CoenzymeQ10 by Ray Sahelian, M.D.

Coenzyme Q10 is a naturally occurring nutrient found in each cell of the body. Coenzyme Q10 was first identified by University of Wisconsin researchers in 1957. Coenzyme Q10 is found in foods, particularly in fish and meats. In addition to playing a significant role in the energy system of each of our cells, Coenzyme Q10 is a good antioxidant. Many who take Coenzyme Q10 notice that this nutrient provides energy and mental clarity.

For which conditions is Coenzyme Q10 helpful?
Studies with Coenzyme Q10 have mostly focused on its role in improving certain types of cardiovascular diseases, including congestive heart failure and hypertension. However, Coenzyme Q10 may benefit those with diabetes and Parkinson's disease.

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Subscribe to a FREE Supplement Research Update newsletter. Twice a month we email a brief abstract of several studies on various supplements and natural medicine topics, and their practical interpretation by Ray Sahelian, M.D. We often discuss research updates on Coenzyme Q10.

How does Coenzyme Q10 work?
Each cell in the body needs a source of energy to survive, so cells break down sugars, fats, and amino acids to make energy. Small enclosures within cells that make this energy are called mitochondria. Coenzyme Q10 exists naturally in our mitochondria and carries electrons involved in energy metabolism. Coenzyme Q10 is essential in the production of adenosine triphosphate (ATP), the basic energy molecule of each cell.
     In the bloodstream, Coenzyme Q10 is mainly transported by lipoproteins such as LDL (low-density lipoprotein) and HDL (high-density lipoprotein). It is thought that Coenzyme Q10 is one of the first antioxidants to be depleted when LDL is subjected to oxidation. Hence, Coenzyme Q10 is an important nutrient that prevents the oxidation of lipoproteins, thus potentially reducing the risk of arteries from forming plaques and getting damaged.
     In healthy individuals, Coenzyme Q10 is found in high concentrations in the heart, kidneys, and liver.

Benefits of Coenzyme Q10
Diabetes: Coenzyme Q10 may be beneficial in diabetics. It helps improve the function of endothelial cells lining blood vessels and may slightly help with blood sugar control. 

Heart Attacks: In a small trial of patients with recent myocardial infarction, Coenzyme Q10 -- used in addition to aspirin and cholesterol-lowering drugs -- decreased the likelihood of further cardiac events for at least one year after the heart attack. The dosage of Coenzyme Q10 used in the study was 60 mg twice daily.

Heart Failure: One study shows significant improvement in functional status, clinical symptoms, and quality of life in end stage heart failure patients who were placed on Coenzyme Q10 (see bottom of page).

Hypertension: Coenzyme Q10 may help lower blood pressure by a small amount.

Coenzyme Q10 benefits people with heart failure
Coenzyme Q10 improves the functional capacity of patients with chronic heart failure, along with strengthening of their heart. Dr. Romualdo Belardinelli, of Lancisi Heart Institute, Italy, and colleagues studied 23 patients, average age 59 years, with moderate to severe heart failure. They were assigned to 4 weeks each of oral Coenzyme Q10 supplements or inactive placebo pills, with or without supervised exercise training five times per week. Supplementation with Coenzyme Q10 led to a significant 3 percent increase in HDL ("good") cholesterol and improvement in peak exercise capacity. There was an increase in cardiac function with Coenzyme Q10 treatment. Combining exercise training with CoQ10 produced more marked improvements in these and all other parameters.
The researchers conclude that oral Coenzyme Q10 improves several aspects of heart failure without any side effects. European Heart Journal, November 2006.

Dr. Sahelian’s Experience with Coenzyme Q10
The effect from 30 mg of Coenzyme Q10 is mild, mostly consisting of a slightly higher energy level. The effects become more noticeable with 60 mg. I have taken up to 100 mg in the morning. On this dose, I notice an increase in energy as the day goes on, with an urge to take a long walk or be physically active. There is enhanced focus, motivation, and productivity, along with the desire to talk to people. The 100-mg dose of CoQ10, though, is too much since I feel too energetic and alert even in late evening when I want to slow down and get ready for sleep. I usually do not recommend more than 30 mg of Coenzyme Q10 on a long term basis without medical supervision.

