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Coenzyme Q-10


What is it?

Coenzyme Q-10 (CoQ-10) 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 Q-10 can also be made in a laboratory. It is used as medicine.

Many people use coenzyme Q-10 for treating heart and blood vessel conditions such as congestive heart failure (CHF), chest pain (angina), high blood pressure, and heart problems linked to certain cancer drugs. It is also used for diabetes, gum disease (both taken by mouth and applied directly to the gums), breast cancer, Huntington’s disease, Parkinson’s disease, muscular dystrophy, increasing exercise tolerance, chronic fatigue syndrome (CFS), and Lyme disease. Some people think coenzyme Q-10 will treat hair loss related to taking warfarin (Coumadin), a medication used to slow blood clotting.

Some people also think coenzyme Q-10 might help increase energy. This is because coenzyme Q-10 has a role in producing ATP, a molecule in body cells that functions like a rechargeable battery in the transfer of energy. Coenzyme Q-10 been tried for treating inherited or acquired disorders that limit energy production in the cells of the body (mitochondrial disorders), and for improving exercise performance.

Some people have also used coenzyme Q-10 for strengthening the immune systems of people with HIV/AIDS, male infertility, migraine headache, and counteracting muscle pain sometimes caused by a group of cholesterol-lowering medications called “statins.”

Coenzyme Q-10 has even been tried for increasing life span. This idea got started because coenzyme Q-10 levels are highest in the first 20 years of life. By age 80, coenzyme-Q10 levels can be lower than they were at birth. Some people thought that restoring high levels of coenzyme-Q10 late in life might cause people to live longer. The idea works in bacteria, but not in lab rats. More research is needed to see if this works in people.

It’s not only time that uses up the body’s store of coenzyme Q-10. Smoking does, too.

Coenzyme Q-10 was first identified in 1957. The “Q-10” refers to the chemical make-up of the substance. These days coenzyme Q-10 is used by millions of people in Japan for heart disease, especially congestive heart failure. Coenzyme Q-10 is also used extensively in Europe and Russia. Most of the coenzyme Q-10 used in the US and Canada is supplied by Japanese companies. Coenzyme Q-10 is manufactured by fermenting beets and sugar cane with special strains of yeast.

How effective is it?

Natural Medicines Comprehensive Database 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.

The effectiveness ratings for COENZYME Q-10 are as follows:

Likely effective for...

  • Coenzyme Q-10 deficiency. Taking coenzyme Q-10 by mouth seems to improve symptoms of coenzyme Q-10 deficiency. This is a very rare condition. The symptoms include weakness, fatigue, and seizures.
  • Inherited or acquired disorders that limit energy production in the cells of the body (mitochondrial disorders). Taking coenzyme Q-10 by mouth seems to reduce symptoms of mitochondrial disorders. However, improvement in symptoms is slow. Some people have to take coenzyme Q-10 for six months to get the most benefit.

Possibly effective for...

