Coenzyme Q10 (CoQ10) is found in every cell in the body and is necessary for the basic functioning of cells. CoQ10 exists inside small organelles of the cell called mitochondria, the powerhouses of the cell, where it is needed to generate energy. A helpful way to recall the function of CoQ10 in the cell is to think about how a spark plug works in an engine. Knowing the role CoQ10 plays in energy production, it is no wonder that the highest concentrations of CoQ10 are where we need the most energy – the heart, immune system, liver and kidneys.
CoQ10 also functions as a powerful antioxidant, which means that it protects cell membranes by defending against damaging compounds called free radicals. Studies have found CoQ10 to be a beneficial nutrient for maintaining strong heart health and function because of its antioxidant function and role in energy production.
In the diet, CoQ10 exists in moderate amounts in meat, poultry and fish and in even smaller amounts in nuts, fruits and vegetables. The body’s primary source of CoQ10 is the supply it produces naturally. That’s right – the human body can naturally make CoQ10.
In the diet, CoQ10 exists in moderate amounts in meat, poultry and fish and in even smaller amounts in nuts, fruits and vegetables. The body’s primary source of CoQ10 is the supply it produces naturally. That’s right – the human body can naturally make CoQ10.
Unfortunately, certain cholesterol-lowering drugs (statins) are known to inhibit the body’s natural production of CoQ10, which is why supplementation is often recommended for statin users to help replenish CoQ10 levels. Additionally, CoQ10 levels are reported to decrease with age and certain health conditions. In these circumstances, supplemental CoQ10 may be advised. Nature Made CoQ10 daily supplements can help maintain and restore optimal CoQ10 levels to support heart health and energy production.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
_______________________________
CoQ10 Benefit and Side Effects by Ray Sahelian, M.D. -
CoQ10 research information
Plus CoQ10 supplement information
CoQ10 is a naturally occurring nutrient found in each cell of the body. CoQ10 was first identified by University of Wisconsin researchers in 1957. CoQ10 -- also spelled CoQ 10 -- 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. Many who take CoQ10 notice that this nutrient enhances physical energy.
CoQ10 Benefit
Studies with CoQ10 have mostly focused on its benefit involving certain types of cardiovascular diseases, including congestive heart failure and hypertension.
However, CoQ10 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 30 to 50 mg daily or a few times a week to counteract the muscle damage from these statin
drugs (consult with your doctor).
Studies with CoQ10 and Parkinson's disease have not yielded consistent results. We still have a long way to go to determine the proper clinical role and benefit of CoQ10.
CoQ10 dosage
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 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 benefit - studies with CoQ10
Diabetes: CoQ10 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.
Heart Attacks: 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 of CoQ10 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 who were placed on CoQ10 (see bottom of page).
Hypertension: CoQ10 may help lower blood pressure by a small amount in some people.
Cholesterol: Individuals on cholesterol medicines of the statin class such as Lipitor and others, may consider taking CoQ10 supplements since statins
decrease blood CoQ10 levels.
CoQ10 reverses muscle damage from statin cholesterol drugs
Those of you who have read my newsletters for the past 3 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 could be helpful. A small study published in the May 15th 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 CoQ10 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;99:1409-1412.
Dr. Sahelian’s experience with CoQ10 The effect from 30 mg of CoQ10 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 20 to 60 mg of CoQ10 on a long term basis without medical supervision.
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CoQ10 and heart failure
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+/-7%], using a double-blind, placebo-controlledcross-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 (EDDBA) improved significantly after CoQ10 and after ET as compared with placebo. CoQ10 main effect was: peak VO(2)+9%, EDDBA +38%, systolic wall thickening score index (SWTI) -12%; ET produced comparable effects. CoQ10 supplementation resulted in a four-fold increase in plasma CoQ10 level, whereas the combination with ET further increased it. No side effects were reported with CoQ10. 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.
How does CoQ10 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, CoQ10 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.
CoQ10 and drug interactions
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.
Side effects of CoQ10
High dosages of CoQ10 can induce restlessness and
insomnia. Long term side effects of high dose CoQ10
use are not clear at this time.
Q. 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.
A. Most of the time it takes 50 to 100 mg of CoQ10
to cause the insomnia side effect, but some people are
much more sensitive than others.
CoQ10 recommendations
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.
CoQ10 Research Update
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 (CoQ10), 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 14.4% for placebo and 47.6%
for CoQ10 (number-needed-to-treat: 3). CoQ10 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 Q(10) (CoQ10)
supplementation.
We used a longitudinal design by subjecting 21 baboons
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. 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.
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.
