CoQ10 supplement benefit and side effects - Review of research information for heart disease, blood pressure, skin and antioxidant, use with statin drugs such as Lipitor and Zocor, by Ray Sahelian, M.D. Available in various dosages including 30 mg, 50, 60 and 100 mg. Use higher dosages, such as 200 mg and 300 mg carefully.
CoQ10 is a naturally
occurring nutrient found in each cell of the body. This nutrient was first
identified by University of Wisconsin researchers in 1957. It 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, CoQ10 is also believed to have antioxidant
properties and may play a role in heart health. Many who
take this supplement notice that this nutrient enhances physical energy. For
long term use I suggest no more than 30 mg or 50 mg a few days a week in those
who are taking it for general health purposes.
Benefit and medical uses
Studies with CoQ10 have mostly focused on its benefit involving certain
types of cardiovascular diseases, including congestive heart failure and
hypertension. However, this nutrient has also been evaluated for high
cholesterol and in diabetes. Patients with high cholesterol levels who are
placed on statin drugs such as Lipitor and Zocor should take additional CoQ10 in
the amount of 10 to 50 mg daily, or a few times a week, to counteract the muscle
damage from statin drugs (consult with your doctor). Studies in relation
to Parkinson's disease treatment have not
yielded consistent results. We still have a long way to go to determine the
proper clinical role and benefit of this nutrient.
Buy
CoQ10 30 mg, 50 mg, 60 mg, and 100 mg
30 mg, 60
capsules
50 mg, 60 capsules

60 mg, 60 capsules
100mg, 60 capsules
Click here to buy a CoQ10 supplement product, Mind Power Rx brain
enhancing formula, Eyesight Rx vision enhancer, MultiVit Rx for more energy, or Passion Rx sexual enhancer
for a man and woman
Subscribe to a
FREE
Supplement
Research Update newsletter. Twice a month you will receive an email with
a review of several studies on various supplements and natural medicine topics. We often discuss research
updates on benefit and side effects of CoQ10 and review the latest natural
treatment developments in heart disease, diabetes, high blood pressure, high
cholesterol, use with cholesterol lowering drugs, and various other medical ailments.
High Quality products formulated by a
medical doctor


Mind Power Rx for better
mental focus, concentration, and mood; Diet Rx which helps you eat less. It really does curb appetite; Eyesight
Rx for better vision, within hours or days; MultiVit
Rx a daily comprehensive multivitamin for more energy and
vitality; Joint Power Rx
with chondroitin, msms, cmo and glucosamine
for healthy joints; Prostate Power Rx
for a healthy prostate gland; and Passion Rx
with tribulus and mucuna pruriens
for sexual enhancement, better libido, and stamina in men and women.
Food sources and daily intake
Meat, fish, nuts, and some oils are the richest nutritional sources, while much
lower levels can be found in most dairy products, vegetables, fruits, and
cereals. Large variations of CoQ10 content in some foods and food products of
different geographical origin have been found. The average dietary intake is
only 3-6 mg a day. Crit Rev Food Science Nutrition, April 2010.
Dosage
for short term use and long term use
CoQ10 is available in a variety of dosages ranging from 10 mg to 300 mg
per capsule. I personally believe that high doses are not needed, and may
even be unhelpful or detrimental. Just as we recently discovered that high doses of
vitamin E, generally over 200 or 400 units, are not beneficial, or even potentially harmful, we may eventually
discover the same about CoQ10. I would not feel comfortable recommending to my
patients to take more than 50 mg, or maximum 100 mg, a day, for long term use unless as a
necessary treatment of a medical condition. For short term use one can take up
to 300 mg a day for a few days.
Benefit and studies
What's your opinion on the use of CoQ10 for cancer treatment or prevention?
I'm not convinced yet that it is an effective
cancer treatment but I'm keeping an open mind for additional research to be
published.
Cataract formation: One lab study found incubation of lenses with this nutrient reduced oxidative damage. Whether benefits could be achieved through oral supplementation remains to be seen.
Cholesterol level: Individuals on cholesterol medicines of the statin class such as
Lipitor and others, may consider taking CoQ10 supplements since statins decrease
blood CoQ10 levels.
Diabetes and high blood sugar:
CoQ 10 may be of slight benefit in diabetics. It helps improve the function of
endothelial cells lining blood vessels and may slightly help with blood sugar
control.
Fatigue and energy levels: Use of this supplement can
reduce fatigue and improve energy levels. However, if too much is taken, the
opposite effect could occur.
Heart attacks and heart disease: In a small trial of patients with recent
myocardial infarction, CoQ10 -- 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 used in the
study was 60 mg twice daily.
Heart failure: One study in patients with heart
failure showed significant
improvement in functional status, clinical symptoms, and quality of life in end
stage heart failure patients.
Hypertension: CoQ10 may help lower blood pressure by a small amount in some
people.
Pre-eclampsia: Supplementation reduces the risk of developing pre-eclampsia in women at risk for the condition.
Coenzyme Q10 supplementation during pregnancy reduces
the risk of pre-eclampsia.
