What is Coenzyme Q10 in more detail?

Coenzyme Q10 is a fat-soluble antioxidant made by your cells when they have the necessary raw materials. Mitochondria contain about half the coenzyme Q10 in cells, and within mitochondria coenzyme Q10 is involved in generating energy (ATP). Coenzyme Q10’s energy-generating and antioxidant actions make it especially important to the function of energy-hungry organs, such as the heart. Bodily levels of coenzyme Q10 decline during aging, are lower in many chronic diseases, and are reduced by some common medications, most notably statins. 

Coenzyme Q10 is naturally present in the human diet, but in amounts well below what seems optimal based on research. The best dietary sources include offal (heart, especially), which few people eat.

Effects of coenzyme Q10 on lifespan and healthspan  

Coenzyme Q10 is not in Coastline because we think it will extend lifespan — we include it more for its proven effects on the functions of various bodily systems. However, there has been a little research on whether coenzyme Q10 can extend lifespan.  

In general, supplementation with coenzyme Q10 has not been found to extend the lifespans of mice (see this too) or rats. It is possible that this might differ in certain conditions. For example, rats fed a sunflower oil rich diet lived shorter lives than rats fed fish oil- or extra-virgin olive oil-rich diets. Interestingly, supplementing the diet with coenzyme Q10 offset some of the lifespan-reducing effect of the sunflower oil diet but had no influence on lifespan in the rats fed either of the other diets. This built on previous research showing that coenzyme Q10 extended the average lifespan (by 12%) and the maximum lifespan (by 24%) of rats fed a diet rich in polyunsaturated fat, a class of fats prone to spoiling (oxidation), in turn damaging cellular structures. Indeed, coenzyme Q10’s reduced DNA damage in white blood cells, suggesting coenzyme Q10 might help protect against genomic instability, a hallmark of aging.  

Based on this and other research, coenzyme Q10 does target several hallmarks of aging. Being a fat-soluble antioxidant, coenzyme Q10 helps defend various lipid-containing structures against oxidative stress, including cell membranes, lipoproteins such as LDL cholesterol, and mitochondria. Coenzyme Q10 counters oxidative stress indirectly too, by helping regenerate the antioxidant vitamins C and E. Through these actions and related mechanisms, coenzyme Q10 can help reduce chronic inflammation.

Mitochondrial dysfunction is the other hallmark coenzyme Q10 targets particularly effectively. Coenzyme Q10 affects mitochondrial ATP production through what’s known as the “Q-cycle”. Your mitochondria use four protein complexes to generate an electrochemical gradient across the inner mitochondrial membrane, which can then be used to make ATP, a bit like the way hydroelectric dams generate energy by creating a water gradient across them. In the Q cycle, coenzyme Q10 shuttles electrons from two protein complexes (complexes I and II) to complex III. These are so-called “redox” reactions, which involve the transfer of electrons between chemicals. In this instance, the “reduced” form of coenzyme Q10 (ubiquinol) loses electrons (gets “oxidised”) to ubiquinone, which can then be restored to ubiquinol by regaining electrons (being “reduced”). (To make matters more confusing, as well as ubiquinol and ubiquinone, coenzyme Q10 can exist in a third, intermediate state named ubisemiquinone.)

Positive effects of coenzyme Q10 on human health

 Randomized, placebo-controlled clinical trials are the gold standard way of assessing the effects of supplements on health. These types of studies have shown positive effects of coenzyme Q10 on an impressively wide range of outcomes. Here are some highlights, starting with the cardiovascular system. 

Coenzyme Q10 improves heart health

 The effects of coenzyme Q10 on cardiovascular health have been most comprehensively studied. Much of this work has focused on heart failure, a condition in which heart muscle cells can become deficient in coenzyme Q10. Perhaps the most stringent review found that, in heart failure patients, there's moderate-quality evidence that coenzyme Q10 reduces hospitalisations and deaths from all causes combined. 

 Coenzyme Q10’s heart-protecting effects probably arise from several mechanisms, including enhanced heart muscle function, as shown by an increase in the amount of blood leaving the heart with each beat (the “ejection fraction”). Supplementation has other effects relevant to cardiovascular health, such as improving the function of the cells that line blood vessel walls, in turn enabling vessels to expand. Supplementation might also positively affect blood lipids and strengthen antioxidant defences. 

 Coenzyme Q10 is also a helpful adjunct to statin use, offsetting some of their negative effects. Statins can deplete coenzyme Q10. They do this by inhibiting an enzyme (HMG Co-A reductase) that speeds the production of not only cholesterol but also a chemical (farnesyl pyrophosphate) that’s needed to make coenzyme Q10. Since statin use is so ubiquitous in countries such as the US nowadays, this alone is a compelling reason many people should take coenzyme Q10. 

