What is the relationship between coenzyme Q10 status and autoimmune diseases?

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As many as 90 autoimmune disorders have been described in the medical literature. Common autoimmune diseases are type 1 diabetes, multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus. Autoimmune disorders are characterized by mitochondrial dysfunction, oxidative stress, and inflammation. Supplementary CoQ10 may help in the management of these disorders.

In autoimmune diseases, the body’s immune system mistakenly attacks its own healthy cells, tissues, or organs. In good health, the immune system should defend against invasive pathogens such as harmful bacteria and viruses. Instead, in autoimmune diseases, the immune system produces antibodies or immune cells that target the body’s own cells. This results in chronic inflammation, elevated oxidative stress, and tissue damage. As a consequence, autoimmune diseases can affect almost any part of the body.

What are characteristics of autoimmune diseases?

  • more common in women
  • may have a genetic component
  • can be triggered by environmental factors

In a 2024 literature review, Dr. Ian P. Hargreaves and I investigated the potential role of CoQ10 in the management of autoimmune disorders. As a consequence, we concluded that supplementary CoQ10 is a plausible adjunctive therapy for autoimmune disorders. However, we recommend the funding of large, well-controlled clinical trials to establish the optimal dosing, clinical efficacy, and long-term safety of CoQ10 supplementation for patients with autoimmune diseases [Mantle & Hargreaves 2024].

How Can Supplementary CoQ10 Help Autoimmune Disease Patients?

Our review of the relevant research showed the following connections between CoQ10 and autoimmune diseases [Mantle & Hargreaves 2024]:

  • reduced plasma or serum CoQ10 concentrations in several autoimmune conditions, including rheumatoid arthritis, multiple sclerosis, lupus, and antiphospholipid syndrome
  • mitochondrial dysfunction in autoimmune conditions resulting in increased oxidative stress and inflammation and leading to disease progression
  • sufficient CoQ10 essential for proper mitochondrial function and for antioxidant and anti-inflammatory functioning in autoimmune disorders

CoQ10 is a lipid-soluble molecule that is found primarily within the inner mitochondrial membrane. There, CoQ10 acts as an essential component of the electron transport chain. Most importantly, CoQ10 is needed to facilitate the cells’ generation of ATP energy.

Moreover, the CoQ10 functions as an antioxidant. It protects cellular membranes, lipids, and proteins against oxidative damage. This function is important because oxidative stress can be a driver of autoimmune activity and a consequence of autoimmune activity. Thus, without adequate antioxidant protection, the elevated oxidative stress will contribute to chronic inflammatory signaling and cell and tissue injury.

Accordingly, CoQ10 may help alleviate several of the pathological processes seen in autoimmune diseases.

What is the Role of CoQ10 in Mitochondrial Function?

We know that deficient CoQ10 status links to impaired mitochondrial function. Unfortunately, mitochondrial dysfunction leads to increased production of harmful free radicals (reactive oxygen species). In turn, the harmful free radicals activate pro-inflammatory pathways. Supplementary CoQ10 can improve mitochondrial efficiency and reduce the production of harmful free radicals.

How Can Supplementary CoQ10 Help to Reduce Inflammation?

CoQ10 can act as a modulator of gene expression. In this way, supplementary CoQ10 can positively influence immune system mediators of inflammation, cytokine production, and cellular signaling pathways that regulate immune responses.

Moreover, CoQ10 has a role to play in the regulation of immune cell function. It seems likely that supplementary CoQ10 can alter cellular energy availability and redox status. Accordingly, CoQ10 affects the activity of T cells, macrophages, and other immune cells. Notably, CoQ10 suppresses the Th17 cells that promote inflammation while increasing regulatory T (Treg) cells that help maintain immune tolerance. In other words, supplementary CoQ10 may help re-balance immune responses that have gone wrong in autoimmune diseases.

CoQ10 Supplementation and Specific Autoimmune Diseases

CoQ10 and type 2 diabetes

Type 2 diabetes has strong links to mitochondrial dysfunction, oxidative stress, and inflammation. These are all processes that supplementary CoQ10 can influence. In a systematic review of 39 RCTs, researchers observed that CoQ10 supplementation (100-200 mg/day), compared to placebo, had beneficial outcomes: statistically significant reductions in fasting blood glucose, fasting insulin, and HbA1c [Collares 2026]. In addition, CoQ10 reduced systolic and diastolic blood pressure, along with lowering triglycerides, aiding cardiovascular risk management in patients with Type 2 diabetes.

