Coenzyme Q10 plays a key role in providing energy to all cells and, in particular, in taking part in redox reactions within the electron transport chain at the mitochondrial level. Because of its important role, a deficit in plasma levels of CoQ10 is associated with many degenerative states and several diseases such as heart failure, myocardial infarction, migraine, chronic kidney disease and hypertension, Alzheimer’s and Parkinson’s disease, as well as muscular dystrophy.
Data on CoQ10 supplementation are mainly limited to the cardiovascular setting, where today clinical evidence supports supplementation with ≥200 mg/day, particularly in patients with heart failure and coronary artery disease to preserve heart health, whereas in other settings the literature is still limited and often conflicting.
A randomized, controlled, double-blind clinical trial with 22 patients treated with placebo and 23 with CoQ10 (400 mg/day) showed a significant prophylactic effect on migraine attacks after three months. Interestingly, less severe, shorter, and less frequent attacks were reported.
A growing body of evidence suggests that this coenzyme shows significant effects on migraine prophylaxis, particularly when combined with other nutraceuticals, including curcumin, magnesium, and Tanacetum parthenium L. or riboflavin. Guidelines recommend it at a dose of 300 mg/day.
Two clinical trials examined the impact of CoQ10 against fatigue in patients with statin-associated myopathy, showing a marked improvement in those treated with 200 mg/day for three months compared with controls. Another study of 50 patients on discontinuous statin therapy supplemented with 240 mg/day of CoQ10 for 22 months showed that the incidence of fatigue decreased from 84%, at the start of treatment, to 16% at the end of the study.
A study conducted in 2012, at a dose of 300 mg/day or placebo for three months, showed a significant reduction in fibromyalgia fatigue as assessed by the Fibromyalgia Impact Questionnaire, Fiq, and the visual analog scale, Vas. Similar results were obtained with 20 female patients treated for 40 days with 300 mg/day of CoQ10.
Evaluation of a potential approach with CoQ10 in cancer patients has shown a general improvement in specific inflammatory, oxidative, and biochemical markers, but unfortunately these studies are highly heterogeneous, both in terms of dosages and the cocktail of drugs or supplements that cancer patients received along with CoQ10.
More recent studies have focused on one particular aspect of breast cancer: fatigue. In an early randomized, double-blind, placebo-controlled study, 236 newly diagnosed women with planned adjuvant chemotherapy received coQ10 300 mg or placebo, each combined with 300 Ui of vit E in three daily doses, for 24 weeks. At the end of the study, the authors found that despite increased coenzyme levels, no significant differences were found in scores obtained through the assessment questionnaires.
In contrast, a randomized clinical trial conducted in Japan of 57 breast cancer patients undergoing chemotherapy receiving a dietary supplement containing branched-chain amino acids (2500 mg), CoQ10 (30 mg), and l-carnitine (50 mg), or regular care for 21 days, reported significant differences between the two arms.
Applications in the area of fertility also seem encouraging given CoQ10’s involvement in energy production in spermatozoa and defense against free radical production. In a randomized clinical trial, supplementation with 200mg/day for six months in infertile men with idiopathic asthenozoospermia showed an increase in sperm motility at the end of therapy.
Although several papers have shown improvements in sperm morphology, motility, and density, and several studies have been performed in men in order to evaluate the role of CoQ10 versus testosterone, at present the evidence is unclear and the papers inconclusive.
In women with polycystic ovary syndrome, which is often a cause of infertility, CoQ10, through an improvement in mitochondrial function and a restoration of energy production at the mitochondrial level, may stimulate steroid hormone biosynthesis and normal reproductive function, such as oocyte maturation, fertilization, and embryonic development.
Coq10 is an ergogenic supplement with an excellent safety profile even with chronic exposure at 900 mg/day and in frail patients, such as the elderly and chronically ill with kidney disease, with no known drug interactions.
Bibliography:
• Coenzyme Q10: clinical applications beyond cardiovascular diseases. Nutrients 2021, 13(5), 1697.
• Coenzyme Q10: from bench to clinic in aging diseases, a translational review. Crit. Rev. Food Sci. Nutr. 2019, 59, 2240–2257.
• Oral coenzyme Q10 supplementation in patients with migraine: effects on clinical features and inflammatory markers. Nutr. Neurosci. 2018, 22, 607–615.
• Effect of coenzyme Q10 supplementation on fatigue: a systematic review of interventional studies. Complement. Ther. Med. 2019, 43, 181–187.
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