  • Age-related vision loss (age-related macular degeneration). Taking a specific product containing coenzyme Q-10, acetyl-L-carnitine, and omega-3 fatty acids (Phototrop) by mouth seems to improve vision in people with age-related vision loss.
  • Congestive heart failure (CHF). Some research suggests that heart failure might be linked with low coenzyme Q-10 levels. Although most evidence shows that taking coenzyme Q-10 alone does not help treat heart failure, there is some evidence that it might be helpful when taken in combination with other heart failure medications and treatments.
  • Nerve damage caused by diabetes (diabetic neuropathy). Research shows that taking coenzyme Q-10 improves nerve damage and nerve pain in people with nerve damage caused by diabetes.
  • HIV/AIDS. Taking coenzyme Q-10 by mouth seems to improve immune function in people with HIV/AIDS.
  • An inherited neurological disorder called Huntington’s disease. Ubiquinol, an altered form of coenzyme Q-10, has been granted “Orphan Drug Status” by the U.S. Food and Drug Administration (FDA). This gives the maker of Ubiquinol some financial incentives to study its effectiveness for Huntington’s, a condition that is so rare (affecting less than 200,000 individuals) that pharmaceutical companies might not otherwise invest in developing a drug for it. However, taking coenzyme Q-10 by mouth in doses of 600 mg daily or less does not seem to be effective for slowing the progression of Huntington’s disease.
  • High blood pressure. The majority of research shows that taking coenzyme Q-10 by itself or along with other medications for treating high blood pressure seems to help lower blood pressure. However, one small study suggests that taking coenzyme Q-10 by mouth may not lower blood pressure in people that also have a condition called metabolic syndrome.
  • Blood vessel complications caused by heart bypass surgery. 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 Q-10 by mouth for a week before heart bypass surgery or blood vessel surgery might help to reduce tissue damage. However, not all research agrees with this finding.
  • A specific type of high blood pressure. Taking coenzyme Q-10 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).
  • Migraine headache. Taking coenzyme Q-10 by mouth seems to help prevent migraine headaches. Studies show it can decrease the frequency of headaches by about 30% and the number of days with headache-related nausea by about 45% in adults. Taking coenzyme Q-10 also appears to reduce migraine frequency in children who have low levels of coenzyme Q-10. It can take up to 3 months for significant benefit. However, coenzyme Q-10 does not seem to be effective in treating migraines once they have developed.
  • An inherited muscle disorder called muscular dystrophy. Taking coenzyme Q-10 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 Q-10 appears to lower the risk of heart-related events, including another heart attack.
  • Parkinson’s disease. Some research shows that taking coenzyme Q-10 supplements might slow decline in people with early Parkinson’s disease. However, taking a coenzyme Q-10 does not seem to improve symptoms in people with mid-stage Parkinson’s disease.
  • Peyronie’s disease (painful erection in men). Research shows that taking coenzyme Q-10 improves erectile function in men with painful erections.

Possibly ineffective for...

  • Alzheimer’s disease. Taking coenzyme Q-10 does not seem to improve mental function in people with Alzheimer’s disease.
  • Neurodegenerative disease called ALS or Lou Gehrid’s disease. Research shows that taking coenzyme Q-10 does not slow the progression of ALS.
  • Cocaine dependence. Taking a combination of coenzyme Q-10 and L-carnitine does not reduce cocaine use.
  • High cholesterol. Some research shows that taking coyenzme Q-10 does not reduce total cholesterol, triglycerides, or low-density lipoprotein (LDL or “bad”) cholesterol, or increase high-density lipoprotein (HDL or “good”) cholesterol. Other research shows that taking coenzyme Q-10 by mouth alone or together with carnitine does not improve cholesterol levels. However, one study in people who can not take statin drugs shows that taking a combination of coenzyme Q-10, berberine, policosanol, red yeast rice, folic acid, and astaxanthin reduces cholesterol levels.
  • Symptoms affecting polio survivors (post-polio syndrome). Research shows that taking coenzyme Q-10 does not improve muscle strength or muscle function in people with post-polio syndrome.

Likely ineffective for...

  • Athletic performance. Taking coenzyme Q-10 by mouth does not improve althetic performance in athletes or non-athletes.

Insufficient evidence to rate effectiveness for...