Int J Gynaecol Obstet. 2009 Apr; Teran E, Hernandez I, Nieto B, Tavara
R, Ocampo JE, Calle A. Experimental Pharmacology and Cellular Metabolism Unit,
Biomedical Center, Central University of Ecuador, Quito, Ecuador.
Women at increased risk of pre-eclampsia were enrolled in a randomized,
double-blind, placebo-controlled trial. Women were assigned to receive 200 mg of
CoQ10 or placebo daily from 20 weeks of pregnancy until delivery. The primary
outcome was rate of pre-eclampsia. Statistical analyses were by
intention-to-treat. Of the 235 women enrolled in the trial, 118 were randomized
to receive CoQ10 and 117 received a placebo. A total of 197 (83%) women were
followed-up. The overall rate of pre-eclampsia was 20%. Thirty women
(25%) in the placebo group developed pre-eclampsia compared with 17 women (14%)
in the CoQ10 group, and this reduction was significant.
CoQ10
reverses muscle damage from statin cholesterol drugs
Those of you who have read my newsletters for the past few years are familiar with
my warnings regarding side effects from statin drug use. I have mentioned before
that statin drugs cause muscle pain and damage, and CoQ10 may be helpful. A
small study published in the May 2007 issue of the American Journal of
Cardiology supports my viewpoint. Statin drugs, such as Lipitor and Zocor,
lower cholesterol levels, but at the same time they interfere with the making of
coenzyme Q10 in the body. Scientists now suspect that CoQ10 deficiency may
partly or fully contribute to the development of muscle damage in those on these
cholesterol lowering drugs.. Dr. Giuseppe Caso and colleagues from Stony Brook
University, Stony Brook, New York gave 100 mg of Coenzyme Q10 for one month to 32
patients using statins. Pain intensity decreased by 40% after a month of CoQ10
treatment whereas patients treated with vitamin E (as placebo) experienced no
change in pain intensity. Sixteen of 18 coenzyme Q10-treated patients
experienced a decrease in pain. Am J Cardiol 2007;99.
Dr. Sahelian’s
experience
The effect from 30 mg is mild, mostly consisting of a slightly
higher energy level. The effects become more noticeable with 50 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 10 to 50 mg of CoQ10 on a long term basis
without medical supervision.
Fatigue
reduction
Antifatigue effect of coenzyme Q10 in mice.
J Med Food. 2010 Feb;13(1):211-5. Department of Women's and Children's
Health, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden.
The aim of this study was to investigate whether coenzyme Q10 has an
antifatigue effect in mice. ICR male mice were orally given CoQ10 in the form of
Bio-Quinone (Pharma Nord, Vejle, Denmark) at doses of 0, 1.5, 15, or 45
mg/kg/day for 4 weeks. Mice were made to perform swimming exercise with loads
attached to their tails, corresponding to approximately 5% of their body
weights, and the total swimming time until exhaustion was measured. Furthermore,
the post-exercise concentration of serum urea nitrogen (SUN), pre-/post-exercise
and post-rest concentration of lactic acid, and pre-exercise hepatic glycogen
were determined. Mice treated with CoQ10 showed a significantly prolonged
exhaustive swim time, increased liver glycogen contents, and decreased SUN
levels compared to control animals. The lactice acid level was not significantly
changed. These results suggest that supplementation improves swimming endurance
and has an antifatigue effect.
Heart failure benefit
CoQ10 may be helpful in heart failure, but more research is needed to find the
ideal dosage range. For the time being I would suggest those with heart failure
not to exceed 30 mg or 50 mg a day.
Coenzyme Q10 and exercise training in chronic heart failure.
Eur Heart J. 2006 Nov;27(22):2675-81. Belardinelli R, et al. Lancisi
Heart Institute, Via Conca, 71 Torrette di Ancona, Italy.
There is evidence that plasma CoQ10 levels decrease in patients with advanced
chronic heart failure (CHF). However, it is not known whether oral CoQ10
supplementation may improve cardiocirculatory efficiency and endothelial
function in patients with CHF. We studied 23 patients in NYHA class II and III
(20 men, three women, mean age 59 years) with stable CHF secondary to ischemic
heart disease [ejection fraction 37%], using a double-blind,
placebo-controlled cross-over design. Patients were assigned to each of the
following treatments: oral CoQ10 100 mg tid, CoQ10 plus supervised exercise
training (ET) (60% of peak VO(2), five times a week), placebo, and placebo plus
ET. Each phase lasted 4 weeks. Both peak VO(2) and endothelium-dependent
dilation of the brachial artery improved significantly after CoQ10 and
after ET as compared with placebo. CoQ10 main effect was: peak VO(2)+9%,
brachial artery dilation
+38%, systolic wall thickening score index (SWTI) -12%; ET produced comparable
effects. Supplementation resulted in a four-fold increase in plasma CoQ10
level, whereas the combination with ET further increased it. No side effects
were reported. Oral CoQ10 improves functional capacity, endothelial
function, and LV contractility in CHF without any side effects. The combination
of CoQ10 and ET resulted in higher plasma CoQ10 levels and more pronounced
effects on all the abovementioned parameters.
