Sarah Dumont-Gale September 03, 2019

Coenzyme Q10 (coQ10) is a vital nutrient for energy production and also provides antioxidant protection. CoQ10 is difficult to source from our diet alone; levels naturally decline with age and statin use can deplete levels further. Supplemental coQ10 is available in different forms, so which one should you choose?

What is coenzyme Q10?

CoQ10 is a vitamin-like substance that is required by every single cell to make energy. Energy production occurs within the cell's mitochondria, which are energy-making powerhouses. The more mitochondria a cell has, the more energy it produces, with the most energy intensive cells being the heart, muscles, kidneys and liver. CoQ10's role within the body doesn't stop there; it is also a powerful antioxidant that works to help protect cells from inflammation and the effects of ageing.

Where to find coenzyme Q10?

CoQ10 is found in many different foods, with the richest sources being meat and fish. However, the amounts found in these foods are likely too small to produce any significant benefit and instead we rely on synthesis within the body to maintain sufficient levels.

Coenzyme Q10 benefits

Energy production

Every cell produces its own energy along a complex chemical pathway. CoQ10 acts as a messenger and interacts with certain molecules to help generate energy in the form of ATP (adenosine triphosphate) - the body's energy currency. Optimal energy production relies on optimal levels of coQ10 and a deficiency is thought to play a role in the development of chronic fatigue syndrome and fibromyalgia.1 Supplementing has shown to be of benefit for some people with these conditions.2

Antioxidant protection

CoQ10 is a powerful antioxidant that helps to reduce the impact of unstable oxygen molecules known as free radicals. Environmental factors such as pollution, radiation and cigarette smoke all increase our free radical burden, but they can also be produced within the body as a byproduct of energy production and other metabolic processes. Not only does coQ10 act as an antioxidant in its own right, it also has the capacity to regenerate other antioxidants such as vitamin E. Antioxidants help to prevent oxidative stress - an imbalance between antioxidant and free radical levels. Oxidative stress creates inflammation in the body and has been linked to the development of many chronic health conditions such as cardiovascular disease, diabetes and dementia.3

Cardiovascular health

Mitochondrial dysfunction and low coQ10 levels are associated with an increased cardiovascular risk.4 A meta-analysis of 2,149 heart failure patients showed that participants who supplemented with coQ10 had a lower mortality rate and a higher exercise capacity than those using a placebo. 5 Furthermore, coQ10 has been shown to help lower blood pressure in hypertensive patients.6

Fertility

Both eggs and sperm require a huge amount of energy to effectively complete their role in reproduction. They are packed full of mitochondria to produce this energy, so a deficiency in coQ10 could negatively impact their function. Supplementing with coQ10 has shown to be of benefit for both men and women suffering from infertility.7, 8

Migraine

Mitochondrial dysfunction has been implicated in the progression of migraines and improving energy production in the brain has been a suggested intervention. A meta-analysis of 346 people who supplemented with coQ10 showed a beneficial reduction in migraine duration and the number of migraine days in a month.9

Factors impacting coenzyme Q10

Age

Levels of coQ10 naturally decline with age. Levels start to decline at age 20, and by age 80 levels are approximately half of what they were at their peak.10 As levels fall, so does the cell's capacity to make energy. It's suggested that the decline in coQ10 could play a part in cellular ageing, due to less efficient energy production and reduced antioxidant protection.11

Statins

Statins are frequently prescribed to lower cholesterol by inhibiting the pathway that produces the fat-like substance. Statins also inhibit the production pathway of coQ10 and it has been shown that statin use significantly decreases coQ10 levels.12 It is suggested that supplementing with coQ10 while taking statins may help to alleviate the muscle-related side effects.13 However, it is important to ask your GP before taking coQ10 to check for any potential interactions.

Nutrient deficiencies

CoQ10 production in the body is complex and the synthesis requires multiple nutrients including folate, vitamin C, vitamin B12, vitamin B6, pantothenic acid and selenium. If these nutrients are depleted it can have a knock-on impact on coQ10 production.

What about ubiquinol?

Coenzyme Q10 is available in two different forms. Historically, coQ10 was only available as ubiquinone, but more recently ubiquinol, the active form, has become available. While both forms are needed by the mitochondria and the body has the ability to convert between the two, ubiquinol is considered the more 'body-ready' form and has superior bioavailability over ubiquinone.14 What's more, conversion from ubiquinone to ubiquinol reduces with age, so it may be wise to supplement with coQ10 as ubiquinol instead of ubiquinone if you are over 50.


References
1Maes, M. et al (2009). Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder. Neuro Endocrinology Letters 30(4)
2Cordero, M.D et al. (2014). NLRP3 inflammasome is activated in fibromyalgia: the effect of coenzyme Q10. Antioxidants & Redox Signalling 20(8)
3Liguori, I. et al (2018). Oxidative stress, aging, and diseases. Clinical Interventions In Aging 13
4Shimizu, M. et al. (2017). Low circulating coenzyme Q10 during acute phase is associated with inflammation, malnutrition, and in-hospital mortality in patients admitted to the coronary care unit. Heart and Vessels 32(6)
5Lei, L. and Liu, Y. (2017). Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials. BMC Cardiovascular Disorders 17(1)
6Rosenfeldt, F.L et al. (2007). Coenzyme Q 10 in the treatment of hypertension: a meta-analysis of the clinical trials. Journal of Human Hypertension 21(4)
7Ben-Meir, A. et al (2015). Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell 14(5)
8Safarinejad, M.R. et al. (2012). Effects of the reduced form of coenzyme Q10 (ubiquinol) on semen parameters in men with idiopathic infertility: a double-blind, placebo controlled, randomized study. The Journal of Urology 188(2)
9Zend, Z. et al. (2019). Efficacy of CoQ10 as supplementation for migraine: A meta‐analysis. Acta Neurologica Scandinavica 139(3)
10Alehagen, U. et al. (2019). Decrease in inflammatory biomarker concentration by intervention with selenium and coenzyme Q10: a subanalysis of osteopontin, osteoprotergerin, TNFr1, TNFr2 and TWEAK. Journal of Inflammation 16(1)
11Gruber, J., Schaffer, S. and Halliwell, B. (2008). The mitochondrial free radical theory of ageing—where do we stand. Front Biosci 13
12Banach, M. et al. (2015). Statin therapy and plasma coenzyme Q10 concentrations—a systematic review and meta-analysis of placebo-controlled trials. Pharmalogical Research 99
13Qu, H. et al. (2018). The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials. European Journal of Medical Research 23(1)
14Langsjoen, P.H. and Langsjoen, A.M. (2014). Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clinical Pharmacology in Drug Development 3(1)

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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