CoQ 10: Supplement or Drug?
Who would benefit from CoQ 10 Supplementation?
Answer: CoQ10 is clearly safe and well-tolerated (LINK), but the evidence is no better than tenuous that healthy individuals benefit from supplemental CoQ10. If, however, you have a neurodegenerative disease or a condition associated with high levels of oxidative stress like diabetes or autism, you may want to consider supplementation. This article describes what CoQ10 supplements do and explains why some people need them.
The skin/brain connection
What does fighting wrinkles have in common with Alzheimer's and Parkinson's diseases? The exact same rationales apply for treating these diseases as for treating skin aged by the sun. In all cases, high levels of oxidative stress and some associated mitochondrial dysfunction (1).
CoQ 10 is known to act as an antioxidant (combating oxidative stress), and as an essential mitochondrial cofactor (helping the mitochondrial dysfunction). These observations create an opportunity to combat age-associated losses in cognition due to oxidative damage and diminished cellular respiration. At a cellular level, CoQ 10 has been shown to protect neurons from a variety of toxic insults (2). Also, in a mouse model of learning, mice supplemented with CoQ 10 and tocopherol were demonstrated to learn faster than controls (3).
But as we have seen before, once we get to humans, the story gets far more complicated. In the case of human skin, topically supplementing CoQ 10 back into aging skin creates measurable benefits. However, except for some preliminary evidence of efficacy for atherosclerosis, very little positive data has been published supporting aging-related benefits to CoQ10 supplements in healthy humans. To cite one in particular, researchers described a way that CoQ10 supplements could curtail an age-related source of oxidative stress (4), but the implications of remain unclear. Moreover, lifespan studies in mice have shown no life-extension benefit to CoQ 10 supplementation (5).
But what about CoQ 10 as a drug?
This is a different story. When a neuropathology shows up, then the data from the neurotoxic insults starts to get relevant (2). In fact, a fairly extensive set of data from cellular and animal models supports the exploration of CoQ10 as a therapy for Parkinson's, Huntington's, ALS, Alzheimer's, and other neurodegenerative diseases like Friedreich's ataxia (1, 6, 7). A large number of clinical trials involving CoQ10 along with other therapies are in progress (8). In fact, some positive results have come back for a combination of CoQ10 and vitamin E in treating the neurodegenerative disease Friedreich's ataxia (9).
Ppatients with congestive heart failure and coronary artery disease were found to have lower levels of CoQ10 than control subjects. Some small-scale exploratory studies have shown improvements in various cardiac health metrics, but larger trials are needed here (10).
What should you do?
If you are healthy, evidence is pretty sparse in support of CoQ10 supplementation. I think that something will emerge in this area in the next couple of years, but right now it's not there. Moreover, CoQ10 is very poorly absorbed, so most of what you are taking is going straight out of your body. No need for that.
If you are not healthy, talk to your doctor. CoQ10 supplements may be helpful for you. Fortunately, they have been tested at very high doses in patients and healthy subjects with very little in the way of side effects.
If you do choose to supplement with CoQ10, it is important that you know about the
risks and side effects
before you begin.
Another very exciting area for CoQ10 research is a recent study suggesting that CoQ10 supplementation can improve metrics of male fertility.
1. Beal, MF, "Mitochondrial dysfunction and oxidative damage in Alzheimer's and Parkinson's diseases and coenzyme Q10 as a potential treatment." J Bioenerg Biomembr. 36 (2004) 381-6.
2. Kooncumchoo, P, Sharma, S, Porter, J, et al. "Coenzyme Q(10) provides neuroprotectio in iron-induced apoptosis in dopaminergic neurons." J Mol Neurosci 28 (2006) 125-41.
3. Mcdonald, SR, Sohal, RS, Forster, MJ. "Concurrent administration of coenzyme Q10 and alpha-tocopherol improves learning in aged micec." Free Rad Biol Med. 38 (2005) 729-36.
4. Morre, DM, Morre, Morre, DJ, Rehmus, W, Kern, D. "Supplementation with CoQ10 lowers age-related (ar) NOX levels in healthy subjects." Biofactors 32 (2008) 221-30.
5. Sohal, RS, Kamzalov, S, Sumien, N, et al. "Effect of coenzyme Q10 intake on endogenous coenzyme Q content, mitochondrial electron transport chain, antioxidant defenses, and life span of mice." Free Rad Biol Med. 40 (2006) 480-7.
6. Yang, L, Calingasan, NY, Willie, EJ, et al. "Combination therapy with coenzyme Q10 and creatine produces additive neuroprotective effects in models of Parkinson's and Huntington's diseases." J Neurochem 109 (2009) 1427-39.
7. Cooper, JM, Schapira, AHV. "Friedreich's ataxia: Coenzyme Q10 and vitamin E therapy." Mitochondrion 7S (2007) S127-35.
8. Galpern, WR, Cukowicz, ME. "Coenzyme Q treatment of neurodegenerative diseases of aging." Mitochondrion 7S (2007) S146-53.
9. Cooper, JM, Korlipara, LVP, Hart, PE, et al. "Coenzyme Q10 and vitamin E deficiency in Friedreich's ataxia: predictor of efficacy of vitamin E and coenzyme Q10 therapy." Eur J Neurol. 15 (2008) 1371-9.
10. Belardinelli, R, Mucaj, A, Lacalaprice, F, et al. "Coenzyme Q10 and exercise training in chronic heart failure." Eur Heart J. 27 (2006) 2675-81.