Coenzyme Q10 and Drug interactions
The administration of Coenzyme Q10 and warfarin does not significantly affect the anticoagulant effect of warfarin in rats. A Human trial shows Coenzyme Q10 and Ginkgo biloba do not influence the clinical effect of warfarin.

Coenzyme Q10 Side Effects and Cautions
High dosages of Coenzyme Q10 can have the side effects of restlessness and insomnia.

Coenzyme Q10 Research Update
Neuroprotective effect of Coenzyme Q10 on ischemic hemisphere in aged mice with mutations in the amyloid precursor protein.
Neurobiol Aging. 2006 Jun 26
This study was designed to test whether Coenzyme Q10 supplementation has neuroprotective effect in aged, double-transgenic amyloid precursor protein (APP)/presenilin 1 (PS1), single transgenic APP and PS1 mice exposed to ischemic injury of the brain. We conclude that Coenzyme Q10 has a protective effect on the brain from infarction and atrophy induced by ischemic injury in aged and susceptible transgenic mice.

Coenzyme Q10 protects from aging-related oxidative stress and improves mitochondrial function in heart of rats fed a polyunsaturated fatty acid (PUFA)-rich diet.
J Gerontol A Biol Sci Med Sci. 2005 Aug;60(8):970-5. Institute of Nutrition and Food Technology, Department of Physiology, University of Granada, Spain.
Coenzyme Q10 supplementation on age-related changes in oxidative stress and function of heart mitochondria in rats fed a polyunsaturated fatty acid (PUFA)-rich diet was investigated. Two groups of rats were fed for 24 months on a PUFA-rich diet, differing in supplementation or not with coenzyme Q(10). Animals were killed at 6, 12, or 24 months. Fatty-acid profile, hydroperoxides, alpha-tocopherol, coenzyme Q, catalase and glutathione peroxidase activities, and cytochromes a+a(3), b, c+c(1) and cytochrome c oxidase activity were measured. Coenzyme Q(10)-supplemented animals showed lower hydroperoxide levels; higher content and/or activity of alpha-tocopherol, coenzyme Q10, and catalase; and a slightly lower decrease in mitochondrial function. According to that, previously reported positive effects of coenzyme Q10 supplementation on the life span of rats fed a PUFA-rich diet might be a consequence, at least in part, of a lower oxidative stress level and perhaps, to a minor extent, of a smaller decrease in mitochondrial function.

Preformed beta-amyloid fibrils are destabilized by coenzyme Q10 in vitro.
Biochem Biophys Res Commun. 2005 Apr 29;330(1):111-6.
Inhibition of the formation of beta-amyloid fibrils (fAbeta), as well as the destabilization of preformed fAbeta in the CNS, would be attractive therapeutic targets for the treatment of Alzheimer's disease. We reported previously that nordihydroguaiaretic acid (NDGA) and wine-related polyphenol, myricetin, inhibit fAbeta formation from Abeta and destabilize preformed fAbeta in vitro. Using fluorescence spectroscopic analysis with thioflavin T and electron microscopic studies, we examined the effects of coenzyme Q10 (CoQ(10)) on the formation, extension, and destabilization of fAbeta at pH 7.5 at 37 degrees C in vitro. We next compared the anti-amyloidogenic activities of CoQ10 with NDGA and myricetin. Coenzyme Q10 dose-dependently inhibited fAbeta formation from amyloid beta-peptide (Abeta), as well as their extension. Moreover, it destabilized preformed fAbetas. The anti-amyloidogenic effects of Coenzyme Q10 were slightly weaker than those of NDGA and myricetin. Coenzyme Q10 could be a key molecule for the development of therapeutics for Alzheimer's disease.

