Coenzyme CoQ10 plays a very important role in heart disease. Click here to read about the need for CoQ10 supplementation when taking statins. Click here to learn how to select a CoQ10 supplement and what makes a good one.
CoQ10 can also be useful for several other disease processes, as I will discuss below.
All research referenced are human trials.
CoQ10 as an Anti-inflammatory
Inflammation is believed to be a factor behind all chronic diseases. Bringing down inflammation would have wide ranging benefits and reduce risk of cardiovascular disease, diabetes, autoimmune disease, cancer and the list goes on. Good ways to measure inflammation are circulating blood markers such as C-reactive protein, IL-6 and TNF-a. Although small, the effects below are statistically significant and can make meaningful effects clinically.
How CoQ10 Works as an anti-inflammatory
- CRP reduction by about 0.35 ml/L
- C-reactive protein (aka CRP) is very powerful blood marker for systemic inflammation
- Normal lab values are anything less than 8 ml/L.
- IL-6 reduction by about 1.61 pg/ml 
- IL-6 is a cellular signalling molecule, known to stimulate inflammation and auto-immune processes in many diseases, atherosclerosis, depression, Alzheimer’s Disease and more
- Normal lab values are 5-15 pg/ml
- TNF-α reduction by about 0.49 pg/ml 
- TNF-α is another cellular signalling molecule involved in systemic inflammation
- Normal lab values are 5 – 27.4 pg/ml
CoQ10 as an Anti-Oxidant
Oxidation occurs through the work of reactive oxygen species (ROS); in other words it’s bad. Oxidation is another huge factor in chronic disease. It is true our body has its own built in anti-oxidant systems to quench reactive oxygen species. Many compounds play a role in our oxidation defense systems such as Vitamin C, E, beta carotene and CoQ10. CoQ10 is naturally found in most animals who use oxygen to make energy (humans included!).
How CoQ10 Works as an Anti-oxidant
- CoQ10 exists in two forms, ubiquinone and ubiquionol – both serve as anti-oxidants because they can donate electrons to the reactive oxygen species; hence quenching the threat
- It’s been shown that many diseases mediated by oxidation lead to a CoQ10 deficiency .
CoQ10 for Migraine Headaches
A migraine is a headache with moderate to severe pain, characterized by nausea, vomiting, sensitivity to light/sound/smell. Its believed to be due to a mix between environmental and genetic factors. There are many theories as to why migraines occur – including neurovascular aetiologies and mitochondrial causes (CoQ10 is abundant in mitochondria).
How does CoQ10 help Migraines?
- helps with the number of days a person suffers with a migraine. The number of days dropped by 50% 
- Group supplemented with 150 mg CoQ10 for 3 months. Average days (per month) with headache went from 7.34 down to 2.95 after supplementation.
- CoQ10 combined with Magnesium and B2 saw significant reduction in migraine pain severity and frequency 
- NNT = 3 
- NNT refers to Number needed to treat. In other words, 3 people with migraines would need to be treated with CoQ10 for 1 to see benefit. NNT is a very important statistic to understand efficacy of treatment. Check this website for more information on the concept of Number Needed to Treat
CoQ10 for Diabetes
Diabetes is a blood sugar disorder. There is an increasing body of evidence showing type-2 diabetes is associated with mitochondrial dysfunction secondary to oxidative stress. It’s known that CoQ10 helps with both mitochondrial health and works as a powerful anti-oxidant.
How does CoQ10 help Diabetes?
- Insulin secretion improved on the insulinogenic index
- Hemoglobin A1c (HgA1c) reduced from 1 to 6.8%
- Normal range HbA1c <5%
- Study supplemented 200 mg ubiquinol (coQ10) daily for 12 weeks
CoQ10 for Fibromyalgia
What is Fibromyalgia: it is a syndrome that affects muscles and soft tissue, characterized by chronic muscle pain, weakness, fatigue, sleep problems and often times tender points or trigger points. There is not one known cause of fibromyalgia, but there are many evidence based theories as to why some people suffer from it, including both mitochondrial dysfunction and CoQ10 deficiency
How Does CoQ10 help fibromyalgia?
