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 (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.... Read more about this term energy
- Antioxidants 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,... Read more about this term 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.
We should always be wary of marketing claims for high absorption and superior absorption and so on. We should expect scientific documentation of the absorption and efficacy of the CoQ10 supplement.
How to Enhance Endogenous Production of Coenzyme Q10?
Exercise comes immediately to mind. There is some thought that regular exercise can benefit CoQ10 bio-synthesis and various aspects of mitochondrial function, but the jury is still out [Deichmann].
The big question is: what are the substances that we need to be careful about, what are the substances that can act as antagonists or inhibitors of the bio-synthesis of Coenzyme Q10 and of the biological effect of the Coenzyme Q10 in our cells?
Vitamin C and Coenzyme Q10
Yes, some vitamin C is needed for the bio-synthesis of Coenzyme Q10; however, it may not be a good idea to take large quantities of vitamin C together with your daily CoQ10 capsule.
Professor Guillermo Lopez-Lluch has speculated that too much simultaneous intake of vitamin C and Coenzyme Q10 might affect the net incorporation of Coenzyme Q10 into blood plasma [Lopez-Lluch].
Vitamin E and Coenzyme Q10
Speaking at the 9th international conference of the International Coenzyme Q10 Association at Columbia University, New York, in the summer of 2018, cardiologist Dr. Peter H. Langsjoen reported that high doses of Vitamin E together with CoQ10 supplements can reduce the effectiveness of the Coenzyme Q10 supplements. In a 2005 study, Dr. Langsjoen and colleagues showed that concurrent supplementation with 3000 international units of Vitamin E (3 x 1000 international units per day) and 600 milligrams of Coenzyme Q10 (3 x 200 milligrams per day) in a four-week course of supplementation resulted in a nearly 30% decline in plasma Coenzyme Q10 levels. 1,200 international units of vitamin E (400 international units three times per day) simultaneously with supplemental CoQ10 resulted in nearly 14% decline in the CoQ10 level in one subject supplemented with 600 milligrams of CoQ10 (200 three times per day) and no decline in the CoQ10 level in another subject supplemented with 300 milligrams of CoQ10 (100 mg three times per day) [Langsjoen].
Vitamin E has sometimes been referred to as a synergist of Coenzyme Q10. This confusion may have arisen because ubiquinol, the reduced form of Coenzyme Q10, not only acts as a free-radical-chain-breaking antioxidant itself but also acts to regenerate alpha-tocopherol, the active form of Vitamin E. Thus, Coenzyme Q10 and vitamin E can be considered a fat-soluble antioxidant duo of primary importance [Littarru].
It could be that vitamin E and Coenzyme Q10 compete for absorption in the small intestine absorption cells; alternatively, it could be that vitamin E and Coenzyme Q10 compete for lipoprotein transport in the blood. To stay on the safe side, it may be best not to take more than 300 international units of vitamin E daily and, in that way, avoid the risk of inhibiting the function and effect of Coenzyme Q10 in the body.
PABA (para-aminobenzoic acid) and Coenzyme Q10
PABA, a substance similar to the B vitamins, is sold as a dietary supplement. It is a competitive inhibitor of the CoQ10 bio-synthetic pathway enzyme, CoQ2. In a cell study, PABA treatment resulted in a 54 % decrease in neuronal CoQ10 status (p < 0.01). The reduction in neuronal CoQ10 status was associated with a progressive decrease in mitochondrial See Cellular respiration enzyme activities, with a 67.5 % decrease in cellular ATP production, and with a four-fold increase in mitochondrial oxidative stress [Duberley].
At the conference of the International Coenzyme Q10 Association in New York in 2018, a Ph.D. student presented evidence PABA supplementation is associated with a 50% reduction in cellular Coenzyme Q10 levels compared to control subjects not taking a PABA supplement.
Fish oil and Coenzyme Q10 in the Same Capsule
At SIBR Research, Dr. William Judy and his research team have tested the absorption of supplement formulations combining Coenzyme Q10 and fish oil. To his surprise, Dr. Judy found very poor absorption of the Coenzyme Q10 product when it was mixed with various fish oils. Without the fish oils, the Coenzyme Q10 product had a much better absorption. Dr. Judy theorized that something in the fish oil was interfering with the monoglyceride carrier in the Coenzyme Q10 product [Judy].
Medical Drugs as CoQ10 Antagonists and Inhibitors
The list of medical drugs that counteract or inhibit the bio-synthesis and/or the bio-medical effects of Coenzyme Q10 supplements is a long list. Please click here for a separate article on this topic.
If you are taking prescription medications, it is a good idea to ask your physician or pharmacist whether the drugs are likely to interfere with your body’s bio-synthesis of Coenzyme Q10 or your body’s use of Coenzyme Q10.