Migraine headache
I have read coq10 could possibly be beneficial for migraines in it's different
forms, I read an article that migraines don't necessarily mean pain. They come
in different forms and with different symptoms such as nausea and dizziness. Is
it possible that this nutrient actually works for this? I know many popular
medicines are given for migraines but their side effects are far worse than
beneficial. Is there really hope for these people by taking this nutritional
supplement? I regularly look at your website and love the information on all the
herbs and alternatives. I love educating myself more and I have 100% trust and
respect for your website.
It is possible that a few individuals may benefit from taking
these pills, but there are many factors that influence migraine headaches and
taking this supplement pill alone is not likely to have a major effect.
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 CoQ10 (3 x 100
mg/day) and placebo in 42 migraine patients in a double-blind, randomized,
placebo-controlled trial. CoQ10 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% for placebo and
47% for CoQ10.
How does it 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. CoQ10 exists naturally in our mitochondria and
carries electrons involved in energy metabolism. CoQ10 is essential in the production of
adenosine triphosphate (ATP), the basic energy molecule of each cell.
In the bloodstream, CoQ10 is mainly transported
by lipoproteins such as LDL (low-density lipoprotein) and HDL (high-density lipoprotein).
It is thought that CoQ10 is one of the first antioxidants to be depleted when LDL is
subjected to oxidation. Hence, it 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, CoQ10 is found in high
concentrations in the heart, kidneys, and liver.
Prescription drug interactions
Warfarin - Coumadin blood thinner
The administration of CoQ10 and warfarin does not significantly affect the
anticoagulant effect of warfarin in rats. A Human trial shows Co Q10 and Ginkgo biloba do not influence the clinical
effect of warfarin. Those who take statin drugs may consider taking additional
CoQ10.
I'm an 83 year old retired RPh, I have a pace maker, use Lipitor 80 mg, Coumadin 6 mg daily and 1.000 units of co Q 10 daily. I am maintaining my INR in proper range. Using name brand is warfarin is essential because of the variations in strength in generic brands (changing with every refill). On lower dosages of Co Q 10 I tore a bicep and experienced varying amounts of muscle pain. Although I am on a multi-drug regime for blood pressure control, the Co-Q 10 seems key to my health stability.
Side effects, safety, caution, danger,
risk
High dosages of CoQ10, such as more than 100 or 200 mg, can induce restlessness, insomnia
and fatigue. Long term
side effects of high dose CoQ10 use are not clear at this time.
I usually do not recommend more
than 20 to 60 mg daily on a long term basis without medical supervision or a
good reason to take it.
I have found your web site very helpful. It seems to
provide a very realistic approach to vitamins and supplements. I must be very
sensitive because I had terrible insomnia on daily 30 mg doses of coq10. It was
only through your web site that I finally figured out that correlation.
Most of the time it takes 60 to 100 mg or more to cause the
insomnia side effect, but some people are much more sensitive than others.
I am male, 52 year old from India with mild CHF and
hypertension. This was primarily caused by work related stress (more of the
physical nature, I am an editor and need to type a lot and hear lots of noisy
audio). After several trials of medications, I started feeling better with a
combination of lisinopril and atenolol and an addition of an Ayurvedic compound
the ingredients of which I am not very sure. Soon I started feeling better and
even started exercising on my Bullworker. It so happened that I read about COQ10
in a pharmacy ad here, went through all its articles on the internet and started
taking COQ10 initially 30 mg and then went up to 100 mg. For the first couple of
days I felt better, soon I felt quite sick, by BP seemed to increase, my heart
seemed to pound and my heart rate seemed to increase. Since none of such
side-effects of COQ10 is documented on the internet I continued to take them and
continued to feel sick. Soon I reduced the dosage to only 30 mg. Yesterday
night, since I had already bought the COQ10 100 mg bottle, I took one 100 mg
capsule and again right from today morning I have started feeling sick with
increased hypertension, a feeling of heart pounding etc. Now, I have decided to
stop it. With your wide knowledge on supplements can you please enlighten
me as to why I am going through this paradoxical reaction from COQ10? I am sure
my case will interest you and this could also throw light on a supplement which
seems to be talked about widely as beneficial for heart disease but yet not
approved by US FDA, I presume. I wish to inform you about another anomalous side
reaction i had with this supplement ( I read your article on your site that
COQ10 had a very energising effect on you). On the contrary, any dose of COQ10
above 30 mg makes me extremely drowsy. I wish to add that i am taking this
supplement manufactured by a reputed company here to which very small amounts of
vitamin E, magnesium and l-carnitine are added. Ideally all these supplements
are supposed to be wonderful for the heart.
Different people have different reactions to medications and
supplements, and much depends on dosage and interaction with other medications.
Perhaps 100 mg is too high a dose for you or it is interacting with the
lisinopril and/or atenolol. Some people may do better with a dosage of 10 mg to
30 mg daily or every other day.
Prolonged intake of coenzyme Q10 impairs cognitive
functions in mice.
J Nutr. 2009 Oct; Sumien N, Heinrich KR, Shetty RA, Sohal RS, Forster MJ.
Department of Pharmacology and Neuroscience, Institute for Aging and Alzheimer's
Disease Research, University of North Texas Health Science Center, Fort Worth,
TX 76107, USA.
