Every chemical reaction taking place within our cells is necessary to life. But what powers the cell to perform these reactions? Meet coenzyme Q10 also known as CoQ10. This powerful antioxidant is all the craze just now as an important supplement to include for optimal cellular health.
This article takes a deep dive into CoQ10 and why we need it, it’s mechanism of action and most importantly if it is safe.
What is CoQ10?
Simply put, CoQ10 is a vitamin-like compound used in the body to make energy by joining enzymes together to boost or activate their function. It is also a potent antioxidant. The technical name for CoQ10 is ubiquinone.1 It is known as ubiquinone as it is ubiquitous, meaning it is found everywhere in the body. It occurs naturally in the body and is also found in many dietary foods. CoQ10 is also produced by chemical synthesis, fermentation by gut microbes, or extracted from biological tissues to make it available in a supplement form.2
CoQ10 is found in high quantities in the mitochondria, the ‘powerhouse of the cell’. Inside the mitochondria, CoQ10 turns into a more useable form known as ubiquinol.2 Mitochondria are found in higher quantities in organs that have a higher rate of metabolism. For that reason, CoQ10 is found in high levels in the heart, the liver, and the kidneys. It is also found in smaller amounts in tissues such as muscles.3 The mitochondria use no less than 18 genes to synthesize CoQ10.4
It was first identified in the 1940’s but isolated in 1957 by Frederick Crane. Peter Mitchell of Edinburgh University later discovered that CoQ10 helped produce energy at the cellular level and won a Nobel Prize for Chemistry in 1978 for this important discovery.5 As a fat-soluble compound, absorption of CoQ10 is limited and is dependent on the presence of dietary fat and adequate bile production, as bile aids fat digestion.
The whole body’s content of CoQ10 is actually very small, only about 500 -1500mgs, and this also decreases with age.3
Other causes of CoQ10 deficiency include:
- Nutritional deficiencies, such as vitamin B6 deficiency. Vitamin B6 is required by the body to produce CoQ10
- Increased demands in the body as a consequence of disease and inflammation
- Side effects of statin medications, which are well known to reduce CoQ10 production
- Smoking, which depletes the body of CoQ10
Dietary sources of CoQ10
It is advisable to consume 30-100mg per day of CoQ10 from food sources in addition to what is naturally made in our bodies from the amino acid tyrosine.6
Liver is the richest source of CoQ10 with beef, poultry, and fish being the next highest sources.3
From the plant kingdom, some legumes, such as peanuts, and soy are good sources of CoQ10. However, legumes and soy are both restricted in some diets. Additional plant-based foods high in CoQ10, suitable on most diets, are pistachio, cauliflower, and broccoli.3
Comparatively, animal products are a much richer source of CoQ10 than plant-based foods. On comparison of beef and pistachio, for example, beef is likely over 300% richer in CoQ10 than pistachios.
What does CoQ10 actually do?
CoQ10 is a critical nutrient that powers the chemical reactions that take place within the mitochondria without which the generation of energy would be almost impossible.6
Besides its crucial role in energy production, CoQ10 has important antioxidant functions too.3 An antioxidant is a compound that can prevent or slow damage to cells in the body. In mitochondria, CoQ10 can protect proteins and DNA from the damage that results from natural metabolic processes that take place within each cell. It also has the ability to regenerate other antioxidants such as vitamin E.7
A 2017 meta-analysis concluded that supplementation with CoQ10 significantly reduced inflammations in the body.8
Symptoms of low CoQ10
Symptoms of low CoQ10 levels can range from minor to severe and include:
- Low energy and fatigue
- Difficulty in concentrating
- Muscle weakness
- Low exercise tolerance
- Weaker immune system
- High blood pressure
Benefits of CoQ10 supplementation
The beneficial effects of CoQ10 supplementation are seen in a number of age-related diseases many of which have documented CoQ10 deficiency. CoQ10 is reported to be supportive in several diseases such as cardio-myopathy, Parkinson’s, Alzheimer’s, and diabetes, moreover, they are also found to reduce the risks of statin induced myopathy (muscle weakness and fatigue).
Because CoQ10 is a fat-soluble compound, its absorption is slow and limited and is therefore better absorbed when taken with food containing some fat such as nuts, eggs, avocado, olive oil, meats and fish.
CoQ10 is known to be highly concentrated in heart muscle cells due to the high energy requirements of this cell type.
