Indications
CoQ10 is not FDA-approved to treat any medical condition although it is widely available over-the-counter as a dietary supplement and recommended by primary care physicians and specialists alike. Diseases such as neurodegenerative diseases, fibromyalgia, diabetes, cancer, mitochondrial diseases, muscular diseases, and heart failure are associated with decreased circulating levels of CoQ10.[1][2][3][4] Many studies have been performed on the premise that increasing systemic CoQ10 levels in such conditions would allow for the proper functioning of processes that require CoQ10.[3][2][1]
A recently published, systematic review showed that supplementation with CoQ10, in addition to standard therapy in patients with moderate-to-severe heart failure, is associated with symptom reduction and reduction of major adverse cardiovascular events.[2][5] It may also improve functional capacity, endothelial function, and left ventricle contractility in patients with congestive heart failure.[6][2]
Supplementation has shown promising results in improving endothelial function in several subsets of patients. CoQ10 can improve endothelial function in patients with ischemic left ventricular systolic dysfunction heart failure.[7][8] Likewise, when compared with placebo, CoQ10 appears to improve endothelial function in the peripheral circulation of patients with type-2 diabetes mellitus with hyperlipidemia.[9] Evidence of the routine use of CoQ10 in patients with coronary artery disease apart from congestive heart failure is still scanty.[10][7]
There is also some evidence that, when combined with selenium, CoQ10 supplementation in healthy elderly patients and elderly patients with diabetes, hypertension, and ischemic heart disease, may decrease cardiovascular mortality risk.[11] Data is conflicting whether CoQ10 may play a role in treating high blood pressure.[12]
CoQ10 has shown the potential to decrease pain, fatigue, and morning tiredness compared to placebo in patients with fibromyalgia.[13][14][13]
Some data suggest that supplementation with moderate-to-high dose CoQ10 in patients with mitochondrial disorders may influence bicycle exercise aerobic capacity.[15]
Supplementation with 300 mg daily for 24 weeks in men with Peyronie disease may decrease penile plaque size, reduce penile curvature, and improve erectile function.[16]
Statin drugs, of note, block the production of an intermediate in the mevalonate pathway, a biochemical pathway that leads to the production of CoQ10.[17] Therefore, many physicians hypothesize that statin drugs may deplete the body of CoQ10. As muscle pain and cramping is such a common adverse effect of statins, they believe this depletion is the culprit. Supplementation with 50 mg twice daily has shown the ability to decrease statin-related mild-to-moderate myalgias, resulting in an increased ability to perform daily activities.[18]
Although most studies have used patients with preexisting medical conditions, one study of healthy participants did show that oral supplementation improved subjective fatigue and physical performance during bicycle exercise routines.[19]
CoQ10 has also shown promise in migraine prophylaxis. A double-blind randomized controlled trial showed 300 mg daily to be safe and superior to placebo for migraine prevention.[20] Another randomized double-blind placebo-controlled trial in a cohort of adult women showed that supplementation of 400 mg per day decreased migraine frequency, severity, and duration.[21] A cohort study of 1550 children and adolescents with headaches found that this population has low CoQ10 levels.[22] Supplementation appeared to decrease headache frequency.[22] One study showed that the use of only 100 mg daily decreased the severity of headaches and the number of headaches per month in migraine sufferers. [23]
Interestingly, CoQ10 levels may be decreased in those with acute influenza infection.[24] Studies on supplementation in this subset of patients have yet to be done, however.
When supplemented alongside standard psychiatric medical therapy, CoQ10 appears to lessen symptoms of depression in patients with bipolar disorder.[25]
In patients with polycystic ovary syndrome, supplementation may improve fasting blood glucose, insulin levels, and total testosterone levels.[26]