Coenzyme Q10 is widely consumed as a dietary supplement to enhance bioenergetic capacity and to ameliorate the debilitative effects of the aging
process or certain pathological conditions. Our main purpose in this study was
to determine whether CoQ10 intake does indeed attenuate the age-associated
losses in motor, sensory, and cognitive functions or decrease the rate of
mortality in mice. Mice were fed a control nonpurified diet or that diet
containing 0.68 mg/g (low dosage) or 2.6 mg/g (high dosage) CoQ10, starting at
4 months of age. Amounts of the ubiquinols CoQ(9)H(2) and CoQ(10)H(2) measured in a
parallel study were augmented in the cerebral cortex but not in any other region
of the brain. Intake of the low-CoQ10 diet did not affect age-associated
decrements in muscle strength, balance, coordinated running, or learning / memory,
whereas intake at the higher amount increased spontaneous activity, worsened the
age-related losses in acuity to auditory and shock stimuli, and impaired the
spatial learning / memory of old mice. The Co Q10 diets did not affect
survivorship of mice through 25 mo of age. Our results suggest that prolonged
intake of Co Q10 in low amounts has no discernable impact on cognitive and motor
functions whereas intake at higher amounts exacerbates cognitive and sensory
impairments encountered in old mice.
Has anyone heard of someone taking cqo10 and getting like a indigestion feeling? I had taken 400 mg one day and 200 the next, and then 100mg the next and then felt like gassey in my abdomen.
Recommendations for supplementation,
review, guidelines
CoQ10 is probably beneficial in cardiovascular conditions and this
nutrient will likely be found to play some positive role in cognitive or
neurodegenerative disorders, but more studies are needed. In
the meantime, it would seem appropriate to supplement with this nutrient as part
of a long-term health regimen, particularly for those with cardiovascular
conditions. Long-term therapy with 10 to 60 mg a few days a week seems a reasonable option
for many individuals.
Passion Rx -
Highly-touted
sexual pleasure pills for Men and Women

This natural sexual enhancer provides results that are often seen within
three to five days, but
continue to improve over several days of use. Our feedback
thus far indicates more than 85% user satisfaction.
Passion Rx supports healthy libido and
sexual thoughts, erectile
function, orgasms and
climaxes, energy and
stamina.
After years of research, bestselling author Ray Sahelian,
M.D., author of
Natural Sex Boosters,
has formulated a product that has a positive influence on sex drive, desire, and
performance, along with satisfying erections and orgasms/climaxes. Passion
Rx has a combination of several different
potent herbal extracts, mixed in the right
combination, extract potencies, and dosages to provide all day sexual
support, plus supporting energy and stamina.
The potent herbal extracts include ashwagandha, aspallum purificata,
catuaba, cnidium,
Coleus forskohlii, damiana, horny goat weed, Maca, Mucuna pruriens, Muira puama,
Passion flower, Rehmannia, Rhodiola,
Tongkat-Ali and Tribulus.
CoQ10 liquid, any benefit over
the oral pills?
Is CoQ10 available in liquid form? Does it offer any additional benefit in
liquid as opposed to capsules or softgels?
Yes, some companies do sell CoQ10 in liquid form. I don't see
any reason to take CoQ10 liquid unless a person has difficulty swallowing pills.
Plus, the liquid form is more expensive and could be less stable in terms of
storage.
Influence on skin health and
absorption
The advantages of a novel CoQ10 delivery system in skin photo-protection.
Int J Pharm. 2010 March. Yue Y, Zhou H, Liu G, Li Y, Yan Z, Duan M.
State Key Lab Biomembrane & Membrane Biotechnology, School of Life Sciences,
Tsinghua University, Beijing 100084, China.
Coenzyme Q10 has been reported as a powerful antioxidant in plasma.
However, CoQ10 was barely satisfactory in topical drug delivery because of its
lipid solubility. To improve the anti-oxidative efficiency of CoQ10 in skin
photo-ageing, the present research prepared a novel CoQ10 nano-structured lipid
carrier (CoQ10-NLC) and characterised it by size and freeze-fracture
transmission electron microscopy (FF-TEM). In UVA-irradiated fibroblasts, the
protection of CoQ10-NLC was more effective than the CoQ10-emulsion as
demonstrated by cell viability and morphological changes of the cell body and
nucleus. In addition, malondialdehyde (MDA, the product of lipid peroxidation)
concentration decreased by 61% in the group treated with CoQ10-NLC compared to
the group subjected to general CoQ10-emulsion. In the presence of CoQ10-NLC, the
activities of the anti-oxidative enzymes superoxide dismutase (SOD) and
glutathione peroxidase (GSH-px) were reinstated to 81% and 75%, respectively, of
the control group. In vivo, the CoQ10-NLC displayed a stronger capability to
penetrate the stratum corneum and permeate the dermis after a topical skin
application. These results reveal that CoQ10-NLC has greater antioxidant
properties and topical skin penetration than the CoQ10-emulsion.
Research studies and published clinical trials
Co-supplementation with vitamin E and coenzyme Q10 reduces circulating markers of
inflammation in baboons.
Am J Clin Nutr. 2004 September5.
