Coenzyme Q10 (CoQ10) has been studied for the treatment of many different conditions including lipid reduction, muscle pain, oxidative stress, and even HBa1c levels. 1,2 Just what is CoQ10 and what does research say about it’s effectiveness?

CoQ10, is an enzyme and antioxidant found in cells of animals, plants, and bacteria that supports cellular function.1,2 CoQ10 is utilized in many different ways, particularly in the metabolic process of energy production. 1,2 CoQ10 is also known as coenzyme Q, CoQ, Ubiquinone, Ubiquinine-Q10, Ubidecenone, and Vitamin Q10. 1,2 Regardless of which name is being used, it refers to a fairly small enzyme with 10 repeating isoprenoid side chains with a similar structure to vitamin K. While CoQ10 is found throughout the body, it is concentrated in tissues that perform high levels of metabolism such as the liver, kidney, pancreas, and the heart. 1,2

CoQ10 plays many cellular roles but it’s most known as an energy transfer molecule for the electron transport chain. 2 It is a cofactor that transfers electrons to support the redox reactions for the synthesis of ATP (adenosine triphosphate). Most all functions of the cells and tissues are dependent on ATP creation and storage for energy, making CoQ10 an essential molecule. 1,2

In addition to energy transfer for ATP synthesis, CoQ10 is an antioxidant that quenches free radicals and prevents damage to proteins, lipids and DNA. CoQ10’s antioxidant properties have been shown to assist the immune system. 1,2 Clearly CoQ10 is essential for cellular and body function and getting enough from your diet is important. CoQ10 can be found in fish, meat, and whole grains, but is highest in organ meat since that is where metabolism activity is concentrated.1,2 For the most part a balanced diet will provide the body with enough CoQ10, but certain conditions may cause need for supplementation and as we age, CoQ10 levels decrease. 1,2

Research over the last five years has focused on CoQ10’s to treat or improve outcomes in cardiovascular disease (CVD) and dyslipidemia, diabetes (specifically insulin regulation), oxidative stress, and inflammation.

Lifestyle changes and diet are often the first defense against the development of CVD. However a small trial recently examined use of a neutraceutical compound (NC) containing red yeast rice, policosanol, berberine, folic acid and coenzyme Q10 could help in preventing progression of CVD in patients diagnosed with hypertension and hypercholesterolemia. Focusing outcomes on blood pressure and lipid levels the study enrolled 66 participants who had hypertension and hypercholesterolemia. After 6 months of supplementation with one pill of NC’s per day, the treatment group saw a significant reduction in systolic blood pressure with reductions in total cholesterol (-19%) and triglycerides (-17%), but HDL-C remained the same. No significant changes in these outcomes were seen in the control group during the 6-month intervention. 3

Another small study examined the supplementation of CoQ10 along with red yeast rice for four weeks and its impacts on LDL, endothelial reactivity and arterial stiffness. The study found, when compared to placebo, this supplement combination improved LDL cholesterol (after treatment: -26.3%; after placebo treatment: +3.4%, p < 0.05), endothelial reactivity (after treatment: +6.0%; after placebo treatment: -0.3%, p < 0.05) and arterial stiffness as measure by pulse wave velocity (after treatment: -4.7%; after placebo: +1.1%, p < 0.05) in moderately hypercholesterolemic participants. 4

A randomized clinical trial, RCT, conducted in 2015 examined supplementation of CoQ10 and selenium together in an elderly Swedish population. The study outcomes included improvements in blood pressure, the New York Heat Association function class (NYHA class), heart failure, ECG, and echocardiography. Over the course of supplementation of four years, the study found a dramatic drop in CVD and this improvement remained through to the 10-year follow up. Additionally, there was a reduction in all cause mortality seen in the active group as compared to placebo. However, no mechanisms of action were studied. 5 A cross over study published in 2015 looked at the effects that CoQ10 had on this mechanism in 20 healthy participants. While the study was small and only lasted one week, the results showed that increases in serum CoQ10 positively correlated with cholesterol efflux to HDL and macrophage cells treated with CoQ10 also showed an enhanced cholesterol efflux to HDL. Therefore CoQ10 may have an atheroprotective impact by up regulating the HDL-mediated macrophage cholesterol. 6

Beyond cardiovascular outcomes, studies have been conducted examining whether CoQ10 can impact blood sugar regulation and immune function. A recent meta-analysis examined 18 studies and showed that CoQ10 does improve blood glucose levels but did not show any changes for HBA1c levels. 7 A 2017 systematic review looked at CoQ10 and its role in immune functions, particularly its impact on C-reactive protein (CRP), intelukin-6 (IL-6), and TNF-alpha. 17 studies were analyzed and showed that supplementation with CoQ10 can reduce circulating CRP (p=0.022), IL-6 (p=0.002), and TNF-alpha (p=0.027).8