Statin Medications’ Inhibition of CoQ10 Bio-Synthesis
Especially prominent as an inhibitor of CoQ10 bio-synthesis are the statin medications. Okuyama and Langsjoen  have explained pharmacological mechanisms by which statin medications may actually stimulate the development and progression of Atherosclerosis is the thickening of the artery walls brought about by the build-up of plaque (plaque is made up of cholesterol and other fatty substances and waste products and calcium and fibrin) and the subsequent slowing of the flow of blood through the clogged arteries. More research is needed into the role of Coenzyme Q10 in the prevention and adjunct... Read more about this term and The Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term. They fear that the use of statin medications may play a role in coronary artery calcification and may be mitochondrial toxins that impair heart muscle cell function. Statins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10.... Read more about this term have the following known deleterious health effects:
- depletion of Coenzyme Q10 and thereby of ATP
- inhibition of the synthesis of vitamin K2
- inhibition of the synthesis of selenoproteins such as glutathione peroxidase
Okuyama and Langsjoen  have urged that statin treatment guidelines be urgently re-evaluated.
Summary: CoQ10 for Better Health-Related Quality of Life
- Our bodies produce less and less Coenzyme Q10 as we get older [Kalén].
- Various substances, notably statin medications, can inhibit the body’s bio-synthesis of Coenzyme Q10 [Okuyama].
- CoQ10 supplements are safe, well-tolerated, and affordable, but there is great variability in the extent of their absorption and bio-availability [Lopez-Lluch]. Buyer beware!
- In the KiSel-10 Study, daily supplementation of normal healthy senior citizens (average age at baseline: 78 years) with Coenzyme Q10 (200 milligrams/day) and high-selenium yeast (200 micrograms/day) for four years showed a 53% reduction in cardiovascular related mortality risk, improved heart function seen on echocardiography, and better health-related quality of life compared to placebo [Alehagen].
- In the Q-Symbio Study, daily supplementation of chronic heart failure patients (average age at baseline: 63 years) with 3 times 100 mg/day of Coenzyme Q10 for two years resulted in significantly improved symptoms and survival [Mortensen].
- A major factor affecting youthful ageing and longevity is staying free from degenerative disorders such as heart disease, diabetes, kidney disease, and liver disease [Mantle & Hargreaves].
- CoQ10 supplementation and Selenium (symbol Se, atomic number 34) is a trace element that is an essential nutrient and an essential component of some of the most important antioxidants in the body, in particular the selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Selenium is involved in the optimal functioning of the immune system. Professor Alehagen has pointed out that there exists a... Read more about this term supplementation help to keep us safe from these degenerative diseases through their activity in cellular energy generation, antioxidant protection of cells, and reduction of chronic low-grade Inflammation is an immune system response to an injury to cells or tissues. It is the body’s attempt to defend against invaders such as bacteria andviruses and to mend the damage done by invaders. Typically, inflammation manifests itself in the form of fever and swelling, in the swarming of white blood cells and the release of cytokines to fight against... Read more about this term [Mantle & Hargreaves].
Alehagen U, Johansson P, Björnstedt M, Rosén A & Dahlström U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and Coenzyme Q10 supplementation: a 5-year prospective randomized A double-blind study is a study in which neither the investigators nor the study participants know which participants are receiving the active treatment and which participants are receiving the control treatment until the study has been completed and the seal on the code has been broken.... Read more about this term placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.
Alehagen U & Aaseth J. (2014). Selenium and Coenzyme Q10 interrelationship in cardiovascular diseases – A clinician’s point of view. Journal of Trace Elements in Medicine and Biology; 31:157-162.
Deichmann RE, Lavie CJ & Dornelles AC. (2012). Impact of Coenzyme Q-10 on parameters of cardiorespiratory fitness and muscle performance inolder athletes taking statins. Phys Sportsmed; 40:88-95.
Duberley KE, Abramov AY, Chalasani A, Heales SJ, Rahman S & Hargreaves IP. (2013). Human neuronal Coenzyme Q10 deficiency results in global loss of mitochondrial respiratory chain activity, increased mitochondrial oxidative stress and reversal of ATP synthase activity. J Inherit Metab Dis; 36(1):63-73.
Judy WV. (2018). E-mail communication.
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Langsjoen, JO, Langsjoen AM & Langsjoen PH. (2005). A reduction in plasma Coenzyme Q10 (CoQ10) secondary to supplemental vitamin E. Los Angeles: 4th CoQ10 Conference of the International CoQ10 Association.
Littarru GP & Lambrechts P. (2011). Coenzyme Q10: multiple benefits in one ingredient; OCL (Oilseeds and Fats, Crops and Lipids); 18: 76-82.
López-Lluch G, Del Pozo-Cruz J, Sánchez-Cuesta A, Cortés-Rodríguez A B & Navas P. (2019). Bioavailability of Coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition, 57, 133–140.
Mantle D & Hargreaves I. (2019). Coenzyme Q10 and degenerative disorders affecting longevity: an overview. Antioxidants (Basel); 8(2): 44.
Mortensen S A, Rosenfeldt F, Kumar A, Dolliner P, Filipiak K J, Pella D & Littarru GP (2014). The effect of Coenzyme Q10 on morbidity and mortality in The Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term: results from Q-SYMBIO: a randomized double-blind trial. JACC. Heart Failure, 2(6), 641-649.
Okuyama H, Langsjoen P H, Hamazaki T, Ogushi Y, Hama R, Kobayashi T & Uchino H. (2015). Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Review of Clinical Pharmacology, 8(2), 189-199.
Pelton R & LaValle JB. (2000). Nutritional Cost of Prescription Drugs. 1st ed. Englewood, CO: Morton Pub.
The information contained in this review article is not intended as medical advice and should not be construed as such.
2 January 2020