Coenzyme Q10

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What is it?

Coenzyme Q10 is a vitamin-like substance found throughout the body, but especially in the heart, liver, kidney, and pancreas. It is eaten in small amounts in meats and seafood. Coenzyme Q10 can also be made in a laboratory.

Coenzyme Q10 is most commonly used for conditions that affect the heart such as heart failure and fluid build up in the body (congestive heart failure or CHF), chest pain (angina), and high blood pressure. It is also used for preventing migraine headache, Parkinson disease, and many other conditions.

Coenzyme Q10 was first identified in 1957. The “Q10” refers to the chemical make-up of the substance.

It is effective?
Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Probably Effective for …

  • Coenzyme Q10 deficiency. Taking coenzyme Q10 by mouth seems to improve symptoms of coenzyme Q10 deficiency. This is a very rare condition. The symptoms include weakness, fatigue, and seizures.
  • A group of disorders that most often cause muscle weakness (mitochondrial myopathies). Taking coenzyme Q10 by mouth seems to reduce symptoms of mitochondrial myopathies. However, improvement in symptoms is slow. Some people have to take coenzyme Q10 for 6 months to get the most benefit.

Possibly Effective for …

  • Heart failure and fluid build up in the body (congestive heart failure or CHF). Early research found that heart failure might be linked with low coenzyme Q10 levels. Some research shows that taking coenzyme Q10 might help reduce some symptoms of heart failure. Coenzyme Q10 might also reduce the chances of death or hospitalization related to heart failure.
  • Nerve pain in people with diabetes (diabetic neuropathy). Research shows that taking coenzyme Q10 improves nerve damage and nerve pain in people with nerve damage caused by diabetes.
  • Fibromyalgia. Some research shows that taking coenzyme Q10 by mouth reduces pain, tenderness, fatigue, and sleep issues in people with fibromyalgia.
  • Tissue damage caused when there is limited blood flow and then blood flow is restored (ischemia-reperfusion injury). Reduced blood supply during heart or blood vessel surgery can deprive tissue of oxygen. When blood supply returns to this tissue, the tissue can become damaged. There is some evidence that taking coenzyme Q10 by mouth for at least one week before heart bypass surgery or blood vessel surgery might help to reduce tissue damage. However, not all research agrees with this finding.
  • Migraine. Taking coenzyme Q10 by mouth seems to help prevent migraine. Research shows it can decrease the frequency of these headaches by about 30% and the number of days with headache-related nausea by about 45% in adults. More than half of patients taking coenzyme Q10 experience a 50% decrease in the number of headache days per month. Taking coenzyme Q10 also appears to reduce migraine frequency in children who have low levels of coenzyme Q10. It can take up to 3 months to see any benefit.
  • Multiple sclerosis (MS). Taking coenzyme Q10 by mouth seems to reduce tiredness and low mood in people with MS.
  • A group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy). Taking coenzyme Q10 by mouth seems to improve physical performance in some people with muscular dystrophy.
  • Heart attack. When started within 72 hours of a heart attack and taken for one year, coenzyme Q10 appears to lower the risk of heart-related events, including another heart attack.
  • A disease that causes curved, painful erections (Peyronie disease). Research shows that taking coenzyme Q10 improves erectile function in men with painful erections.

Possibly Ineffective for …

  • Alzheimer disease. Taking coenzyme Q10 does not seem to improve mental function in people with Alzheimer disease.
  • Lou Gehrig’s disease (amyotrophic lateral sclerosis or ALS). Research shows that taking coenzyme Q10 does not slow the progression of ALS.
  • Tiredness in people treated with cancer drugs. Taking coenzyme Q10 does not seem to reduce fatigue in people being treated for breast cancer.
  • Diabetes. Research has found that taking coenzyme Q10 does not lower blood sugar levels in people with type 1 or type 2 diabetes.
  • Symptoms such as muscle weakness and fatigue that affect polio survivors. Research shows that taking coenzyme Q10 does not improve muscle strength, muscle function, or fatigue in polio survivors.

Probably Ineffective for …

  • Athletic performance. Taking coenzyme Q10 by mouth, alone or with other ingredients, doesn’t improve athletic performance in athletes or non-athletes.
  • An inherited brain disorder that affects movements, emotions, and thinking (Huntington disease). One large research study shows that taking coenzyme Q10 in large doses (2.4 grams daily) for up to 5 years does not stop Huntington disease symptoms from getting worse.

