Natural Standard® Patient Monograph, Copyright © 2014 (www.naturalstandard.com). All Rights Reserved. Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Background

Coenzyme Q10 (CoQ10) is an antioxidant that is made in the human body. CoQ10 is needed for basic cell function. CoQ10 levels decrease with age and may be low in people with cancer, certain genetic disorders, diabetes, heart conditions, HIV/AIDS, muscular dystrophies, and Parkinson's disease. Some prescription drugs may also lower CoQ10 levels.

CoQ10 in the body can be increased by taking CoQ10 supplements. There is evidence that idebenone, a man-made compound similar to CoQ10, may help treat Alzheimer's disease. However, evidence is lacking to support the use of CoQ10 itself for this condition. There is some evidence to support the use of CoQ10 for high blood pressure and heart failure.

Promising uses of CoQ10 include eye disease, chest pain caused by exercise, asthma, chronic fatigue, and high cholesterol, as well as the treatment of chemotherapy side effects in children.

Evidence is conflicting for the use of CoQ10 in heart muscle problems and exercise performance. There is some negative evidence for the use of CoQ10 in the treatment of diabetes, hepatitis C, and Huntington's disease.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

In general, manufacturers have recommended doses of CoQ10 ranging between 22-400 milligrams.

To treat Alzheimer's disease, 90-360 milligrams of idebenone (a man-made compound similar to CoQ10) has been taken by mouth daily in single or divided doses for 6-16 months. A dose of 400 milligrams of CoQ10 has been taken by mouth three times daily for 16 weeks.

To treat amyotrophic lateral sclerosis (ALS), 1,800 or 2,700 milligrams of CoQ10 has been taken by mouth daily in three divided doses for nine months. Doses of CoQ10 as high as 3,000 milligrams have been taken by mouth daily for eight months.

To treat chest pain, 60-600 milligrams of CoQ10 has been taken by mouth daily in single or divided doses for four weeks.

As an antioxidant, 60-150 milligrams of CoQ10 has been taken by mouth daily for 2-12 weeks. A dose of 30 milligrams of CoQ10 in oil or 20 milligrams of CoQ10 as a powder has been taken by mouth three times daily for two months. A dose of 100 milligrams of CoQ10 has been taken by mouth daily before hemodialysis over a six-month period.

To treat muscle control problems, 5-30 milligrams per kilogram of CoQ10 has been taken by mouth daily for 2-5 years. Doses of 300-3,000 milligrams of CoQ10 have been taken by mouth daily. A dose of 5 milligrams per kilogram of idebenone has been taken by mouth daily for up to five years.

To treat weakening of the heart muscle, 30-600 milligrams of CoQ10 has been taken by mouth daily for up to eight years. A dose of 2 milligrams per kilogram of CoQ10 has been taken by mouth in two or three divided doses along with regular heart medication, and increased to a maximum of 10 milligrams per kilogram by mouth daily for six months. A dose of 0.6 milligrams per kilogram has been taken by mouth daily for nine months.

To prevent heart disease, 200 milligrams of CoQ10 has been taken by mouth once daily for 12 weeks.

To treat side effects of chemotherapy, 50-90 milligrams of CoQ10 have been taken by mouth daily. An ointment containing ubiquinone has been applied to the skin. CoQ10 has been injected into the vein at a dose of 1 milligram per kilogram the day before anticancer treatment, on the day of treatment, and for two more days after treatment.

To treat coronary heart disease, 20-100 milligrams of CoQ10 have been taken by mouth three times daily for 4-8 weeks.

To treat type 1 diabetes, 100 milligrams of CoQ10 has been taken by mouth daily for 12 weeks.

To treat type 2 diabetes, 100 milligrams of CoQ10 has been taken by mouth twice daily for up to 12 weeks.

To improve exercise performance, doses of 50-300 milligrams of CoQ10 have been taken by mouth daily for up to 12 weeks. A dose of 100 milligrams or 300 milligrams of CoQ10 has been taken by mouth in two divided doses daily for one week, with one dose of three capsules on the morning of the eighth day prior to exercise.

To treat fibromyalgia, 300 milligrams of CoQ10 have been taken by mouth daily for nine months.

