With the changing lifestyle that constitutes junk diet and sedentary habits, the incidence of inflammatory conditions such as heart disease and cancer is increasing. This alarming situation has called for more antioxidant-based diets and supplements, and coenzyme Q10 is an important one of them.
Coenzyme Q10 is a vitamin-like antioxidant substance, chemically a quinone, naturally produced by the body. As the human body ages, the rate of its natural production in the body declines. To fulfill its requirement, synthetic coenzyme Q10 can be consumed in the form of supplements.
This antioxidant is also found abundantly in some food sources, such as organ meats, and has become an important drug therapy partner for many conditions. We will discuss in detail the specific health conditions that benefit from coenzyme Q10 supplementation, its biomedical and clinical aspects, safe dosage, and all possible side effects.
How does Coenzyme Q10 work?
Coenzyme Q10 is an essential nutrient used by the cells for growth and maintenance. In fact, it is a central compound in the Electron Transport Chain in the mitochondria, the most important step in producing ATP for survival and sustenance.
Its role in the electron transport chain of cellular respiration is so vital that the cycle is not complete without coenzyme Q10. Organs and tissues that require greater and instant energy, such as the brain, kidney, heart, and skeletal muscle, have higher levels of coenzyme Q10. These are the same vital organs affected the most in the case of its deficiency.
Co Q10 has the redox potential to neutralize the reactive free radicals and prevent damage to the crucial cell membranes. It also prevents lipid peroxidation with the same mechanism. Another important mechanism of action of coenzyme Q10 is stabilizing the calcium channels in the cell membranes. Migraine headaches benefit from this mechanism.
A systematic review of a controlled trial showed that coenzyme Q10, for the most part, benefits cardiovascular conditions such as heart failure, high blood pressure, pre-, and post-heart surgery, and fluid retaining conditions such as congestive heart failure.
Coenzyme Q supplementation for Cardiovascular Health
Coenzyme Q10 is an essential compound in the body involved in various energy-producing and anti-inflammatory mechanisms. Its involvement in improving heart and vascular health is of particular interest here. Because it benefits the cardiovascular system of the body in a multi-faceted way, working by various mechanisms.
Co Q10 supplementation has been shown to considerably reduce cardiovascular risk factors such as fatty acid levels, inflammatory biomarkers, and high blood pressure. Branching out its benefits for the cardiovascular system, we get the following:
1. Reduce the Risk of Developing Cardiovascular Disease
Cardiovascular disease such as dilated cardiac myopathy, ischemic heart disease, and chronic heart failure has been associated with low levels of coenzyme Q10 in the body. The levels fall in proportion to the progression of the disease.
Besides, for the prevention of cardiovascular disease, the anti-inflammatory and antioxidant role of the coenzyme Q10 is the most important. It prevents free radical injury and the resultant damage to the membranes of the cardiac cells and blood vessels.
These antioxidant effects lower blood pressure, prevent endothelial injury and delay the development of cardiovascular disease in susceptible individuals.
Another important mechanism in action here is the involvement of Co Q10 in the energy production processes of the cardiac cells. Cardiovascular diseases related to heart failure are associated with the loss of contractile power of the heart cells. Coenzyme Q10 ameliorates that by taking part in the ATP production inside the cardiac cell’s mitochondria.
Clinical trials show that when patients are administered oral coenzyme Q10 for a few days before coronary artery bypass surgery considerably reduces the risk of a recurrent heart attack.
2. Congestive Heart Failure
Patients with a risk of congestive heart failure actually have an underlying mitochondrial disease that impairs the energy production for the cardiac muscle. Hence, the contractile force and cardiac output reduce, and the blood backs up in the lungs.
The whole situation results in cardiac congestion and pulmonary edema. Since Co Q10 is directly involved in ATP production by the mitochondria, patients of congestive heart failure experience improved quality of life with its supplementation.
Another mechanism of action of coenzyme Q10 that ameliorates the congestive heart failure situation is its ability to increase the contractile force of the heart muscle. This enables the heart to meet the cardiac output needs adequately.
Left ventricular dysfunction is a prominent feature of congestive heart disease. But we have insufficient evidence till now to confirm whether coenzyme Q10 improves left ventricular function or not.
A systematic review of the Italian multicenter study, a placebo-controlled trial, revealed an improvement in the clinical signs and symptoms in patients with cardiovascular disease.
