CoQ10 Benefit dosage statin drug use and side effects, use with statins such as Lipitor and Zocor
Coenzyme Q10 dosage for cholesterol, high blood pressure and heart failure, what is the right dose to take on a regular basis?
Which dosage is best, 30, 50, 60, 100, 200 or 300 mg capsules? Are there safety issues with very high doses?
Use for cancer, Parkinson's, fibromyalgia, energy, effect on blood pressure, for weight loss and fertility patients
March 7 2014

Many people who take a CoQ10 supplement notice an increase in energy. But some are under the misconception that the more they take, the healthier they will be. Perhaps you have already heard of it being touted for heart health, vitality, and other benefits. But before you take coenzyme q10 as a supplement, learning some simple facts could help you make a more informed decision.

 

Is it a vitamin?
Coq10 is not a vitamin but a nutrient. It is naturally made in the body. Technically, a vitamin is a substance that the body cannot synthesize or cannot synthesize enough to maintain health and physiological functioning.
Coenzyme Q10 is a naturally occurring nutrient and antioxidant found in each cell of the body. This nutrient was first identified by University of Wisconsin researchers in 1957. The supplements is gradually becoming more popular in the USA.

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Review and recommendations, contraindications
CoQ10 is probably beneficial in certain cardiovascular conditions and as an energy booster. There is debate in the medical community regarding the benefit for Parkinson's disease. As of 2014, we are not convinced that CoQ10 is of significant benefit for those with Parkinson's disease. Long-term therapy with 10 to 60 mg a few days a week seems a reasonable option for many individuals. Fortunately, the pace of CoQ10 research has increased over the past decade and the next few years will provide us with additional information on the best way to take advantage of this wonderful nutrient.


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How does it work?

Each cell in the body needs a source of energy to survive, so cells break down sugars, fats, and amino acids to make energy. Small enclosures within cells that make this energy are called mitochondria. CoQ10 exists naturally in our mitochondria and carries electrons involved in energy metabolism. CoQ10 is essential in the production of adenosine triphosphate (ATP), the basic energy molecule of each cell. This necessary nutrient is also called ubiquinone.
   In the bloodstream, CoQ10 is mainly transported by lipoproteins such as LDL (low-density lipoprotein) and HDL (high-density lipoprotein). It is thought that CoQ10 is one of the first antioxidants to be depleted when LDL is subjected to oxidation. Hence, it is an important nutrient that prevents the oxidation of lipoproteins, thus potentially reducing the risk of arteries from forming plaques and getting damaged.
   In healthy individuals, CoQ10 is found in high concentrations in the heart, kidneys, and liver.

 

What foods contain coenzyme q10?
CoQ10 is found in foods, particularly in fish and meats, and small amounts are found in nuts. There is little or none in grains, vegetables or fruits. Hence, some vegetarians may not get adequate amounts of this nutrient, although, fortunately, the body is able to synthesize it when dietary sources are not adequate. Dietary intake through food is about 2 to 5 mg per day.

 

Benefit

Studies with CoQ10 have mostly focused on its benefit involving certain types of cardiovascular diseases, including congestive heart failure and hypertension and to a certain extent for high cholesterol and in diabetes. Not all the results have been positive and much more research is needed before we determine the full benefits, side effects, and appropriate dosage.

 

Antioxidant benefit
CoQ10 is an excellent antioxidant.

 

Cancer
Not enough research is available to determine its role in the treatment of cancer. CoQ10 supplement use may improve sense of wellbeing, but whether extra intake increases longevity is not fully clear.

 

Melanoma
A 3-year trial with low-dose recombinant interferon alpha-2b (9 000 000 000 IU weekly) administered twice daily and coenzyme Q10 (400 mg a day) was conducted in patients with stage I and II melanoma. Long-term administration of an optimized dose of recombinant interferon alpha-2b in combination with coenzyme Q10 seemed to induce significantly decreased rates of recurrence and had negligible adverse effects. A survival study could not be undertaken owing to the small patient sample and the short duration of follow-up. Melanoma Res. 2007.