To improve blood vessel widening, 200 milligrams of CoQ10 have been taken by mouth daily for 12 weeks.

To treat gum disease, 5 milliliters of CoQ10 (200 milligrams per milliliter) in corn oil have been taken by mouth daily in divided doses.CoQ10 has been taken by mouth in soybean oil at a concentration of 85 milligrams per milliliter once per week for six weeks.

To treat hearing loss, 160-200 milligrams of Q-TER® have been taken by mouth once daily for 7-30 days. CoQ10 has been used as an 85 milligram per milliliter suspension in soybean oil and applied directly to the gum.

To treat heart attack, 120 milligrams of CoQ10 have been taken by mouth daily for a range of 28 days to one year. A dose of 250 milligrams of liquid CoQ10, followed by 150 milligrams of liquid CoQ10, have been given three times daily for five days through nasal tubes.

To treat chronic myocardial disease, 33 milligrams of CoQ10 has been taken by mouth three times daily for 12 weeks.

To treat heart failure, a dose of 2 milligrams per kilogram of CoQ10 has been taken by mouth daily for one year. Doses of 50-600 milligrams of CoQ10 have been taken by mouth daily for one month to 2 years.

To protect the heart during surgery, a dose of 100 milligrams of CoQ10 has been taken by mouth daily for 14 days before and 30 days after surgery. Doses of 30-200 milligrams of CoQ10 have been taken by mouth daily for 5-7 days before bypass surgery. A dose of 300 milligrams of CoQ10 have been taken by mouth daily for two weeks after surgery. A dose of 600 milligrams of CoQ10 has been taken by mouth in two divided doses at 6 p.m. the evening before the procedure and 6 a.m. the morning of the procedure. A dose of 150 milligrams of CoQ10 (in people weighing fewer than 60 kilograms) or 180 milligrams of CoQ10 (in people weighing more than 60 kilograms) has been taken by mouth in three divided doses daily for 7-10 days before surgery. A dose of 5 milligrams per kilogram of CoQ10 has been injected into the vein two hours before bypass surgery.

To treat hepatitis C, 40 milligrams or 80 milligrams of mitoquinone has been taken by mouth once daily with a glass of water following an overnight fasting period and a minimum of one hour before eating, for 28 days.

To treat HIV/AIDS, 200 milligrams of CoQ10 has been taken by mouth daily as a single dose or in three divided doses.

To treat Huntington's disease, 300-600 milligrams of CoQ10 has been taken by mouth daily for 120 weeks. A dose of 270 milligrams of idebenone (90 milligrams three times daily) has been taken by mouth daily for 52 weeks.

To treat high blood pressure, 60-360 milligrams of CoQ10 has been taken by mouth daily, with the average daily dose being 225 milligrams, for 8-12 weeks.

To treat heart disorders (left ventricular diastolic function), a dose of 20 milligrams of atorvastatin (Lipitor®) have been taken by mouth daily for 3-6 months and supplemented with 300 milligrams of CoQ10 daily (100 milligrams, three times daily) for an additional three months.

To lower cholesterol, 50-100 milligrams of CoQ10 has been taken by mouth daily for up to three months.

To treat male infertility, 30-300 milligrams of CoQ10 has been taken by mouth once daily or in divided doses for up to 26 weeks. Q-absorb® soft gels containing 100 milligrams of CoQ10 have been taken by mouth as one soft gel twice daily for six months.

To treat migraine, 150-300 milligrams of CoQ10 has been taken by mouth daily for up to three months. Doses of 1-3 milligrams per kilogram of CoQ10 have been taken by mouth in liquid gel capsules daily.

To treat mitochondrial diseases, 120-1,200 milligrams of CoQ10 has been taken by mouth daily for up to one year. A liquid form of CoQ10 has been taken by mouth at a dose of 5 milligrams per kilogram daily. A dose of 2 milligrams per kilogram of CoQ10 has been taken by mouth daily for six months.

To treat muscular dystrophies, 100 milligrams of CoQ10 has been taken by mouth daily.

To treat muscle disease caused by statins, 100-240 milligrams of CoQ10 (including Q-Sorb™) has been taken by mouth daily for up to 2.5 years.