  • Chest pain (angina). Some early research suggests that taking coenzyme Q-10 by mouth might improve exercise tolerance in patients with angina.
  • Asthma. Some early research suggests that taking a combination of coenzyme Q-10, vitamin E (alpha-tocopherol), and vitamin C in addition to conventional asthma treatment reduces the dosage of drugs needed by people with mild-to-moderate asthma.
  • Breast cancer. Some research in Chinese women suggests that having low blood levels of coenzyme Q-10 is linked to an increased risk of breat cancer. There is preliminary evidence that taking coenzyme Q-10 by mouth might be helpful in advanced breast cancer when used along with surgery and conventional treatment plus other antioxidants and omega-3 and omega-6 fatty acids.
  • Cancer. Research suggests that low coenzyme Q-10 levels are associated with an increased risk of skin cancer. Also, early research suggests that taking coenzyme Q-10 along with other antioxidants increases survival time by 40% in patients with terminal cancer.
  • Heart toxicity caused by chemotherapy drugs. Some research suggests that taking coenzyme Q-10 by mouth may protect the heart in children and adults receiving the chemotherapy drug anthracycline. However, other research suggests that administering coenzyme Q-10 intravenously (by IV) does not provide this benefit.
  • Lung disease called chronic obstructive pulmonary disease (COPD). Early research suggests that taking coenzyme Q-10 improves lung function and exercise tolerance in people with COPD.
  • Cyclic vomiting syndrome. Some early research suggests that taking coenzyme Q-10 might work as well as prescription medications used to treat cyclic vomiting syndrome.
  • Diabetes. Research about the effectiveness of coenzyme Q-10 for diabetes is conflicting. Some research shows that taking coenzyme Q-10 might lower blood sugar levels. However, other research has found no benefit.
  • Weakend and enlarged heart (dilated cardiomyopathy). Early evidence suggests that taking coenzyme Q-10 improves heart function in children with dilated cardiomyopathy.
  • Dry mouth. Early research suggests that taking coenzyme Q-10 (ubiquinol) improves dry mouth.
  • Eye surgery. Research suggests that administering an eye solution containing coenzyme Q-10 and vitamin E increases the speed of nerve regeneration after cataract eye surgery
  • Fibromyalgia. Some early research suggests that taking coenzyme Q-10 along with ginkgo might increase feelings of wellness and overall health, as well as reduce pain in people with fibromyalgia.
  • Uncoordinated movement due to brain damage (cerebellar ataxia). Early research suggests that coenzyme Q-10 improves muscle coordination and movement in people with cerebellar ataxia.
  • Rare inherited disease that causes nerve damage (Friedreich’s ataxia). Early research suggests that taking vitamin E together with coenzyme Q-10 improves coordination, posture, and movement in people with Friedreich’s ataxia.
  • Hearing loss. Research suggests that taking a specific coenzyme Q-10 product (Q-TER) by mouth improves hearing in people with age-related hearing loss. However, combining coenzyme Q-10 with conventional steroid treatments does not improve hearing more than steroid treatment alone.
  • Hepatitis C. Research shows that taking coenzyme Q-10 does not improve liver function in people with hepatitis C who are not responding to conventional treatment.
  • A heart condition called hypertrophic cardiomyopathy. Taking coenzyme Q-10 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.
  • Rare genetic disorder called Prader-Willi syndrome. Early research suggests that administering coenzyme Q-10 improves development in children with Prader-Labhart-Willi syndrome. However, it is not clear if these improvements are due to the coenzyme Q-10 or an age-related phenomenon.
  • Male infertility. There is some early evidence that coenzyme Q-10 treatment can improve the movement and density of sperm in men with certain types of infertility. However, other research shows that it does not have a beneficial effect on sperm movement.
  • Inherited diabetes and deafness. There is some early evidence that taking coenzyme Q-10 by mouth might prevent the progression of a rare form of diabetes that is maternally inherited.
  • Gum disease. Applying coenzyme Q-10 to the gums is not effective for treating gum disease. However, there is some early evidence that taking coenzyme Q-10 by mouth might be helpful in treating gum disease.
  • High blood pressure during pregnancy (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 Q-10 from week 20 of pregnancy until the baby is delivered
  • Prostate cancer. Research shows that taking a combination of vitamin E, selenium, vitamin C, and coenzyme Q-10 does not improve prostate cancer.
  • Kidney failure. Some early research suggests that taking coenzyme Q-10 improves kidney function in people with end-stage kidney disease. However, other research shows that taking coenzyme Q-10 does not improve kidney function.
  • A muscle condition called “statin-induced myopathy.” Statins, a class of drugs used to lower cholesterol, can sometimes cause muscle pain. There is some evidence that taking coenzyme Q-10 might reduce this pain. However, not all evidence has been positive.
  • Hair loss related to use of the warfarin. There is some early evidence that taking coenzyme Q-10 might be helpful for preventing hair loss caused by the blood-thinning drug, warfarin.
  • Wrinkled skin. Early evidence suggests that applying a coenzyme Q-10 cream to the skin improves wrinkled skin.
  • Fatigue.
  • Lyme disease.
  • Other conditions.
More evidence is needed to rate coenzyme Q-10 for these uses.

How does it work?

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Coenzyme Q-10 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 Q-10 also seems to have antioxidant activity. People with certain diseases, such as congestive heart failure, high blood pressure, periodontal disease, Parkinson’s disease, certain muscular diseases, and AIDS, might have lower levels of coenzyme Q-10.

Are there safety concerns?

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Coenzyme Q-10 is LIKELY SAFE for most adults when taken by mouth or when applied directly to the gums. While most people tolerate coenzyme Q-10 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 a day instead of a large amount all at once can help reduce side effects.