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
Q(10) (CoQ10) supplementation. We used a longitudinal design by subjecting 21
baboons 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 CoQ10 (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 CoQ10
significantly altered the serum concentrations of P-selectin or von Willebrand
factor. Dietary supplementation with vitamin E alone reduces the
baseline inflammatory status that is indicated by the CRP concentration in
healthy adult baboons. Cosupplementation with CoQ10, however, significantly
enhances this antiinflammatory effect of vitamin E.
Pilot trial of high dosages of CoQ10 in patients with Parkinson's
disease.
Exp Neurol. 2004 Aug;188(2):491-4.
The safety and tolerability of high dosages of coenzyme Q10 were studied in 17
patients with Parkinson's disease (PD) in an open label study. The subjects
received an escalating dosage of coQ10 -- 1200, 1800, 2400, and 3000 mg per day
with a stable dosage of vitamin E (alpha-tocopherol) 1200 IU/day. The plasma
level of coQ10 was measured at each dosage. Thirteen of the subjects
achieved the maximal dosage, and adverse events were typically considered to be
unrelated to coQ10. The plasma level reached a plateau at the 2400 mg/day
dosage and did not increase further at the 3000 mg/day dosage. Our data suggest
that in future studies of CoQ10 in Parkinson's disease, a dosage of 2400 mg/day (with
vitamin E/alpha-tocopherol 1200 IU per day) is an appropriate highest dosage to be
studied.
Co-supplementation with vitamin E and
CoQ10 reduces circulating markers of inflammation in baboons
American Journal of Clinical Nutrition, Vol. 80, No. 3, 649-655, September 2004
Background: Inflammation and oxidative stress are processes
that mark early metabolic abnormalities in vascular diseases. Objectives:
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 (CoQ10) supplementation. Design: We used a longitudinal
design by subjecting 21 baboons (Papio hamadryas) to sequential dietary
challenges. Results: 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 from 0.9 to
0.4 mg/dL. Additional supplementation with CoQ10 (2 gram /kg diet) further
reduced serum CRP to 30% of baseline (0.28 ± 0.03 mg/dL; compared with the HFHC diet). Introduction of the HFHC diet itself significantly
decr eased serum P-selectin and von Willebrand factor (from 187 to 161%) concentrations. However, neither vitamin E alone nor vitamin E plus CoQ10
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 CoQ10, however, significantly
enhances this antiinflammatory effect of vitamin E.
Atorvastatin decreases the CoQ10 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 Q(10) (CoQ10)
deficiency because inhibition of cholesterol biosynthesis also inhibits the
synthesis of CoQ10. To measure CoQ10 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 CoQ10. Stroke
center at an academic tertiary care hospital. We examined a cohort of 34
subjects eligible for statin treatment according to National Cholesterol
Education Program: Adult Treatment Panel III criteria. The mean
blood concentration of CoQ10 was 1.26 micro g/mL at baseline, and
decreased to 0.62 micro g/mL after 30 days of atorvastatin therapy. A
significant decrease was already detectable after 14 days of treatment.
Even brief exposure to atorvastatin causes a marked decrease in
blood CoQ10 concentration. Widespread inhibition of CoQ10 synthesis could
explain the most commonly reported adverse effects of statins, especially
exercise intolerance, myalgia, and myoglobinuria.
Parkinson's Disease:
A small but promising study found
that coenzyme CoQ10 may help stop the nerve cell death that characterizes
Parkinson's. disease. The study involved just 80 people. Half ate maple-nut flavored
wafers containing various CoQ10 doses, half took a placebo for up to 16 months. By the
study's end, the 23 patients on the highest daily doses had 44 percent less decline in
mental function, movement and ability to perform daily living tasks than the placebo
group. Research has suggested that energy-supplying structures inside cells called
mitochondria may be impaired in Parkinson's disease. Patients studied had early-stage Parkinson's
and took a placebo or CoQ10 in doses of 300 milligrams, 600 mgs or 1,200 mgs daily. Their
symptoms were evaluated for up to 16 months. By the eighth month, the 23 patients on the
highest dose showed significantly less impairment than the others. Side effects, including
back pain, headaches and dizziness, were mostly mild.
Dr. Sahelian comments: I'm surprised these patients could tolerate these very high doses
of CoQ10. I have had feedback from those using high doses of CoQ10 that, in some people,
there is excessive stimulant-like effect and high levels of alertness that may cause
insomnia.
CoQ10 in patients with end-stage heart failure awaiting cardiac
transplantation: a randomized, placebo-controlled study.
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.
The purpose of the present double-blind, placebo-controlled,
randomized study was to assess the effect of CoQ10 on patients with end-stage
heart failure and to determine if CoQ10 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--CoQ10
(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.
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 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. The administration of CoQ10 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 coQ10 for two months in a randomized
controlled study.
Biofactors. 2003;18(1-4):185-93.