To treat nerve pain of diabetes, 400 milligrams of CoQ10 has been taken by mouth daily for 12 weeks.

To treat Parkinson's disease, nanoparticular and standard CoQ10 formulas have been taken by mouth in doses of 300-2,400 milligrams daily for four weeks to 16 months.

To treat Peyronie's disease (pain and curvature of penis), 300 milligrams of CoQ10 have been taken by mouth daily for a period of 24 weeks.

To treat high blood pressure of pregnancy, 100 milligrams of CoQ10 has been taken by mouth twice daily (Q-absorb®) until delivery, a total of about 20-24 weeks.

To treat kidney failure, 180-200 milligrams of CoQ10 have been taken by mouth daily for up to eight weeks.

To promote weight loss, 100 milligrams of CoQ10 has been taken by mouth daily for three months.

For anti-aging purposes, a 1 percent CoQ10 cream has been applied to the skin for five months.

Children (under 18 years old)

To treat muscle control problems, 5-20 milligrams per kilogram of CoQ10 has been taken by mouth daily for 3-5 years. A dose of 900-2,250 milligrams daily of idebenone has been taken by mouth for subjects weighing at least 45 kilograms, or 450-1,350 milligrams daily for those weighing 45 kilograms or less for up to one year. Idebenone has been taken by mouth three times daily for a target dose of 5, 15, or 45 milligrams per kilogram daily for six months.

To treat heart muscle weakening, 2 milligrams per kilogram of CoQ10 has been taken by mouth daily in two or three divided doses, increasing to a maximum of 10 milligrams per kilogram daily for six months. A dose of 10 milligrams per kilogram of CoQ10 has been taken by mouth daily in two or three divided doses for eight months.

To treat chemotherapy side effects, 100 milligrams of CoQ10 have been taken by mouth twice daily.

To treat Down's syndrome, 10 milligrams per kilogram of CoQ10 have been taken by mouth daily in single or divided doses for two months, after a low dose of CoQ10 (1 milligram per kilogram daily) for one month.

To treat migraine, 100 milligrams of CoQ10 chewable tablets have been taken by mouth daily for 16 weeks. Doses of 1-3 milligrams per kilogram of CoQ10 have been taken by mouth daily in liquid gel capsules.

To treat mitral valve prolapse, in which a heart valve does not close properly, 0.6-3.4 milligrams per kilogram of CoQ10 have been taken by mouth daily for up to 43 months.

To treat muscular dystrophies, 100 milligrams of CoQ10 has been taken by mouth daily. A dose of 150 milligrams of idebenone has been taken by mouth three times daily (with meals) for 52 weeks.

To treat Prader-Labhart-Willi syndrome, a genetic disorder causing growth and development problems, 2.5 milligrams per kilogram of CoQ10 has been taken by mouth.

Evidence

These uses have been tested in humans or animals.  Safety and effectiveness have not always been proven.  Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Key to grades

A
Strong scientific evidence for this use
B
Good scientific evidence for this use
C
Unclear scientific evidence for this use
D
Fair scientific evidence against this use (it may not work)
F
Strong scientific evidence against this use (it likely does not work)

Grading rationale

Evidence gradeCondition to which grade level applies
A

Coenzyme Q10 deficiency

CoQ10 is made naturally in the body, but deficiency may occur due to disease, low dietary intake, or high CoQ10 use by the body. Symptoms of deficiency include heart failure, high blood pressure, and chest pain. Depending on the cause of deficiency, supplementing with CoQ10 or increasing dietary intake may be effective.
B

Heart failure

Early evidence suggests that CoQ10 may be effective for chronic heart failure. Low blood levels of CoQ10 have been associated with this condition. CoQ10 has been used in combination with other herbs and supplements for chronic heart failure.
B

High blood pressure

There is good evidence to support the use of CoQ10 in the treatment of high blood pressure. However, more studies evaluating a higher dose for a longer treatment period are needed.
C

Age-related macular degeneration

Age-related macular degeneration (AMD) is an eye condition that causes vision loss in older adults. Early research suggests that a combination of acetyl-L-carnitine, omega-3, and CoQ10 may improve visual function in early AMD. More research is needed on the effects of CoQ10 alone.
C

