Coenzyme Q10

Last Updated: February 26, 2024

Coenzyme Q10 is a molecule found in mitochondria that has a critical role in producing energy for the body. It also plays an important role in the endogenous antioxidant system.

Coenzyme Q10 is most often used for

What is coenzyme Q10?

Coenzyme Q10 (CoQ10) is a lipid-soluble, vitamin-like compound synthesized by the body from mevalonate and tyrosine. CoQ10 plays a crucial role in the production of adenosine triphosphate (ATP) in mitochondria, and serves as a potent endogenous (i.e., produced in the body) antioxidant capable of neutralizing free radicals in lipid structures.[10][11][12]

While the body naturally produces CoQ10, it can also be obtained from supplements or specific foods (refer to the question “What are the main sources of coenzyme Q10?” for more details). CoQ10 exists in either its oxidized form (ubiquinone) or its reduced form (ubiquinol), with the body interchanging the two depending on the cell’s oxidative state.[11][10] The ubiquinol/ubiquinone ratio is often used as an indicator to measure the body’s response to oxidative stress. A low ubiquinol and high ubiquinone ratio may suggest ineffective conversion between the two, potentially indicating decreased antioxidant activity.[13]

What are the main benefits of coenzyme Q10?

CoQ10 is a key endogenous antioxidant; however, its production in the body can be affected by age, underlying medical conditions, and other factors. One meta-analysis, involving healthy participants and those with cardiovascular or metabolic disease, revealed that supplementation with 30–500 mg daily of CoQ10 significantly increased total antioxidant capacity (TAC) scores and decreased malondialdehyde (MDA) levels (an oxidative stress marker) compared to the control group, although it did not significantly affect levels of another endogenous antioxidant, superoxide dismutase (SOD).[11]

Another meta-analysis indicated that supplementation with CoQ10 significantly lowered levels of inflammatory markers such as c-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-alpha), suggesting a potential anti-inflammatory effect.[14]

Additionally, CoQ10 demonstrated potential for reduction of migraine and non-migraine headaches in both adults[6] and children aged 6–12 years.[15]

Furthermore, extensive research has explored the cardiovascular and metabolic benefits of CoQ10, yielding promising results. For detailed information on CoQ10's main benefits on cardiovascular and metabolic health, please refer to the question “What are coenzyme Q10’s main benefits on cardiovascular and metabolic health?”

Finally, preliminary evidence suggests that supplementation with CoQ10 (300 mg) may be effective in reducing symptoms associated with fibromyalgia.[16]

What are the main drawbacks of coenzyme Q10?

Supplementation with CoQ10 is generally considered safe and well-tolerated, even at high dosages (1,200 mg per day)[4] and for durations up to 12 months.[4]

Regarding potential interactions, there is mixed clinical evidence that CoQ10 may interact with warfarin.[17][18][19] Additionally, animal studies suggest a potential interaction between CoQ10 and theophylline (a drug used for asthma and chronic obstructive pulmonary disease).[20]

How does coenzyme Q10 work?

CoQ10 acts as a non-enzymatic endogenous antioxidant,[21] exerting its effects by increasing the production of key antioxidants (e.g., SOD) and by inhibiting lipid peroxyl radicals, thereby reducing lipid peroxidation levels.[4] Additionally, CoQ10 serves as a cofactor in the mitochondrial electron transport chain, transporting electrons from complex I and II to complex III to synthesize ATP, and reducing the production of superoxide (a free radical).[11] Furthermore, CoQ10 appears to regenerate α-tocopherol (vitamin E’s active metabolite) from its radical state back to its antioxidative state.[22][11] Finally, another potential mechanism observed in vitro and in animal studies is the activation of nuclear factor erythroid 2-related factor 2 (Nrf-2), which regulates the cellular response to oxidative stress. However, more research is needed to verify this mechanism of action.[11]

CoQ10 appears to improve glycemic control in individuals affected by type 2 diabetes (characterized by elevated oxidative stress and abnormalities in mitochondrial function), thanks to its antioxidant activity.[5][13]

CoQ10 may improve the lipid profile through several potential mechanisms. In vitro studies showed that exposure of endothelial cells to CoQ10 was linked to downregulation of lectin-like oxLDL receptor (LOX-1), to which oxidized LDL (oxLDL) bind causing an increase in reactive oxygen species (ROS) levels, and stimulation of 5’ adenosine monophosphate-activated protein kinase (AMPK), which regulates mitochondrial ROS production and oxidative stress resistance.[23][24] Furthermore, CoQ10 may increase fatty acid oxidation, therefore reducing the level of free fatty acids in mitochondria,[25] and it may decrease triglyceride levels by increasing lipolysis.[24]

What are other names for Coenzyme Q10?
Note that Coenzyme Q10 is also known as:
  • CoQ10
  • Ubiquinone
  • Ubiquinol
  • 4-benzoquinone
  • Vitamin Q
Coenzyme Q10 should not be confused with:
Dosage information

The total daily requirement for coenzyme Q10 (CoQ10), encompassing both endogenous synthesis and external sources like food or supplements, is estimated to be approximately 500 mg per day. Notably, only a minimal amount of around 5 mg daily is typically acquired through dietary intake.[1][2]

For supplementation, the recommended dosage usually falls within 100–200 mg per day.[3][4][5] Although some studies have explored doses as high as 1200 mg per day,[4], there is currently no evidence that a higher dosage offers additional benefits.

In the context of migraine prevention, a dosage of 300 mg per day of CoQ10 has been studied with positive outcomes.[6]

CoQ10 is commonly available in capsule form, with oral administration peaking in blood levels 5–10 hours after intake, and an elimination half-life of approximately 33.19 hours.[7]

Due to its lipophilic nature, it’s advised to take CoQ10 with fat-containing foods, and capsules should ideally be formulated with a lipophilic transport (e.g., a carrier oil) for better absorption.[8] Additionally, grapefruit juice, known to inhibit the transporter P-glycoprotein which mediates CoQ10 efflux in intestinal cells, has been found to enhance CoQ10 absorption when combined in vitro.[9]

Examine Database: Coenzyme Q10