Does CoQ10 Deserve a Spot on Your Longevity Plan?

By Dr Frank Yap, MD - February 12, 2024

If you want to live a long life with few wrinkles, no headaches, no blood sugar problems, no heart attacks, and an incredible sense of well being, you might want to consider supplementing with CoQ10.

After all, CoQ10 supplementation has been shown in trials to improve female fertility, sperm health, and hormones in women with PCOS; blood glucose control, which protects against diabetes, a major killer; it helps lower lipid peroxidation and the inflammatory marker interleukin-6, which helps protect against most chronic disease; it reduces mortality from cardiovascular disease, seems to help with wrinkles and skin elasticity, lowers depression and anxiety, reduces migraines, and improves subjective well being.

On the other hand, we synthesize CoQ10 ourselves.

If we are making enough of our own, isn’t CoQ10 a waste of money?

Further, what is the cause of not making enough, in those who need a supplement? Is supplementing just papering over a bigger problem?

To make matters worse, supplementing mice with CoQ10 across the entire length of their adulthood worsens age-related hearing loss and impairs spatial learning and memory. The human-adjusted dose in this study is the equivalent of 1700 milligrams a day, but standard risk assessment adjustments would indicate caution for long-term use of doses as low as 170 milligrams per day. There are no studies in humans that last this long, so the cautionary impulse from this study has to be taken seriously.

One client of mine benefits a lot from doses in the 100-160 milligram range but gets fatigue from doses of 200 milligrams or higher, but there is no clear dose-response shown for benefits or harms in clinical trials, so we clearly need a way to individualize the dose to each person who needs it.

In fact, there are numerous CoQ10 synthesis mutations requiring doses as high as 3000 milligrams per day, and heterozygosity for these mutations is a lot more common than the homozygosity that gets treated. Meanwhile, that dose could overload numerous biochemical pathways in someone who doesn’t need it, creating all sorts of imbalances.

In fact, an analysis of 26 trials found that 100-200 milligrams per day lowers blood pressure, but that 400 milligrams per day raises blood pressure on average.

Glycemic control shows a similar U-shaped curve, and antioxidant status is best optimized at a dose of only 100-150 milligrams.

By contrast, an analysis of 13 trials found that fatigue responds best when the dose is higher, even up to 500 milligrams a day.

These conflicting results emphasize how essential it is to figure out for each person what dose is needed, and whether CoQ10 is needed at all.

CoQ10 and Longevity: The Short Answer

Coenzyme Q10 (CoQ10) is an antioxidant that your body produces. It plays an essential role in energy production and protects against cellular damage (Source).

Research suggests that levels of CoQ10 decline as you age. Supplementing with it has been shown to improve certain aspects of health in older individuals.

For instance, a 4-year study in 443 older adults demonstrated that supplementing with CoQ10 and selenium improved overall quality of life, reduced hospital visits, and slowed physical and mental deterioration (Source).

CoQ10 supplements may work by reducing oxidative stress, a condition characterized by an accumulation of free radicals that accelerates the aging process and the onset of age-related disease (Source).

Additionally, CoQ10 supplements may benefit heart health by reducing stiffness in your arteries, lowering blood pressure, and preventing the buildup of oxidized cholesterol in your arteries (Source).

CoQ10 is also part of Dr. David Sinclair’s supplement list.

However, various studies show that coenzyme Q10 does not extend lifespan (R,R,R,R). Some studies show that coenzyme Q10 can actually shorten lifespan (R).

There are of course also some studies showing that co-enzyme Q10 can extend lifespan, but often these studies have not been well conducted, or they use organisms that are not ideal representation of normal aging, like using co-enzyme Q10 deficient mice.

Lastly, the interventions testing program (ITP) tested a similar compound, MitoQ (a better absorbable nutrient based on coQ10), and didn’t find a life extension effect (R).

That said, CoQ10 decline as you age and it plays an essential role in energy production and protects against cellular damage. Supplementing with CoQ10 might allow for more physical activity and therefore more likely to have a protective effect than a negative one.

Benefits of CoQ10

Many conditions, including heart disease and migraines — for which CoQ10 has been found beneficial — appear to be rooted in mitochondrial dysfunction.2 CoQ10 is used by every cell in your body, but especially your heart cells.

Cardiac muscle cells have about 5,000 mitochondria per cell, while liver cells have 1,000 to 2,000 mitochondria each.3 As another reference, mitochondria make up about 35% of the volume of cardiac tissue and only 3% to 8% of the volume of skeletal muscle tissue.4

About 90% or more of the ROS in your body are made by your mitochondria.5 Using the analogy of the mitochondria as an engine, the combustion (metabolism) that takes place in there creates exhaust fumes — damaging byproducts when produced in excessive amounts.