[Coenzyme Q10: its biosynthesis and biological significance in animal organisms and in humans]
Postepy Hig Med Dosw (Online). 2005 Apr 18;59:150-9.
Coenzyme Q10 (ubiquinone) is a naturally occurring compound widely distributed in animal organisms and in humans. The primary compounds involved in the biosynthesis of ubiquinone are 4-hydroxybenzoate and the polyprenyl chain. An essential role of coenzyme Q10 is as an electron carrier in the mitochondrial respiratory chain. Moreover, coenzyme Q10 is one of the most important lipophilic antioxidants, preventing the generation of free radicals as well as oxidative modifications of proteins, lipids, and DNA, it and can also regenerate the other powerful lipophilic antioxidant, alpha-tocopherol. Antioxidant action is a property of the reduced form of coenzyme Q10, ubiquinol (CoQ10H2), and the ubisemiquinone radical (CoQ10H*). Paradoxically, independently of the known antioxidant properties of coenzyme Q10, the ubisemiquinone radical anion (CoQ10-) possesses prooxidative properties. Decreased levels of coenzyme Q10 in humans are observed in many pathologies (e.g. cardiac disorders, neurodegenerative diseases, AIDS, cancer) associated with intensive generation of free radicals and their action on cells and tissues. In these cases, treatment involves pharmaceutical supplementation or increased consumption of coenzyme Q10 with meals as well as treatment with suitable chemical compounds (i.e. folic acid or B-group vitamins) which significantly increase ubiquinone biosynthesis in the organism. Estimation of coenzyme Q10 deficiency and efficiency of its supplementation requires a determination of ubiquinone levels in the organism. Therefore, highly selective and sensitive methods must be applied, such as HPLC with UV or coulometric detection.

Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial.
Neurology. 2005 Feb 22;64(4):713-5.
Riboflavin, which improves energy metabolism similarly to coenzyme Q10, is effective in migraine prophylaxis. We compared Coenzyme Q10 (3 x 100 mg/day) and placebo in 42 migraine patients in a double-blind, randomized, placebo-controlled trial. Coenzyme Q10 was superior to placebo for attack-frequency, headache-days and days-with-nausea in the third treatment month and well tolerated; 50%-responder-rate for attack frequency was 14.4% for placebo and 47.6% for Coenzyme Q10 (number-needed-to-treat: 3). Coenzyme Q10 is efficacious and well tolerated.

Cosupplementation with vitamin E and Coenzyme Q10 reduces circulating markers of inflammation in baboons.
Am J Clin Nutr. 2004 Sep;80(3):649-55.
Inflammation and oxidative stress are processes that mark early metabolic abnormalities in vascular diseases. We explored the effects of a high-fat, high-cholesterol (HFHC) diet on vascular responses in baboons and the potential response-attenuating effects of vitamin E and coenzyme Q10 supplementation. DESIGN: We used a longitudinal design by subjecting 21 baboons (Papio hamadryas) to sequential dietary challenges. After being maintained for 3 mo on a baseline diet (low in fat and cholesterol), 21 baboons were challenged with an HFHC diet for 7 wk. The serum C-reactive protein (CRP) concentrations did not change. Subsequent supplementation of the HFHC diet with the antioxidant vitamin E (250, 500, or 1000 IU/kg diet) for 2 wk reduced serum CRP concentrations. Additional supplementation with Coenzyme Q10 (2 g/kg diet) further reduced serum CRP to approximately 30% of baseline. Introduction of the HFHC diet itself significantly decreased serum P-selectin and von Willebrand factor concentrations. However, neither vitamin E alone nor vitamin E plus Coenzyme Q10 significantly altered the serum concentrations of P-selectin or von Willebrand factor. CONCLUSIONS: Dietary supplementation with vitamin E alone reduces the baseline inflammatory status that is indicated by the CRP concentration in healthy adult baboons. Cosupplementation with Coenzyme Q10, however, significantly enhances this antiinflammatory effect of vitamin E.