CoQ10 has recently been observed to help improve pain and fatigue symptoms associated with fibromyalgia. A cross over study of 22 women looked at the results of supplementing 200 mg/day of CoQ10 and saw pain symptoms reduced by 37%, fatigue reduced by 22% and sleep disturbance lowered by 33%. While this was a small trial that did not address mechanism it does show that an intense antioxidant like CoQ10 may help alleviate fibromyalgia symptoms. 9 CoQ10 has also been indicated in relieving some statin-induced myopathy conditions. The exact mechanism for these processes are unclear but the supplementation of CoQ10 seems to have positive impacts on these conditions and may provide needed metabolites and antioxidants. 10

Based on the results from these recent studies and many past studies CoQ10 appears to have very positive effects on a wide-range of health issues. CoQ10 supplements can be found in most drug and health food stores. Capsules and tablets can be purchased. Dosage and duration depends on what is being treated and a clinical expert should be consulted, but typically 30 to 90 mg per day is used. 2 Since CoQ10 is fat-soluble it is better absorbed when taken with a meal that contains fats or oils. 1,2 Therapeutic effects may not be seen until 8 weeks of consistent supplementation. 2 There have been no serious side effects reported for the supplementation with CoQ10 and common side effects may include insomnia; increase liver enzymes, rash, diarrhea, dizziness, headaches, and heartburn. 1,2 There is not enough evidence to evaluate if it safe for pregnant or breast-feeding women and children and is not recommended for use in these patients. CoQ10 may interfere with the effectiveness with blood thinners. 2

Clinically CpQ10 can be used to treat:

  • Cardiovascular associated blood pressure, lipid levels, and endothelial function
  • Increase anti-inflammatory cytokines and decrease CRP levels
  • Positively impact fatigue and pain associated with statin use and fibromyalgia

CoQ10 is a powerful antioxidant that can prevent damage to proteins, lipids and DNA.2 It also plays a very important role ATP production and support immune function.1,2 Those with diabetes mellitus or are older likely have reduced levels of serum CoQ10. 2,7 CoQ10 has been shown to support cardiovascular health including metabolism and lipid levels, blood sugar regulation, and specialized diseases such as infertility, fibromyalgia cancer, and muscle pain from statin use.1,2  While CoQ10 may not be for everyone, it is considered safe and effective for many uses.

References

  1. Coenzyme Q10 (CoQ10): In Depth. National Institutes of Health. https://nccih.nih.gov/health/supplements/coq10. Published June 23, 2016. Accessed April 24, 2017.
  1. Saini R. Coenzyme Q10: The essential nutrient. Journal of Pharmacy and Bioallied Sciences. 2011;3(3):466. doi:10.4103/0975-7406.84471.
  1. Mazza A, Lenti S, Schiavon L, et al. Nutraceuticals for Serum Lipid and Blood Pressure Control in Hypertensive and Hypercholesterolemic Subjects at Low Cardiovascular Risk. Advances in Therapy. 2015;32(7):680-690. doi:10.1007/s12325-015-0229-x.
  1. Cicero AF, Morbini M, Rosticci M, D”addato S, Grandi E, Borghi C. Middle-Term Dietary Supplementation with Red Yeast Rice Plus Coenzyme Q10 Improves Lipid Pattern, Endothelial Reactivity and Arterial Stiffness in Moderately Hypercholesterolemic Subjects. Annals of Nutrition and Metabolism. 2016;68(3):213-219. doi:10.1159/000445359.
  1. Alehagen U, Aaseth J, Johansson P. Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens. Plos One. 2015;10(12). doi:10.1371/journal.pone.0141641.
  1. Yan X, Shen T, Jiang X, et al. Coenzyme Q10 consumption promotes ABCG1-mediated macrophage cholesterol efflux: A randomized, double-blind, placebo-controlled, cross-over study in healthy volunteers. Molecular Nutrition & Food Research. 2015;59(9):1725-1734. doi:10.1002/mnfr.201500186.
  1. Stojanović M, Radenković M. A meta-analysis of randomized and placebo-controlled clinical trials suggests that coenzyme Q10 at low dose improves glucose and HbA1c levels. Nutrition Research. 2017;38:1-12. doi:10.1016/j.nutres.2016.12.001.
  1. Fan L, Feng Y, Chen G-C, Qin L-Q, Fu C-L, Chen L-H. Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Pharmacological Research. 2017;119:128-136. doi:10.1016/j.phrs.2017.01.032.
  1. DePierro F, ROssi A, Consensi A, Giacomelli C, Bazzichi L. Role for a water-soluble form of CoQ10 in female subjects affected by fibromyalgia. A preliminary study. Role for a water-soluble form of CoQ10 in female subjects affected by fibromyalgia A preliminary study. December 2016.
  1. Norata GD, Tibolla G, Catapano AL. Statins and skeletal muscles toxicity: From clinical trials to everyday practice. Pharmacological Research. 2014;88:107-113. doi:10.1016/j.phrs.2014.04.012.

 

 

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