Aging

Early study suggests that a combination of CoQ10 and other antioxidants and minerals may improve skin roughness and fine wrinkles. Further research is needed to understand CoQ10's role in skin aging.
C

Alzheimer's disease

There is some evidence that idebenone, a man-made compound similar to CoQ10, may benefit people with Alzheimer's disease. However, the effect of CoQ10 itself is unclear.
C

Amyotrophic lateral sclerosis (ALS)

CoQ10 has been studied for amyotrophic lateral sclerosis (ALS), a disease affecting brain and spinal cord nerve cells that control muscle movement. More research is needed in this area.
C

Antioxidant

CoQ10 has been studied for use as an antioxidant to protect cells from damage. CoQ10 has been used in combination with other antioxidants. Early study suggests that it may have antioxidant benefits in people with heart disease. More information is needed on the potential benefits of CoQ10 alone.
C

Asthma

Early study reports that CoQ10 in combination with vitamin E, vitamin C, and conventional therapy may reduce the dosage of asthma medication required. More research using CoQ10 alone is needed.
C

Breast cancer

Low levels of CoQ10 may be linked to risk of breast cancer. There is promising evidence to support the use of CoQ10 in the treatment of breast cancer, possibly in combination with conventional therapy. More research is needed.
C

Cancer

CoQ10 levels may help predict the risk of skin cancer progression. One study found lower CoQ10 levels in people who have cancer, compared to those who do not. Early research suggests that CoQ10 in combination with other antioxidants may increase survival in end-stage cancer. However, more information is needed on CoQ10 alone.
C

Cataracts

Early study suggests that CoQ10 may benefit eye health. CoQ10 has been used in combination with vitamin A to improve nerve regeneration in the eye. However, the effect of CoQ10 alone is unclear. More research is needed.
C

Chemotherapy side effects

There is unclear evidence to support the use of CoQ10 for side effects of chemotherapy on the heart. Additional research is needed in this area.
C

Chest pain

CoQ10 has been studied for chest pain caused by exercise. More research is needed in this area.
C

Chronic fatigue syndrome

Early research shows that CoQ10 may improve symptoms of chronic fatigue syndrome. More high-quality research is needed in this area.
C

Cocaine dependence

The effect of CoQ10 on cocaine usage is unclear. More research is needed on this topic.
C

Coronary heart disease

CoQ10 used in combination with the cholesterol-lowering drug simvastatin may benefit people who have coronary heart disease. CoQ10 may also help reduce inflammation in those with this condition. Further research on CoQ10 alone is needed.
C

Cystic fibrosis

Low levels of CoQ10 have been found in children with cystic fibrosis, a disease that causes mucus buildup in lungs. Combination products containing CoQ10 have been studied. More research on the effects of CoQ10 alone is needed.
C

Dry mouth

Early research suggests that CoQ10 may improve symptoms of dry mouth. More well-designed studies are needed.
C

Exercise performance

Overall, strong evidence is lacking on the use of CoQ10 for improving exercise performance. CoQ10 may most benefit people who have chronic lung diseases, such as asthma. More research is needed on this topic.
C

Fibromyalgia

Fibromyalgia is a condition in which there is long-term pain and tenderness in the muscles and joints. Early study suggests that people with this disorder may benefit from the use of CoQ10. More research is needed.
C

Gum disease

Early research suggests that CoQ10 levels may be lower in the gum tissue of people with gum disease. There is promising evidence to support CoQ10 for treating gum disease. However, more research is needed.
C

Hearing loss

Low levels of CoQ10 may be associated with a higher risk of hearing loss. Evidence is mixed regarding the use of CoQ10 for hearing loss. More well-designed research is needed.
C

Heart attack

CoQ10 may benefit people who have had a previous heart attack. More studies are needed in this area.
C

Heart disease (chronic myocardial disease)

CoQ10 may have benefits in people with a chronic disease of the heart muscle. More well-designed research is needed.
C

Heart disease prevention

CoQ10 may improve blood flow and blood vessel widening in people with diabetes. A combination of CoQ10 and garlic extract may benefit heart health associated with stress. More high-quality studies are needed on this topic.
C

