What is CoQ10?

Coenzyme Q (or CoQ10) is a vitamin like, fat-soluble substance found in every cell membrane in the body and synthesized in the mitochondria (the powerhouse of the cell). However, unlike a lot of  vitamins, it does not need to be obtained from the diet. It is found in especially large quantities in the heart, making it essential for cardiovascular health. CoQ10 helps the mitochondria use oxygen to create ATP (energy). It also is a powerful antioxidant, helping to protect the mitochondria from oxidative stress/damage (I liken this to our internal rusting process) due to free radical damage.

What are the benefits of CoQ10?

CoQ10 is particularly important for heart health, as it’s used for energy production and found in high concentrations in the heart.  Studies show that CoQ10 may help prevent heart attacks and stroke, lower blood pressure, and help slow the progression of heart failure while improving exercise tolerance. It also plays a role in reducing LDL oxidation in the arteries due to its antioxidant properties. Oxidation of LDL cholesterol leads to hardening of the arteries due to atherosclerotic plaques.

Let’s break down some of the research on CoQ10:

Heart Failure – Heart failure is characterized by the inability of the heart to pump blood efficiently, leading to shortness of breath, fatigue and pooling of blood in the body’s extremities. A 2003 study determined that heart failure patients that supplemented with 150 mg of CoQ10 had improved serum levels of CoQ10, heart function and exercise tolerance over the group receiving a placebo. Additionally, a 2017 meta-analysis of sixteen studies had similar findings, showing that CoQ10 supplementation reduced all cause mortality in conjunction with conventional treatment in those with CHF and also improved exercise tolerance.

Coronary Artery Disease (CAD) – CAD is characterized by a buildup of oxidized cholesterol in the arterial walls, causing narrowing and hardening of the arteries. This can lead to high blood pressure and an increased risk of blood clots and heart attack. CoQ10 may play a role in preventing oxidation of arterial plaques due to its antioxidant properties. A 2012 meta-analysis found that 150 mg CQ10 supplementation over 12 weeks in those with CAD showed reduced markers of oxidative stress and increased antioxidant activity over the group that did not get the CoQ10 supplement.

Hypertension –  High blood pressure or HTN increases risk for heart attack and stroke because the increased pressure may weaken arterial walls and cause the heart to work harder. Some studies show a benefit of supplemental CoQ10 on lowering blood pressure, while others have been inconclusive. However, a 2017 review of meta-analyses found that supplementation of over 100 mg of CoQ10 showed significant reductions in systolic and diastolic blood pressure.

Exercise tolerance – Supplementation of CoQ10 at 100 mg 2x/day for two weeks has been found to improve time to exhaustion during exercise, reduce oxidative stress and increase CoQ10 concentration in muscles.

Using CoQ10 Supplements

It’s important to note that we make less CoQ10 as we age and the only food sources are found in organ meats like heart and liver, and in very small amounts in beef, fatty fish, eggs and sardines. That means that many of us might benefit from taking a CoQ10 supplement. However, results are mixed on the efficacy of taking CoQ10 in supplement form, possibly due to a low absorption rate into the mitochondria or tissues. Fast melt or quick dissolve tablets (effervescent tablets) seem to have the best absorption rates into the blood stream over capsule or tablet forms.

Ubiquinol and Ubiquone are the two forms of CoQ10 available as a supplement. The ubiquinol form is the activated form of CoQ10 (your body converts ubiquinone to ubiquinol) and is generally more expensive. There is not a lot of data that concludes that this form is substantially better than ubiquinone, but due to the low absorption rate of CoQ10 supplements it may make sense to buy the activated form.

One population that really stands out as needing a CoQ10 supplement are those taking statin drugs to lower cholesterol. The metabolic pathway in the body that makes cholesterol also makes CoQ10. Since statins shut this pathway down we recommend a CoQ10 supplement to help correct deficiency. Those with diabetes, cancer, heart failure also tend to have lower than optimal concentrations of CoQ10, perhaps due to the oxidative stress/inflammation that occurs in these conditions.