Atorvastatin decreases the Coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke.
Rundek T. olumbia University College of Physicians & Surgeons, New York, NY 10032, USA.
Arch Neurol. 2004 Jun;61(6):889-92.
Statins are widely used for the treatment of hypercholesterolemia and coronary heart disease and for the prevention of stroke. There have been various adverse effects, most commonly affecting muscle and ranging from myalgia to rhabdomyolysis. These adverse effects may be due to a Coenzyme Q10 deficiency because inhibition of cholesterol biosynthesis also inhibits the synthesis of Coenzyme Q10. OBJECTIVE: To measure Coenzyme Q10 levels in blood from hypercholesterolemic subjects before and after exposure to atorvastatin calcium, 80 mg/d, for 14 and 30 days.  Prospective blinded study of the effects of short-term exposure to atorvastatin on blood levels of Coenzyme Q10. SETTING: Stroke center at an academic tertiary care hospital. Patients We examined a cohort of 34 subjects eligible for statin treatment according to National Cholesterol Education Program: Adult Treatment Panel III criteria. RESULTS: The mean +/- SD blood concentration of Coenzyme Q10 was 1.26 +/- 0.47 micro g/mL at baseline, and decreased to 0.62 +/- 0.39 micro g/mL after 30 days of atorvastatin therapy. A significant decrease was already detectable after 14 days of treatment. CONCLUSIONS: Even brief exposure to atorvastatin causes a marked decrease in blood Coenzyme Q10 concentration. Widespread inhibition of Coenzyme Q10 synthesis could explain the most commonly reported adverse effects of statins, especially exercise intolerance, myalgia, and myoglobinuria.

Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: a randomized, placebo-controlled study.
Berman M, Erman A, Ben-Gal T, Heart-Lung Transplant Unit, Rabin Medical Center, Beilinson Campus, Potah Tikva, Israel.
Clin Cardiol. 2004 May;27(5):295-9.
The number of patients awaiting heart transplantation is increasing in proportion to the waiting period for a donor. Studies have shown that coenzyme Q10 (CoQ10) has a beneficial effect on patients with heart failure. HYPOTHESIS: The purpose of the present double-blind, placebo-controlled, randomized study was to assess the effect of coenzyme Q10 on patients with end-stage heart failure and to determine if coenzyme Q10 can improve the pharmacological bridge to heart transplantation. METHODS: A prospective double-blind design was used. Thirty-two patients with end-stage heart failure awaiting heart transplantation were randomly allocated to receive either 60 mg U/day of Ultrasome--coenzyme Q10 (special preparation to increase intestinal absorption) or placebo for 3 months. All patients continued their regular medication regimen. Assessments included anamnesis with an extended questionnaire based partially on the Minnesota Living with Heart Failure Questionnaire, 6-min walk test, blood tests for atrial natriuretic factor (ANF) and tumor necrosis factor (TNF), and echocardiography. RESULTS: Twenty-seven patients completed the study. The study group showed significant improvement in the 6-min walk test and a decrease in dyspnea, New York Heart Association (NYHA) classification, nocturia, and fatigue. No significant changes were noted after 3 months of treatment in echocardiography parameters (dimensions and contractility of cardiac chambers) or ANF and TNF blood levels. CONCLUSIONS: The administration of coenzyme Q10 to heart transplant candidates led to a significant improvement in functional status, clinical symptoms, and quality of life. However, there were no objective changes in echo measurements or ANF and TNF blood levels. Coenzyme Q10 may serve as an optional addition to the pharmacologic armamentarium of patients with end-stage heart failure. The apparent discrepancy between significant clinical improvement and unchanged cardiac status requires further investigation.

