With nearly 40 years of medical research showing its importance in managing a wide range of serious illnesses, it’s not surprising that CoQ10 has at times been described as “The Miracle Vitamin” and “The New Fountain of Youth.”
Coenzyme Q10 (CoQ10) is a vitamin-like nutrient that is present in virtually every cell of the body and is an essential component of each cell’s ability to produce energy. It is also a powerful antioxidant – a chemical that “mops up” potentially harmful substances.
In order to understand how CoQ10 works, it is first necessary to understand mitochondria. Imagine that each cell in your body is a car. Mitochondria are the engines – or energy producers – in each cell that make your “car” run. It is the job of the mitochondria to supply this energy in the form of adenosine triphosphate (ATP). This is where CoQ10 comes in. To continue the car analogy, it is the oil that enables the engine to work.
CoQ10 is the catalyst that makes it possible for the mitochondria to produce ATP, the molecule upon which all cellular functions in the body depend.
The Implications of CoQ10 Deficiency
Because CoQ10 is so essential to the proper functioning of every cell in the body, it’s not surprising that researchers have found a deficiency of CoQ10 may be linked to a number of diverse diseases. A few of the illnesses in which low levels of CoQ10 may be implicated include:
- Heart Disease
- Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS)
- Lyme Disease
- Parkinson’s Disease
Small amounts of CoQ10 can be found in foods, primarily meat and fish. The highest amounts are found in organ meats (heart, liver, kidneys) as well as beef, soy oil, sardines, mackerel and peanuts. CoQ10 is also synthesized in bodily tissues. In healthy individuals, the combination of dietary intake and biosynthesis work to maintain normal CoQ10 levels.
Why then do so many people seem to be deficient in CoQ10?
No one knows for sure. There are likely multiple causes. Perhaps the emphasis in recent years on eating less red meat as well as generally poor eating habits have contributed to reducing our dietary intake of CoQ10. And a number of other factors, such as environmental toxins, chronic diseases and some prescription medications may contribute to the impairment of the body’s ability to synthesize CoQ10.
For example, research has shown that the cholesterol-lowering drugs known as “statins” (Lipitor, Zocor, etc.) not only lower cholesterol, but also inhibit the biosynthesis of CoQ10 by as much as 40 percent.(1)
Anyone taking medication to lower cholesterol should seriously consider also taking CoQ10 supplements.
Other types of medications thought to deplete the body of CoQ10 include beta-blockers, diuretics, tricyclic antidepressants, and diabetes medications such as metformin, tolazamide and glyburide.
CoQ10 and the Heart
Due to their high energy requirements, the heart and liver contain the most mitochondria per cell and consequently need a very high concentration of CoQ10 in order to function properly. Because of this, much of CoQ10 research has concentrated on heart disease. Researcher Peter H. Langsjoen, MD, FACC, reviewed numerous studies and scientific papers related to the management of heart disease with CoQ10 and found their conclusions to be remarkably consistent: “that treatment with CoQ10 significantly improved heart muscle function while producing no adverse effects or drug interactions.”(2)
Particularly interesting have been the studies showing a strong correlation between very low levels of CoQ10 and congestive heart failure. The severity of the heart failure also correlated with the severity of the CoQ10 deficiency.(3) In general, the sooner patients were given CoQ10 after onset of congestive heart failure, the more dramatic their improvement.
Cardiomyopathy (inflammation/weakening of the heart muscle) is another form of heart disease shown to benefit from CoQ10 supplementation. In a six-year clinical study, 85 percent of cardiomyopathy patients supplemented with CoQ10 in addition to their conventional treatments improved by one or two NYHA classes (New York Heart Association’s functional classification for the four stages of heart failure).(4)
CoQ10 also appears to be beneficial in the management of hypertension (high blood pressure). In one study of 109 patients, 51 percent were able to stop taking between one and three antihypertensive medications an average of 4.4 months after starting CoQ10 supplementation.(5)
The Importance of CoQ10 for ME/CFS Patients
When plasma CoQ10 was analyzed in 58 ME/CFS patients and 22 normal controls, researchers found that CoQ10 levels were significantly lower in the ME/CFS patients than in the normal controls.(6) This finding has far greater implications than the obvious lack of energy experienced by people with ME/CFS. Because CoQ10 is essential to every cell in the body, a severe CoQ10 deficiency can cause mitochondrial dysfunction, which in turn has a serious negative impact on multiple organs and body systems and can ultimately result in heart failure.
In fact, that is exactly what happens, according to Dr. Sarah Myhill, MD, a UK-based ME/CFS researcher and clinician. In her recent paper, “Chronic Fatigue Syndrome and Mitochondrial Dysfunction,” she makes her case that ME/CFS is actually a symptom of mitochondrial failure.(7) Dr. Myhill recommends that ME/CFS patients have their CoQ10 levels checked and begin taking CoQ10 supplements if they are low. She also notes that CoQ10 will work best in conjunction with acetyl L-carnitine, magnesium, D-ribose and Vitamin B3 (niacinamide).(8)
CoQ10’s Role in Other Illnesses
Because a deficiency of CoQ10 can potentially affect every cell in the body, more and more research is being done to determine how much of a role it may play in other illnesses. Animal and/or preliminary human studies have been conducted to uncover how CoQ10 may work in managing a number of diseases including: melanoma, Parkinson’s disease, Huntington’s disease, Alzheimer’s, and migraines.(9-13) All have had promising results indicating that CoQ10 may be helpful in supporting the prevention or treatment of those diseases.