Heart muscle injury

Research suggests that CoQ10 may benefit people who have cardiomyopathy, a weakening or problem with the heart muscle. Levels of CoQ10 may be lower in people with this condition. More research is needed in this area.
C

Heart protection during surgery

There is promising evidence to support the use of CoQ10 before heart surgery. More studies are needed in this area.
C

High cholesterol

Evidence is conflicting in support of the cholesterol-lowering effects of CoQ10. More research is needed in this area.
C

HIV/AIDS

Early research suggests that evidence is lacking to support of the use of CoQ10 for treating HIV/AIDS. More research is needed in this field.
C

Hypertriglyceridemia

CoQ10 may improve blood pressure and other measures of heart health in people who have high triglyceride levels. Additional research is needed in this area.
C

Immune enhancement

CoQ10 has been studied for immune enhancement. However, details are lacking, and more research is needed on this topic before conclusions can be made.
C

Infant development / neonatal care

Early research suggests that CoQ10 may help treat symptoms of Prader-Labhart-Willi syndrome, a genetic disorder affecting growth and development. More research is needed in this area.
C

Kidney failure

Results are conflicting in support of CoQ10 for the treatment of kidney failure. More well-designed studies are needed.
C

Male infertility

There is early evidence that supports the use of CoQ10 for improving sperm health. More well-designed studies are needed in this area.
C

Migraine

CoQ10 has been studied for use in treating migraines. More well-designed studies are needed before a conclusion can be made.
C

Mitochondrial diseases

CoQ10 has been studied for diseases affecting the mitochondria, which are energy-creating components found in every cell in the body. There is promising evidence to support CoQ10 use for conditions such as Kearns-Sayre syndrome, which may cause drooping eyelids and vision problems. More research is needed in this area.
C

Mitral valve prolapse

Early evidence supports the use of CoQ10 in children with mitral valve prolapse, a condition in which a heart valve does not close properly. More studies are needed this area.
C

Movement disorders

Early evidence suggests that CoQ10 may be useful in treating symptoms of Friedreich's ataxia, a disease that damages the nervous system. More research is needed to confirm whether CoQ10 may benefit people who have this condition.
C

Muscle weakness

CoQ10 may help reduce some side effects of statin therapy, including muscle weakness. More research is needed in this area.
C

Muscular dystrophies

There is mixed evidence in support of CoQ10 or idebenone (a man-made compound similar to CoQ10) for treating muscular dystrophies, diseases in which there is muscle damage or loss. Further study is needed.
C

Myelodysplastic syndrome

CoQ10 has been studied for myelodysplastic syndrome, a condition in which there is cell damage in the bone marrow. Early evidence suggests that CoQ10 may benefit people who have this condition. Further research is needed in this area.
C

Nerve pain

Early research reports that CoQ10 may benefit people who have nerve pain caused by diabetes. More research is needed to confirm these findings.
C

Parkinson's disease

CoQ10 has been studied for the treatment of Parkinson's disease. There is promising evidence in support of the use of CoQ10 for this condition. However, more high-quality studies are needed.
C

Peyronie's disease

CoQ10 may benefit men with Peyronie's disease (abnormal curvature, pain, and scar tissue in the penis) in terms of slowing disease progression and reducing curvature. More well-designed studies are needed in this area.
C

Pre-eclampsia

Early research suggests that CoQ10 may lower the occurrence of pre-eclampsia (high blood pressure during pregnancy) in women who are at risk. Further research is needed in this area.
C

Prostate cancer

A combination product containing CoQ10 lacked benefit in men with prostate cancer. Further study is needed before firm conclusions can be made.
C

Psoriasis

A combination product containing CoQ10 may improve symptoms of psoriasis, an inflammatory skin condition. More research on the effects of CoQ10 alone is needed.
C

Recovery from surgery

CoQ10 combined with the use of conventional drugs may benefit people recovering from skin cancer surgery and reduce recurrence. Although promising, more research is needed to confirm these findings.
C

Ringing in the ears

In early research, people with ringing in the ears and low CoQ10 levels had decreased symptoms with CoQ10 supplementation. More research is needed on this topic.
C