Coenzyme Q10 reduces chronic inflammation

Some states that compromise immunity deplete coenzyme Q10, as shown by lower blood coenzyme Q10 levels during influenza infection. Markers of antioxidant capacity and chronic inflammation have been assessed in many studies of coenzyme Q10. Based on an analysis of double-blind randomized, controlled trials of coenzyme Q10 supplementation, supplementation tends to reduce several non-specific markers of chronic inflammation, namely C-reactive protein, interleukin-6, and TNF-α. 

Coenzyme Q10 supports reproductive health in both men and women

It's thought that 6 to 20% of reproductive-age women have polycystic ovary syndrome (PCOS), a condition typified by impaired fertility, enlarged ovaries with cysts on them, painful periods (“dysmenorrhoea”), and excessive levels of male sex hormones (“hyperandrogenism”), leading to acne, hair loss from the scalp (“alopecia”), and male-pattern hair growth (“hirsutism”). PCOS is often downstream of metabolic dysfunction such as high body fat levels and insulin resistance. Several studies have found positive effects of coenzyme Q10 supplementation on PCOS. For example, 12 weeks of 100 mg per day improved glucose, insulin, insulin sensitivity, and blood lipids. Another study found 100 mg per day for 12 weeks improved reproductive hormone levels. These findings are consistent with the overall body of evidence, as shown by a meta-analysis of relevant studies. Most studies have used 100 to 200 mg per day, consistent with the 200 mg dose in Coastline.

Regarding men, coenzyme Q10 is key to energy production by sperm and acts as an antioxidant in sperm, mitigating DNA damage. In a meta-analysis comparing the effects of different antioxidant supplements on sperm parameters in men with suboptimal fertility, coenzyme Q10 had the greatest beneficial effect on sperm numbers and the second greatest on sperm motility. While a meta-analysis from the same year suggested this doesn't necessarily translate into increased pregnancy rates, these changes certainly won’t hurt fertility, and it could be that there is a small positive effect of supplementation currently masked by a lack of statistical power to unveil it. Regarding doses, studies have reported that 200 to 400 mg per day for 12 to 26 weeks improve sperm morphology, motility, and density in men with oligoasthenotetrazoospermia, a condition in which men have few, abnormally-shaped sperm that don’t move very well. Furthermore, 100 mg per day for 3 months improved sperm density, motility, and antioxidant levels in men with varicoceles, but this was an open-label, uncontrolled study, meaning the men knew they were getting coenzyme Q10 and there was no placebo control group. 

Coenzyme Q10 reduces the frequency of migraines

Migraines are a bitch and are quite common, affecting about 12% of people. Regular coenzyme Q10 is one of the few interventions that can decrease the frequency of migraines, as shown by a meta-analysis of relevant studies. This also documented reduced duration of headache attacks. The evidence in favour of using coenzyme Q10 to counter migraines is sufficient that the American Academy of Neurology recommends 1 to 3 mg coenzyme Q10 per day to help keep migraines at bay, and for most people, the dose in PRODUCT NAME is consistent with this.

Coenzyme Q10 helps counter fatigue in some clinical populations

As mitochondrial dysfunction and chronic inflammation can contribute to fatigue, scientists have studied whether coenzyme Q10 could help reduce tiredness in several chronic health conditions. In some of these populations, coenzyme Q10 hasn’t been found to alleviate fatigue. In others, however, it has. Perhaps the best proven of these populations is people with fibromyalgia, a poorly-understood chronic pain syndrome made worse by severe fatigue. At least 4 randomized controlled trials (one in children) have found positive effects of supplementation on fatigue, and some of these studies have also documented reductions in pain. Coenzyme Q10 can reduce fatigue in end-stage heart failure patients too, perhaps starting from as little as 60 mg per day for 3 months. 

Coenzyme Q10 probably has an array of other positive effects

 Due to the relevance of its actions to so many outcomes, coenzyme Q10 has been studied for numerous use cases. Understandably, lots of these have focused on health and function in disease. 

 There’s also promising evidence that coenzyme Q10 might aid in the treatment of what’s now called metabolic-dysfunction associated steatotic liver disease (which is basically what we used to call non-alcoholic fatty liver disease, if you’re more familiar with that). When patients with this diagnosis took 240 mg coenzyme Q10 each day for 6 months, they had improvements in a non-invasive marker of liver fat, along with several beneficial changes in measures of heart and blood vessel health. 

