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CoQ10 Coenzyme Q10 supplement

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«Coenzyme Q₁₀, also known as ubiquinone, ubidecarenone, coenzyme Q, and abbreviated at times to CoQ₁₀/ˌkoʊˌkjuːˈtɛn/, CoQ, or Q₁₀ is a coenzyme that is ubiquitous in animals and most bacteria (hence the name ubiquinone). It is a 1,4-benzoquinone, where Q refers to the quinone chemical group and 10 refers to the number of isoprenyl chemical subunits in its tail.

This fat-soluble substance, which resembles a vitamin, is present in all respiring eukaryotic cell, primarily in the mitochondria. It is a component of the electron transport chain and participates in aerobic cellular respiration, which generates energy in the form of ATP. Ninety-five percent of the human body's energy is generated this way.^[1]^[2] Therefore, those organs with the highest energy requirements—such as the heart, liver, and kidney—have the highest CoQ₁₀ concentration.^[3]^[4]^[5]

There are three redox states of CoQ₁₀: fully oxidized (ubiquinone), semiquinone (ubisemiquinone), and fully reduced (ubiquinol). The capacity of this molecule to act as a two-electron carrier (moving between the quinone and quinol form) and a one-electron carrier (moving between the semiquinone and one of these other forms) is central to its role in the electron transport chain due to the iron–sulfur clusters that can only accept one electron at a time, and as a free-radical–scavenging antioxidant.

There are two major factors that lead to deficiency of CoQ₁₀ in humans: reduced biosynthesis, and increased use by the body. Biosynthesis is the major source of CoQ₁₀. Biosynthesis requires at least 12 genes, and mutations in many of them cause CoQ deficiency. CoQ₁₀ levels also may be affected by other genetic defects (such as mutations of mitochondrial DNA, ETFDH, APTX, FXN, and BRAF, genes that are not directly related to the CoQ₁₀ biosynthetic process). The role of statins in deficiencies is controversial.^[6] Some chronic disease conditions (cancer, heart disease, etc.) also are thought to reduce the biosynthesis of and increase the demand for CoQ₁₀ in the body, but there are no definite data to support these claims.

Usually, toxicity is not observed with high doses of CoQ₁₀. A daily dosage up to 3,600 mg was found to be tolerated by healthy as well as unhealthy persons.^[7] Some adverse effects, however, largely gastrointestinal, are reported with very high intakes. The observed safe level (OSL) risk assessment method indicated that the evidence of safety is strong at intakes up to 1200 mg/day, and this level is identified as the OSL.^[8]

Although CoQ₁₀ may be measured in blood plasma, these measurements reflect dietary intake rather than tissue status. Currently, most clinical centers measure CoQ₁₀ levels in cultured skin fibroblasts, muscle biopsies, and blood mononuclear cell.^[6] Culture fibroblasts can be used also to evaluate the rate of endogenous CoQ₁₀ biosynthesis, by measuring the uptake of ¹⁴C-labelledp-hydroxybenzoate.^[9]

CoQ₁₀ shares a biosynthetic pathway with cholesterol. The synthesis of an intermediary precursor of CoQ₁₀, mevalonate, is inhibited by some beta blockers, blood pressure-lowering medication,^[10] and statins, a class of cholesterol-lowering drugs.^[11] Statins can reduce serum levels of CoQ₁₀ by up to 40%.^[12]

CoQ₁₀ is not approved by the U.S. Food and Drug Administration (FDA) for the treatment of any medical condition.^[13] It is sold as a dietary supplement. In the U.S., supplements are not regulated as drugs, but as foods. How CoQ₁₀ is manufactured is not regulated and different batches and brands may vary significantly.^[13]

A 2004 laboratory analysis by ConsumerLab.com of CoQ₁₀ supplements on the market found that some did not contain the quantity identified on the product label. Amounts varied from "no detectable CoQ₁₀", to 75% of stated dose, and up to a 75% excess.^[14]

Generally, CoQ₁₀ is well tolerated. The most common side effects are gastrointestinal symptoms (nausea, vomiting, appetite suppression, and stomachaches), rash, and headache.^[15]

While there is no established ideal dosage of CoQ₁₀, a typical daily dose is 100–200 milligrams. Note that different supplement brands may have varying ingredients and strengths ^[16]

A 2014 prospective study of 420 chronic heart failure patients for two years found a statistically significant 44% reduction in both cardiovascular and all-cause mortality in patients taking 300 mg CoQ₁₀ a day versus placebo, as well as reductions in hospitalizations, cardiovascular events, and NYHA class severity.^[17]» (wikipedia)