CoQ10 is a dietary supplement that claims to have many health benefits. Which of these are well supported by research and how much should you take?
CoQ10 is a naturally occurring antioxidant that used for energy production in the cells. It is made by the heart, liver, kidney and pancreas. In the tissues, 90% of CoQ10 is converted to Ubiquinol. The body generally produces enough CoQ10, and only small amounts are present in food, mainly in beef and chicken. Body levels of CoQ10 decrease with age and in heart disease. Taking common cholesterol medications know as statins (atorvastatin, rosuvastatin, simvastatin and others) may also lead to a decrease in CoQ10 levels
Clinical uses for CoQ10 may include the following:
- To decrease the side effects of statin drugs. A review of 12 randomized placebo controlled studies concluded that taking CoQ10 improved statin related muscle symptoms, which are a major reason for the discontinuation of these medications. The recommended dose for those experiencing muscle aches is 100mg/day.
- Congestive Heart Failure. A review of 13 clinical studies showed that 100mg/day of CoQ10 significantly improves how well the heart pumps blood. Another large study show that 100mg taken three times daily for 2 years significantly decreased the chance of an adverse cardiac event in 50% of CHF patients. An improved quality of life was noted with patients reporting an increase in activity and a decrease in fatigue and shortness of breath.
- Aortic Valve Replacement. CoQ10 may decrease the incidence of negative outcomes when taken starting 7 days before surgery.
- High cholesterol. CoQ10 may moderately lower elevated cholesterol levels when taken in a dose of 100-200mg/day. This effect is not seen in patients who are taking statin medications
- Migraine. There have been slight decreases in frequency of migraines in patients taking 200-300mg/day of CoQ10.
- Fibromyalgia and Chronic Fatigue. Doses of 300mg daily may improve symptoms due to an increase in energy production.
CoQ10 has also been investigated for Type 2 Diabetes, Alzheimers, Atrial Fibrillation, Hypertension and Parkinson’s Disease but there have been no conclusive results found.
Generally, taking a CoQ10 supplement is safe. The most significant side effect is GI upset which occurs in less than 1% of patients. It may also have an effect on blood clotting so caution should be exercised when using in patients on warfarin or other blood thinners. CoQ10 is best absorbed in the presence of fats so it should be taken with a meal. If that is not possible there are supplements available that contain bioavailability enhancers such as polysorbate 80 and cyclodextrin, but these tend to be more expensive. Supplements where the CoQ10 is already converted into its active form, ubiquinol, are also available.
So what does all this mean? I would consider supplementing with CoQ10 in patients who are experiencing muscle aches while taking statin medications. I would also recommend it for patients with congestive heart failure. Based on the fact that Chronic Fatigue, Fibromyalgia and recurring Migraine are so difficult to treat I think a trial of CoQ10 is reasonable. Plan on taking 100 to 300 mg/day of a reputable brand, you can contact me for suggestions.
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