Coenzyme Q 10 (CoQ10) is a fat-soluble nutrient we make ourselves that is considered the” powerhouse of the cell”. It converts food into energy so is a very important molecule for overall health.

Importantly, it acts as an antioxidant that neutralises the toxic effect of free radicals. Ubiquinone, the active ingredient of CoQ10 comes from the word ‘ubiquitous’; it is present in virtually every single cell in the body. This means it is essential for overall health with deficiencies leading to a multitude of chronic problems.

We make our own CoQ10 and produce less as we get older or when we have chronic conditions like diabetes, cancer and heart failure.[i] By the same token, concentrations are highest in those with lower risk factors for heart disease.[ii]

There could be many reasons why individuals may have decreased levels of CoQ10. They:

1. may not be getting enough from the diet,
2. are using too much CoQ10 or
3. have a impaired pathway for producing CoQ10
4. have All of the above

Food or Supplement?

Food is my first choice of intake: dietary sources of CoQ10 include meat, poultry and fish. A good starting point is to check whether you’re eating enough protein. Apart from being a building block for CoQ10, sufficient protein intake is required for building the immune system (e.g. antibodies). The Australian & New Zealand government recommend protein intake of 0.84g/kg/day for men <70 years and 0.75g/kg/day for women <70 years[iii].

It turns out the body requires 8 amino acids and 9 different vitamins for optimal health so eat a variety of foods.

However, if you suspect you are not getting enough CoQ10 from the diet or have a chronic disease, trialling a bottle of supplement may be advantageous. Some data suggest CoQ10 supplementation may be helpful in patients with heart failure with a reduced ejection fraction. [iv][v]

Most promising are the effects seen in heart disease, preventing complications before surgery and age-related diseases (neurodegenerative diseases).[vi][vii]

While there is controversy whether supplementation makes a difference, the mixed results suggest individual variation (e.g. how much are you producing already at baseline) and whether you are getting the right dose and formulation matters.[viii]  

Simply stated, supplements should be used on a ‘trial-basis’: firstly, test for efficacy and side-effects with the first batch and then re-assess for benefit every time you finish a bottle.

If you were to supplement, does it matter which formulation you take?

CoQ10 can go by the following names: Coenzyme Q10, CQ10, ubidecarenone, and ubiquinone

Ubiquinone is broken down to ubiquinol, the reduced form of CoQ10, whereas ubiquinone is the oxidized form. 
Most of the data showing effectiveness is with ubiquinone. Ubiquinol, the newer kid on the block is more expensive however may be useful if you have problems breaking down ubiquinone to ubiquinol e.g. aging.

Keeping in mind that CoQ10 is fat-soluble, I would favour a formulation that is oil-based with minimal fillers and excludes potentially toxic additives like vegetable oil (rice bran, soya, sunfower oil etc).

I’ve done the research on oil-based supplements and sorted the following according to price (low to highest price)

Country Life CoQ10 100mg

Sports Research CoQ10 100mg

Nordic Naturals ProOmega CoQ10 1000mg (handy if you’re looking at supplementing with omega 3 oils as well)

If you are not getting much improvement from the oil-based formulation, you could try the reduced form of CoQ10, ubiquinol.

How much to take?

Let me explain, the dose varies from person to person. As we make our own CoQ10, you will need to individualise this accordingly, based on which form is being used and what effect is being targeted. In heart disease, daily doses of 100-400mg have been used while in neurodegenerative diseases, doses of 600-3000mg have been used[ix]. Note these dose ranges used different formulations therefore adjust dose according to effect and symptoms.

Keep in mind that most people can tolerate up to 1,200mg per day[x] of CoQ10.

Here’s a general rule of thumb’ follow the manufacturer’s dose recommendations, monitor for effect and symptoms and adjust accordingly after finishing each bottle.

References:

[i] DiNicolantonio JJ, McCarty MF, O’Keefe JH. Coenzyme Q10 deficiency can be expected to compromise Sirt1 activity. Open Heart. 2022;9(1):e001927. doi:10.1136/openhrt-2021-001927

[ii] de la Bella-Garzón R, Fernández-Portero C, Alarcón D, Amián JG, López-Lluch G. Levels of Plasma Coenzyme Q₁₀ Are Associated with Physical Capacity and Cardiovascular Risk in the Elderly. Antioxidants (Basel). 2022;11(2):279. Published 2022 Jan 29. doi:10.3390/antiox11020279

[iii] Australian National Health and Medical Research Council (NHMRC), Australian Government Department of Health and Ageing and the New Zealand Ministry of Health (NZ MoH).

[iv] Al Saadi T, Assaf Y, Farwati M, Turkmani K, Al-Mouakeh A, Shebli B, Khoja M, Essali A, Madmani ME. Coenzyme Q10 for heart failure. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No.: CD008684. DOI: 10.1002/14651858.CD008684.pub3. Accessed 09 May 2022.

[v] Claxton L, Simmonds M, Beresford L, et al. Coenzyme Q10 to manage chronic heart failure with a reduced ejection fraction: a systematic review and economic evaluation. Health Technol Assess. 2022;26(4):1-128. doi:10.3310/KVOU6959

[vi] Hernández-Camacho JD, Bernier M, López-Lluch G, Navas P. Coenzyme Q10 Supplementation in Aging and Disease. Front Physiol. 2018;9:44. Published 2018 Feb 5. doi:10.3389/fphys.2018.00044

[vii] Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol. 2002;59(10):1541-1550. doi:10.1001/archneur.59.10.1541

[viii] Pallotti F, Bergamini C, Lamperti C, Fato R. The Roles of Coenzyme Q in Disease: Direct and Indirect Involvement in Cellular Functions. International Journal of Molecular Sciences. 2022; 23(1):128. https://doi.org/10.3390/ijms23010128

[ix] Raizner AE. Coenzyme Q10. Methodist Debakey Cardiovasc J. 2019;15(3):185-191. doi:10.14797/mdcj-15-3-185

[x] Hathcock JN, Shao A. Risk assessment for coenzyme Q10 (Ubiquinone). Regul Toxicol Pharmacol. 2006;45(3):282-288. doi:10.1016/j.yrtph.2006.05.006

Affiliate Disclosure: Products and services recommended are limited to products that Therese’s uses and recommends to clients. The educational materials may contain affiliate links, which means The Pharmacist Edit may receive a commission on any product or service you purchase using the links provided. You will pay the same price (or lower) for all products and services, and your purchase helps support Therese‘s ongoing research and work.