Serum CoQ10 concentrations were evaluated in healthy male volunteers
supplemented with 30 mg or 100 mg CoQ10 or placebo as a single daily dose for
two months in a randomized, double-blind, placebo-controlled study. Median
baseline serum CoQ10 concentration in 99 men was 1.2 mg/l. Baseline serum
CoQ10 concentration did not depend on age,
while borderline significant positive associations were found for body weight
and smoking 1-10 cigarettes / day. Supplementation with 30 mg or 100 mg CoQ10 resulted
in median increases in serum CoQ10 concentration of 0.55 mg/l and 1.3 mg/l,
respectively, compared with a median decrease of 0.2 mg/l with placebo. The
changes in the CoQ10 groups were significantly different from that in the placebo
group, and the increase in the 100 mg CoQ10 group was significantly greater than
that in the 30 mg CoQ10 group. The change in serum CoQ10 concentration in the CoQ10 groups did not depend on baseline serum
CoQ10 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.
In a randomized, double-blind, controlled trial, the effects of oral treatment
with CoQ10, 120 mg/day, a bioenergetic and antioxidant
cytoprotective agent, were compared for 1 year, on the risk factors of
atherosclerosis, in 73 (CoQ10, group A) and 71 (B vitamin group B) patients
after acute myocardial infarction (AMI). After 1 year, total cardiac events
(24 vs. 45%) including non-fatal infarction 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 and high density lipoprotein
cholesterol showed significant increase whereas thiobarbituric acid
reactive substances, malondialdehyde and diene conjugates showed significant reduction respectively in the CoQ10 group
compared to control group. Approximately half of the patients in each group 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 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 CoQ10 group.
Open label trial of coenzyme Q10 as a migraine preventive.
Cephalalgia. 2002 Mar;22(2):137-41.
The objective was to assess the efficacy of CoQ10 as a preventive treatment
for migraine headaches. Thirty-two patients (26 women, 6 men) with a history of
episodic migraine with or without aura were treated with coenzyme Q10 at a dose
of 150 mg per day. Thirty-one of 32 patients completed the study; 61% of
patients had a greater than 50% reduction in number of days with migraine
headache. The average number of days with migraine during the baseline period
was 7.3 and this decreased to 2.9 after 3 months of therapy, which was a
statistically significant response. Mean reduction in migraine frequency after 1
month of treatment was 13% and this increased to 55% by the end of 3 months.
Mean migraine attack frequency was 4.8 during the baseline period and this
decreased to 2.8 attacks by the end of the study period, which was a
statistically significant response. There were no side-effects noted
with CoQ10. From this open label investigation CoQ10 appears to be a good
migraine preventive. Placebo-controlled trials are now necessary to determine
the true efficacy of CoQ10 in migraine prevention.
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 3 month randomized, double-blind,
placebo-controlled trial with twice daily administration of 60 mg of oral CoQ10
and determination of plasma CoQ10 levels before and after the
treatment. The mean reduction in systolic blood pressure of the
CoQ10-treated group was 17 mm Hg. None of the patients
exhibited orthostatic blood pressure changes. Our results suggest
supplementation may be safely offered to hypertensive patients as an alternative treatment
option.
CoQ10 supplement emails
Q. I read your site because I was
doing some research on coq10, and it struck me as ironic. My doctor told me to
take 100mg of it every day, and I am feeling worse than ever: tired, no get up
and go, difficulty concentrating, waking up more tied than when I got to bed,
falling asleep during the day, you name it. I feel as if I had aged 10 years in
a month. Ever seen a case like that?
A. Everyone responds differently to supplements. The
dose of a supplement can make a huge difference. As to CoQ10, too high a dose
can cause insomnia or shallow sleep resulting in tiredness the next day. I
personally do not take more than 30 or 60 mg.
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 coq10. I
immediately ordered coq10 and began giving William 90 mg daily he almost
immediately responded with a normal wake / sleep pattern. Have you done any
research with coq10 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
coq10, however we will mention it on our website and maybe others with this
condition may try it and give us feedback.
Q. I've read of a study done that
was published in the journal Cephalgia regarding the use of Coq10 in reducing
the frequency of migraines. I'm not sure if this news is available on your site
yet. On your page you mention that higher doses of 100-300 mg
are poorly absorbed. In light of the study that used such doses, do you still
feel higher doses not to be as beneficial? Seeing that CoQ10 is synthesized in
most human tissue, do you feel a similarly equal response would be gained from
making certain that protein intake, especially that from a good source of
tyrosine & phenylalanine, & of vitamin B6 is maintained?
A. We've added the study you mention (see above). At
this point I would like to see one or two more studies with CoQ10 and headache
before recommending this nutrient for the purpose of headache prevention. I
don't see where on this page mentioning that CoQ10 is poorly absorbed in high
doses. I'm not yet convinced that people need to take more than 60 mg on a long
term basis. Based on my knowledge of biochemistry, I don't think the amino acids
and Viamint B6 would have much of an influence on CoQ10 levels.
Q. Dr. Sahelian, do you take CoQ10 yourself? And if
so, how much?
A. I take 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 of this nutrient along with other supplements that I experiment with.
Q. I just wanted to mention that I recently began taking COQ10 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 CoQ10 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 CoQ10 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
it 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 Co 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 CoQ10 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 CoQ10 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.
Q.
I’ve read conflicting articles regarding the amount of CoQ10 absorbed from the
intestines depending on its form. Can you tell me if there’s a difference
between different product?