3. High Blood Pressure
Superoxide radicals cause oxidative stress and use up the nitric oxide reserves of the endothelial cells of the blood vessels. This free radical injury reduces the bioavailability of nitric oxide for vasodilation, and hence blood pressure increases in response to increased blood flow.
Coenzyme Q fights off the reactive free radicals and prevents injury in the first place. It also directly increases the bioavailability of nitric oxide and facilitates the relaxation of arteries. Scientific research also reveals that administration of coenzyme Q to hypertensive patients decreases the levels of angiotensin and aldosterone, which again lowers blood pressure.
A randomized controlled trial revealed that coenzyme Q10 could lower systolic blood pressure and diastolic blood pressure by a few mm Hg and improve the overall profile before and after cardiac surgery.
4. Statin Induced Myopathy
In a placebo-controlled trial, coenzyme Q10 dietary supplements reduced the muscle symptoms associated with the cholesterol-lowering drugs, statins. statins are prescribed to patients with high cholesterol levels who are on the verge of developing life-endangering heart disease.
Coenzyme Q10 also helps the statin function and ameliorates its side effects. Almost 75 percent of individuals on statin therapy in the placebo-controlled trial experienced reduced severity of muscle pain.
5. Cardiac Emergencies
Mild hypothermia is beneficial after a cardiac arrest and cardiopulmonary resuscitation (CPR). Accompanying hypothermia with coenzyme Q10 supplements has produced better clinical implications than any other conventional treatment.
After myocardial infarction or tissue ischemia in the heart, reperfusion follows that sets in a dangerous series of events called ischemia-reperfusion injury. Tissue ischemia was terrible, but the reperfusion injury is the worst.
To prevent and treat heart failure in such a situation, coenzyme Q10 supplements have a positive efficacy in preventing sudden vascular responses.
Health Benefits of Coenzyme Q10 Proved by Clinical Trials
While its use as an adjunct in heart failure therapy remains dominant, research has revealed various other health benefits and applications too. For some health benefits of coenzyme Q10 as dietary supplements, only preliminary evidence is available. But below are some coenzyme Q10 uses and applications that are supported by sufficient clinical evidence.
1. Coenzyme Q10 can Protect the Respiratory System
Coenzyme Q10 has been shown to reduce fluid in the lungs and improve lung performance. Coenzyme Q10 supplements can improve the endurance of physical activity by various mechanisms. These include enhanced energy production, antioxidant effects, and better lactic acid clearance.
For individuals who suffer from inflammatory conditions of the respiratory system such as asthma or allergic rhinitis, coenzyme Q10 can benefit in various ways. Firstly, it increases the transcription and translation of an important antioxidant gene: Nuclear factor-erythroid factor 2-related factor 2 (Nrf2).
Besides, these conditions also benefit from the intrinsic anti-inflammatory and antioxidant actions of coenzyme q. In patients with chronic obstructive pulmonary disease (COPD), supplementation with coenzyme Q10 improved exercise capacity and heart rate.
For a normal, healthy adult, oxidative damage is the main threat to the lungs, which are the organs most exposed to oxygen from the environment. By protecting against oxidative damage, coenzyme q improves the overall functioning of the respiratory system.
2. Coenzyme Q10 can help with Fertility Issues
Randomized controlled trials have confirmed the antioxidant and anti-inflammatory potential of coenzyme Q10. This implies that coenzyme q can protect against age-related decline in fertility in both males and females.
Female infertility is associated with oxidative damage to the eggs. With increasing age, the antioxidant levels in the body are insufficient to help with that. Coenzyme Q10 dietary supplements prevent oxidative damage and improve female fertility.
On the other hand, male infertility is related to loss of endothelial function, various heart conditions such as essential hypertension, chronic heart failure, and oxidative damage. The former causes impair erection while the latter interferes with the sperm counts.
Coenzyme Q10 supplements help treat heart failure by improving myocardial function, as discussed above, protecting the blood vessels against lipid peroxidation. These effects collectively improve erection, sperm counts, sperm quality, and hence male fertility.
3. Coenzyme Q10 Slows the Progression of neurodegenerative diseases
Neurodegenerative disorders have various factors in play, such as genetics, mitochondrial disorders that impair energy production in the brain cells, and chronic inflammation.
