Introduction

Coenzyme Q10, is a coenzyme that is ubiquitous in animals and most bacteria (hence the name ubiquinone).This fat-soluble substance, which resembles a vitamin, is present in all respiring eukaryotic cells, primarily in the mitochondria. It is a component of the electron transport chain and participates in aerobic cellular respiration, which generates energy in the form of ATP. Ninety-five percent of the human body‘s energy is generated this way.(1)(2) Therefore, those organs with the highest energy requirements—such as the heart, liver, and kidney—have the highest CoQ10 concentrations.(3)(4)(5)

There are three redox states of CoQ10: fully oxidized (ubiquinone), semiquinone (ubisemiquinone), and fully reduced (ubiquinol). The capacity of this molecule to act as a two-electron carrier (moving between the quinone and quinol form) and a one-electron carrier (moving between the semiquinone and one of these other forms) is central to its role in the electron transport chain due to the iron–sulfur clusters that can only accept one electron at a time, and as a free-radical–scavenging antioxidant.

Why Coenzyme Q 10??

  1. Coenzyme Q 10 in Cardiovascular System (CVS) pharmacotherapy
    SAFE ADJUVANT TO STANDARD THERAPY IN CARDIOVASCULAR SYSTEM
  • Inhibits LDL(Low density lipoprotein )oxidation
  • Inhibits progression of arthrosclerosis
  • Decreases pro-inflammatory cytokines and decreases blood viscosity
  • Improves cellular Bioenergetics
  • Improves ischemia and reperfusion injury in coronary revascularization
  • Improves body immune system
  • Cognitive benefits(strong antioxidants )

Ref:(6), (7). (8), (9)

 

  1. Coenzyme Q 10 in IVF AND GYNAE
  • Boosts sperm count in male(13)
  • Coenzyme Q10 supplementation, 600 mg/day for 60 days, in improving the ovarian response in women with decreased ovarian reserve (11)(12)
  1. Coenzyme Q 10 in Ageing/Adults for General supplements
  • Protects your delicates tissues of eye and ear form free-radical damage(15)
  • Boosts energy and stamina(10)
  • Keeps cell of mouth and gums healthy
  • Help control stress and balances your mood
  • Healthy cardiovascular system(10)
  • Promotes smooth , youthful skin(16)
  • Keeps brains cells healthy, supporting mental energy and clarity .Helps combat stress and balances your mood
  • Powerful anti-oxidants , prevents cells from free radical damage(16)

 

Miscellaneous

  • In arthritis: CoQ10 exerts a therapeutic effect on OA via pain suppression and cartilage degeneration by inhibiting inflammatory mediators (14)
  • For improvement of diabetic symptoms(19)
  • Migraine: Reduces the frequency of migraines(10)
  • Protects essential organs like kidney, liver and internal organs from free radical toxins.(16)

 

Pharmacokinetics

Available data on the absorption, metabolism and pharmacokinetics of coenzyme Q10 (CoQ10) are reviewed in this paper. CoQ10 has a fundamental role in cellular bioenergetics. CoQ10 is also an important antioxidant. Because of its hydrophobicity and large molecular weight, absorption of dietary CoQ10 is slow and limited. In the case of dietary supplements, solubilized CoQ10 formulations show enhanced bioavailability. The T(max) is around 6 h, with an elimination half-life of about 33 h. The reference intervals for plasma CoQ10 range from 0.40 to 1.91 micromol/l in healthy adults. With CoQ10 supplements there is reasonable correlation between increase in plasma CoQ10 and ingested dose up to a certain point. Animal data show that CoQ10 in large doses is taken up by all tissues including heart and brain mitochondria. This has implications for therapeutic applications in human diseases, and there is evidence for its beneficial effect in cardiovascular and neurodegenerative diseases. CoQ10 has an excellent safety record. (17)

What are the risks of taking CoQ10?

Generally, CoQ10 is well tolerated.(6)

  • Side effects from CoQ10 seem to be rare and mild. They include diarrhea, nausea, and heartburn
  • Risks. People with chronic diseases such as heart failure, kidney or liver problems, or diabetes should be wary of using this supplement. CoQ10 may lower blood sugar levels and blood pressure. Doses of more than 300 milligrams may affect liver enzyme levels.
  • Interactions. People taking blood thinners and thyroid medications as well as chemotherapy should check with their doctors before using CoQ10 supplements.

Given the lack of evidence about its safety, CoQ10 supplements are not recommended for children or for women who are pregnant or breastfeeding.

Ref (6), (10)

Interactions(18)

If you are currently being treated with any of the following medications, you should not use CoQ10 without first talking to your health care provider.

Daunorubicin and doxorubicin — Coenzyme Q10 may help to reduce the toxic effects on the heart caused by daunorubicin (Cerubidin) and doxorubicin (Adriamycin),

Blood pressure medications — In a clinical study of individuals taking blood pressure medications, including diltiazem (Cardizem), metoprolol (Lopressor or Toprol), enalapril (Vasotec), and nitroglycerin (Nitrostat or Nitrobid), CoQ10 supplementation allowed the individuals to take lower dosages of these drugs.

Blood-thinning medications — There have been reports that coenzyme Q10 may decrease the effectiveness of medications such as warfarin (Coumadin) or clopidigrel. CoQ10 should be used with warfarin only under careful supervision by your health care provider.

