What is it?

Discovered in 1957, coenzyme (CoQ10) is a fat-soluble antioxidant made by the body’s cells, and it is concentrated in the energy producing parts called mitochondria. CoQ10 is part of a complex series of processes that convert the oxygen we breathe in into the water we pass out. In between, the cells extract energy, particular in tissues that have high levels of activity like muscle, sperm, liver, heart and skin cells. CoQ1) is also transported in lipids around the body.

As humans make CoQ10 endogenously, it is not considered a vitamin. However, it is an important nutrient in supplements and dietary sources contributes to as much as 25% of the body’s stores [1].

Why is it important in ageing?

CoQ10 is gradually depleted by the body as we age and lower levels are predictive of cardiovascular problems [2]. This is because it is concentrated in muscles, muscle mass gradually declines with age (sarcopenia). This includes muscles in the heart, skeleton and arteries. The processes of energy production and metabolism also decline, while oxidative stress and inflammation gradually increases.

Another problem is that some older adults who take cholesterol lowering medications (statins) report problems with muscle functioning, called statin induced muscle disease [3]. These are associated with a muscle pain, weakness and stiffness, and coQ10 is frequently used to help alleviate these problems [4].

What does the evidence say?

CoQ10 has been extensively researched throughout the United States, Asia and Europe[5]. The effect of CoQ10 supplementation has been widely studied in adults with cardiovascular risk factors.

Since 2018 alone, there have been at least 9 clinical reviews (meta-analyses) of randomized controlled trials, which have examined the effect of CoQ10 supplementation on a range of cardiovascular health outcomes. Studies on adults with type 2 diabetes consistently report significant reductions in fasting blood glucose and HbA1c (an indicator of glycemic load). For example, Huang et al. [6] reported that CoQ10 helped in the control of fasting blood glucose by -0.59 mmol/L (P= 0.01) and HbA1c by -0.28% (P= 0.03).

While, in meta-analyses of studies of coronary artery disease, significant improvements were generally observed in blood lipid profiles, as well as biomarkers of inflammation and oxidative stress [7, 8].

Such effects on blood lipids and inflammatory status were echoed in patients with chronic kidney disease [9]. Interestingly, in the two meta-analyses that examined malondialdehyde, a marker of lipid mediated oxidative stress, both reported a beneficial impact [8, 9].

Summary

Collectively, the evidence suggests that CoQ10 is likely to mediate a range of beneficial cardiovascular effects, although the effects vary between different groups of adults. Maintaining enough meat, fish, nuts, and some oils, as well as using CoQ10 in a supplementary form, may help to add back what may is lost or lacking from our tissues as we age.

References

1. Kagan, V.E. and P.J. Quinn, Dietary Intake and Absorption of Coenzyme Q, in Coenzyme Q. 2000, CRC Press. p. 225-234.
2. de la Bella-Garzón, R., et al., Levels of Plasma Coenzyme Q(10) Are Associated with Physical Capacity and Cardiovascular Risk in the Elderly. Antioxidants (Basel). 2022. 11(2): p. 279. doi: 10.3390/antiox11020279.
3. Taylor, B.A. and P.D. Thompson, Statin-Associated Muscle Disease: Advances in Diagnosis and Management. Neurotherapeutics., 2018. 15(4): p. 1006-1017. doi: 10.1007/s13311-018-0670-z.
4. Qu, H., et al., Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc., 2018. 7(19): p. e009835. doi: 10.1161/JAHA.118.009835.
5. Sarter, B., Coenzyme Q10 and cardiovascular disease: a review. Journal of Cardiovascular Nursing, 2002. 16(4): p. 9-20.
6. Huang, H., et al., Effects of coenzyme Q10 on cardiovascular and metabolic biomarkers in overweight and obese patients with type 2 diabetes mellitus: a pooled analysis. Diabetes, metabolic syndrome and obesity: targets and therapy, 2018. 11: p. 875.
7. Jorat, M.V., et al., The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: A systematic review and meta-analysis of randomized controlled trials. Lipids in health and disease, 2018. 17(1): p. 230.
8. Jorat, M.V., et al., The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Inflammopharmacology, 2019: p. 1-16.
9. Bakhshayeshkaram, M., et al., The effects of coenzyme Q10 supplementation on metabolic profiles of patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials. Current pharmaceutical design, 2018. 24(31): p. 3710-3723.

from an Expert Author

George Thouas

BSc, MRepSc, PhD – Biomedical Scientist

George has worked as a medical researcher for 17 years in the university sector, at both Monash University health institutes, and The University of Melbourne. He spent 12 of those years in reproductive health and fertility research, in roles such as Clinical Research Associate, Clinical Embryologist, Post-graduate Demonstrator, Lecturer, and later as a Senior Research Fellow and Lab Manager. His doctoral thesis investigated the effects of mitochondrial damage in the oocyte. He also worked on improving the nutrient and growth requirements for in vitro fertilization and embryo development.

George has authored and coauthored more than 50 publications, including 1 book, 5 book chapters, 30 peer-reviewed journal reports and reviews, 6 patents, international scientific conference proceedings and health practitioner journal articles.

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