 Moving on to the urinary system, most research on coenzyme Q10 has combined it with other active ingredients, making it hard to decipher the effects of coenzyme Q10 per se. Regarding isolated use, there has been research on patients with urinary tract stones (“lithiasis”) undergoing a treatment named extracorporeal shockwave lithotripsy to remove the stones. The patients got either placebo or 200 mg coenzyme Q10 per day for the week before and week after surgery, respectively. Supplementation improved measures of kidney function (increased glomerular filtration rate and decreased albumin/creatinine ratio and B2-microglobulin) after a week of treatment, and these changes were maintained at a later follow-up. Supplementation also improved blood vessel function and levels of hormones involved in electrolyte and fluid balance and blood pressure. 

It’s also possible that coenzyme Q10 supports the function of the respiratory system in people with lung dysfunction. A randomized controlled trial had patients with chronic obstructive pulmonary disease supplement with coenzyme Q10 and creatine (160 mg and 170 mg, respectively, twice daily) for 2 months. Supplementation improved walking performance, measures of lung function, and performance in activities of daily living. While it's not clear if the coenzyme Q10, the creatine, or both were at play, we mention this study because Coastline also combines coenzyme Q10 and creatine, albeit at higher doses.

Our use of coenzyme Q10

Regarding dose, Coastline contains 200 mg coenzyme Q10, a dose within the ranges of doses found to have each of the positive effects on health listed above.

Regarding timing, coenzyme Q10 is in the Coastline SoftGels. The timing of coenzyme Q10 is unlikely to matter much for the simple reason that it is absorbed and metabolised slowly — its half-life is typically over a day! To be transparent, there is some evidence that splitting a daily coenzyme Q10 dose in two might increase its bioavailability. However, we believe that asking you to take the gel capsules twice a day would be unnecessarily confusing and hard to stick to. Overall, we don’t think the timing of when you take the gel capsules matters significantly. Some of our team members take these in the morning with the Coastline morning step. Other team members, however, take them in the evening for convenience because they prefer to take all their capsules at once. The choice is yours! 

Regarding form, Coastline contains ubiquinone suspended in oil, for coenzyme Q10 is fat soluble. Your body is able to convert ubiquinone into ubiquinol and vice versa and does so depending on its specific need for the two forms. What matters, therefore, is how well the form is absorbed in the digestive tract. Despite what many people claim nowadays, the data generally indicate that ubiquinone is more effective than ubiquinol. For example, studies of ubiquinone supplementation have yielded much better improvements in cardiovascular health and lower rates of death in patients with heart failure, and lower doses of ubiquinone are needed compared to ubiquinol.  

Regarding direct comparisons of different forms, the most helpful study compared seven supplements differing in formulation (oxidation state, type of carrier oil used, etc). The scientists gave 100 mg of each of them, one at a time, to 14 healthy people. They found that the most bioavailable product was a crystalline-dispersed ubiquinone product. The crystal dispersion matters here: most coenzyme Q10 comes in the form of molecules linked together in crystals. But coenzyme Q10 can only be absorbed as individual molecules, so dispersing these crystals improves coenzyme Q10 uptake. Despite the data showing that ubiquinone is superior to ubiquinol, ubiquinol is in vogue at the moment, even though many ubiquinol products on the market aren’t even ubiquinol. Ubiquinol is white and turns yellow when oxidised to ubiquinone. Random checks of “ubiquinol” products often find the raw material is actually yellow, probably because the ubiquinol wasn’t adequately protected when encapsulated, resulting in its reaction with oxygen, producing ubiquinone. PRODUCT NAME contains ubiquinone in its trans- form (not the cis- form), the same form made in the body.

Coenzyme Q10 typical dietary intakes and safety

There is some coenzyme Q10 in many foods, including both plants (nuts and legumes, for instance) and animal foods (meat, fish, eggs). On average, however, people consume very little coenzyme Q10 — perhaps just 5 mg per day in a relatively typical diet. Animal foods are the richest sources, and because coenzyme Q10 gets distributed unevenly between tissues, some organ meats are much richer than others. For example, a comparison of coenzyme Q10 concentrations in beef muscle, liver, and heart found that heart (11 mg per 100 g) contained over three times the amount in liver and nearly five times the amount in muscle.  

Coenzyme Q10 has an excellent safety profile, even at 900 mg per day taken in the long term. In fact, a safety assessment reported that the frequency of adverse events is similar when supplementing 1,200 mg per day to when supplementing 60 mg per day.