Coenzyme Q-10 is POSSIBLY SAFE for children when taken by mouth. However, coenzyme Q-10 should not be used in children without medical supervision.

Special precautions & warnings:

Pregnancy and breast-feeding: Coenzyme Q-10 is POSSIBLY SAFE when taken by mouth appropriately during preganancy. Coenzyme Q-10 has been used safely twice daily starting at 20 weeks until delivery. Not enough is known about the use of coenzyme Q-10 during breast-feeding. Stay on the safe side and avoid use.

Chemotherapy: There is some concern that coenzyme Q-10 might lower the effectiveness of some chemotherapy drugs. People undergoing chemotherapy with certain drugs should use coenzyme Q-10 with caution.

High blood pressure or low blood pressure: Coenzyme Q-10 might lower blood pressure. It can increase the effects of medications used to lower blood pressure. Discuss your use of coenzyme Q-10 with your healthcare provider if you have blood pressure problems.

Smoking: Cigarette smoking depletes the amount of coenzyme Q-10 stored by the body.

Surgery: Coenzyme Q-10 might interfere with blood pressure control during and after surgery. Stop using coenzyme Q-10 at least two weeks before a scheduled surgery.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Medications for cancer (Chemotherapy)
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)
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)
Warfarin (Coumadin) is used to slow blood clotting while coenzyme Q-10 might increase blood clotting. By helping the blood clot, coenzyme Q-10 might decrease the effectiveness of warfarin (Coumadin) and increase the risk of dangerous clots. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Are there interactions with herbs and supplements?

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Acacia
Taking coenzyme Q-10 with acacia gum seems to increase the body's absorption of coenzyme Q-10. In theory, this might increase the effects and side effects of coenzyme Q-10.

Beta-carotene
Coenzyme Q-10 can increase blood levels of beta-carotene. In theory, this might increase the effects and side effects of beta-carotene.

Herbs and supplements that lower blood pressure
Coenzyme Q-10 might decrease blood pressure. Combining coenzyme Q-10 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 Q-10 with omega-3 fatty acids can reduce blood levels of coenzyme Q-10. In theory, this might reduce the effects of coenzyme Q-10.

Red yeast
Red yeast might reduce coenzyme Q-10 levels. In theory, this might reduce the effects of coenzyme Q-10.

Vitamin A
Coenzyme Q-10 can increase blood levels of vitamin A. In theory, this might increase the effects and side effects of vitamin A.

Vitamin C
Coenzyme Q-10 can increase blood levels of vitamin C. In theory, this might increase the effects and side effects of vitamin C.

Vitamin E
Coenzyme Q-10 can increase blood levels of vitamin E. In theory, this might increase the effects and side effects of vitamin E.

Vitamin K
Coenzyme Q-10 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 Q-10 with vitamin K might cause additive effects and increase the risk of blood clotting in people taking blood thinning drugs.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For known coenzyme Q-10 deficiency: 150 mg daily.
  • For mitochondrial disorders (mitochondrial encephalomyopathies): 150-160 mg, or 2 mg/kg/day. In some cases, doses may be gradually increased to 3000 mg per day.
  • For heart failure in adults: 100 mg per day divided into 2 or 3 doses.
  • For reducing the risk of future cardiac events in patients with recent myocardial infarction: 120 mg daily in 2 divided doses.
  • For high blood pressure: 120-200 mg per day divided into 2 doses.
  • For isolated systolic hypertension: 60 mg twice daily.
  • For preventing migraine headache: 100 mg three times daily. A dose of 1-3 mg/kg has also been used in pediatric and adolescent patients.
  • For Parkinson’s disease: 300 mg, 600 mg, 1200 mg, and 2400 mg per day in 3-4 divided doses.
  • For HIV/AIDS: 200 mg per day.
  • For infertility in men: 200-300 mg per day.
  • For muscular dystrophy: 100 mg per day.
  • For pre-eclampsia: 100 mg twice daily starting at week 20 of pregnancy until delivery.
Dividing the total daily dose by taking smaller amounts two or three times a day instead of a large amount all at once can help reduce side effects.

Other names

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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, Ubidcarenone, Ubidécarénone, Ubiquinone-10.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Coenzyme Q-10 page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/938.html.

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Page last updated: 10 December 2014