Supplemental coenzyme Q10 has been shown to improve the quality of life for patients with neurodegenerative diseases. It is directly involved in the anti-inflammatory processes in the body, and studies have shown its role in improving memory and cognitive abilities.
These effects improve the signs and symptoms of brain diseases such as Alzheimer’s, Parkinson disease, and Huntington’s disease. Besides, the anti-inflammatory potential of the coenzyme Q10 also slows the progression of the disease and delays the development of the same in the first place.
By setting in processes and mechanisms that fight off inflammation-causing heavy metals and toxins, coenzyme Q10 prevents migraine headaches and the worsening of various neurodegenerative disorders such as Huntington’s disease. Coenzyme Q10 also improves the mitochondrial dysfunction and energy production for the cells of the brain, which again ameliorates the disease symptoms and progression of Alzheimer’s, Parkinson disease, and Huntington’s disease.
Optimum coenzyme Q10 levels support psycho cognitive abilities and improve general brain health just like the growth hormone does in the early years of age. The similarity with the same growth hormone in the case of physical development has not yet been confirmed though.
4. Coenzyme Q10 can help with Migraine
In a controlled trial, coenzyme Q10 was shown to be more effective in reducing migraines in almost 42 people than with a placebo.
Moreover, researchers have observed reduced levels of coenzyme Q10 and other antioxidant vitamins and minerals in patients with Migraine.
Migraine essentially involves an ion channel that loses function. This and some other factors collectively result in the dilation of the blood vessels of the brain, which then touch the meninges and pain nerve endings in the brain. And the dysfunction of the ion channel has been repeatedly connected to abnormal mitochondrial function.
So, one of the clinical aspects of the coenzyme q is its efficacy for treating and preventing headaches caused by muscle weakness and the somewhat less understood phenomenon called Migraine.
5. Coenzyme Q10 helps Treat Diabetes Mellitus
Coenzyme Q10 is involved in cellular energy metabolism and hence can increase the combustion and uptake of glucose by the cells. Besides, it has a pronounced antioxidant role which again benefits diabetic patients in several ways.
Randomized controlled trials have demonstrated that supplementation with coenzyme Q considerably improves glycemic control in diabetic patients. Firstly, it stimulates the production and release of insulin and also improves insulin sensitivity in the body.
Patients with Diabetes mellitus are prescribed cholesterol-lowering drugs such as statins to manage endothelial dysfunction, chronic atherosclerosis, and cardiovascular risk factors. Statins have known side effects related to muscle pain and weakness. Coenzyme Q10 treats the side effects of statin therapy and also plays a synergistic role in their cholesterol-lowering effect.
Coenzyme Q10 hence improves the lipid profile of diabetic patients, leading to reduced incidence of chest pain, high blood pressure, and endothelial dysfunction. Nutritional supplementation with coenzyme Q10 plays an even more important role in type 2 diabetes mellitus because it can reduce insulin resistance in such patients.
Increased insulin secretion, improved insulin response, and increased cellular uptake of glucose eventually result in normal blood sugar levels and improved glycemic control. Chronic high blood sugar levels eventually cause diabetic neuropathy. Low blood sugar levels caused by the coenzyme Q10 effects discussed above also prevent that.
6. Coenzyme Q10 can improve Exercise Performance and Endurance
Exercise performance and endurance decrease due to chronic inflammatory conditions such as diabetes mellitus, asthma, and COPD. The same could happen with age or in a young adult with deteriorating health due to any reason.
Nutritional supplementation with antioxidant vitamins and minerals such as the coenzyme Q10 can benefit these individuals by several mechanisms.
The lactic acid builds up due to insufficient energy-producing mechanisms and causes fatigue. Coenzyme Q10 enhances mitochondrial function, produces more energy by enhancing muscle metabolism so that muscles have more energy available for the required physical work, and prevents fatigue.
One factor that compromises exercise performance of the body is the oxidative stress that is caused by the accumulation of free radicals, superoxide species, and toxic heavy metals. The antioxidant effect of coenzyme Q10 improves the performance and endurance of physical exercise.
Research suggests that an increased time to exhaustion was observed after two weeks of coenzyme Q10 supplementation. This effect increases exercise capacity, which is of considerable importance for patients with heart failure.