Weight loss

CoQ10 may help promote weight loss in obese people. Levels of CoQ10 may be lower in people with a higher body mass index (BMI). More high-quality research is needed to confirm these findings.
D

Diabetes

Early evidence supports the use of CoQ10 in the treatment of heart-related complications in people with diabetes. However, overall study results suggest that CoQ10 may lack effect on blood sugar control. More research is needed.
D

Hepatitis C

Limited research reports that CoQ10 may lack benefit in people who have hepatitis C. More research is needed on this topic.
D

Huntington's disease

There is negative evidence to support the use of CoQ10 or idebenone (a man-made compound similar to CoQ10) for the treatment of Huntington's disease. More research assessing long-term benefit is needed.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Abnormal heart rhythms, acidosis (acid buildup in the body), adrenal insufficiency (hormone production problem), anemia, antiviral, autoimmune diseases (lupus), Bell's palsy (facial nerve disorder), blood flow disorders, cardiac ischemia (blocked blood flow to heart), celiac disease (gluten allergy), chronic obstructive pulmonary disease (long-term lung disease), clogged arteries, depression, diabetic foot pain, DIDMOAD (genetic disorder causing diabetes and deafness), dizziness, Down's syndrome, encephalopathy (brain disease), eye disorders (CPEO, a disease causing eye weakness), fluid in the lungs, gallbladder disorders, glaucoma (eye disorder causing optic nerve damage), hair loss, headache, hepatitis B, iatrogenic lipodystrophy (fat storage disorder), inflammation, insomnia, liver protection, lung disease, mental illness, mental performance, metabolic abnormalities, multiple sclerosis, muscle wasting, nutrition, phenylketonuria (inability to break down amino acid), shock, shortness of breath, skin conditions, skin irritation (caused by chemicals), speech disorders, stomach disorders, stomach ulcer, viral myocarditis (heart inflammation caused by virus), vomiting.

Interactions

Interactions with Drugs

CoQ10 may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). CoQ10 may also reduce the effectiveness of warfarin, which will increase risk of blood clot.

CoQ10 may affect blood sugar levels. Caution is advised when using medications that may also affect blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

CoQ10 may cause low blood pressure. Caution is advised in people taking drugs that affect blood pressure.

CoQ10 may also interact with acetylsalicylic acid, agents that may affect the immune system, agents that may affect the nervous system, agents that may enhance exercise performance, agents that may promote urination, agents that may treat asthma, agents that may treat mental illnesses, agents that may treat HIV, Alzheimer's agents, amiodarone, amitriptyline, anabolic androgenic steroids, angiotensin-converting enzyme inhibitors, anticancer agents, antidepressants, antifungal agents, anti-inflammatories, beta-blockers, cholesterol-lowering agents, clonidine, corticosteroids, cyclosporin A, dopamine agonists/antagonists, doxorubicin, eye agents, ezetimibe, fenofibrate, fertility agents, heart agents, heart rate-regulating agents, hormonal agents, hydralazine, immunoglobulins, iridium, lung agents, mercury, methyldopa, nicotine, nitroglycerin, orlistat, P-glycoprotein-regulated agents, skin agents, statins, steroids, thyroid hormones, timolol, and weight loss agents.

Interactions with Herbs and Dietary Supplements

CoQ10 may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases. CoQ10 may also reduce the effectiveness of warfarin, which will increase risk of blood clot.

CoQ10 may affect blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

CoQ10 may cause low blood pressure. Caution is advised in people taking herbs or supplements that affect blood pressure.

CoQ10 may also interact with alpha-lipoic acid, Alzheimer's agents, anticancer herbs and supplements, antidepressants, antifungal herbs and supplements, anti-inflammatories, antioxidants, antiviral herbs and supplements, beta-carotene, cholesterol-lowering herbs and supplements, dopamine agonists/antagonists, eye health herbs and supplements, fertility herbs and supplements, garlic, geranylgeraniol, gum arabic, heart health herbs and supplements, heart rate-regulating herbs and supplements, herbs and supplements that may affect the immune system, herbs and supplements that may affect the nervous system, herbs and supplements that may enhance exercise performance, herbs and supplements that may promote urination, herbs and supplements that may treat asthma, herbs and supplements that may treat mental disorders, hormonal herbs and supplements, L-carnitine, lung health herbs and supplements, MyoVive™, nutritional mitochondrial herbs and supplements, omega-3 fatty acids, Orthosiphon stamineus, P-glycoprotein-regulated herbs and supplements, red yeast rice (Monascus purpureus), salicylates, skin health herbs and supplements, thyroid herbs and supplements, vitamin A, vitamin B6, vitamin C, vitamin E, and weight loss herbs and supplements.

