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REF:  http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/31402.html  

Coenzyme Q10 (Ubiquinone)

Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain coenzyme Q10. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacist or health care provider before starting.

• Unproven Uses
• Potential Dangers
• Interactions
• Dosing
• Summary
• Resources

Evidence     

Scientists have studied coenzyme Q10 for the following health problems:

Heart failure, cardiomyopathy

Several studies have shown benefits of coenzyme Q10 in people who have been diagnosed with chronic heart failure (with or without cardiomyopathy), including transplant recipients. Although the results are promising, some of them are conflicting. Further research is needed.

Angina

A small amount of research suggests that coenzyme Q10 is of benefit in people with exercise-induced angina. Further research is needed.

Heart attack

A small amount of research reports that coenzyme Q10 has benefits when given after a heart attack. There may be fewer additional heart attacks or fewer dangerous heart arrhythmias. However, additional studies are needed before a strong recommendation can be made.

High blood pressure

Several studies suggest that supplementation with coenzyme Q10 may lower systolic and diastolic blood pressure in some people who have high blood pressure. It is not clear if coenzyme Q10 deficiency is a cause of high blood pressure. Research has not clearly shown what doses are safe and effective, and long-term effects have not been measured.

Protection against heart muscle damage from chemotherapy, heart surgery or diabetes

There is early evidence that coenzyme Q10 may protect the heart from damage during chemotherapy or bypass surgery or in diabetes. However, studies have been small, with flaws in their designs, and results have disagreed with each other. Additional research is needed. It is not clear what doses may be safe or effective.

Alzheimer's disease

Some studies suggest that coenzyme Q10 may slow the progression of dementia associated with Alzheimer's disease. However, these studies have been small, and more research is needed before a conclusion can be made.

Periodontitis

Coenzyme Q10 has been proposed as a possible therapy for gum disease. Early evidence suggests that coenzyme Q10 may decrease pus formation, redness, bleeding, pain and swelling of the gums. Most studies in humans have been small, with flaws in their designs, and it is not clear what dose may be safe or effective.

HIV/AIDS

Coenzyme Q10 has been proposed as a possible therapy for HIV or AIDS. Early evidence suggests that coenzyme Q10 may reduce an HIV-positive individual's risk of getting other infections. However, studies in humans have been small, with flaws in their designs. It remains unclear if coenzyme Q10 is beneficial in HIV-positive people.

Decreased sperm movement

There is early evidence from one study in humans that coenzyme Q10 may help increase sperm activity in men with reduced sperm movement (idiopathic asthenospermia). However, this study was small and had flaws in its design. Therefore, it is unclear whether there is any benefit from coenzyme Q10 in improving sperm movement and it is not known what dose may be safe or effective.

Chronic kidney failure

Coenzyme Q10 has been proposed as a possible therapy for treating chronic kidney failure. Early evidence suggests that coenzyme Q10 may improve kidney function and reduce the need for chronic dialysis. More studies using larger numbers of people are needed to determine if coenzyme Q10 is safe and effective for this use.

Exercise performance

Coenzyme Q10 has been proposed as a possible therapy for improving exercise performance. There is only limited research in humans using coenzyme Q10 specifically for this use, and results of different studies have disagreed with each other. Coenzyme Q10 may benefit people with chronic lung diseases, but it does not appear to offer advantages for most athletes. It is unclear what dose is safe and effective.

Huntington's disease

One study was conducted to determine if coenzyme Q10 is beneficial in treating Huntington's disease. Although this study did not find any support for using coenzyme Q10, the study was small, with flaws in its design.

Neuromuscular disorders (muscular dystrophy, Parkinson's disease, mitochondrial disease, Kearns-Sayre syndrome)

Several studies have suggested that coenzyme Q10 may help treat various diseases associated with muscle or nerve degeneration. Early evidence suggests that coenzyme Q10 may improve heart function in people with progressive muscular dystrophies, may slightly improve muscle function in people with Parkinson's disease and may reduce fatigue or improve mood disturbances in people with mitochondrial diseases or diseases that inhibit the body's ability to store and use energy appropriately. However, these studies have been small, with flaws in their designs. Therefore, it is unclear whether there is any benefit from coenzyme Q10 in these diseases, and it is not known what dose may be safe or effective. Another study in humans with neurological disease showed the effectiveness of coenzyme Q10 in Friedreich's ataxia and as a neuroprotectant against ischemia, trauma, oxidative damage and neurotoxins.

Breast cancer

Several studies in women with breast cancer report reduced levels of coenzyme Q10 in diseased breast tissue or blood. Some researchers have suggested that raising coenzyme Q10 levels with supplements may be helpful. However, it is not clear if coenzyme Q10 is beneficial in these patients or if the low levels of coenzyme Q10 may actually be a part of the body’s natural response to cancer, helping to fight disease. Supplementation with coenzyme Q10 has not been proven to reduce cancer and has not been compared with other forms of treatment for breast cancer.

Unproven Uses     

Coenzyme Q10 has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before taking coenzyme Q10 for any unproven use.

