CoQ10: Dr Peter J. Rice



Coenzyme Q10:  CoQ10 

Some time back, while shopping at Costco, my wife was concerned about staying healthy and was looking for something to take. With no particular symptom or problem in mind, I suggested Coenzyme Q10: CoQ10. We already both take multivitamins and I take additional vitamin C and vitamin D. 

CoQ10 is a dietary supplement that helps mitochondria function well. CoQ10 is not a vitamin because humans can make their own supply, with about half coming from diet and about half made by the body. CoQ10 is present in almost all cells and in high concentrations of the heart, liver, kidney, and pancreas. 

CoQ10

CoQ10


CoQ10 plays an important role in several pathways that help mitochondria:

  • it facilitates energy production in mitochondria, which generate energy for cells all around the body;
  • it protects against oxidative stress produced by free radicals;
  • it helps regenerate other antioxidants, like vitamin C and vitamin E.

Coenzyme Q10 has been used orally for a variety of diseases involving muscle, heart, nerves and other organs. CoQ10 has been used in Europe and Japan for many years to improve cardiac muscle function in heart failure patients.

It usually bothers me to encounter medications that work for “everything”.  Knowing that a medication – or in this case a dietary supplement – can do a lot of things always suggests to me that it may not do any of them well.  But in the case of CoQ10, there is a rationale for why it may help individual patients with diverse clinical problems.

Mitochondria are inherited from our mothers separate from our other chromosomal traits, like hair and eye color. Mitochondria are the powerhouses of the cell, and can differ between parts of the body, so some tissues may have better energy production than other tissues. If a tissue’s mitochondria falter, that tissue can dysfunction and contribute to disease; so, mitochondrial dysfunction has been implicated in many disease states, including those helped by CoQ10.

Coenzyme Q-10 is fat soluble and acts similar to a vitamin.

  • Its primary functions include activity as an antioxidant, membrane stabilizer, and a cofactor in many metabolic pathways, particularly in the production of energy within cells.
  • Highest concentrations are in the first 20 years of life and decrease with age.

CoQ10 has been shown to be safe to take in studies lasting up to 2½ years. The recommended dose of CoQ10 is 200mg daily; some studies have used a dosage of 600mg/day. CoQ10 has been well-tolerated in clinical studies, with no significant adverse effects.

CoQ10 is considered likely effective (by the Natural Medicines Database) for CoQ10 deficiency, which is characterized by weakness, fatigue and sometimes seizures, and for mitochondrial dysfunction.

CoQ10 is considered possibly effective in:

  • age related macular degeneration
  • congestive heart failure
  • diabetic neuropathy
  • Huntington’s disease
  • hypertension
  • ischemic reperfusion injury
  • migraine headaches
  • muscular dystrophy
  • myocardial infarction
  • Parkinson’s disease.

CoQ10 is considered possibly ineffective for Alzheimer’s disease, Lou Gehrig’s disease, high cholesterol and post-polio syndrome. There are many other symptoms for which there is insufficient evidence on the effectiveness of CoQ10.  But don’t expect CoQ10 to help with athletic performance.

In my opinion, CoQ10 is safe and worth a try if you believe it might help you. One never knows if your mitochondria would benefit from a boost. Since we had no therapeutic goal in mind, I can’t say that CoQ10 helped Sandy, but she continues to take it. It is also one of the pricier supplements. 

As with so many drugs and dietary supplements, it is a good idea to speak with your primary care physician or pharmacist.  Have your pharmacist check for possible drug interactions if you are taking other medicines. 

Plan on taking CoQ10 for at least 2-4 weeks before deciding if it is effective.  Take care of yourself.

References:

Natural Medicines Database
http://naturaldatabase.therapeuticresearch.com/

National Institutes of Health Office of Dietary Supplements

https://ods.od.nih.gov/factsheets/list-all/CoenzymeQ10/

National Center for Complementary and Integrative Medicine

https://nccih.nih.gov/health/supplements/coq10

Co-author:

Anastasia Sosa Vozza Bell, PharmD candidate at the University of Colorado Skaggs School of Pharmacy

CoQ10 1

Dr. Peter J. Rice

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.
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