 

Q. I see a lot of people with cancer and a Danish Doctor who has been doing a lot of research with coq10 and cancer found that they needed 400mg daily to get any real benefit. I have had people on coQ10 for at least 2 years on that dosage and never seen a side effect of any kind. All my adult cancers take this CoQ10 dosage.
   A. When people take CoQ10 in high dosages as a daily supplement for many years or decades, we have no idea how this will interfere with their metabolism. It is unnatural to expose the body to such high dosages. What if we learn 20 years from now that people taking more than 200 mg a day actually live a few years shorter or somehow their mitochondria are not functioning as well? As with hormone replacement therapy, it took decades for the scientific community to find out that it caused more problems than in solved. CoQ10 appears to be a healthy supplement, but who knows for certain that taking more than 100 mg is healthier than taking less? Many people who take CoQ10 also take other supplements or medicines and we have no idea the interactions that could be caused. Plus, what if someone who is used to taking 400 mg a day goes on a trip and forgets their bottle and in the foreign country they can't find CoQ10? If, after years of taking 400 mg their body is used to it, what happens if they stop? What if when they are older and they are on a limited budget they can't afford buying it anymore? There are many answers about high dose CoQ10 use that we don't know yet. We also have reports from quite a few people who actually feel fatigued when they take more than 100 mg. Perhaps high doses for cancer or other conditions is appropriate, but for the general public taking CoQ10 as a supplement for health promotion, there is no proof that taking high dosages is beneficial. We also have to consider the cost, CoQ10 is expensive. For the time being we suggest 30 or 50 mg most days of the week for those who wish to take this supplement.

 

Benefit for cholesterol

Individuals on cholesterol medicines of the statin class such as Lipitor, Zocor, and others, may consider taking CoQ10 supplements since statins decrease blood CoQ10 levels. To be on the safe side, 30 or 50 mg can be taken a few times a week by those on statin drugs.
   Dietary supplementation results in increased levels of coenzyme Q10 within circulating lipoproteins and increased resistance of human low-density lipoproteins to the initiation of lipid peroxidation. Taking a coenzyme q10 supplement is not likely to make a significant influence on cholesterol levels.

CoQ10 reverses muscle damage from statin cholesterol drugs
Scientists now suspect that CoQ10 deficiency may partly or fully contribute to the development of muscle damage in those on these cholesterol lowering drugs. Dr. Giuseppe Caso and colleagues from Stony Brook University, Stony Brook, New York gave 100 mg of CoQ10 for one month to 32 patients using statins. Pain intensity decreased by 40% after a month of treatment whereas patients treated with vitamin E (as placebo) experienced no change in pain intensity. Sixteen of 18 coenzyme Q10-treated patients experienced a decrease in pain. Am J Cardiol 2007.
   In clinical practice, we have found that not everyone benefits from coenzyme Q10 for the prevention or treatment of muscle damage from the use of statin drugs.

Lipitor
The use of the statin drug Lipitor may cause muscle aches and pains and muscle damage in some patients. It is a good idea to take CoQ10 along with Lipitor. However, there is no guarantee that muscle aches or Lipitor side effects will be prevented with the use of a coenzyme q10 supplement.

A small study published in the May 15th, 2007 issue of the American Journal of Cardiology supports the viewpoint that coenzyme Q10 supplements could be helpful. Scientists now suspect that CoQ10 deficiency as a result of stating drug use may partly, or fully, contribute to the development of muscle damage. Dr. Giuseppe Caso and colleagues from Stony Brook University, Stony Brook, New York gave 100 mg of CoQ10 for one month to 32 patients using statins. Pain intensity decreased by 40% after a month of CoQ10 treatment whereas patients treated with vitamin E (as placebo) experienced no change in pain intensity. Sixteen of 18 coenzyme Q10-treated patients experienced a decrease in pain.
   We are not sure 100 mg is needed in the long run. If 30 mg or 50 mg works for you, then take these lower amounts. Researchers often have a limited time to do a study and use high dosages of a medicine to elicit a response, but that does not mean that same dosage should be used forever.

Red yeast rice
Is it necessary to take CoQ10 supplement with red yeast rice supplement"
   If the red yeast rice extract supplement has compounds that are similar to statins, it may be a good idea to take it. However, if the red yeast rice does not have substances in it that are similar to statin drugs, then there would be no need to take CoQ10 with red yeast rice extract.

Benefit for diabetes

CoQ10 may be beneficial in diabetics. It helps improve the function of endothelial cells lining blood vessels and may slightly help with blood sugar control. 

 

Energy increase
Most people who take a reasonable amount -- not too high -- notice more energy.

I just wanted to mention that I recently began taking 30 mg of COQ10 and noticed that there was a significant change in my health. I've felt so much better physically and mentally. My ability to focus had been lacking in the past year or so but after taking the nutraceutical I've been able to think clearer. My energy levels are higher, and although I've given up eating beef, I'm noticing a difference in my physical self.

 

Benefit for heart attacks

In a small trial of patients with new myocardial infarction, CoQ10 -- used in addition to aspirin and cholesterol-lowering drugs -- decreased the likelihood of further cardiac events for at least one year after the heart attack.