7. Coenzyme Q10 may help with Gum Disease
Gum disease or periodontitis is an inflammatory condition that benefits from the antioxidant activity of coenzyme q. The dietary supplement regenerates protective antioxidants and neutralizes the free radicals.
Gum disease is caused in old age when the antioxidants in the body deplete due to chronic free radical damage, an unhealthy diet, and an increase in the level of stress markers in the body. Another important cause is the use of statin drugs for the cholesterol-lowering effect, which uses up the coenzyme q in the body.
Besides, the pathogens and bacteria attacking the gums and causing periodontal disease also interact with the host inflammatory response and stimulate the production of reactive oxygen species (ROS). So, the basic mechanism behind gum disease is actually oxidative stress.
Any of the risk factors for the decline in gum health can be counteracted by incorporating dietary supplements with a sufficient antioxidant coenzyme Q10 content.
8. Coenzyme Q10 may Help Improve Skin Health
Coenzyme Q10 provides antioxidant protection to the skin. Sun exposure brings UV light rays and dangerous free radicals that act as external factors damaging the skin.
These environmental aggressors expose the cells of the skin to DNA damage that may give rise to cancers. The free radical and reactive oxygen species (ROS) can also attack and damage the skin internally.
The skin, as a result, becomes thin and fragile. This same free radical damage by oxidation is also the main culprit behind aging, wrinkles, and excessive dryness.
Coenzyme Q10, along with other antioxidant substances, vitamins, and minerals such as vitamin C replenish the antioxidant status of the body. These neutralize the free radicals and prevent damage to the DNA and cell membranes.
The role of coenzyme Q10 in the production of energy and mitochondrial function keeps the skin young and fresh. The cells grow and divide at their natural timings, and aging sets in later in life.
9. Coenzyme Q10 can Prevent and Treat cancer
Oxidative stress can react and damage the DNA and integral proteins of the body, impairing the normal metabolism, growth, and reproduction of the cells. Cancer may develop if the conditions are favorable enough, such as the low levels of antioxidants and increased levels of toxins and free radicals in the body.
Also, when the general health of a body declines due to poor lipid profile and decreased availability of minerals, vitamins, and essential nutrients, cells begin to die. Coenzyme Q10 optimizes the health of the cells by promoting the essential ATP-producing processes and ensuring survival.
Research suggests that the levels of coenzyme Q are reduced than normal in cancer patients. This way, coenzyme Q10 prevents the formation and development of cancer in the first place.
One type of cancer that especially benefits from the radical scavenging activity of coenzyme Q10 is breast cancer. Breast cancer demonstrates higher levels of inflammatory cytokines such as interleukins, tumor necrosis factor-Alpha (TNF-alpha), and superoxide radicals.
A systematic review of randomized clinical trials reveals that coenzyme Q10, along with cancer chemotherapy, can considerably improve outcomes in patients with colon cancer, breast cancer, and all health conditions associated with compromised immunity and antioxidant status.
Is Coenzyme Q10 supplementation important for normal, healthy adults too?
Coenzyme Q10 is an essential nutrient for the energy-producing processes on the cellular level. When coenzyme Q10 levels fall in the body, the risk of developing a chronic inflammatory disease increases, and immunity to infections declines.
Although the body produces this nutrient naturally, its production tends to fall with age. Besides, the body cannot store coenzyme Q10 for long. So, frequent supplementation with this antioxidant is important for the normal, healthy working of the human body.
What are the signs and symptoms of Low Coenzyme Q10 levels?
The signs and symptoms of coenzyme Q10 deficiency vary with the age of onset and severity.
Congenital or infantile deficiency of coenzyme Q10 has clear signs and symptoms. It manifests as growth retardation, mental dysfunction, and muscle weakness.
Coenzyme Q10 deficiency later in life manifests as dysfunction of various organs and neurological disorders such as:
- Cerebellar ataxia; loss of coordination of movement
- Kidney dysfunction, called nephrotic syndrome, allows proteins to be passed in the urine
- Neurological abnormalities such as memory loss, confusion, and intellectual disability.
- Vision loss due to optic atrophy
- Loss of muscle tension (hypotonia)
- High cholesterol levels in the blood can be dangerous if an individual has an underlying cardiovascular condition
- Involuntary muscle contractions
Research suggests that coenzyme Q10 deficiency can be caused by a gene mutation that would typically instruct the transcription and translation of the protein coenzyme q. These gene mutations are inherited in an autosomal recessive pattern.
