inhibitor statins). Talk to your doctor about being monitored if you take these medications.
- CoQ10, also called Coenzyme Q10 or ubiquinone, is a natural substance found in the body and certain foods that helps fight oxidative stress and prevent tissue damage.
- The top benefits of CoQ10 include sustaining natural energy, improving heart and brain health, slowing aging and fighting cancer.
- Coenzyme Q10 is produced by the body naturally and also found in small amounts in some foods. CoQ10 foods include meat, fish, nuts, seeds, veggies and eggs. However, our ability to produce and use it decreases significantly with age.
- CoQ10 supplement dosages range between 30—1,200 milligrams/daily, the typically recommended dosage is between 100-200 milligrams each day for most conditions.
- CoQ10 side effects