A. Studies of the effectiveness of coenzyme Q10 (CoQ10) have been
confusing due to the variable bioavailability of numerous CoQ10 preparations.
Researchers at the Alfred Hospital and Baker Medical Research Institute, in
Melbourne, Australia evaluated two different preparations of CoQ10: a soybean
oil-based preparation and a complex micelle emulsion. Twelve healthy individuals
received 300 mg CoQ10 daily of either preparation for 7 days in a double-blind
cross-over design. Blood samples to determine serum levels of CoQ10 and lipids
were taken at baseline, after 24 h and after 7 days. Both preparations induced
significant increases in serum CoQ10 levels at 24 h and 7 days and there was
were no differences between CoQ10 levels for the two preparations at either time
point.
Since most people take a large dose
of coQ10, such as 60 or 100 mg, even if one preparation were not absorbed as
well, there should still be plenty of CoQ10 to be helpful.
Q.
I am 32 years old with a 10 month old daughter. My
menstrual period returned about a month after her birth and has remained on a
regular 28 day cycle. I started to take CoQ10 about a month ago ( CoQ10 120 mg
a day) after reading articles about its role in possibly preventing migraine
headaches. (Tests have given migraine sufferers CoQ10 between 125mg to 250mg per
day). I haven’t had a migraine since taking the CoQ10,
however I have missed my period this month. I am currently 15 days late and
have had a negative pregnancy test today. I am wondering if the CoQ10 could have
affected my cycle in anyway or is it just a coincidence that I am late after
taking the tablets for just a month? I’ve been
looking for a list of CoQ10 side effects but haven’t really come across
anything. Are you aware of anything like this happening?
A. We have not had such reports regarding CoQ10 and menstrual changes but we
still know very little about high dose nutrient interactions within the body.
Article Submitted to a Health
and Wellness magazine
Many of my patients who take CoQ10 notice an increase in energy. But some are under the misconception that the more CoQ10 they take, the healthier they will be. Perhaps you have already heard of it being touted for heart health, vitality, and other benefits. But before you take this interesting nutrient as a supplement, learning some simple facts could help you make a more informed decision.
What is it?
CoQ10 – short for Coenzyme Q10 -- is a naturally occurring nutrient and
antioxidant found in each cell of the body. CoQ10 was first identified by
University of
Wisconsin researchers in 1957. CoQ10 has been gradually becoming more popular in
the past decade.
How does it 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 produce this energy are called mitochondria. CoQ10 exists naturally in our mitochondria and carries electrons involved in energy metabolism. CoQ10 is essential in the production of adenosine triphosphate (ATP), the basic energy molecule of each cell. Other mechanisms of action may include stabilization of calcium dependent slow channels and alteration of prostaglandin metabolism.
What Foods Contain this natural substance?
CoQ10 is found in foods, particularly in
fish and meats, and small amounts are found in nuts. There is little or no CoQ10
in grains, vegetables or fruits. Hence, some vegetarians may not get adequate
amounts of this nutrient, although, fortunately, the body is able to synthesize
CoQ10 when dietary sources are not adequate. Dietary intake of CoQ10 is about 2
to 5 mg per day.
Benefit
Studies with CoQ10 have mostly focused on its benefit involving certain types of cardiovascular diseases, including congestive heart failure and hypertension and to a certain extent for high cholesterol and in diabetes. Not all the results have been positive and much more research is needed before we determine the full benefits, side effects, and appropriate dosage.
Dosage
CoQ10 is available in a variety of dosages
ranging from 10 mg to 300 mg per capsule, but most commonly in 30, 50, and 60
mg. I personally believe that high doses are not needed, and may even be
unhelpful or detrimental. I’ve had patients who have reported fatigue when
taking dosages above 100 mg. Just as we recently discovered that high doses of
vitamin E, generally over 400 units, are not beneficial, or even potentially
harmful, we may eventually discover the same about CoQ10. I would not feel
comfortable recommending to my patients to take more than 50 mg or maximum 100
mg of CoQ10 a day, unless for the temporary treatment of a medical condition.
CoQ10 is best taken in the morning, before or with breakfast.
Questions on research, side effects,
benefit and the right dosage
Q.
Is Coq10 a vitamin ?
A. Coq10 is not a vitamin but a nutrient. CoQ10 is
naturally made in the body. Technically, a vitamin is a substance that the body
cannot synthesize or cannot synthesize enough to maintain health and
physiological functioning.
Q. Is better libido a CoQ10 benefit ?
A. I don't think this supplement has a benefit of sexual
enhancement, at least the effects, if any, are not easily noticed.
Q. I think I got a side effect from ClQ10. I took 300 mg CoQ10 for a week and I
think I was having trouble sleeping at night.
A. My impression is that high dosage CoQ10 side effect
is shallow sleep but I am not 100 percent sure.
Q. What is the right CoQ10 dosage. I read on some web sites that 300 mg is the
right CoQ10 dosage but you seem to be more cautious and you recommend a lower
C0Q10 dosage.
A. I think people often take too high a dosage of CoQ10
and other supplements. I don't see why most people require more than 50 mg a few
times a week. We just don't know what kind of CoQ10 side effects may occur by
taking several hundred mgs for months and years. More is not necessarily better
when it comes to supplements. Plus, many people who take CoQ10 also take other
supplements and we don't know what kind of interactions would occur with other
herbs, nutrients, and medicines.