Dosage of Coenzyme Q10
Coenzyme Q10 is available in two forms: ubiquinone and ubiquinol.
The coenzyme Q10 supplements your doctor will prescribe will most probably be the quinol form. It is the form of coenzyme most abundant in the blood and is most easily absorbed as well.
While coenzyme Q10 is safe for a wide range of dosage and potency and has no serious reported side effects, the safe recommended dosage for a healthy adult is 90 to 200 mg per day. But dosages as high as 500 mg have not reported any side effects or adverse reactions.
To ingest these supplements, you must take these with or after a meal. Coenzyme q is a fat-soluble nutrient, and it absorbs better with a meal than with an empty stomach or water.
Possible Drug Interactions
There are a few rarely reported cases where discretion is advised when taking coenzyme Q10 supplements:
- Coenzyme Q10 may interact with blood-thinning medications such as warfarin and coumarin. If you have a blood clotting disorder and you take such medicines, it is better to consult your physician before starting Coenzyme Q10.
- People taking blood pressure medications along with coenzyme Q10 reported lower blood pressures which are helpful for patients with heart disease such as congestive heart failure. At the same time, some research suggests interactions between coenzyme Q10 and blood pressure medications as well.
When should you take Coenzyme Q10 Supplements?
Some individuals have reported insomnia when they take coenzyme Q10 tablets or capsules just before bedtime. Individuals taking other medications such as hypotensive drugs, statins, or antiplatelet medications should also avoid taking coenzyme Q10 before going to bed. These may interact and cause an emergency during sleep, which is life-endangering.
Therefore, it is suggested that you take these dietary supplements in the morning or afternoon. Pair them up with a meal for better and quick absorption.
Side Effects of Coenzyme Q10 Supplementation
Coenzyme Q10 supplements of dosages as high as 1200 mg have been safely administered to patients with Parkinson’s disease. At most, the common side effects of dietary supplements may be experienced, such as nausea and mild diarrhea.
In that case, the prescribed dosage should be divided into two or three small dosages for better tolerance and clearance.
Contraindications to the Use of Coenzyme Q10 Supplements
the following group of people should be extra careful when using coenzyme Q10 supplement tablets:
- Coenzyme Q10 has prominent antiplatelet effects. So, patients taking blood-thinning drugs should take care of the uncontrolled anti-clotting effects of both.
- Due to its anti-diabetic effects, patients taking insulin should incorporate coenzyme Q10 after a professional consultation. Otherwise, it can result in dangerously low blood sugar levels.
- Individuals using medications that lower blood pressure should use coenzyme q supplements with care. Otherwise, it may result in dangerous hypotension.
Natural Sources of Coenzyme Q10
Red meat, especially the organ meats such as liver, kidney, and heart
- Citrus fruits, mainly oranges
- Soybeans, lentils, and peanuts
- Legume oils such as canola oil, soybean oil
- Fish with high-fat content, such as trout and sardine
- Muscle meats such as beef and chicken
- Green vegetables such as spinach, broccoli, and cauliflower
- Dry fruits, nuts, and seeds
How long does it take for the effects of the Coenzyme Q10 supplements to appear?
The most prominently documented effect of coenzyme Q10 supplements is that they manage blood pressure and thrombosis after a heart attack and replenish essential cardiac myocyte nutrients. Research suggests it takes almost 4 to 12 weeks for the blood pressure-lowering effect of coenzyme q to appear.
The ingested coenzyme q can be detected in the blood in its absorbed form within 6 hours. Its half-life is 33 hours, so that’s how long it stays in the blood. This is why it has applications before and after cardiac surgeries.
For its benefits in Alzheimer’s disease and Parkinson’s disease, any duration can be expected when these supplements are used along with the prescribed drug therapies. This is because research is still insufficient to declare the exact duration.
The Bottom Line
Coenzyme Q10 is an essential part of the functioning of cells. It not only promotes health but also supports survival. Synthetic coenzyme Q10 in the form of supplements can promote brain health, boost the immune system, and increase exercise endurance. Most importantly, it is now being used as an adjunct to drug therapy for patients with a history or risk of cardiovascular disease.
It is entirely safe to consume except for a few interactions, which can be ruled out with the advice of your physician.