- Improved findings: lowered FIQ, pain reduction, fatigue, morning tiredness, reduction in tender points, recovery from inflammation 
- Trial used 300 mg of CoQ10 per day, for 40 days
CoQ10 for Exercise Tolerance
Exercise tolerance can not only be applied to athletic populations, but serve as an indicator for overall heath – even in a diseased state.
How Does CoQ10 help exercise tolerance?
- Anti-fatigue effects during physical exercise 
- Oral supplementation improved subjective fatigue sensation and physical performance (bike riding at maximal exertion) during fatigue-inducing workload trials
Recap of CoQ10’s effect on heart disease:
Congestive Heart Disease
Congestive heart failure is a sequela of heart failure. Heart failure doesn’t mean the heart stops altogether – rather it fails to pump as efficiently as it should. The hearts main purpose is to pump blood throughout the body. The muscle itself contracts, squeezing the blood forcefully out of the heart and through the arteries. If the heart is unable to do this, pressure builds up, fluids build up and the body retains water and salt. Its congestive heart failure once the system (body and heart) become congested with extra fluid.
How CoQ10 helps Congestive heart disease:
- CoQ10 levels observed to be lower in patients with heart failure 
- CoQ10 has been shown to improve left ventricular ejection fraction (in other words the heart pumps more efficiently) 
- Benefits in symptom relief – 6 min walking distance, exercise duration, peak oxygen consumption and quality of life (results obtained through objective and subjective measures  
Coronary Heart Disease (CAD)
CAD is the most common type of heart disease, characterized by limitation of blood flow to the heart itself. The arteries that feed the heart oxygen become obstructed, hardened, stiffened or swollen, and blood through those arteries becomes hindered.
How CoQ10 works in CAD
- Lp(a) reduction by about 3.54 mg/dL in patients with elevated LpA (greater than 30 mg/dL
- Lipoprotein(a) is a LDL- like particle known to be a powerful risk factor for CAD
- Reducing Lp(a) would reduce risk of heart complications
- It should be noted, in the human trial referenced, total cholesterol and cholesterol subtractions and triglycerides levels were not affected by CoQ10 supplementation. This is still interesting as most cholesterol drugs target total cholesterol and subfractions but are notorious for having minimal effect on Lp(a)
- Reference Ranges:
- Desirable levels are <14 mg/dL
- Borderline risk: 14 – 30 mg/dL
- High Risk: 31- 50 mg/dL
- Very high risk: >50 mg/dL
It is elevated blood pressure.More than a disease, it is simply a symptom or risk factor for other conditions.
How CoQ10 works with Blood Pressure
- Potential to reduce systolic blood pressure by up to 17 mmHg in hypertensive patients 
- Potential reduce diastolic blood pressure by up to 10 mmHg in hypertensive patients 
- Normal blood pressure ranges 
- Non-diabetics: 140/90
- Diabetics: 130/80
Click to expand references
 L. Fan, Y. Feng, G. Chen, L. Qin, C. Fu and L. Chen, “Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials.,” Pharmacological Research, vol. 119, pp. 128-136, 2017. [https://www.ncbi.nlm.nih.gov/pubmed/28179205].
 M. Battino, P. Bullon, M. Wilson and H. Newman, “Oxidative injury and inflammatory periodontal diseases: the challenge of anti-oxidants to free radicals and reactive oxygen species.,” Critical Reviews in oral biology and medicine, vol. 10, no. 4, pp. 458-476, 1999.[https://www.ncbi.nlm.nih.gov/pubmed/10634583].
 T. Rozen, M. Oshinsky, C. Gebeline, K. Bradley, W. Young, A. Shechter and S. Silberstein, “Open label trial of coenzyme Q10 as a migraine preventive.,” Cephalagia, vol. 22, no. 2, pp. 137-141, 2002. [https://www.ncbi.nlm.nih.gov/pubmed/11972582].
 C. Gaul, H. Diener and U. Danesch, “Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial,” Journal of Headache and Pain, vol. 16, p. 32, 2015. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393401/].