One of the functions of CoQ10, or ubiquinol, is to neutralize those byproducts.6 When ubiquinol is lacking, the byproducts remain and begin to damage the cell. Ubiquinol is particularly beneficial for your heart health. C-reactive protein (CRP) is a marker for inflammation, and when your CRP is elevated, it suggests you have a heightened risk for heart disease.7

Two other markers for inflammation are gamma-glutamyl transferase (GGT),8 which is an early marker of heart failure, and N-terminal pro b-type natriuretic peptide (NT-proBNP).9

There's an association between the levels of these two markers and ubiquinol as well. When ubiquinol is supplemented, both these markers go down and genes associated with them are downregulated.

Low CoQ10 levels have also been detected in people with certain types of cancer,10 including lung, breast and pancreatic cancer, as well as melanoma metastasis, further strengthening the metabolic theory of cancer. The word “coenzyme” also provides a clue to its importance; it works synergistically with other enzymes to digest food, for example.

It also has the ability to increase your body’s absorption of important nutrients. More specifically, it helps recycle vitamins C and E,11,12 thereby maximizing their beneficial effects.

CoQ10 Can Help Improve Atrial Fibrillation (AFib)

AFib is an abnormal, often rapid, heart rhythm that occurs when the atria, your heart’s upper chambers, beat out of sync with the ventricles, the heart’s lower chambers. It’s a common symptom in those with heart failure or heart disease but can also occur on its own.

Oxidative stress and increased ROS can play a role in the development of AFib. Conversely, scavenging of ROS and a reduction in oxidative stress have been shown to be an essential part of keeping the heart functioning normally.13

In one study, 102 patients with AFib were divided into two groups. One group was given a CoQ10 supplement while the other group was given a placebo. After 12 months of supplementation, 12 people in the placebo group had AFib episodes compared to only three people in the CoQ10 group.14

CoQ10 Can Stop the Progression of NAFLD

NAFLD is the most common cause of chronic liver disease around the world, with a prevalence of 25%.15 Obesity and insulin resistance increase your risk of NAFLD. Mitochondrial dysfunction and oxidative stress, two hallmarks of CoQ10 deficiency, have also been shown to play a role,16 as has choline deficiency, as detailed in “Fatty Liver Disease Is Caused by Choline Deficiency.”

Currently, there are no approved medical treatments for NAFLD. Lifestyle changes, such as elimination of processed vegetable oils and processed carbs, remain the gold standard for managing NAFLD and, hopefully, preventing its progression. Since CoQ10 levels tend to be depleted in those with NAFLD, supplementation has been shown to help reduce oxidative stress and inflammation.17

In one study,18 44 patients were divided into two groups. One group was given 100 mg of CoQ10 each day, while the other was given a placebo. After four weeks of supplementation, the group taking CoQ10 dropped weight and had lower levels of serum AST, a blood marker that indicates liver disease and/or damage.

Benefits of CoQ10 for Several Other Conditions

In addition to helping with AFib and NAFLD, CoQ10 may be the answer to correcting several other chronic health conditions, including the following:CoQ10 acts directly on your endothelium, dilating your blood vessels and lowering blood pressure.(19,20) CoQ10 also decreases aldosterone, a hormone that makes you retain salt and water.(21,22) When aldosterone goes down, excess salt and water are excreted through your kidneys, often causing your blood pressure to go down.

Dyslipidemia — In one study,23 101 participants with dyslipidemia were given 120 mg of Coq10 or a placebo every day for 24 weeks. Without taking any lipid-lower drugs, participants taking the CoQ10 had decreases in harmful LDL and triglycerides and increases in total antioxidant capacity.

Heart failure — CoQ10 deficiency is linked to poorer prognosis for those with heart failure.24 Supplementing with CoQ10 can restore normal CoQ10 levels, helping to prevent heart cell damage and significantly improving heart failure.25

Chronic kidney disease — Increased oxidative stress is a major factor in chronic kidney disease and related cases of cardiovascular disease.26 Patients with chronic kidney disease tend to have decreased levels of CoQ10 in their blood. CoQ10 has been shown to improve mitochondrial function and decrease oxidative stress in chronic kidney disease patients, with and without dialysis.27

Systemic inflammation — Studies28,29 show that supplementing with 60 mg to 500 mg of CoQ10 for eight to 12 weeks can significantly reduce tumor necrosis factor alpha (TNF-α), IL-6 and CRP; three measures of widespread inflammation.

Stroke — Systemic inflammation, oxidative stress and nerve cell damage play a role in the development of stroke. Studies30 show that supplementing with CoQ10 can reduce ischemic lesions and improve outcomes in patients who have been treated with a statin after having a stroke (statins reduce CoQ10 levels in your body).