Serum Coenzyme Q10 concentrations in healthy men supplemented with 30 mg or 100 mg coenzyme Q10 for two months in a randomised controlled study.
Zita C. Clinic of Geographic Medicine, Prague, Czech Republic.
Serum coenzyme Q10 concentrations were evaluated in healthy male volunteers supplemented with 30 mg or 100 mg coenzyme Q10 or placebo as a single daily dose for two months in a randomised, double-blind, placebo-controlled study. Median baseline serum coenzyme Q10 concentration in 99 men was 1.26 mg/l (10%, 90% fractiles: 0.82, 1.83). Baseline serum coenzyme Q10 concentration did not depend on age, while borderline significant positive associations were found for body weight and smoking 1-10 cigarettes/d. Supplementation with 30 mg or 100 mg coenzyme Q10 resulted in median increases in serum coenzyme Q10 concentration of 0.55 mg/l and 1.36 mg/l, respectively, compared with a median decrease of 0.23 mg/l with placebo. The changes in the coenzyme Q10 groups were significantly different from that in the placebo group, and the increase in the 100 mg coenzyme Q10 group was significantly greater than that in the 30 mg Q10 group. The change in serum coenzyme Q10 concentration in the Q10 groups did not depend on baseline serum coenzyme Q10 concentration, age, or body weight.

Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction.
Singh RB,. Mol Cell Biochem. 2003 Apr;246(1-2):75-82.
Medical Hospital and Research Centre, Moradabad, India
In a randomized, double-blind, controlled trial, the effects of oral treatment with coenzyme Q10 (CoQ10, 120 mg/day), a bioenergetic and antioxidant cytoprotective agent, were compared for 1 year, on the risk factors of atherosclerosis, in 73 (coenzyme Q10, group A) and 71 (B vitamin group B) patients after acute myocardial infarction (AMI). After 1 year, total cardiac events including non-fatal infarction (13.7 vs. 25.3%, p < 0.05) and cardiac deaths were significantly lower in the intervention group compared to control group. The extent of cardiac disease, elevation in cardiac enzymes, left ventricular enlargement, previous coronary artery disease and elapsed time from symptom onset to infarction at entry to study showed no significant differences between the two groups. Plasma level of vitamin E (32.4 +/- 4.3 vs. 22.1 +/- 3.6 umol/L) and high density lipoprotein cholesterol (1.26 +/- 0.43 vs. 1.12 +/- 0.32 mmol/L) showed significant (p < 0.05) increase whereas thiobarbituric acid reactive substances, malondialdehyde and diene conjugates showed significant reduction respectively in the coenzyme Q10 group compared to control group. Approximately half of the patients in each group (n = 36 vs. 31) were receiving lovastatin (10 mg/day) and both groups had a significant reduction in total and low density lipoprotein cholesterol compared to baseline levels. It is possible that treatment with coenzyme Q10 in patients with recent MI may be beneficial in patients with high risk of atherothrombosis, despite optimal lipid lowering therapy during a follow-up of 1 year. Adverse effect of treatments showed that fatigue was more common in the control group than coenzyme Q10 group.

Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension.
South Med J. 2001 Nov;94(11):1112-7.
Increasing numbers of the adult population are using alternative or complementary health resources in the treatment of chronic medical conditions. Systemic hypertension affects more than 50 million adults and is one of the most common risk factors for cardiovascular morbidity and mortality. This study evaluates the antihypertensive effectiveness of oral coenzyme Q10, an over-the-counter nutritional supplement, in a cohort of 46 men and 37 women with isolated systolic hypertension. We conducted a 12-week randomized, double-blind, placebo-controlled trial with twice daily administration of 60 mg of oral coenzyme Q10 and determination of plasma coenzyme Q10 levels before and after the 12 weeks of treatment. RESULTS: The mean reduction in systolic blood pressure of the coenzyme Q10 -treated group was 17.8 +/- 7.3 mm Hg (mean +/- SEM). None of the patients exhibited orthostatic blood pressure changes. CONCLUSIONS: Our results suggest coenzyme Q10 may be safely offered to hypertensive patients as an alternative treatment option.