 

Heart failure

Coenzyme Q10 has certain benefits for heart health and heart disease. A study in patients with heart failure showed improvement in functional status, clinical symptoms, and quality of life in end stage heart failure patients who were placed on CoQ10.  More research is needed to find the ideal dosage range. For the time being those with heart failure should not to exceed 50 mg or 100 mg a day.

 

Kardiologiia. 2013. Coenzyme q10 in complex therapy of patients with ischemic heart disease. The paper contains results of assessment of clinical efficacy and safety of coenzyme Q10 in patients with ischemic heart disease. Coenzyme Q10 (60 mg/day for 8 weeks) added to basic treatment of patients with stable class II-III angina significantly improved clinical status of these patients without clinically significant side effects.

 

Dr. Romualdo Belardinelli, of Lancisi Heart Institute in Italy studied 23 patients with moderate to severe heart failure. They were assigned to four weeks each of CoQ10 supplements or placebo pills, with or without supervised exercise training. The dosage was 100 mg three times a day. Those taking CoQ10 had improvement in peak exercise capacity. There was an improvement in cardiac function with treatment. Combining with exercise training produced more marked improvements than the nutrient alone. The use of CoQ10 improves several aspects of heart failure without any side effects.
   We tend to be more cautious on dosages and would prefer keeping the amount of CoQ10, at least initially, to 30 mg or 50 mg once or twice a day. CoQ10 can be taken with breakfast and or lunch. The study went on only for one month, and even though the researchers did not observe side effects on 100 mg three times a day, it is possible that prolonged use of 300 mg a day over several weeks or months could lead to adverse events. We also don't have a good understanding how Coenzyme Q10 supplements interact with heart medicines.

 

Hypertension or high blood pressure

CoQ10 may help lower blood pressure by a small amount in some people.

 

Benefit for migraine headache
Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial.
Neurology. 20055.
Riboflavin, which improves energy metabolism similarly to coenzyme Q10, is effective in migraine prophylaxis. We compared CoQ10 100 mg three times a day and placebo in 42 migraine patients in a double-blind, randomized, placebo-controlled trial. The supplement was superior to placebo for attack-frequency, headache-days and days-with-nausea in the third treatment month and well tolerated; 50%-responder-rate for attack frequency was 14% for placebo and 47% for CoQ10 (number-needed-to-treat: 3). CoQ10 is efficacious and well tolerated.

 

Parkinson's disease
Studies with CoQ10 and Parkinson's disease have not yielded consistent results. CoQ10 at a dosage of 100 mg three times a day was well tolerated but did not show much benefit in midstage Parkinson disease patients. Arch Neurol. 2007.

 

Weight loss
We have not seen any research that indicates the use of CoQ10 leads to weight loss.
 

Side effects, danger, risk

CoQ10 is a safe nutrient, but side effects can occur if you take too high a dosage for too long without a break. High dosages, such as more than 100 or 200 mg a day, can induce restlessness, fatigue and insomnia. Long term CoQ10 side effects use are not clear at this time. We do not recommend more than 20 to 60 mg of CoQ10 daily on a long term basis without medical supervision. Headaches are rare on high dosages.

My doctor told me to take 100mg of it every day, and I am feeling worse than ever: tired, no get up and go, difficulty concentrating, waking up more tied than when I got to bed, falling asleep during the day, you name it. Ever seen a case like that regarding coenzyme q10 side effects?
   Everyone responds differently to supplements. The dosage of a supplement can make a huge difference. Too high a dose can cause several side effects including insomnia or shallow sleep resulting in tiredness the next day. We do not recommend more than 30 or 60 mg a day for long term use.

Dosage and dose

We believe that high doses are not needed, and may even be unhelpful or detrimental. We have had reports of fatigue when taking dosages above 100 mg. Just as we recently discovered that high doses of vitamin E, generally over 400 units, are not beneficial, or even potentially harmful, we may eventually discover the same about CoQ10.we would not feel comfortable recommending taking more than 50 mg or maximum 100 mg a day, unless for the temporary treatment of a medical condition. CoQ10 is best taken in the morning, before or with breakfast.  People often take too high a dosage of Co enzyme Q10 and other supplements. We don't see why most people require more than 30 or 50 mg a few times a week. We just don't know what kind of CoQ10 side effects may occur by taking several hundred mgs for months and years. More is not necessarily better when it comes to supplements. Plus, many people who take CoQ10 also take other supplements and we don't know what kind of interactions would occur with other herbs, nutrients, and medicines.