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/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 PD, a dosage of 2400 mg/day
(with vitamin E/alpha-tocopherol 1200 IU/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 0.91 ± 0.02 to 0.43 ± 0.06 mg/dL. Additional
supplementation with CoQ10 (2 g/kg diet) further
reduced serum CRP to 30% of baseline (0.28 ± 0.03
mg/dL; P = 0.036 compared with the HFHC diet).
Introduction of the HFHC diet itself significantly
decreased serum P-selectin and von Willebrand factor
(from 187.0 ± 10.1 to 161.9 ±
9.0%,P=0.02concentrations. 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.
OBJECTIVE: To measure CoQ10 levels in blood from
hypercholesterolemic subjects before and after
exposure to atorvastatin calcium, 80 mg/d, for 14 and
30 days. DESIGN: Prospective blinded study of the
effects of short-term exposure to atorvastatin on
blood levels of CoQ10.
SETTING: 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.
RESULTS: The mean +/- SD blood concentration of CoQ10
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 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.
HYPOTHESIS: 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.
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 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 1.26 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/d. Supplementation with 30 mg
or 100 mg CoQ10 resulted in median increases in serum
CoQ10 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 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 (24.6 vs. 45.0%, p
< 0.02) 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 (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 CoQ10 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 CoQ10 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 (40.8 vs.
6.8%, p < 0.01) 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; 61.3%
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 7.34 and this decreased to 2.95
after 3 months of therapy, which was a statistically
significant response. Mean reduction in migraine
frequency after 1 month of treatment was 13.1% and
this increased to 55.3% by the end of 3 months. Mean
migraine attack frequency was 4.85 during the baseline
period and this decreased to 2.81 attacks by the end
of the study period, which was a statistically
significant response (P < 0.001). 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 (CoQ10), 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 CoQ10
and determination of plasma CoQ10 levels before and
after the 12 weeks of treatment.
RESULTS: The mean reduction in systolic blood pressure
of the CoQ10-treated group was 17.8 +/- 7.3 mm Hg
(mean +/- SEM). None of the patients exhibited
orthostatic blood pressure changes.
CONCLUSIONS: Our results suggest CoQ10 may be safely
offered to hypertensive patients as an alternative
treatment option.
CoQ10 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
regarding CoQ10, 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 CoQ10 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 CoQ10 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
CoQ10 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.
Burke BE, et al. Randomized, double-blind,
placebo-controlled trial of CoQ10 in isolated systolic
hypertension. South Med J 2001 Nov;94(11):1112-7.
Watts GF, et al. CoQ10 improves endothelial
dysfunction of the brachial artery in Type II diabetes
mellitus. Diabetologia 2002 Mar;45(3):420-6.
Article on CoQ10 Submitted to Today's Health and
Wellness - July 2006
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 CoQ10 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 CoQ10?
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 CoQ10 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 CoQ10?
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.
CoQ10 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.
Diabetes
CoQ10 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 new 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.
Heart Failure
A study in patients with heart failure showed
improvement in functional status, clinical symptoms,
and quality of life in end stage heart failure
patients who were placed on CoQ10.
Hypertension
CoQ10 may help lower blood pressure by a small amount
in some people.
Cholesterol
Individuals on cholesterol medicines of the statin
class such as Lipitor, Zocor, and others, may consider
taking CoQ10 supplements since statins decrease blood
CoQ10 levels. Some doctors are routinely advising
their patients on statin drugs to take small amounts
of CoQ10.
Side Effects of CoQ10
High dosages of CoQ10, such as more than 100 or 200
mg, can induce restlessness, fatigue and insomnia.
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 of CoQ10 daily on a long term basis
without medical supervision.
CoQ10 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.
CoQ10 Summary
CoQ10 is probably beneficial in certain cardiovascular
conditions and as an energy booster. Long-term therapy
with 10 to 60 mg a few days a week seems a reasonable
option for many individuals. Fortunately, the pace of
CoQ10 research has increased over the past decade and
the next few years will provide us with additional
information on the best way to take advantage of this
wonderful nutrient.
Questions on CoQ10 research, coq10 side effects,
coq10, benefit coq10 and the right CoQ10 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 CoQ10 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.
Q. What's your opinion on the use of CoQ10 for cancer
treatment or prevention?
A. I'm not convinced yet that CoQ10 is an
effective cancer treatment but I'm keeping an open
mind for additional research to be published.
Q. 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
skiping today and see what happens.
A. Some people are quite sensitive to nutrients,
in your case you may only need coq10 30 mg every other
day. Too high a dose of CoQ10 could perhaps lead to
fatigue in some people.
Q. 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 CoQ10 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.
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