Methodology

This information is based on a systematic review of scientific literature and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Monograph methodology

Related terms

2,3-Dimethoxy-5 methyl-6-decaprenyl benzoquinone, 6-[10-hydroxydecyl]-2,3-dimethoxy-5-methyl-1,4-benzoquinone, All-Q™, Andelir®, atovaquone, Bio-Quinone®, Capsule Bio-Quinone, Coenzyme Q, Co-enzyme Q10, Coenzyme Q(50), CoenzymeQ, CoQ, CoQ10, Co-Q10, CoQ-10, CoQ(50), CV-2619, Heartcin®, hydroxydecyl ubiquinone, idebenone (synthetic analog), Kaneka Q10™, Kino-Q-10, MitoQ, MitoQ10, mitoquinone, Neuquinone®, noben, prenylquinones, Q10, Q-Gel®, Solu™ Q10, SterolQ10, Taidecanone®, ubidecarenone, ubiquinol-10, ubiquinone, ubiquinone-10, ubiquinone-Q10, Udekinon®, vitamin q10, vitamin Q10.

Combination product examples: Phototrop® (acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10), PycnoQ10 (Pycnogenol® plus CoQ10), Cutanova Nanorepair Q10 cream, Proxeed® (L-carnitine, acetyl-L-carnitine, fructose, citric acid, selenium, zinc, ascorbic acid, cyanocobalamin, folic acid, and CoQ10).

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid if allergic or sensitive to CoQ10, idebenone, or related substances.

Side Effects and Warnings

CoQ10 is likely safe when up to 3,000 milligrams is taken by mouth daily for up to eight months in healthy people. Nanoparticular CoQ10 is safe at doses of 300 milligrams daily for up to three months. CoQ10 is safe when taken by mouth daily in recommended doses in people who are about to have heart surgery, or those who have heart disease, gum disease, muscle wasting/weakness, Parkinson's disease, Alzheimer's disease, cancer, diabetes, or HIV/AIDS. CoQ10 is also likely safe in healthy people when taken for exercise performance and in children who have chemotherapy side effects. Idebenone is likely safe in doses of up to 60 milligrams per kilogram daily.

Use cautiously in high doses over a long period of time.

Use cautiously in high doses in people with liver problems. Doses of greater than 300 milligrams daily may affect levels of liver enzymes.

Use cautiously in people who have bile duct blockage or liver dysfunction. These conditions may increase CoQ10 levels.

Use cautiously in people who are taking warfarin. CoQ10 may reduce the effectiveness of warfarin.

CoQ10 may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Use cautiously in people who have skin disorders. CoQ10 may cause skin itching and rashes.

Use cautiously in people who have stomach disorders. CoQ10 may cause nausea, upset stomach, and vomiting.

Use cautiously in people who have mitochondrial disorders. CoQ10 may worsen mobility.

Use cautiously in people who have headache or migraines. CoQ10 may cause headache.

CoQ10 may affect blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

CoQ10 may cause low blood pressure. Caution is advised in people taking drugs or herbs and supplements that affect blood pressure.

Use cautiously in people who have thyroid problems or those taking thyroid agents. CoQ10 may affect thyroid hormone levels and interact with thyroid agents (such as Synthroid®).

Use cautiously in people who take heart rate-regulating agents. CoQ10 may affect heart rate.

