CoQ10 Supplementation

CoQ10 is a potent antioxidant and reduced levels are associated with aging, hyperthyroidism, hypertesion and cardiovascular disease. The highest tissue concentration of CoQ10 is found in the heart tissue. 

Medications that can lower the levels of CoQ10 in the body include:

  • Statins for cholesterol, including atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor)
  • Fibric acid derivatives for cholesterol, including gemfibrozil (Lopid)
  • Beta-blockers for high blood pressure, such as atenolol (Tenormin), labetolol (Normodyne), metoprolol (Lopressor or Toprol), and propranolol (Inderal)
  • Tricyclic antidepressant medications, including amitriptyline (Elavil), doxepin (Sinequan), and imipramine (Tofranil).

Statin drugs and beta-blockers can reduce your natural production of CoQ10 by as much as 40%. A study of patients with high blood pressure showed a significant reduction in systolic blood pressure of (-12mmHg) and diastolic blood pressure (-9mmHg) after taking CoQ10 (75-360mg /day) for 4.4 months. 

Clinical evidence shows that CoQ10 supplementation with doses of 200 mg/day or higher for prolonged periods is safe, well-tolerated and significantly increases the concentration of CoQ10 in plasma, and reduces oxidative stress and mortality from cardiovascular causes. Dietary CoQ10 also modulates a number of risk factors through an anti-atherogenic effect that prevents the accumulation of oxLDL in arteries, decreases vascular stiffness and hypertension, improves endothelial dysfunction (by reducing the source of ROS in the vascular system) and increases NO levels for vasodilation (1). 

CoQ10 versus Ubiquinol

CoQ10 is not easily absorbed. CoQ10 absorption follows the same process as that of lipids in the gastrointestinal tract, but the uptake in the whole body ranges between 2 and 3% of the total dose. Taking CoQ10 with a high fat meal can increase absorption. 

Ubiquinol is the active antioxidant form of CoQ10 (ubiquinone). The presence of two additional hydrogen atoms allow ubiquinol to work as an antioxidant. Ubiquinol comprises the majority of the ubiquinone/ubiquinol pool in the plasma of healthy subjects. Ubiquinol may be especially important for older individuals and subjects with greater levels of oxidative or physical stress. Ubiquinol may be indicated for individuals who fail to respond to regular CoQ10 supplementation (possibly due to poor conversion of CoQ10 to ubiquinol in the body) (2). Research suggests that it may be more readily absorbed than ubiquinone (3). In a comparison study involving healthy subjects, supplementation with 200 mg ubiquinol for 4 weeks increased plasma total CoQ10 from 0.9 to 4.3 μg/mL (p<0.001) compared to 0.9 to 2.5 μg/mL with ubiquinone. It was also noted that ubiquinol supported a healthy ratio of CoQ10 to lipids (4).  In addition to its antioxidant benefits, some evidence suggests that ubiquinol supports healthy ejection fraction and mitral valve function (5). The safety, tolerability, and oral bioavailability of ubiquinol have been confirmed in single dose and 4-week multiple dose studies. Significant gastrointestinal absorption was confirmed with no clinically significant adverse effects (6). 

  1. Rabanal-Ruiz Y, Llanos-González E, Alcain FJ. The Use of Coenzyme Q10 in Cardiovascular Diseases. Antioxidants (Basel). 2021 May 10;10(5):755. doi: 10.3390/antiox10050755. PMID: 34068578; PMCID: PMC8151454.
  2. Aejmelaeusa R, et al. Mol Aspects of Med. 1997. 18(1); 113-120.
  3. Evans M, et al. Journal of Functional Foods. 2009; 1(1): 65-73.
  4. Langsjoen PH, et al. Clinical Pharmacology in Drug Development. 2014. 3(1); 13–17.
  5. Langsjoen et al. Biofactors. 2008;32(1-4):119-28.
  6. Hosoe K, et al. Regul Toxicol Pharmacol. 2007 Feb;47(1):19-28.