Many Lyme disease experts include CoQ10 in their treatment protocols because it can protect the brain and nervous system, improve cellular function and boost energy. WARNING: Do not use while taking the anti-Babesia drug atovaquone (Mepron, Malarone) because CoQ10 interferes with the action of the medication.
How Much CoQ10 is Needed?
The dosage of CoQ10 used for cardiac patients varies from 200 to 600 mg daily. For ME/CFS, Dr. Myhill recommends from 100 to 400 mg daily, depending on how low CoQ10 blood levels are. There is little danger of taking too much. In one study, CoQ10 was safe and well tolerated in ALS patients who were supplemented with dosages as high as 3,000 mg per day for eight months.(14) The total daily dosage should be divided and taken in 2 to 4 doses throughout the day.
It is virtually impossible to adequately supplement CoQ10 from dietary sources. To put it into perspective, it would take one pound of sardines, two pounds of beef, or two and one half pounds of peanuts to provide 30 mg of CoQ10. Since anyone who is low in CoQ10 needs much more than 30 mg per day, CoQ10 supplements are the best solution.
How to Take CoQ10
CoQ10 is fat soluble, and ideally should be taken with a fatty or oily meal. It could also be taken with a single high-fat food, like an avocado, or even with a teaspoon of olive oil. Another good option would be to take a CoQ10-Vitamin E combo supplement. Not only are both good antioxidants that fight free radical damage, but vitamin E is an oil, which increases the absorption of the CoQ10 – and you don’t have to worry about taking it with a fatty meal.
1. Ghirlanda, et al., Evidence of plasma CoQ10-lowering effect of HMG-COA reductase inhibitors: a double-blind, placebo-controlled study. Journal of Clinical Pharmacology. 1993 Mar; 33(3):226-229.
2. Jangsjoen, P.H. (1994). Introduction to coenzyme q10. http://faculty.washington.edu/~ely/coenzq10.html
3. Folkers K., Vadhanavikit S., Mortensen S.A. Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with coenzyme Q10. Proc. Natl. Acad. Sci., U.S.A., 1985; 82(3):901-904. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC397155/
4. Langsjoen P. H., Langsjoen P. H., Folkers K. A six-year clinical study of therapy of cardiomyopathy with coenzyme Q10. Int J Tissue React. 1990; 12(3): 169-171. http://www.ncbi.nlm.nih.gov/pubmed/2276895
5. Langsjoen P. H., Langsjoen P. H., Willis R., Folkers K. Treatment of essential hypertension with coenzyme Q10. Molecular Aspects of Medicine. 1994; 15:S265-72. http://www.ncbi.nlm.nih.gov/pubmed/7752851
6. Maes M, et al. Coenzyme Q10 deficiency in myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardi… Neuroendocrinology Letters. 2009;30(4).
7. Myhill S., Booth NE, McLaren-Howard J. Chronic fatigue syndrome and mitochondrial dysfunction. Int J Clin Exp Med. 2009; 2(1): 1–16. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680051/
8. Myhill S. (Oct. 2008) Co-enzyme Q10 in Chronic Fatigue Syndrome. http://www.drmyhill.co.uk/article.cfm?id=428
10. Rusciani L, et al. Recombinant interferon alpha-2b and coenzyme Q10 as a postsurgical adjuvant therapy for melanoma: a 3-year trial with recombinant interferon-alpha and 5-year follow-up. Melanoma Res. 2007 Jun;17(3):177-83. http://www.ncbi.nlm.nih.gov/pubmed/16443053
11. Yang L, et al. Combination therapy with coenzyme Q10 and creatine produces additive neuroprotective effects in models of Parkinson’s and Huntington’s diseases. J Neurochem. 2009 Jun;109(5):1427-39. http://www.ncbi.nlm.nih.gov/pubmed/19476553
12. Yang X, et al. Coenzyme Q10 Reduces beta-Amyloid Plaque in an APP/PS1 Transgenic Mouse Model of Alzheimer’s Disease. J Mol Neurosci. 2009 Oct 16. http://www.ncbi.nlm.nih.gov/pubmed/19834824
13. Sandor PS, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology 2005;64:713-715. http://www.ncbi.nlm.nih.gov/pubmed/15728298
14. Ferrante. KL, et al. Tolerance of high-dose (3,000 mg/day) coenzyme Q10 in ALS; Neurology 2005 Dec 13;65(11):1834-6.
* Karen Lee Richards is Lead Expert specializing in Fibromyalgia and ME/CFS, for HealthCentral’s ChronicPainConnection (www.chronicpainconnection.com). Karen is co-founder of the National Fibromyalgia Association (NFA) and was Executive Editor of Fibromyalgia AWARE magazine for four years.
Note: This information has not been evaluated by the FDA. It is general and is not meant to prevent, diagnose, treat or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.