Insufficient Evidence to Make a Determination for …

  • Chest pain (angina). Some early research shows that taking coenzyme Q10 by mouth might reduce chest pain and improve exercise ability in people with chest pain.
  • Heart damage caused by certain cancer drugs (anthracycline cardiotoxicity). Early research shows that taking coenzyme Q10 by mouth might protect the heart in children aged 3-12 years who are being treated with a class of drugs called anthracyclines. But results from larger studies are inconsistent.
  • Autism. Early research shows that taking a specific form of coenzyme Q10 called ubiquinol improves autism symptoms in autism patients aged 3-6 years according to parent assessment. Higher quality studies are needed to confirm these results.
  • Bipolar disorder. Early research shows that taking coenzyme Q10 improves symptoms of depression in people over 55 years of age with bipolar disorder.
  • Breast cancer. Some research in Chinese women suggests that having low blood levels of coenzyme Q10 is linked to an increased risk of breast cancer.
  • Cancer. Low coenzyme Q10 levels seem to be linked with an increased risk of skin cancer. Early research suggests that taking coenzyme Q10 along with other antioxidants increases survival time by 40% in patients with terminal cancer. Higher quality studies are needed to confirm these results.
  • Brain damage that affects muscle movement (cerebellar ataxia). Early research suggests that taking coenzyme Q10 by mouth can improve posture and muscle function in people with cerebellar ataxia and low coenzyme Q10 levels. However, it doesn’t seem to benefit people with normal coenzyme Q10 levels.
  • A lung disease that makes it harder to breathe (chronic obstructive pulmonary disease or COPD). Early research suggests that taking coenzyme Q10 does not improve lung function or exercise performance in people with COPD.
  • A disorder that causes repeated episodes of nausea and vomiting (cyclic vomiting syndrome or CVS). Early research suggests that taking coenzyme Q10 might work as well as prescription medications used to treat CVS.
  • Weakened and enlarged heart (dilated cardiomyopathy). Early research suggests that taking coenzyme Q10 improves heart function in children and adolescents with dilated cardiomyopathy.
  • Dry mouth. Early research suggests that taking an altered form of coenzyme Q10 called ubiquinol improves dry mouth.
  • Hearing loss. Some research suggests that taking coenzyme Q10 can improve hearing in some people with age-related hearing loss. But combining coenzyme Q10 with conventional steroid treatments doesn’t improve hearing in people with sudden deafness. Also, it doesn’t appear to improve hearing in people with noise-induced hearing loss.
  • Swelling (inflammation) of the liver caused by the hepatitis C virus (hepatitis C). Research shows that taking coenzyme Q10 does not improve liver function in people with hepatitis C who are not responding to conventional treatment.
  • High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). It’s unclear if coenzyme Q10 reduces cholesterol levels. One study shows it might lower triglycerides and LDL (or “bad” cholesterol) by a small amount. Other studies show no benefit of taking coenzyme Q10 for lowering total cholesterol or LDL or increasing HDL (or “good” cholesterol) levels. It may take at least 3 months to see any benefit.
  • High blood pressure. Some research shows that taking coenzyme Q10 by itself or along with other medications for treating high blood pressure helps lowers blood pressure in people with high blood pressure. However, not all research has shown benefit. Coenzyme Q10 might only benefit people with high blood pressure who also have diabetes or low blood levels of coenzyme Q10 before treatment. Taking coenzyme Q10 by mouth daily appears to lower systolic blood pressure (the top number) in some people with high systolic blood pressure but normal diastolic blood pressure (the bottom number).
  • Weakened and thickened heart (hypertrophic cardiomyopathy). Taking coenzyme Q10 by mouth seems to decrease the thickness of the heart wall and decrease symptoms of shortness of breath and fatigue in people with hypertrophic cardiomyopathy.
  • Inability to become pregnant within a year of trying to conceive (infertility). Although coenzyme Q10 might increase the chance of getting pregnant, it might not reduce miscarriage or increase successful pregnancies in women with this condition.
  • Kidney failure. Some early research suggests that taking coenzyme Q10 improves kidney function in people with kidney failure. But it might not be helpful in people with less severe kidney disease.
  • Conditions in a man that prevent him from getting a woman pregnant within a year of trying to conceive (male infertility). There is some early evidence that taking coenzyme Q10 or an altered form of coenzyme Q10 called ubiquinol by mouth for 3-6 months can improve the movement and density of sperm in men with certain types of infertility. It’s unclear if these improvements increase pregnancy rate.
  • An inherited form of diabetes that is linked with deafness. Early research suggests that taking coenzyme Q10 by mouth might prevent the progression of a rare form of diabetes that is inherited from the mother.
  • Build up of fat in the liver in people who drink little or no alcohol (nonalcoholic fatty liver disease or NAFLD). Early research shows that taking coenzyme Q10 can improve markers of liver injury and disease severity in people with NAFLD.
  • Parkinson disease. Some research shows that taking coenzyme Q10 by itself or along with other supplements might slow mental decline in people with early-stage Parkinson disease. At least 16 months of treatment and doses above 600 mg daily appear to be needed to achieve these benefits. However, not all data has been positive. Some research shows that coenzyme Q10 does not benefit people with early or mid-stage Parkinson disease.
  • A serious gum infection (periodontitis). Applying coenzyme Q10 to the gums is not effective for treating gum disease. However, there is some early evidence that taking coenzyme Q10 by mouth might be helpful.
  • A hormonal disorder that causes enlarged ovaries with cysts (polycystic ovary syndrome or PCOS). Early research shows that taking coenzyme Q10 can reduce hair loss and acne in women with PCOS. It might also reduce blood sugar levels and cholesterol levels.
  • A rare inherited disorder that causes obesity, short stature, and learning disability (Prader-Willi syndrome or PWS). Early research suggests that taking coenzyme Q10 improves mental and physical development in children with PWS. But it is not clear if these improvements are due to the coenzyme Q10 or an age-related phenomenon.
  • A pregnancy complication marked by high blood pressure and protein in the urine (pre-eclampsia). Pre-eclampsia is a condition that some women develop during pregnancy. Some research shows that women who are at risk have a lower chance of developing the condition if they take coenzyme Q10 from week 20 of pregnancy until the baby is delivered.
  • Blood infection (sepsis). Some early research shows that taking coenzyme Q10 might prevent death in people with blood infections. But other research shows that taking a form of coenzyme Q10 called ubiquinol doesn’t prevent death. Coenzyme Q10 doesn’t seem to reduce time in the hospital due to a blood infection.
  • Muscle pain caused by statin drugs (statin-induced myalgia). Statins, a class of drugs used to lower cholesterol, can sometimes cause muscle pain. There is some evidence that taking coenzyme Q10 might reduce this pain. But not all research agrees.
  • Muscle weakness caused by statin drugs (statin-induced myopathy). Statins, a class of drugs used to lower cholesterol, can sometimes cause muscle weakness. There is some evidence that taking coenzyme Q10 might improve this weakness. But not all research agrees.
  • Skin wrinkles from sun damage. Early evidence suggests that applying a coenzyme Q10 cream to the skin improves wrinkled skin.
  • An eye disease that leads to vision loss in older adults (age-related macular degeneration or AMD).
  • Aging.
  • An inherited disease of the nerves and muscles (Friedreich ataxia).
  • Asthma.
  • Cataracts.
  • Chronic fatigue syndrome (CFS).
  • Cocaine use disorder.
  • Dry eye.
  • Heart disease.
  • Kidney damage in people with diabetes (diabetic nephropathy).
  • Other conditions.

