Review Article

Coenzyme Q-10 in Human Health: Supporting Evidence?

Authors: Sibu P. Saha, MD, Thomas F. Whayne, MD, PhD

Abstract

Coenzyme Q-10 (CoQ10) is a widely used alternative medication or dietary supplement and one of its roles is as an antioxidant. It naturally functions as a coenzyme and component of oxidative phosphorylation in mitochondria. Decreased levels have been demonstrated in diseased myocardium and in Parkinson disease. Farnesyl pyrophosphate is a critical intermediate for CoQ10 synthesis and blockage of this step may be important in statin myopathy. Deficiency of CoQ10 also has been associated with encephalomyopathy, severe infantile multisystemic disease, cerebellar ataxia, nephrotic syndrome, and isolated myopathy. Although supplementation with CoQ10 has been reported to be beneficial in treating hypertension, congestive heart failure, statin myopathy, and problems associated with chemotherapy for cancer treatement, this use of CoQ10 as a supplement has not been con- firmed in randomized controlled clinical trials. Nevertheless, it appears to be a safe supplementary medication where usage in selected clinical situations may not be inappropriate. This review is an attempt to actualize the available information on CoQ10 and define its potential benefit and appropriate usage.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Bonakdar RA, Guarneri E. Coenzyme Q10. Am Fam Physician 2005;72:1065-1070.
 
2. Bhagavan HN, Chopra RK. Coenzyme Q10: absorption, tissue uptake, metabolism and pharmacokinetics. Free Radic Res 2006;40:445-453.
 
3. Sood A, Sood R, Brinker FJ, et al. Potential for interactions between dietary supplements and prescription medications. Am J Med 2008;121:207-211.
 
4. Peng CC, Glassman PA, Trilli LE, et al. Incidence and severity of potential drug-dietary supplement interactions in primary care patients: an exploratory study of 2 outpatient practices. Arch Intern Med 2004;164:630-636.
 
5. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990Y1997: results of a follow-up national survey. JAMA 1998;280:1569-1575.
 
6. Quinzii CM, Hirano M. Primary and secondary CoQ(10) deficiencies in humans. Biofactors 2011;37:361-365.
 
7. Arcaniolo D, Favilla V, Tiscione D, et al. Is there a place for nutritional supplements in the treatment of idiopathic male infertility? Arch Ital Urol Androl 2014;86:164-170.
 
8. Lafuente R, Gonzalez-Comadran M, Sola I, et al. Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet 2013;30:1147-1156.
 
9. Mancini A, De Marinis L, Littarru GP, et al. An update of coenzyme Q10 implications in male infertility: biochemical and therapeutic aspects. Biofactors 2005;25:165-174.
 
10. Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain 2009;25:446-452.
 
11. Montero R, Pineda M, Aracil A, et al. Clinical, biochemical and molecular aspects of cerebellar ataxia and coenzyme Q10 deficiency. Cerebellum 2007;6:118-122.
 
12. Wang D, Yan X, Xia M, et al. Coenzyme Q10 promotes macrophage cholesterol efflux by regulation of the activator protein-1/miR-378/ATP-binding cassette transporter G1-signaling pathway. Arterioscler Thromb Vasc Biol 2014;34:1860-1870.
 
13. Lin YT, Kincaid RP, Arasappan D, et al. Small RNA profiling reveals antisense transcription throughout the KSHV genome and novel small RNAs. RNA 2010;16:1540-1558.
 
14. Allen RM, Vickers KC. Coenzyme Q10 increases cholesterol efflux and inhibits atherosclerosis through microRNAs. Arterioscler Thromb Vasc Biol 2014;34:1795-1797.
 
15. Flowers N, Hartley L, Todkill D, et al. Co-enzyme Q10 supplementation for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2014;12:CD010405.
 
16. Lee BJ, Lin YC, Huang YC, et al. The relationship between coenzyme Q10, oxidative stress, and antioxidant enzymes activities and coronary artery disease. ScientificWorldJournal 2012;2012:792756.
 
17. Hargreaves IP, Duncan AJ, Heales SJ, et al. The effect of HMG-CoA reductase inhibitors on coenzyme Q10: possible biochemical/clinical implications. Drug Saf 2005;28:659-676.
 
18. Moyad MA. The placebo effect and randomized trials: analysis of alternative medicine. Urol Clin North Am 2002;29:135-155.
 
19. Kendler BS. Supplemental conditionally essential nutrients in cardiovascular disease therapy. J Cardiovasc Nurs 2006;21:9-16.
 
20. Hidaka T, Fujii K, Funahashi I, et al. Safety assessment of coenzyme Q10 (CoQ10). Biofactors 2008;32:199-208.
 
21. Janson M. Orthomolecular medicine: the therapeutic use of dietary supplements for anti-aging. Clin Interv Aging 2006;1:261Y265.
 
22. Shults CW. Coenzyme Q10 in neurodegenerative diseases. Curr Med Chem 2003;10:1917-1921.
 
23. Nahas R. Complementary and alternative medicine approaches to blood pressure reduction: an evidence-based review. Can Fam Physician 2008;54:1529-1533.
 
24. Rosenfeldt F, Hilton D, Pepe S, et al. Systematic review of effect of coenzyme Q10 in physical exercise, hypertension and heart failure. Biofactors 2003;18:91-100.
 
25. Singh U, Devaraj S, Jialal I. Coenzyme Q10 supplementation and heart failure. Nutr Rev 2007;65(6 Pt 1):286-293.
 
26. Soja AM, Mortensen SA. Treatment of congestive heart failure with coenzyme Q10 illuminated by meta-analyses of clinical trials. Mol Aspects Med 1997;18(Suppl):S159-S168.
 
27. Molyneux SL, Florkowski CM, George PM, et al. Coenzyme Q10: an independent predictor of mortality in chronic heart failure. J Am Coll Cardiol 2008;52:1435-1441.
 
28. McMurray JJ, Dunselman P, Wedel H, et al. Coenzyme Q10, rosuvastatin, and clinical outcomes in heart failure: a pre-specified substudy of CORONA (controlled rosuvastatin multinational study in heart failure). J Am Coll Cardiol 2010;56:1196-1204.
 
29. Felker GM. Coenzyme Q10 and statins in heart failure: the dog that didn’t bark. J Am Coll Cardiol 2010;56:1205-1206.
 
30. Madmani ME, Yusuf Solaiman A, Tamr Agha K, et al. Coenzyme Q10 for heart failure. Cochrane Database Syst Rev 2014;6:CD008684.
 
31. Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy: a systematic review. J Am Coll Cardiol 2007;49:2231-2237.
 
32. Singh RB, Niaz MA, Kumar A, et al. Effect on absorption and oxidative stress of different oral coenzyme Q10 dosages and intake strategy in healthy men. Biofactors 2005;25:219-224.
 
33. Caso G, Kelly P, McNurlan MA, et al. Effect of coenzyme q10 on myopathic symptoms in patients treated with statins. Am J Cardiol 2007;99:1409-1412.
 
34. Banach M, Serban C, Sahebkar A, et al. Effects of coenzyme Q10 on statin-induced myopathy: a meta-analysis of randomized controlled trials. Mayo Clin Proc 2015;90:24-34.
 
35. Banach M, Mikhailidis DP, Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. In replyVcoenzyme Q10 and statin-induced myopathy. Mayo Clin Proc 2015;90:420-421.
 
36. Roffe L, Schmidt K, Ernst E. Efficacy of coenzyme Q10 for improved tolerability of cancer treatments: a systematic review. J Clin Oncol 2004;22:4418-4424.