Migraine — CoQ10 deficiency is a common underlying factor of idiopathic migraines. Supplementing with CoQ10 can help reduce frequency and severity of migraines and alleviate associated symptoms such as nausea and sensitivity to light.31

Polycystic ovary syndrome (PCOS) — In one study,32 86 women with PCOS were given CoQ10 alone, CoQ10 with vitamin E, vitamin alone or a placebo. After eight weeks, the group taking CoQ10 alone had improved levels of sex hormones (lower levels of testosterone and luteinizing hormone) and improved insulin resistance.

Cancer — In one study,33 two women with breast cancer were given fatty acids, antioxidants and 300 mg to 390 mg of CoQ10. After two to three months, mammograms showed no tumors or residual tumor tissue, indicating cancer regression. A review34 in the Journal of Clinical Oncology that looked at how CoQ10 affected cancer treatment found it may help protect the heart and liver from toxicity during treatment.

Insulin resistance — CoQ10 levels are lower in mitochondria in insulin-resistant tissues.35 In one study,36 daily intake of 100 mg of CoQ10 improved insulin resistance and serum insulin levels in patients with markers of metabolic syndrome.

CoQ10 Vs Ubiquinol vs Ubiquinone

As mentioned, ubiquinol is the reduced version of CoQ10 (aka ubiquinone). They’re actually the same molecule, but when CoQ10 is reduced it takes on two electrons, which turns it into ubiquinol. In your body, this conversion occurs thousands of times every second inside your mitochondria.

The flipping back and forth between these two molecular forms is part of the process that transforms food into energy. Ubiquinol production ramps up from early childhood until your mid- to late 20s. By the time you hit 30, it begins to decline.37 Young people are able to use CoQ10 supplements quite well, but older people do better with ubiquinol, as it’s more readily absorbed.

Both ubiquinol and ubiquinone are forms of CoQ10 (coenzyme Q10). Some studies showed that ubiquinol may be more bioavailable than ubiquinone. However, the study is still inconsistent.

A study aimed to compare the effectiveness between ubiquinone and ubiquinol to enhance the CoQ10 status in older men suggests that ubiquinol supplement are more effective than ubiquinone supplement.

Another study found no significant differences between ubiquinone capsules and ubiquinol capsules in the redox status of the absorbed CoQ10.

The main differences between ubiquinol and ubiquinone is that ubiquinol is the reduced form of CoQ10, whereas ubiquinone is the oxidized form. Therefore, ubiquinone has more electrons than ubiquinol.

Ubiquinone = oxidized CoQ10 = yellow
Ubiquinol = reduced CoQ10 = white

In contrast to ubiquinone, which has a characteristic yellowish color, ubiquinol is essentially white. As soon as ubiquinol is exposed to oxygen, it transforms back into ubiquinone, which is its oxidized (and yellow) form.

How to Supplement With Ubiquinol

Your body can naturally make CoQ10, but genetic alterations in metabolism, poor diet, oxidative stress, chronic conditions and aging can all interfere with CoQ10 production and lead to CoQ10 deficiency. Statin drugs can also deplete CoQ10.

To maintain good health, an adult body should contain 0.5 to 1.5 g of CoQ1038 and sometimes it takes a supplement to keep you there. Dosing requirements will vary depending on your individual situation and needs.

As a general rule, the sicker you are, the more you need. The suggested dose is usually between 30 mg to 100 mg per day if you’re healthy, or 60 to 1,200 mg daily if you’re sick or have underlying health conditions.

If you have an active lifestyle, exercise a lot or are under a lot of stress, you may want to increase your dose to 200 to 300 mg per day. Importantly, if you're on a statin drug, you need at least 100 mg to 200 mg of ubiquinol or CoQ10 per day, or more. Ideally, you’ll want to work with your physician to determine your ideal dose.

Who Should Avoid Taking CoQ10?

CoQ10 has possible interaction with anticoagulants. CoQ10 may reduce the effectiveness of blood-thinning medications like warfarin (Jantoven). This could increase the risk of a blood clot.

CoQ10 in Foods

Yes, you can get CoQ10 (Coenzyme Q10) from food. Here are some food sources of CoQ10:

Organ meats such as liver and kidneys
Fatty fish such as salmon, tuna, and sardines
Whole grains such as wheat germ and whole wheat bread
Nuts and seeds such as peanuts and sesame seeds
Vegetables such as broccoli, spinach, and cauliflower

Nevertheless, since these foods only contain a small quantity of CoQ10, it can be challenging to get enough of it through diet to have therapeutic effects. Many times, people decide to increase their intake by taking CoQ10 supplements. Best to consult with your healthcare provider before starting any new supplements.

Sources and References

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