Can a normal healthy person start taking CoQ10 with his or her diet on a regular basis like other multivitamins without any harmful side effects. On the other hand, if your body doesn't need CoQ10 but you are taking, would it hurt your body or do any damage?
   There is no easy answer to this. Some people may benefit from taking it, others may not. Much depends on a person's diet and metabolism and what other supplements and medicines they are taking. If a person wants to take CoQ10, 30 mg a few times a week could offer benefits without any foreseeable side effects. If high dosages of CoQ10 are used, such as 100 mg a day, side effects could occur including difficulty sleeping or fatigue. However, we can't see any harm in taking 30 mg of CoQ10 a few times a week.

Availability -- CoQ10  30 mg, 50 mg, 60 mg, 100 mg, 200 mg and and 400 mg
30 mg - this dosage can be taken safely by most people for long term use. We do suggest taking a day off each week, and a few days off each month.
50 mg - this dosage can be taken a few days a week.
60 mg - this can be taken a few days a week.
100 mg - we do not recommend these pills for long term use unless clearly indicated for a medical condition.
200 mg - we do not recommend these pills for more than a few days.
400 mg - we do not recommend these high dosages unless recommended by a health care provider who is experienced with this supplement.

Does the effectiveness matter if it is taken in capsule form or if emulsified in an oil like alpha tocopherol.  I read an advertising leaflet that said not to waste money on CoQ10 tablets or capsules, because they cannot be absorbed into blood stream.
   There are probably differences in absorption between different CoQ10 products, and perhaps oil emulsified products are better absorbed, however, most CoQ10 supplements contain 30, 60 or 100 mg which are dosages far greater than normally needed by the body. Hence, even if 100 percent of the CoQ10 is not absorbed, practically speaking it should not make too much of a difference.

I was watching home shopping network and they were selling CoQ10 in capsule form as opposed to softgel with oil. This nutrient is fat soluble, isn't oil necessary in the softgel for the CoQ10 to be absorbed and won't it in a capsule not be as effective?
   We don't see a problem with the capsule. Since CoQ10 is taken with breakfast, there's always some form of fat or oil in one's breakfast and I think the CoQ10 will be absorbed whether taken as a softgel or a capsule. Some people, in my opinion, are taking too high a dose, so even if there is a slight reduced absorption (which I doubt), perhaps that's for the better.

Does liquid CoQ10 offer advantages over capsules?
   CoQ10 supplement taken orally as a capsule of softgel works very well and is well-absorbed. For practical purposes, we don't think liquid CoQ10 offers any major benefits.

Drug interactions
The administration of CoQ10 and warfarin does not significantly affect the anticoagulant effect of warfarin in rats.
A Human trial shows Co Q10 and Ginkgo biloba do not influence the clinical effect of Coumadin.

L carnitine
Can a vitamin CoQ10 supplement be taken together with L carnitine supplement?
   If your dosage is less than 50 mg, and L carnitine is less than 200 mg, then they may taken together a few times a week.

How is it made?
Coenzyme Q, also known as ubiquinone, is a naturally occurring coenzyme formed from the conjugation of a benzoquinone ring and an isoprenoid chain of varying length. Coenzyme Q10 is the main Coenzyme Q produced by humans,. Production for the purposes of supplements is usually done by microbes that produce high levels of Coenzyme Q10 naturally. New methods of making it are now being evaluated.

Influence on blood levels
Effects of coenzyme Q10 supplementation on plasma adiponectin, interleukin-6, and tumor necrosis factor-alpha levels in men.
J Med Food. 2010.
The aim of the study was to determine the effects of coenzyme Q10 supplementation on plasma adiponectin, interleukin (IL)-6, and tumor necrosis factor (TNF )-alpha levels in sedentary men. The participants were randomly allocated to two groups. Seven participants received oral coenzyme Q10 (100 mg/day) supplementation, and seven participants received placebo (glucose) for 8 weeks. Supplementation did not affect plasma adiponectin, IL-6, and TNF-alpha levels in sedentary men.

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Q. I was reading information about a form of CoQ10 (branded as Accel) that is allegedly much better absorbed into the bloodstream. The Accel folks say it skips the conversion process from ubiquinone to ubuquinol.
   A. We are not aware of any human studies that indicate Accel is a healthier way to supplement with CoQ10 than the standard and accepted forms that have been available for decades.

I have some tremors in my hands. I am on Rhytmol / Propafenon for my arrythmias. I tried going off it, but the arrythmias returned. I tried substituting with Magnesium, CoQ10, and fish oil, but to no avail. I've heard the taurine can help reduce the tremors. Is that true? What else might someone take?

See a YouTube information video on Coenzyme Q10 health benefit