Coenzyme Q10 Supplements: What You Need To Know

Coenzyme Q10 capsules
The thing is, there are considerable differences in the absorption and bioavailability of the many commercial CoQ10 supplements.  An inexpensive CoQ10 supplement is not inexpensive if it gives only negligible absorption and bioavailability.  It is a waste of money.  It is important to choose a CoQ10 supplement with documented absorption and efficacy.

The active substance in the best Coenzyme Q10 nutritional supplements is a natural substance that is extracted in a yeast fermentation process; the Coenzyme Q10 is not a synthetic substance.

The CoQ10 molecules in the best nutritional supplements are the same molecules as the CoQ10 molecules synthesized inside the mitochondria in human cells.

As we get older, our cells’ ability to synthesize Coenzyme Q10 declines. Furthermore, the use of some drugs such as statin medications inhibits the cells’ synthesis of Coenzyme Q10.  We need a good supplement to make up for the loss.

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A Pharmacist Looks at Coenzyme Q10

Dr. Ross Pelton
Dr. Ross Pelton brands himself as The Natural Pharmacist; he is also a certified clinical nutritionist. He is currently the Scientific Director for Essential Formulas. Dr. Pelton is the author of The Drug-Induced Nutrient Depletion Handbook. For a FREE copy of Dr. Pelton’s Quick Reference Guide to Drug-Induced Nutrient Depletions, go to naturalpharmacist.net/dind.

In the April/May 2020 issue of the journal IMCJ: Integrative Medicine: A Clinician’s Journal, pharmacist Dr. Ross Pelton reviews the most important developments in Coenzyme Q10 clinical research:

• The Q-Symbio Study in which researchers gave chronic heart failure patients 3 x 100 mg of Coenzyme Q10 or placebo daily as an adjuvant treatment together with conventional heart failure medications for two years. The outcome was significantly improved symptoms, quality of life, and survival in the CoQ10 treatment group compared to the placebo group [Mortensen 2014].

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Testing the Potency of Coenzyme Q10 Supplements

CoQ10 capsules in blister pack
Yes, of course, the capsule must contain 100 mg of Coenzyme Q10 if that is what the label says. However, the absorption of Coenzyme Q10 is complex. The CoQ10 potency test results do not take important factors into consideration:  Dissolving the CoQ10 Crystals – Dividing the CoQ10 Daily Dosage – Deciding on the Form (ubiquinone or ubiquinol) and Formulation 

A US supplements manufacturer reports that its testing shows some of the CoQ10 supplements sold on amazon.com do not contain the quantity of Coenzyme Q10 indicated on the product label [Schultz, 2020, May 14].

The testing shows that seven of the ten tested products had less than 80% potency. These seven named products are not products from major sellers of CoQ10 supplements in the USA.

The other three tested products tested are labeled “X Brand” in the test report. These three products are said to contain 93%, 96.5%, and 86% of the declared active ingredient [NOW® Testing].

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Enzyme Systems Convert Ubiquinone to Ubiquinol

Dr. Judy COQ10 Insider's Guide book
Dr. William Judy in his 2018 book, Coenzyme Q10: An Insider’s Guide, discusses the absorption and bioavailability of the ubiquinone and ubiquinol forms of Coenzyme Q10. The book is available from amazon.com. ISBN: 978-87-7776-186-7

There are numerous enzyme systems at work in the body to convert ubiquinone, the oxidized form of Coenzyme Q10, to ubiquinol, the reduced form of Coenzyme Q10.  Despite marketing claims to the contrary, it is not necessary to take a ubiquinol supplement to get sufficient ubiquinol in the body [Mantle & Dybring 2020].  No worries there.

This is the take-home message in a peer-reviewed journal article published on May 5, 2020, in the Antioxidants journal [Mantle & Dybring 2020].

Ubiquinone (Oxidized Form) and Ubiquinol (Reduced Form)

Coenzyme Q10 molecules are redox molecules. In the body, they convert back and forward between their oxidized form, ubiquinone, and their reduced form, ubiquinol.  What does that mean, oxidized and reduced?

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Facts About Coenzyme Q10 Absorption and Bio-Availability

Dr. Judy in lab coat
Dr. William V. Judy, SIBR Research Institute, explains: Absorption is the movement of the ingested Coenzyme Q10 through the stomach and small intestines into the lymph and then into the blood circulation. Bioavailability is the accumulation of the ingested Coenzyme Q10 in the blood over time in response to daily doses. It is the amount of Coenzyme Q10 that is available for transport into the tissue cells.

Fact: Without decent absorption and bio-availability of our CoQ10 supplement, we cannot hope to get good heart health effects.

Fact: There is much variability from one CoQ10 supplement to another. It is important to choose a CoQ10 supplement for which there is documented evidence of absorption and bio-availability as well as published evidence of improvement of heart health signs and symptoms.

Sadly, the claims for the absorption of many CoQ10 supplements have been greatly exaggerated in many cases.

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Undocumented Claims for Coenzyme Q10 Absorption and Efficacy in the US Market

Back cover of Dr. Judy's book An Insider's Guide to Coenzyme Q10
In his 2018 book, An Insider’s Guide to Coenzyme Q10, Dr. William Judy of SIBR Research summarizes the results of clinical studies using ubiquinone CoQ10 supplements. He also includes anecdotes about the use of CoQ10 supplements. The book is available from amazon.com.