 P. Sandor, L. Di Clemente, G. Coppola, A. Fumal, U. Saenger, L. Seidel, R. Agosti, D. Magis and J. Schoenen, “Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial.,” Neurology, vol. 64, no. 4, pp. 713-715, 2005. [https://www.ncbi.nlm.nih.gov/pubmed/15728298].
 M. Cordero, E. Alcocer-Gómez, M. de Miguel, O. Culic, A. Carrión, A.-S. J, P. Bullón, M. Battino, A. Fernández-Rodríguez and J. Sánchez-Alcazar, “Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia?,” Antioxidants and Redox Signalling , vol. 19, no. 12, pp. 1356-1361, 2013. [https://www.ncbi.nlm.nih.gov/pubmed/23458405].
 K. Mizuno, M. Tanaka, S. Nozaki, M. H, A. S, T. T, T. Sugino, T. Shirai, Y. Kajimoto, H. Kuratsune, O. Kajimoto and Y. Watanabe, “Antifatigue effects of coenzyme Q10 during physical fatigue.,” Nutrition, vol. 24, no. 4, pp. 293-299, 2008. [https://www.ncbi.nlm.nih.gov/pubmed/18272335].
 J. Jankowski, K. Korzeniowska, A. Cieślewicz and A. Jabłecka, “Coenzyme Q10 – A new player in the treatment of heart failure?,” Pharmocological Reports, vol. 68, no. 5, pp. 1015-1019, 2016. [https://www.ncbi.nlm.nih.gov/pubmed/27428763].
 E. Sciatti, C. Lombardi, A. Ravera, E. Vizzardi, I. Bonade, V. Carubelli, E. Gorga and M. Metra, “Nutritional Deficiency in Patients with Heart Failure.,” Nutrients, vol. 8, no. 7, 2016. [https://www.ncbi.nlm.nih.gov/pubmed/27455314].
 M. Berman, A. Erman, T. Ben-Gal, D. Dvir, G. Georghiou, A. Stamler, Y. Vered, B. Vidne and D. Aravot, “Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: A randomized, placebo-controlled study,” Clinical Cardiology, vol. 27, pp. 295-299, 2004. [https://www.ncbi.nlm.nih.gov/pubmed/15188947].
 C. Hofman-Bang, N. Rehnqvist, K. Swedberg, I. Wiklund and H. Aström, “Coenzyme Q10 as an adjunctive in the treatment of chronic congestive heart failure. The Q10 Study Group.,” Journal of Cardiac Failure, vol. 1, no. 2, pp. 101-107, 1995. [https://www.ncbi.nlm.nih.gov/pubmed/9420639].
 A. Keogh, S. Fenton, C. Leslie, C. Aboyoun, P. Macdonald, Y. Zhao, M. Bailey and F. Rosenfeldt, “Randomised double-blind, placebo-controlled trial of coenzyme Q10 therapy in class II and III systolic heart failure.,” Heart, Lung & Circulation, vol. 12, no. 3, pp. 135-141, 2003. [https://www.ncbi.nlm.nih.gov/pubmed/18705154].
 A. Sahebkar, L. Simental-Mendía, C. Stefanutti and M. Pirro, “Supplementation with coenzyme Q10 reduces plasma lipoprotein(a) concentrations but not other lipid indices: A systematic review and meta-analysis.,” Pharmacological Research, vol. 105, pp. 198-209, 2016. [https://www.ncbi.nlm.nih.gov/pubmed/26836888].
 F. Rosenfeldt, S. Haas, H. Krum, A. Hadj, K. Ng, J. Leong and G. Watts, “Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials.,” Journal of Human Hypertension, vol. 21, no. 4, pp. 297-306, 2007. [https://www.ncbi.nlm.nih.gov/pubmed/17287847].
 A. Leung, “Hypertension Canada’s 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults,” Canadian Journal of Cardiology, vol. 33, no. 5, pp. 557-576, 2017. [http://guidelines.hypertension.ca/diagnosis-assessment/diagnosis/].
About the Author
I’m Johann de Chickera, a Naturopathic Doctor, practicing in Ontario, Canada. My clinical practice relies on keeping up with the most up-to-date research and continued education. This blog serves as a way to provide others with a compilation of everything I’ve learned along the way. Please click here if you’re local and want to see me in practice.