CoQ10 may also cause abnormal breathing, back pain, bronchitis, changes in attention, changes in sperm motility, cholesterol, chest pain, constipation, coughing, diarrhea, dizziness, fainting, falling, fatigue, flu-like symptoms, fungal skin infection, gas, head pressure, hearing loss, heart attack, heartburn, heart dysfunction, indigestion, insomnia, irritability, light sensitivity, loss of appetite, low energy, lung inflammation, muscle pain, night sweats, reduced g-force tolerance, respiratory tract infection, runny nose, sinus inflammation, sore throat, stomach pain, trembling, urinary infection, and viral infection.

Pregnancy and Breastfeeding

There is a lack of scientific evidence on the use of CoQ10 during pregnancy or breastfeeding.

According to the National Institute of Health's Lactation and Toxicology Database (LactMed), CoQ10 is a normal part of human breast milk. Levels may depend on dietary or other differences.

Selected references

  1. Armstrong MJ and Miyasaki JM. Evidence-based guideline: pharmacologic treatment of chorea in Huntington disease: report of the guideline development subcommittee of the American Academy of Neurology. Neurology 8-7-2012;79(6):597-603.
  2. Bababeygy SR, Wang MY, Khaderi KR, et al. Visual improvement with the use of idebenone in the treatment of Wolfram syndrome. J.Neuroophthalmol. 2012;32(4):386-389.
  3. Barboni P, Valentino ML, La Morgia C, et al. Idebenone treatment in patients with OPA1-mutant dominant optic atrophy. Brain 2013;136(Pt 2):e231.
  4. Bloomer RJ, Canale RE, McCarthy CG, et al. Impact of oral ubiquinol on blood oxidative stress and exercise performance. Oxid.Med.Cell Longev. 2012;2012:465020.
  5. Deichmann RE, Lavie CJ, and Dornelles AC. Impact of coenzyme Q-10 on parameters of cardiorespiratory fitness and muscle performance in older athletes taking statins. Phys.Sportsmed. 2012;40(4):88-95.
  6. Fogagnolo P, Sacchi M, Ceresara G, et al. The effects of topical coenzyme Q10 and vitamin E D-alpha-tocopheryl polyethylene glycol 1000 succinate after cataract surgery: a clinical and in vivo confocal study. Ophthalmologica 2013;229(1):26-31.
  7. Fotino AD, Thompson-Paul AM, and Bazzano LA. Effect of coenzyme Q(1)(0) supplementation on heart failure: a meta-analysis. Am.J.Clin.Nutr. 2013;97(2):268-275.
  8. Galasko DR, Peskind E, Clark CM, et al. Antioxidants for Alzheimer disease: a randomized clinical trial with cerebrospinal fluid biomarker measures. Arch.Neurol. 2012;69(7):836-841.
  9. Klopstock T, Metz G, Yu-Wai-Man P, et al. Persistence of the treatment effect of idebenone in Leber's hereditary optic neuropathy. Brain 2013;136(Pt 2):e230.
  10. Larijani VN, Ahmadi N, Zeb I, et al. Beneficial effects of aged garlic extract and coenzyme Q10 on vascular elasticity and endothelial function: the FAITH randomized clinical trial. Nutrition 2013;29(1):71-75.
  11. Lee BJ, Huang YC, Chen SJ, et al. Coenzyme Q10 supplementation reduces oxidative stress and increases antioxidant enzyme activity in patients with coronary artery disease. Nutrition 2012;28(3):250-255.
  12. Mortensen SA, Kumar A. Dolliner P, et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure. Results from the Q-SYMBIO study. European Journal of Heart Failure 2013;15:S1-S20.
  13. Schempp CM, Meinke MC, Lademann J, et al. Topical antioxidants protect the skin from chemical-induced irritation in the repetitive washing test: a placebo-controlled, double-blind study. Contact Dermatitis 2012;67(4):234-237.
  14. Yesilada AK, Sevim KZ, Sirvan SS, et al. Severe symmetrical facial lipoatrophy in a patient with discoid lupus erythematosus. J.Craniofac.Surg. 2012;23(5):e461-e463.
  15. Young JM, Florkowski CM, Molyneux SL, et al. A randomized, double-blind, placebo-controlled crossover study of coenzyme Q10 therapy in hypertensive patients with the metabolic syndrome. Am J Hypertens. 2012;25(2):261-270.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration

www.naturalstandard.com