Even if they are made from the same raw material, the CoQ10 products on the US retail market are very diverse in terms of their absorption and in terms of their health effects. 

We, as consumers, need to see documentation, preferably in peer-reviewed scientific journals, for the absorption and efficacy of the CoQ10 product we buy.

The form of the retail Coenzyme Q10 product can be different (either the ubiquinone form or the ubiquinol form), and the formulation can be different (different carrier oils and different heating and cooling processes).

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Coenzyme Q10 Synergists

Professor Urban Alehagen
Professor Urban Alehagen, the lead researcher on the KiSel-10 Study, has emphasized the clinical significance of daily supplementation with both Coenzyme Q10 and high-selenium yeast.  Both supplements have a protective antioxidant role in the prevention of heart disease.

In the previous article on this site, we discussed substances that can counteract or inhibit the bio-synthesis or absorption or efficacy of Coenzyme Q10.  Today we want to look at substances that might actually boost the bio-synthesis or absorption or efficacy of Coenzyme Q10.

Among the substances we want to consider are the following nutritional supplements:

  • carnitine
  • NADH
  • PQQ
  • riboflavin
  • selenium

High-Selenium Yeast Supplements and Coenzyme Q10

Professor Urban Alehagen writes that a deficiency of selenium may restrict the cells’ ability to get optimal concentrations of Coenzyme Q10.  Moreover, the cells are dependent upon adequate concentrations of Coenzyme Q10 to achieve optimal function of selenium in the body. There seems to be a special interrelationship between Coenzyme Q10 and selenium that can be exploited clinically [Alehagen & Aaseth].

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Coenzyme Q10 Antagonists and Inhibitors

Dr. Judy's book: An Insider's Guide to Coenzyme Q10.
Dr. William Judy, founder and president of SIBR Research, advises against taking a vitamin C supplement within an hour of taking a CoQ10 capsule. In his book, Insider’s Guide to Coenzyme Q10, Dr. Judy summarizes the CoQ10 clinical research results. The book is available from amazon.com.

Human adults’ bio-synthesis of the essential bio-nutrient Coenzyme Q10 declines with increasing age [Kalén].  That is unfortunate.

We humans need sufficient quantities of Coenzyme Q10 for various biological functions:

  • cellular production of ATP energy
  • antioxidant protection of the cells against oxidative damage
  • maintenance of endothelial function in blood vessels
  • anti-inflammatory effects

Coenzyme Q10 Supplementation and Beyond

We can take a daily Coenzyme Q10 supplement, of course, and we should.  However, we should be very careful.

Commercially available CoQ10 supplements vary considerably in their formulation and in their absorption and bio-availability.  A cheap 30-cents-per day CoQ10 supplement at the supermarket or drugstore is most likely a poorly absorbed and ineffective supplement.

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Coenzyme Q10 Crystals and Coenzyme Q10 Absorption

The Coenzyme Q10 raw material is a yellow or orange crystalline powder produced by a yeast fermentation extraction process. The CoQ10 crystals are fat-soluble. They are practically insoluble in water, and any attempt to make them water-soluble will rob them of their CoQ10 characteristics. Coenzyme Q10 is soluble in lipids, but keeping the Coenzyme Q10 molecules from re-crystallizing inside the supplement capsules is difficult.  And humans cannot absorb CoQ10 crystals, only single CoQ10 molecules.

Absorption of the Coenzyme Q10 in commercial nutritional supplements varies considerably.  The dissolution of the CoQ10 crystals and the absorption of the Coenzyme Q10 molecules depend upon the composition of the oil matrix and the formulation of the CoQ10 nutritional supplement.  The manufacturer of a CoQ10 supplement must deal with raw material that is very difficult to work with.

Coenzyme Q10 Soluble in Lipids at Higher Temperatures

Coenzyme Q10 is practically insoluble in water but is soluble in lipids; however, no individual lipids have been found in which 100 milligrams of Coenzyme Q10 can be dissolved so that the dissolved Coenzyme Q10 molecules inside the nutritional supplement capsules will not re-crystallize at normal storage temperatures: typically, between 60 and 75 degrees Fahrenheit.

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Coenzyme Q10 Absorption, Efficacy, and Safety

A significant reduction in the rate of CoQ10 biosynthesis has been associated with the aging process and aging-related diseases [Hernandez-Camacho 2018]. It is not possible to make up for this loss of Coenzyme Q10 by eating more selectively. Supplementation with a well-formulated CoQ10 preparation is necessary. (Graph compliments of SIBR Research Institute)
The active substance in the best Coenzyme Q10 nutritional supplements is a natural substance extracted from a yeast fermentation process; it is not a synthetic substance.

The CoQ10 molecules in the best nutritional supplements are the same molecules as the CoQ10 molecules synthesized inside the mitochondria in human cells.

Absorption and Bio-availability of Coenzyme Q10

Similar to vitamin E, Coenzyme Q10 in food and in nutritional supplements has a low absorption and bio-availability.  In the case of Coenzyme Q10, the difficult absorption is attributed to the relatively large size and the lipid soluble nature of the CoQ10 molecules.

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