Tishcon and Coenzyme Q10
Nutrilearn.com has introduced a new online education module focused on the ingredient coenzyme Q10. “Q-Facts”, developed in collaboration with Tishcon Corp.  "We are pleased to have participated with Nutrilearn.com in the development of the 'Q-Facts' education module. We hope this free service will increase the industry's understanding of coenzyme Q10 and provide a ready source of answers to frequently asked questions," said Raj Chopra, chairman and CEO of Tishcon. This course answers many questions about coenzyme Q10 including its history, the chemical nature, how the body synthesizes coenzyme Q10, production questions, the body’s absorption of coenzyme Q10, clinical conditions and health benefits associated with coenzyme Q10, its bioavailability, good sources of coenzyme Q10, the regulatory status and much more. Upon successful completion of the program, users are issued a Certificate of Proficiency. The program is intended for those involved in sales, marketing and product development in the retail, wholesale and manufacturing sectors.
     About Tishcon Corp. - Tishcon Corp., founded in 1976, has plants in Westbury, NY, and Salisbury, MD. It is a leading manufacturer of dietary supplements and over-the-counter (OTC) pharmaceuticals. Tishcon's flagship products include QGel, Chew Q, Liquid Q, Hydro Q, Gut Buddies, Omega Gel, and Tocospan. It has obtained several orphan drug designations for coenzyme Q10 in the treatment of rare diseases.
     About Nutrilearn and Virgo Publishing. Nutrilearn is an industry-specific professional development and training site offering a variety of informative courses as well as live and on-demand Webinars. Virgo Publishing produces the SupplySide Trade Shows and Conferences, the Focus on the Future Executive Conference and Retreat, and the online training Web site nutrilearn.com; and publishes Natural Products Industry INSIDER, Food Product Design and Natural Products Marketplace magazines.

Coenzyme Q10 Emails
Q. I have been reading through your website.  My interest is in the Coenzyme Q10.  I believe that it has been helpful in healing my gums as I have been diagnosed with periodontal disease.  My gums no longer bleed, and or feel tender to brush which makes for a more effective cleaning.  I believe that Coenzyme Q10 is nothing less than miraculous.  I found relief at 1 30 mg capsule every 12 hours.  This dosage did not affect my ability to sleep.  My menstrual periods were long, tedious and painful.  I no longer experience that difficulty through my cycle.  Thank you for making your info available.

Q. My son William was born on July 31, 2001 with Prader-Willi Syndrome. At the age of 3 months William was still sleeping 20 plus hours a day had no normal wake / sleep pattern when I found information regarding Prader-Willi Syndrome and the benefits of coenzyme q10. I immediately ordered coenzyme q10 and began giving William 90 mg daily he almost immediately responded with a normal wake / sleep pattern. Have you done any research with coenzyme q10 and Prader-Willi Syndrome? I'm very interested in any research information you may have.
     A. We have not evaluated this condition in relation to coenzyme q10, however we will mention it on our website and maybe others with this condition may try it and give us feedback.

Q. Do you take Coenzyme Q10 yourself? And if so, how much?
A. I take Coenzyme Q10 30 mg a couple of days a week. I have so many other herbs and supplements on my kitchen counter that I don't want to over do it and take too much Coenzyme Q10 along with other supplements that I experiment with.

Q. I just wanted to mention that I recently began taking Coenzyme Q10 and noticed that there was a significant change in my health. I've felt so much better physically and mentally. My ability to focus had been lacking in the past year or so but after taking Coenzyme Q10 I've been able to think clearer. My energy levels are higher, and although I've given up eating beef, I'm noticing a difference in my physical self.

Q. Is Coenzyme Q10 helpful in maintaining healthy gums particularly for those who are lax in daily flossing. If so, what dosage is recommended.
A. Although a couple of studies have indicated that Coenzyme Q10 may be helpful in gum disease, the most important way to keep healthy gums is to remove the food particles that are stuck between teeth. This is best accomplished by flossing. You may wish to keep your floss by your bed at night or near your favorite sofa while watching TV before bed and thus have a reminder to floss at night. I personally prefer flossing before brushing.