Q. I am a medical doctor and have been taking 100mg of
CoQ10 for several years--originally for GI dysmotility ("Hollow Visceral
Neuropathy"), now more for what is hopefully resolving diabetes (iatrogenic). A
knowledgeable supplement representative informed me recently that CoQ10 toxicity
has been noted, but could not provide more information.
A. I have not come across human trials for any length
of time with CoQ10 that have shown any significant toxicity, however, I am quite
cautious when it comes to taking high doses of supplements for prolonged
periods. My personal limit is 50 mg of CoQ10 two or three times a week.
Q. Do you think those taking statins should take CoQ10 ?
A. To be on the safe side, 50 mg CoQ10 can be taken a
few times a week by those on statin drugs.
I buy CoQ10 100 mg and last 2 days took 100 mg in
morning with water, I'm so tired i cannot do anything, complete tired whole
body, i don't know if i should try 50mg instead or just quit using? I'm skipping
today and see what happens.
Some people are quite sensitive to nutrients, in
your case you may only need 30 mg every other day. Too high a dose of
CoQ10 could perhaps lead to fatigue in some people.
I just wanted to share my story with CoQ10. I am a nurse and well acquainted with traditional medicine, but I have been interested and increasingly convinced that alternative "natural" treatment is highly advantageous and overlooked as the better choice. I was diagnosed with breast cancer in February 2008. My younger sister was diagnosed several years ago. Our cancers were IDC and strongly ER and PR positive. Her cancer involved lymph nodes, mine non nodal. She went through chemo and radiation treatments, tried anti-hormonal (but too many adverse side effects). I have just finished radiation and will be encouraged to take Tamoxifen in July 2008. I started using "natural" progesterone cream when my sister was diagnosed after reading Dr John R. Lee's book on progesterone and his comment on his breast cancer patients maintaining remission while using the cream, my sister started at this time as well, I used the cream in hopes of deterring breast cancer and estrogen dominance...she used it to deter a breast cancer recurrence. My sister used many other supplements as well, has taken 100mg CoQ10 and other supplements. When my excisional biopsy Lumpectomy came back positive with unclear margins, I asked my sister about her supplements and she mentioned the CoQ10, so I googled it and found about Dr. Folkers study in Denmark, using CoQ10 390 mg and other supplements. So after OK'ing it with my surgeon that I could take the CoQ10 supplement, I increased daily until I reached a 400 mg dose. MRI with CAD determined no other noticeable breast cancer, so partial mastectomy was schedule for 3 weeks later to get clear margins and sentinel node biopsy. Well I took CoQ10 400mg all the way until the night before surgery. The fairly large resected area came back with only a single 2.5mm cribiform cancer and at least a 5mm clear margin from there, I asked the surgeon for a copy of the path report, because I wanted to know how clear the margins actually were, I was shocked, initially the surgeon told me the first path report the cancer went to the edge of the margins, so to only find a single area on the whole resection made me think the supplement may have helped clear things up, Just as the women in the Denmark study experienced. I was taking the CoQ10 through the first week of radiation, but my sister saw me Mother's day and commented I looked a little "Jaundice", just on my tanned face, the rest of my body was my usual pale creamy white, but I decide to take a break on the CoQ10 400mg and also the turmeric I was trying (it caused indigestion), But I can't prove the CoQ10 supplement had anything to do with it, but you have to wonder.
Hello and thank you for putting up what I consider THE
best supplement site on the web -- I saw a question about lower dose Q10 in your
April 2009 research update and was wondering what you may think doing this my
liquid-form Q10: Opening it up and pouring the 100mg liquid-filled capsule into
a small 1-2 oz. jar of high quality oil, then taking it by sipping the oil as
needed? Will it even absorb properly taking it this way?
It will absorb well, but there is a concern of getting too many
calories from the oil. Another option is to take the 100 mg with breakfast 2 or
3 times a week till the bottle is finished and then purchasing a lower dosage.
Do you consider CoQ10 to be a super antioxidant that
can slow down the aging process?
I have not seen human studies regarding the long term use of
this supplement and its effect on the aging process.
We commenced supplementing by Coq10 when simvastatin has
been prescribed. For better absorption I switched, recently, to use the SUPER
UBIQUINOL (from Life extension) variety. In order to optimize the use I searched
the Internet and came across your fine publication: CoQ10 supplement benefit and
side effects. In the above referenced site, scale of dosages is provided for the
various conditions I understand the recommended dosage is - amongst others -
determined by the ABSORPTION EFFICIENCY. For which variety of CoQ10 is the range
of dosages - in your above mentioned paper - intended?
Too much is being made about absorption of this nutrient and
many companies are selling different varieties of this supplement and making
unjustified promises when simple and cheaper forms are just as good and the
differences in absorption and efficiency are not that different between various
brands. Even if they are slightly different, for practical purposes this makes
hardly any clinical difference. There is no clear evidence that taking a more
expensive CoQ10 version will improve health any more than a standard product.
See a YouTube information video on CoQ10 health benefit