Amyotrophic lateral sclerosis Anemia Antioxidant Asthma Bell's palsy Cancer Chronic fatigue syndrome Chronic obstructive pulmonary disease Clogged arteries Deafness Diabetes Difficulty breathing Drug-induced muscle deterioration Hair loss

Hepatitis B Immune dysfunction Insomnia Irregular heart beats Life extension Liver disease Lung cancer MELAS syndrome (mitochondrial myopathy, encephalopathy, lactacidosis, stroke) Mitral valve prolapse Neurodegenerative disorders Nutrition Obesity Oxidative stress components Papillon-Le Fevre syndrome Peripheral edema Psychiatric disorders Stomach ulcers

Potential Dangers     

Allergies

• There do not appear to be any reports of allergy associated with the use of coenzyme Q10 supplements, although rash and itching have been reported rarely.

Side Effects

• Coenzyme Q10 has been well tolerated in most studies. Some people may experience stomach discomfort, nausea or vomiting. Rare side effects include rash or itching. Other side effects may include dizziness, difficulty sleeping, irritability, headache, sensitivity to light, fatigue or flulike symptoms. In theory, coenzyme Q10 may increase the risk of blood clots. In contrast, coenzyme Q10 may also theoretically increase the risk of bleeding in some people, based on one report that coenzyme Q10 has effects on components of the blood that are involved with forming blood clots. If you have a blood clotting disorder or a history of blood clots or if you use anticoagulants (blood thinners) or antiplatelet drugs such as warfarin (Coumadin), heparin or clopidogrel (Plavix), speak with your health care provider before using coenzyme Q10.

Pregnancy And Breast-Feeding

• Coenzyme Q10 cannot be recommended during pregnancy or breast-feeding because of a lack of scientific information.

Interactions     

Interactions with drugs, herbs and other supplements have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements.

Interactions With Drugs

• In theory, coenzyme Q10 may increase the risk of blood clots or of bleeding. People with clotting disorders or those taking anticoagulants (blood thinners) or antiplatelet drugs, such as warfarin (Coumadin), heparin and clopidogrel (Plavix), should discuss coenzyme Q10 with their health care provider before starting therapy. In theory, coenzyme Q10 may add to the effects of some blood pressure-lowering drugs, causing blood pressure fall too low.
• Metformin (Glucophage), antidepressants, antipsychotics, some drugs used to treat high blood pressure, statins (drugs that lower high cholesterol levels) and certain diuretics may reduce coenzyme Q10 levels in the body.

Interactions With Herbs And Dietary Supplements

• In theory, coenzyme Q10 may increase the risk of the blood clotting or of bleeding. The effects of herbs and supplements that have blood-thinning effects may be altered, such as Ginkgo biloba or garlic (Allium sativum). Vitamin E may increase the effects of coenzyme Q10. Herbs and supplements that lower cholesterol such as red yeast (Monascus purpureus) and diuretics such as horsetail (Equisetum arvense) may reduce coenzyme Q10 levels in the body.

Dosing     

The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. Appropriate dosing should be discussed with a health care provider before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.

There are no well-established doses of coenzyme Q10, and many different doses have been used and studied.

Adults (Aged 18 Or Older)

• Tablets/capsules/liquid: For heart failure or cardiomyopathy, doses of 100 to 600 milligrams of coenzyme Q10, or two milligrams per kilogram of body weight taken by mouth daily, have been used. After a heart attack, a dose of 120 milligrams of coenzyme Q10 has been used. When treating high blood pressure, a dose of 75 to 360 milligrams taken by mouth each day has been used. For heart protection during bypass surgery, a dose of 150 milligrams daily for seven days before surgery or 600 milligrams taken in divided doses 24 hours before surgery has been used. For Alzheimer's disease, doses have not been well studied, although a dose of 120 milligrams has been used by mouth three times daily or 60 milligrams per day in combination with 150 milligrams of iron and 180 milligrams of vitamin B6. For periodontitis, a dose of five milliliters (one teaspoon) of coenzyme Q10 in a concentration of 200 milligrams per milliliter taken daily by mouth in divided doses has been used. In HIV/AIDS, a dose of 200 milligrams taken by mouth each day has been suggested, although effectiveness has not been clearly established. For exercise tolerance, a dose of 90 milligrams per day has been recommended. For muscular dystrophies, a dose of 100 milligrams taken by mouth in divided doses has been suggested. For Parkinson's disease, a dose of 400 milligrams per day has been used.
• Topical: For treating periodontitis, coenzyme Q10 applied topically to the affected area in the mouth in a concentration of 85 milligrams per milliliter has been used.
• Intravenous/intramuscular: Coenzyme Q10 has been used as an injection for heart protection during cardiac bypass surgery. This type of dosing should be used only under medical supervision.

Children (Younger Than 18): There are a few studies using coenzyme Q10 in children. For reducing heart damage associated with some chemotherapy drugs, a dose of 100 milligrams taken by mouth twice daily has been used. Safety in children is not well established, and use of this supplement should be discussed with your child's health care provider.

Summary     

Coenzyme Q10 has been suggested as a treatment for many conditions. Some research supports the use of coenzyme Q10 for congestive heart failure, after heart attacks, high blood pressure, heart complications associated with diabetes and Alzheimer's disease, although it is not well-established what doses may be safe and effective. There is not enough scientific evidence to support the use of coenzyme Q10 for any other medical condition. Coenzyme Q10 may cause flulike symptoms, stomach upset or headache. It should be avoided in pregnant or breast-feeding women, but it has been studied and used in children under the supervision of a qualified health care provider. Coenzyme Q10 may increase the risk of blood clotting or bleeding. Consult your health care provider immediately if you have any side effects.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Resources       

Selected Scientific Studies: Coenzyme Q10

• Natural Standard reviewed more than 525 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

Last updated June 22, 2005