Q. Does the effectiveness of Coenzyme Q10 matter if it is taken in capsule form or if emulsified in an oil like alpha tocopherol.  I read an advertising leaflet that said not to waste money on Coenzyme Q10 tablets or capsules, because they cannot be absorbed into blood stream.
A. There are probably differences in absorption between different CoQ10 products, and perhaps oil emulsified products are better absorbed, however, most Coenzyme Q10 supplements contain 30, 60 or 100 mg which are dosages far greater than normally needed by the body. Hence, even if 100 percent of the CoQ10 is not absorbed, practically speaking it should not make too much difference.

Burke BE, et al. Randomized, double-blind, placebo-controlled trial of Coenzyme Q10 in isolated systolic hypertension. South Med J 2001 Nov;94(11):1112-7.
Watts GF, et al. Coenzyme Q10 improves endothelial dysfunction of the brachial artery in Type II diabetes mellitus. Diabetologia 2002 Mar;45(3):420-6.

Q. is there anyway you can carry (make) 10mg Coenzyme Q10 ? I'm telling you, the difference between 10mg and even just 30 mg is huge. A ton of benefits on 10mg coenzyme q10, start losing them if I HAVE to take a 30 mg. And the coenzyme q10 doses they are now recommending (100-1,000 mg) are a disaster in the making. I can presently get 10mg CoQ10 from NOW. But I wrote them asking (begging) them not to stop offering the 10mg. Their response? Typical.....they are probably going to discontinue it due to 'all the new research coming out showing HIGH doses are much more effective'. I KNOW this not to be the case for me and I would imagine many many others. Can you start offering a 10mg Coenzyme Q10? And also a 10mg R Lipoic Acid? How about a 1-2 mg DHEA ? :-) Those are the doses I take and they are soooooo good for me. Whereas the higher doses cause me such major problems I just can't/wont take them anymore. Thank you. Love your understanding of low dose supplements.

Q.  Read your article about the side effects of Coenzyme q10 . I am a 40 year old female. I have been taking coenzyme q10  30mg for the last one yr. Recently I upped the dosage to 50mg. After about a week, I started experiencing insomnia. However I did not relate it the to intake of Coenzyme 10 till I had already taken the supplement for a month. It has been 10 days since I stopped taking Coenzyme q10. However my symptons have not gone. I am still experiencing insomnia and high energy. Do you know how  long it can take before the effects go away completely ?
     A. This side effect of coenzyme q10 should go away in a few more days. Take long daily walks to use up the excess energy.

Q. I am a nutritionist and I'm writing to tell you something I've discovered about coenzyme Q10 that I have not been able to find anything about anywhere. For 15 years I suffered from very unpleasant muscle aches that came and went and were strong enough to interrupt my sleep. They seemed to be caused by eating food to which I was allergic. At first it was just fermented food and milk. If I avoided allergens I could avoid these really uncomfortable aches. But as time went on I had them all the time. I tested allergic to all but 4 foods. Then last January I had a brain storm. I knew that if you take statin drugs you can get both muscle pain and depletion of coenzyme Q10. It occurred to me that increasing my dose of coenzyme Q10 might get rid of the muscle pain. So I bumped my dose up from 100 to 300 mg. Amazingly enough the first night I had no muscle pain. When I dropped the dose down to 100 mg, the muscle pain came back. When I upped the dose to 400 I did a little better. The interesting thing is that on 300 or 400 mg of coenzyme Q10 I was able to drink red wine and eat all the food to which I was allergic with no noticeable negative effects. I'm wondering what the mechanism might be. Could the coenzyme Q10 have healed my presumably leaky gut?

Q. There are some other M.D.s, wanting to sell "their" coenzymeQ10, by saying that many others are synthetic, or are in a powder form or in capsules, and thus have very limited absorption rates, and offer a gel based formula instead? What is your opinion on these issues?
   A. There is no need to go fancy or expensive with Coenzyme Q10 supplements. They are all very well absorbed when taken with food. Even if there is a few percentage difference between brands, in practical terms this makes little or no difference. Most people are taking too high doses of Coenzyme q10, anyway so a little less absorption could be a better option. Most people don't need to take more than 30 mg a day and if they are taking a 50 or 100 mg coenzyme q10 capsule or softgel, what difference does it make if there are minor absorption differences?