Coenzyme Q10 and energy for the immune system

The immune system protects us against bacterial and viral infections. Coenzyme Q10 is an important bio-nutrient for the optimal functioning of the immune system. It helps to provide energy for the bio-synthesis of immune system cells and energy for the activities of immune system cells.

Energy starvation in the immune system?  Immune system cells starved for energy?  There is a very plausible theory that chronic heart failure is a disease caused by the energy starvation of the heart muscle cells.  Lacking adequate Coenzyme Q10 – an indispensable component of the human cell respiration and oxidative phosphorylation process – the heart muscle cells produce less ATP than is needed to supply the cells with energy. (A concomitant theory holds that Coenzyme Q10, in its reduced form, also protects the heart muscle cells against oxidative damage.)

Coenzyme Q10 and white blood cells
In the same way as the heart muscle cells, the white blood cells (lymphocytes) that are responsible for immune system responses to invading bacteria and viruses need energy.  The natural killer (NK) cells, the B-cells that bio-synthesize specific antibodies to target invading antigens (bacteria or viruses or toxic chemicals), the T-cells that kill the invading bacteria and viruses, they all need energy to do what they do.

Of course, the white blood cells need energy to produce and differentiate and proliferate all kinds of antibodies.  And for that energy process, the white blood cells need Coenzyme Q10 in much the same way as the heart muscle cells need Coenzyme Q10 for the process of bio-energetics.  It makes sense, doesn’t it?

What are antibodies, and why do they need Coenzyme Q10?
To destroy invading antigens (harmful bacteria, viruses, toxins), the body’s adaptive immune system produces and distributes specific antibodies (also called immunoglobulins) that are targeted against specific antigens.  There are specific antibodies for each antigen.

There is essentially a four-step process in the adaptive immune defense.  The immune system’s B-cells recognize antigens and create and produce the needed antibodies.  Next, the antibodies find and attach themselves to the antigens for which they were created, and, in so doing, they mark the antigens. Then, the immune system’s T-cells attack and kill the invading antigens.  Finally, cells called immune system phagocytes scavenge the remains of the destroyed antigens.

Coenzyme Q10 needed for energy in the immune system
The point is: all of this adaptive immune defense activity requires energy.  And Coenzyme Q10 is absolutely essential for the bio-energetic process to function.  The production of B-cells and T-cells and phagocytes requires energy.  The activity of B-cells and T-cells and phagocytes also requires energy.  If there is less Coenzyme Q10 available, then there is less energy produced in the immune system cells.

Let’s take a look at some of the clinical research.

Karl Folkers
Dr. Karl Folkers was one of the first researchers to realize that Coenzyme Q10 and Vitamin B6 are necessary for immune responses.

Coenzyme Q10 and Immunoglobulin G
The antibody called Immunoglobulin G (IgG) is the most common type of antibody; it is non-specific (part of the innate immune system), and it is found overall in the body’s fluids. It provides an almost immediate defense response against bacterial and viral infections.

Dr. Karl Folkers and his colleagues did a study of patients with heart disease, cancer, and diabetes, all of them patients in which there was a deficiency of Coenzyme Q10 [Folkers 1982].  Supplementation of these patients with Coenzyme Q10 resulted in increased levels of IgG antibodies.  The Coenzyme Q10 supplementation was seen to improve the bio-synthesis of IgG immunoglobulins.

Coenzyme Q10 and NK cells
An Italian study has shown that reduced NK cell function – another component of the innate immune system — is associated with low levels of Coenzyme Q10 and Vitamin E, especially in women [Ravaglia 2000].

Coenzyme Q10 and macrophage activity
In a study of the survival of cancer patients treated with Coenzyme Q10, Dr. Karl Folkers and Dr. William Judy noted increased macrophage activity [Folkers 1993].  Macrophage activity is another aspect of the innate immune system.  Coenzyme Q10 supplementation was, thus, associated with improved immune system response.

Coenzyme Q10 and HIV infection
Groups of AIDS patients tend to have a significant blood Coenzyme Q10 deficiency as compared to control groups, and, typically, the Coenzyme Q10 deficiency increases with the increasing severity of the disease, from HIV positive (with no symptoms) to Aids-Related Complex (with symptoms but still without opportunistic infections) to AIDS (HIV infection with opportunistic infections).

Awareness of the likelihood of a Coenzyme Q10 deficiency in HIV patients combined with data on the effect of Coenzyme Q10 supplementation on components of the immune system provide a rationale for treatment of HIV patients with Coenzyme Q10.  In small studies, some AIDs patients have shown “striking” clinical responses to treatment with Coenzyme Q10 [Folkers 1988].

Coenzyme Q10 and immunomodulation
Dr. Folkers reviewed the early work by Dr. Emile A. Bliznakov and the subsequent work associating Coenzyme Q10 deficiency with weakened immune system response [Folkers 1985].  Dr. Folkers came to the following conclusions, which continue to be valid today:

  • Coenzyme Q10 is an important component, at the mitochondrial level, for the optimal functioning of the immune system.
  • Coenzyme Q10 supplementation seems to improve immune system activity through the increased activity of existing cells involved in the immune system rather than by an increase in the numbers of immune system cells.
  • Coenzyme Q10 supplementation is a safe, affordable, and appropriate option in clinical cases in which the patient’s immune system is not operating as well as it should.



Folkers, K., Morita, M., & McRea, J. (1993).   The activities of Coenzyme Q10 and Vitamin B6 for immune responses.” Biochemical and Biophysical Research Communications, 193(1), 88-92.

Folkers, K., Langsjoen, P., Nara, Y., Muratsu, K., Komorowski, J., Richardson, P. C., & Smith, T. H. (1988). Biochemical deficiencies of coenzyme Q10 in HIV-infection and exploratory treatment. Biochemical and Biophysical Research Communications, 153(2), 888-896.

Folkers, K.  (1992).  Critique of 30 years of research on hematopoietic and immunological activities of CoQ10 and potentiality for therapy of AIDS and cancer.  Med. Chem. Res., 2, 48-60.

Folkers, K., Shizukuishi, S., Takemura, K., Drzewoski, J., Richardson, P., Ellis, J., & Kuzell, W. C. (1982). Increase in levels of IgG in serum of patients treated with coenzyme Q10. Research Communications in Chemical Pathology and Pharmacology, 38(2), 335-338.

Folkers, K. & Wolaniuk, A. (1985). Research on Coenzyme Q10 in clinical medicine and in immunomodulation. Drugs Exptl. Clin. Res., 11(8): 539-545.

Folkers, K., Brown, R., Judy, W. V., & Morita, M. (1993). Survival of cancer patients on therapy with coenzyme Q10. Biochemical and Biophysical Research Communications, 192(1), 241-245.

Ravaglia, G., Forti, P., Maioli, F., Bastagli, L., Facchini, A., Mariani, E., Savarino, L., Sassi, S., Cucinotta, D., & Lenaz, G. (2000).  Effect of micronutrient status on natural killer cell immune function in healthy free-living subjects aged ≥ 90 years.  Am J Clin Nutr. 2000 Feb;71(2):590-8.


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