More evidence is needed to rate coenzyme Q10 for these uses.

How does it work?
Coenzyme Q10 is an important vitamin-like substance required for the proper function of many organs and chemical reactions in the body. It helps provide energy to cells. Coenzyme Q10 also seems to have antioxidant activity. People with certain diseases, such as heart failure, high blood pressure, gum disease, Parkinson disease, blood infections, certain diseases of the muscles, and HIV infection, might have lower levels of coenzyme Q10.

Is there concern for the safety of its use?
When taken by mouth: Coenzyme Q10 is LIKELY SAFE for most adults. While most people tolerate coenzyme Q10 well, it can cause some mild side effects including stomach upset, loss of appetite, nausea, vomiting, and diarrhea. It can cause allergic skin rashes in some people. It also might lower blood pressure, so check your blood pressure carefully if you have very low blood pressure. Dividing the total daily dose by taking smaller amounts two or three times daily instead of a large amount all at once can help reduce side effects.

When applied to the skin: Coenzyme Q10 is LIKELY SAFE for most adults when applied directly to the gums.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Coenzyme Q10 is POSSIBLY SAFE when taken by mouth appropriately during pregnancy. Coenzyme Q10 has been used safely when taken twice daily starting at 20 weeks until delivery. Not enough is known about the use of coenzyme Q10 during breast-feeding. Stay on the safe side and avoid use.

Children: Coenzyme Q10 is POSSIBLY SAFE for children when taken by mouth. However, coenzyme Q10 should not be used in children without medical supervision.