Numerous studies have investigated the benefit of CoQ10 supplementation in improving cardiovascular function due to its enhanced energy production and potent antioxidant properties. The largest study to date is the Italian multicenter trial, involving 2664 patients with heart failure which after three months of treatment showed that 49.3% - 68.6% of patients improved in a range of clinical signs and symptoms, including arrhythmia, palpitations, and uneasy breathing to name a few.9
One systematic review of 12 clinical trials found that CoQ10 was able to lower blood pressure, an indicator of heart disease risk .10
Studies have shown that the supplementation of CoQ10 reduced the susceptibility of LDL cholesterol to lipid peroxidation.11 Lipid oxidation is a process that results in rancidity and deterioration of fats. CoQ10 has also been found to improve endothelial dysfunction associated with atherosclerosis likely through regulating nitric oxide levels. Nitric oxide is a naturally occurring compound in the body that supports healthy blood vessels and circulation.
Statins, a medication used to lower cholesterol, reduces the body’s production of CoQ10, and therefore supplementation may be important in those on statin medication. The most common side effects reported by individuals on statins are muscle aches and weakness, collectively known as statin-induced myopathy. Coenzyme Q10 supplementation has therefore been proposed to reduce the adverse muscular effects sometimes seen with statins.12
A randomised controlled trial of 42 patients found that 100 mg of CoQ10 three times daily decreased the frequency of migraine headaches by 30% and the number of days with headache-related nausea by 45%.13 CoQ10 decreases inflammation in your body which helps reduce migraine-associated pain.
Studies have shown that supplementation with CoQ10 over time, slowed down symptom progression in people with early Parkinson’s disease. Significantly reduced levels of CoQ10 have been observed in blood and platelet mitochondria and plasma of Parkinson’s disease patients.1
An earlier study from 1998 showed that oral administration of CoQ10 increases both brain and brain mitochondrial concentrations.6
Many studies have recognised CoQ10 as a nutrient that supports energy function, but recently some research has highlighted its support in oral health too.
CoQ10 strengthens gum tissue and helps reduce the unwanted bacteria in the mouth that can cause plaque.14 A clinical study demonstrated that patients with periodontitis frequently have significant CoQ10 deficiencies.14
Chronic fatigue and fibromyalgia
A 2009 study investigating CoQ10 concentrations in patients diagnosed with chronic fatigue syndrome found that the CoQ10 levels in the chronic fatigue patients were significantly lower than the CoQ10 levels in the normal healthy study participants. They also found lower levels of CoQ10 were correlated with a higher intensity of chronic fatigue symptoms.15
The results of a 2015 clinical trial suggests that CoQ10 plus NADH supplementation for 8 weeks is potentially effective in reducing fatigue in chronic fatigue syndrome.16
CoQ10 has shown the potential to decrease pain, fatigue, and morning tiredness compared to placebo in patients with fibromyalgia.17
Boost physical performance and endurance
Since CoQ10 supports mitochondria including those found in muscles, it can support the production of energy and a deficiency may hinder physical performance.
One study found that supplementing and increasing levels of CoQ10 can boost endurance in both trained and untrained participants.18
CoQ10 side effects and contraindications
Clinical and preclinical trials indicate that CoQ10 is highly safe as a supplement, and while the evidence is staggering for the benefits of CoQ10, over-supplementing for a long period of time could cause some side effects.19
- Digestive complaints
- Low blood sugar levels
- Low blood pressure
- Loss of appetite
- Light sensitivity
CoQ10 may decrease the effectiveness of blood-thinning medications such as warfarin (Coumadin) leading to the need for increased doses. CoQ10 should be used with warfarin only under careful supervision by a health care provider.
CoQ10 can reduce blood pressure and blood sugar levels. The combination with blood pressure and blood-sugar lowering medication may lead to very low blood pressure or blood sugar.
CoQ10 is processed by the liver and is eliminated through bile. Individuals with poor liver function or blocked bile ducts who supplement with CoQ10 consider supervision by a health care provider.
The safety of use of CoQ10 during pregnancy and breast-feeding hasn't been established.
CoQ10 is vitally important for maintaining energy levels and as a potent antioxidant throughout the body, especially in the heart.
Although CoQ10 is found naturally in some foods and the body produces it in small amounts, it may be worth supplementing in certain situations.
Research has shown several benefits to additional supplementation of CoQ10 at varying dosages for those individuals with certain conditions. Make sure that you talk with your health care provider about dosing and possible interactions with any medications you’re taking.
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12. Qu, H. Guo, M. Chai, H. et al. (2018),’Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials’, J Am Heart Assoc, 7(19):e009835.
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