Timolol — CoQ10 supplementation may reduce the heart-related side effects of timolol drops, a beta-blocker medication used to treat glaucoma, without decreasing the effectiveness of the medication.

Other — Medications that can lower the levels of coenzyme Q10 in the body include statins for cholesterol , beta-blockers for high blood pressure, and tricyclic antidepressant medications.

 

Dose:

Dosage recommendations for CoQ10 vary depending on individual needs and goals

  • Infertility
    • For male :  200-300 mg per day
    • For female: 100-600  mg per
  • For improvement of diabetic symptoms: 100- 300 mg per day
  • For migraine headache: 300-400 mg per day
  • For improvement of CVS profile: 100-600 mg per day
  • Study in 50 people taking statin medications found that a dose of 100 mg of CoQ10 per day for 30 days effectively reduced statin-related muscle pain in 75% of patients – 30-200 mg per day(19)
  • Ageing – 100-300 mg per day(19)

Typically, 90–200 mg of CoQ10 per day are recommended, though some conditions may require higher dosages of 300–600 mg.

 

Refrences

  1. Ernster, L.; Dallner, G. (1995). “Biochemical, physiological and medical aspects of ubiquinone function”. Biochimica et Biophysica Acta. 1271 (1): 195–204.
  2. Dutton, P. L.; Ohnishi, T.; Darrouzet, E.; Leonard, M. A.; Sharp, R. E.; Cibney, B. R.; Daldal, F.; Moser, C. C. (2000). “4 Coenzyme Q oxidation reduction reactions in mitochondrial electron transport”. In Kagan, V. E.; Quinn, P. J. Coenzyme Q: Molecular mechanisms in health and disease. Boca Raton: CRC Press. pp. 65–82.
  3. Okamoto, T.; Matsuya, T.; Fukunaga, Y.; Kishi, T.; Yamagami, T. (1989). “Human serum ubiquinol-10 levels and relationship to serum lipids”. International Journal for Vitamin and Nutrition Research. 59 (3): 288–292.
  4. Aberg, F.; Appelkvist, E. L.; Dallner, G.; Ernster, L. (1992). “Distribution and redox state of ubiquinones in rat and human tissues”. Archives of Biochemistry and Biophysics. 295 (2): 230–234.
  5. Shindo, Y.; Witt, E.; Han, D.; Epstein, W.; Packer, L. (1994). “Enzymic and non-enzymic antioxidants in epidermis and dermis of human skin”. Journal of Investigative Dermatology. 102 (1): 122–124.
  6. Madmani, M. E.; Yusuf Solaiman, A.; Tamr Agha, K.; Madmani, Y.; Shahrour, Y.; Essali, A.; Kadro, W. (2 Jun 2014). “Coenzyme Q10 for heart failure”. Heart Group. Cochrane Database of Systematic Reviews (6): CD008684.
  7. Fotino, A Domnica; Thompson-Paul, Angela M; Bazzano, Lydia A (2013). “Effect of coenzyme Q10 supplementation on heart failure: a meta-analysis”. The American Journal of Clinical Nutrition. 97 (2): 268–275. doi:3945/ajcn.112.040741. PMC 3742297. PMID 23221577. Retrieved 20 March 2018.
  8. Flowers, N.; Hartley, L.; Todkill, D.; Stranges, S.; Rees, K. (4 Dec 2014). “Co-enzyme Q10 supplementation for the primary prevention of cardiovascular disease”. The Cochrane Database of Systematic Reviews. 12 (12): CD010405..
  9. Ho, M. J.; Li, E. C.; Wright, J. M. (3 Mar 2016). “Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension”. The Cochrane Database of Systematic Reviews. 3 (3): CD007435.
  10. https://www.drugs.com/mca/coenzyme-q10
  11. Gat I., Blanco Mejia S., Balakier H., Librach C.L., Claessens A., Ryan E.A. The use of coenzyme Q10 and DHEA during IUI and IVF cycles in patients with decreased ovarian reserve. Gynecol. Endocrinol. 2016;32:534–537. doi: 10.3109/09513590.2015.1137095. [PubMed] [CrossRef] [Google Scholar]
  12. Xu Y., Nisenblat V., Lu C., Li R., Qiao J., Zhen X., Wang S. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: A randomized controlled trial. Reprod. Biol. Endocrinol. 2018;16:29. doi: 10.1186/s12958-018-0343-0. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
  13. Mol Aspects Med. 1997;18 Suppl:S213-9.”The effect of coenzyme Q10 on sperm motility and function.Lewin A, Lavon H.
  14. PLoS One. 2013; 8(7): e69362. Published online 2013 Jul 22. doi: 1371/journal.pone.0069362 PMCID: PMC3718733, PMID: 23894457”Coenzyme Q10 Ameliorates Pain and Cartilage Degradation in a Rat Model of Osteoarthritis by Regulating Nitric Oxide and Inflammatory Cytokines” Lee J. et.all
  15. https://iovs.arvojournals.org/article.aspx?articleid=2165655
  16. https://www.researchgate.net/publication/5931180_Bioenergetic_and_Antioxidant_Properties_of_Coenzyme_Q10_Recent_Developments
  17. https://www.researchgate.net/publication/7226624_Coenzyme_Q10_Absorption_tissue_uptake_metabolism_and_pharmacokinetics
  18. http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000950
  19. https://www.healthline.com/nutrition/coq10-dosage#side-effects