In the Mechanisms of Ageing and Development journal, Professor Jan Aaseth, Professor Urban Alehagen, and I have published a review of the research literature relating to Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More and aging. Here, I want to summarize the main points briefly.

What is Coenzyme Q10 and Why is it Important?

Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More is a substance with vitamin-like effects on our health; however, our cells can synthesize Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, so, by definition, it is not a vitamin. Among its important health-promoting effects are the following:

• an essential component in the process of ATPATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production. More energy generation
• an important fat-soluble antioxidantAntioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... More in cellular membranes and lipoproteinsLipoproteins are particles comprised of protein and lipids, with a core of triglycerides and cholesterol esters and an outer layer of phospholipids. Lipoproteins transport lipids through the bloodstream. LDL-lipoproteins carry cholesterol from the liver to the body tissues. HDL- lipoproteins carry cholesterol back to the liver from the body tissues. LDL-lipoproteins also bind and transport Coenzyme Q10 molecules, predominately in... More
• an anti-inflammatory agent

What Causes Sub-Optimal Coenzyme Q10 Levels?

Once we have passed our 20s, our cells’ ability to synthesize Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More declines and decreases steadily with increasing age [Kalén 1989]. It is reasonable to think that most individuals in middle age and in their senior years might benefit from a CoQ10 supplement.

Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More is important to our understanding of the progression of the aging process and to our understanding of aging-related diseases such as cancer, cardiovascular disease, metabolic syndromeMetabolic syndrome is the medical term for a cluster of conditions such as excess body fat around the waist, high blood sugar, high blood pressure, high cholesterol or triglyceride levels. Metabolic syndrome is associated with increased risk of diabetes, heart disease, and stroke. Individuals with metabolic syndrome are at higher risk of heart disease, diabetes, and stroke and have, therefore,... More and diabetes, neurodegenerative disorders, and kidney diseases [López-Lluch 2020].

This is the message of a 369-page book entitled Coenzyme Q in Aging. The book is edited by Professor Guillermo López-Lluch, Pablo de Olavide University, Sevilla, Spain. It is dedicated to the memory of Professor Fred L. Crane (December 3, 1925 – August 11, 2016), who first discovered Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, one of the most important molecules in humans [López-Lluch 2020].

Most recently, nicotinamide adenine dinucleotide (NAD+ in its oxidized form and NADH in its reduced form) has been getting much attention as a possible anti-ageing substance.

• Like Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, NAD+/NADH is a coenzyme that is present in nearly all human cells.
• Like Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, NAD+/NADH exists in both an oxidized form and a reduced form.
• Like Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, NAD+/NADH is needed for the cellular process of producing ATPATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production. More energy from the food that we eat.
• Like Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, NAD+/NADH has an antioxidantAntioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... More function in the cells protecting against the damage caused by oxidative stress.
• Like Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, NAD+/NADH is essential for life.  Without NAD+/NADH, the cells will not produce energy and will die.
• Like Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, NAD+/NADH levels decrease as we get older.

Coenzyme Q10 and NAD+/NADH and Chronic Fatigue Syndrome

The results of a 2015 Spanish study indicate that Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More and NADH supplementation could be a beneficial treatment of chronic fatigue syndromeChronic fatigue syndrome (CFS) is a complicated disorder with an unknown cause.  CFS is characterized by persistent fatigue that does not improve with rest and that cannot be explained by any identifiable medical condition. CFS is also known as myalgic encephalomyelitis (ME) and systemic exertion intolerance disease (SEID).  It is sometimes abbreviated ME/CFS. CFS patients typically have low levels of... More and other chronic fatiguing illnesses for three reasons [Castro-Marrero]:

• Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More and NADH are essential co-factors in the process of cellular bio-energeticsBio-energetics is both the process and the study of the flow and transformation of energy in living beings.  Coenzyme Q10 has both a bio-energetics function and an antioxidant function in the body. More; they can boost mitochondrial function.
• Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More and NADH are powerful free radical scavengers that mitigate lipid peroxidationOxidation is the chemical reaction of a substance with oxygen. Peroxidation is the extreme form of oxidation that results from free radicals’ stealing electrons from lipids, either in the cell membranes or in the lipoproteins. The final product of lipid peroxidation is highly reactive malondialdehyde, a bio-marker for oxidative stress and damage. More and DNA damage caused by oxidative stress.
• Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More and NADH supplementation can reduce the extent of oxidative damage and mitochondrial dysfunctionMitochondrial dysfunction is the loss of efficiency in the process of ATP energy production.  As such, mitochondrial dysfunction is a factor in the ageing process and in virtually all chronic diseases including cancer, cardiovascular diseases, chronic fatigue syndrome and fibromyalgia, diabetes and metabolic syndrome, and neurodegenerative diseases. Coenzyme Q10 is an essential component in the mitochondrial production of ATP energy. More associated with chronic fatigue syndromeChronic fatigue syndrome (CFS) is a complicated disorder with an unknown cause.  CFS is characterized by persistent fatigue that does not improve with rest and that cannot be explained by any identifiable medical condition. CFS is also known as myalgic encephalomyelitis (ME) and systemic exertion intolerance disease (SEID).  It is sometimes abbreviated ME/CFS. CFS patients typically have low levels of... More.

In sum, oral CoQ10 plus NADH supplementation seems to be a safe and effective therapy to reduce fatigue, restore mitochondrial function and bio-energetic metabolism, and ameliorate oxidative damage in chronic fatigue syndromeChronic fatigue syndrome (CFS) is a complicated disorder with an unknown cause.  CFS is characterized by persistent fatigue that does not improve with rest and that cannot be explained by any identifiable medical condition. CFS is also known as myalgic encephalomyelitis (ME) and systemic exertion intolerance disease (SEID).  It is sometimes abbreviated ME/CFS. CFS patients typically have low levels of... More [Castro-Marrero].

There is a significantThe outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant.   More reduction in the rate of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More bio-synthesis during the ageing process and in ageing-related diseases.  Mice studies have given us reason to believe that there is a direct relationship between a longer and healthier life and Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More function in the mitochondriaThe mitochondria are the bean-shaped organelles in the cells. They are the key organelles with responsibility for the production of ATP energy molecules. More of the cells [Hernandez-Camacho 2018].  

Human studies of Coenzyme Q10 status and healthy ageing

Professor Alehagen’s KiSel-10 study:

Four years of daily supplementation with 200 milligrams of Coenzyme Q10 and 200 micrograms of high-selenium yeast resulted in significantThe outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant.   More health benefits for elderly community-living study participants as compared to placebo supplementation [Johansson 2015]:

So, it seems clear that Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplementation is not needed when we are young and healthy, in our teenage years and in our early 20’s.  But … definitely … from our 20s onward, and increasingly as we get older, we need a well-formulated daily Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More (preferably taken twice daily with meals) … or we need to take nutritional supplements that will enhance our bodies’ bio-synthesis of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More.  Or both.

Because there is no doubt that we need to maintain functional levels of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More in the cell membranesThe cell membranes, sometimes called plasma membranes, are the physical barrier that protects the contents of the cells from everything that is outside the cells. The cell membranes also regulate what can move in and out of the cells. Coenzyme Q10 is present in all cell membranes in the body except in the red blood cells. It helps to prevent... More and in the mitochondriaThe mitochondria are the bean-shaped organelles in the cells. They are the key organelles with responsibility for the production of ATP energy molecules. More, particularly in the brain and muscle tissue.  Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More is essential in the process of cellular ATPATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production. More energy production, and Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More is the most important fat-soluble antioxidantAntioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... More protector of the cells [Littarru].