CoQ10 and multiple sclerosis

Mitochondrial dysfunction and reduced antioxidant status are known problems for patients with multiple sclerosis. Several studies show that CoQ10 supplementation can reduce oxidative stress and inflammation, reduce fatigue and depression, and improve quality of life in cases of multiple sclerosis. Studies typically used a higher CoQ10 dose of 500 mg/day, focusing on patients with relapsing-remitting MS [Salekzamani 2025; Mantle & Hargreaves 2023].

CoQ10 and rheumatoid arthritis

Small clinical trials and a 2024 review show that CoQ10 supplements are useful as an adjunctive therapy. The studies indicate that CoQ10 supplementation (100 mg/day for 2-3 months) reduces oxidative stress and inflammation. In addition, the adjunctive treatment improves clinical symptoms with reduced pain and fatigue. [Carvalho & Skare 2024].

CoQ10 and systemic lupus erythematosus

To date, there have been no clinical trials of the effect of CoQ10 supplementation in lupus patients. Patients with lupus suffer from mitochondrial dysfunction, immune system dysregulation, and oxidative stress. CoQ10 supplementation may help; there is currently an active clinical trial (NCT07096557) examining the effect of CoQ10 on pediatric lupus patients (“Evaluation of the Effect of Co-enzyme Q10 on the Clinical Outcome of Pediatric Patients with Systemic Lupus Erythematosus”).

In this study, the effect of CoQ10 plus standard treatment is compared against standard treatment alone over a 3-month period to measure changes in mitochondrial dysfunction and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) disease activity scores. A randomized controlled trial in patients with antiphospholipid syndrome—an autoimmune condition frequently linked to lupus—showed that 200 mg/day of ubiquinol (the reduced form of CoQ10) for one month improved endothelial function and reduced pro-inflammatory mediators.

Preclinical evidence shows that the use of CoQ10 analogues idebenone and MitoQ improves clinical and immunological characteristics in mouse models of lupus, with improved mitochondrial function, reduced inflammation, and improved kidney function. [Mantle & Hargreaves 2024].

Conclusion: Role of CoQ10 in Autoimmune Diseases?

The overall clinical evidence for an effect of supplementary CoQ10 in autoimmune diseases is still quite limited. The available studies are small with heterogeneous study participants.

However, supplementary CoQ10 appears to be a plausible adjunctive therapy for autoimmune diseases. CoQ10 is important for mitochondrial function, antioxidant defense, and inflammation modulation, all of which play a role in autoimmune diseases.

CoQ10 supplements can be helpful in mitigating the effects of autoimmune diseases only if the CoQ10 in the supplements is absorbed and bioavailable. In commercially available CoQ10 supplements, there is considerable variability in absorption and tissue uptake. It is important to use a CoQ10 supplement with documented bioavailability and efficacy.

Sources

Carvalho JF, Skare TL. Coenzyme Q10 supplementation in rheumatic diseases: A systematic review. Clinical Nutrition ESPEN. 2024 Feb;59:63–69.

Collares LN, et al. The effects of coenzyme Q10 supplementation on glycemic control in diabetic and non-diabetic individuals: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2026 Feb 2:1-23. Epub ahead of print.

Cordero MD et al. Can coenzyme Q10 improve clinical and molecular parameters in fibromyalgia? Antioxid. Redox Signal. 2013;19:1356–1361.

Mantle D, Hargreaves IP. Coenzyme Q10 and autoimmune disorders: an overview. Int J Mol Sci. 2024 Apr 22;25(8):4576.

Mantle D & Hargreaves IP. Multiple sclerosis: Is there a role for Coenzyme Q10? British Journal of Neuroscience Nursing. 2023;19(Sup3):S21-S25.

Salekzamani S et al. Coenzyme Q10 supplementation in multiple sclerosis: A systematic review. Multiple Sclerosis and Related Disorders. 2025;93:106212.

The information presented in this review article is not intended as medical advice. It should not be used as such.