Are there any drug interactions?

Medications for cancer (Chemotherapy)

Interaction Rating=Moderate Be cautious with this combination.

Coenzyme Q-10 is an antioxidant. There is some concern that antioxidants might decrease the effectiveness of some medications used for cancers. But it is too soon to know if the interaction occurs.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Coenzyme Q-10 seems to decrease blood pressure. Taking coenzyme Q-10 along with medications for high blood pressure might cause your blood pressure to go too low.
Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Warfarin (Coumadin)

Interaction Rating=Moderate Be cautious with this combination.

Warfarin (Coumadin) is used to slow blood clotting. Coenzyme Q-10 might help the blood clot. By helping the blood clot, coenzyme Q-10 might decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Are there any interactions with herbs and supplements?
Acacia: Taking coenzyme Q10 with acacia gum seems to increase the body’s absorption of coenzyme Q10. In theory, this might increase the effects and side effects of coenzyme Q10.
Beta-carotene: Coenzyme Q10 can increase blood levels of beta-carotene. In theory, this might increase the effects and side effects of beta-carotene.
Herbs and supplements that might lower blood pressure: Coenzyme Q10 might decrease blood pressure. Combining coenzyme Q10 with other herbs and supplements with that lower blood pressure might make blood pressure go too low. Some of these herbs and supplements include andrographis, casein peptides, cat’s claw, fish oil, L-arginine, lycium, stinging nettle, theanine, and others.
Omega-3 fatty acids: Combining coenzyme Q10 with omega-3 fatty acids can reduce blood levels of coenzyme Q10. In theory, this might reduce the effects of coenzyme Q10.
Red yeast rice: Red yeast rice might reduce coenzyme Q10 levels in the body.
Vitamin K: Coenzyme Q10 can have effects in the body that are similar to vitamin K, including inhibiting the effects of blood thinning drugs such as warfarin. Taking coenzyme Q10 with vitamin K might increase the risk of blood clotting in people taking blood thinning drugs.

Are there any interactions with food?
There are no known interactions with foods.

What dose is used?
The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

  • For coenzyme Q10 deficiency: 150-2400 mg per day.
  • For a group of disorders that most often cause muscle weakness (mitochondrial myopathies): 150-160 mg per day, or 2 mg/kg per day. In some cases, doses may be gradually increased to 3000 mg per day.
  • For heart failure and fluid build up in the body (congestive heart failure or CHF): 30 mg once daily, or up to 300 mg per day divided into two or three doses for up to 2 years. Also, 2 mg/kg daily for up to one year has been used.
  • For nerve pain in people with diabetes (diabetic neuropathy): 400 mg per day for 12 weeks.
  • For fibromyalgia: 300 mg daily for about 6 weeks or 200 mg twice daily for 3 months has been used. A combination of 200 mg of coenzyme Q10 (Bio-Quinon Q10, Pharma Nord) plus 200 mg of ginkgo (Bio-Biloba, Pharma Nord) per day for 12 weeks.
  • For tissue damage caused when there is limited blood flow and then blood flow is restored (ischemia-reperfusion injury): 150-300 mg per day in up to three divided doses for 1-2 weeks before surgery.
  • For preventing migraine: 100 mg three times per day, 150 mg once per day, or 100mg once per day for 3 months. A dose of 1-3 mg/kg per day for 3 months has also been used.
  • For multiple sclerosis (MS): 500 mg twice daily for 3 months.
  • For a group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy): 100 mg per day for 3 months.
  • For heart attack: 120 mg per day in two divided doses for up to one year. A combination of 100 mg of coenzyme Q10 (Bio-Quinon, Pharma Nord) and 100 mcg of selenium (Bio-Selenium, Pharma Nord) per day for up to one year has also been used.
  • For Peyronie disease: 300 mg per day for 6 months

CHILDREN

BY MOUTH:

  • For coenzyme Q10 deficiency: 60-250 mg per day in up to three divided doses.
  • For preventing migraine: 1-3 mg/kg daily for 3 months has been used in patients aged 3-18 years.
  • For a group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy): 100 mg daily for 3 months in children aged 8-15 years.

By what other names is the product known?
Co Q10, Co Q-10, Coenzima Q-10, Co-Enzyme 10, Coenzyme Q 10, Coenzyme Q10, Co-Enzyme Q10, Co-Enzyme Q-10, Co-Q 10, CoQ10, Co-Q10, CoQ-10, Ubidecarenone, Ubidécarénone, Ubiquinone-10.

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