Heart failure (HF) is a public health issue of global importance. In Ghana, a study by Amoah and Kallen (2000) revealed that the main causes of heart failure were hypertension (21.3%), rheumatic heart disease (20.1%), and cardiomyopathy (16.8%). Additionally, congenital heart disease and coronary artery disease accounted for 9.8 and 10% of cases respectively.
Another study by Bosu (2010) also revealed that between 1988 and 2007, the number of reported new cases of hypertension in the country’s outpatient public health facilities increased by more than 1,000 percent. Interestingly, the World Health Organization (WHO) predicted that there would be nearly 20 million cardiovascular disease (CVD) related deaths globally by the year 2015.
Fast forward, Owusu and Adu-Boakye (2013) found a high prevalence of heart failure (about 76%), which supports the fact that HF is a major contributor to cardiovascular related mortality. Due to this burden, a recent study by Sanuade et al., (2021) advocates for health education programs to promote practical knowledge on CVD symptoms, risks and treatment.
Despite the existence of pharmaceutical or conventional approaches to managing cardiovascular related diseases, there are natural approaches which have equally proven to be effective. One such ingredient is CoQ10. In this article, I provide a scientific review on this ingredient in cardiovascular management.
CoQ10 is a vital nutrient which works like an antioxidant in the body. In its active form, it is called Ubiquinone or Ubiquinol. CoQ10 is found in the human body particularly in the heart, liver, kidneys and pancreas. It is stored in the mitochondria of your cells, often called the cells’ “powerhouse,” which is why it is involved in energy production.
There are two types of CoQ10: ubiquinone and ubiquinol. Ubiquinol is the active form that your body makes from ubiquinone. Your levels of both forms drop as early as your twenties, and your body loses the ability to make more.
CoQ10 is synthesized naturally within the body and is used for important functions such as supplying the cells with energy, transporting electrons and regulating blood pressure levels. As a “coenzyme,” CoQ10 also helps other enzymes to work properly. The reason it is not considered a “vitamin” is because all animals, including humans, can make small amounts of coenzymes on their own, even without the help of food. While the human body makes some CoQ10, CoQ10 supplements are also available in various forms; including capsules, tablets and IVs; for people who have low levels and can benefit from these supplements.
CoQ 10 Functions
- To sustain enough energy to perform bodily functions, inside our cells, tiny organelles called mitochondria take fat and other nutrients and turn them into useable sources of energy. This conversion process requires the presence of CoQ10.
- Coenzyme Q10 is not only necessary for producing cellular energy, but also for defending cells from damage caused by harmful free radicals.
- Coenzyme Q10 can exist in three different oxidation states, and the ability in some forms to accept and donate electrons is a critical feature in its biochemical functions that cancel out free radical damage.
- As a powerful antioxidant, Coenzyme Q10 can increase absorption of other essential nutrients. It has been shown that it helps recycle vitamin C and vitamin E , further maximizing the effects of these vitamins and antioxidants that are already at work in the body.
COQ 10, To take or not?
Recently, I chanced on a health program on one of the Television channels, where one Medical Doctor who specializes in urology kicked against marketing of nutritional supplements. He argued that, once you eat well, there is no need to take supplements. In fact, according to him, he doesn’t prescribe supplements. He could be right; but he lacks the understanding on natural ingredients. This is just a case of academic arrogance. For instance, though the body has the ability to make some CoQ10 on its own, CoQ10 production naturally declines as we age; just when we need our cells to help defend us most. This decline is most apparent in people over the age of 40, particularly those taking statin drugs. It has also been found that people with diabetes, cancer and congestive heart failure tend to have decreased plasma levels of coenzyme Q10, although the age-related drop in CoQ10 levels isn’t medically defined as a “deficiency.” In a study by Oregon State University, natural synthesis of CoQ10, plus dietary intake, seemed to provide sufficient amounts to help prevent a CoQ10 deficiency in healthy people.
COQ 10, Scientific Benefits
Treat Heart Failure
Vaduganathan et al., (2015) study found that some treatments for heart failure have undesirable side effects, such as low blood pressure, while others could even further reduce CoQ10 levels. In another study by Mortensen et al., (2014) involving 420 people with heart failure, treatment with CoQ10 for two years improved their symptoms and reduced their risk of dying from heart problems. Another retrospective study was conducted by Morisco et al., (1993) which involved 641 people using CoQ10 or a placebo for a year. The researchers found that the CoQ10 group had been hospitalized less frequently for worsening heart failure and had fewer serious complications.
A prospective study by DiNicolantonio et al., (2015) found that managing patients with CoQ10 support reinstated optimal levels of energy production, reduced oxidative damage and improved heart function, all of which can aid the treatment of heart failure. This means that CoQ10 has strong potential for prevention and treatment of heart ailments.
For those on pharmaceutical drugs such as statins, CoQ10 supplementation may be useful, as it deals with the side effects. Statins are used to reduce an enzyme in the liver that not only decreases the production of cholesterol, but also further lowers the natural production of CoQ10. This notwithstanding, a study by Marcoff and Thompson (2007) found that there is no evidence to prescribe CoQ10 supplementation for patients with statins, although it did recognize that there aren’t any “known risks.” Finally, Marcoff and Thompson (2007) acknowledged the need for better-designed trials and did not actually contradict the possible benefit of CoQ10 to offset statin side effects.
CoQ10 also support the heart in other ways. Watts et al., (2002), Glover et al., (2010), and Fumagalli et al., (2011) found that CoQ10 increases blood flow and improves exercise performance and capacity for people who have suffered heart failure.
CoQ10 and blood pressure?
The National Institutes of Health is reported as saying: “the small amount of evidence currently available suggests that CoQ10 probably doesn’t have a meaningful effect on blood pressure.” However, one review by Barbara (2002) reports that CoQ10 has potential for use in prevention and treatment of cardiovascular disease, particularly hypertension (high blood pressure), hyperlipidemia, coronary artery disease, and heart failure. Further clinical trials are warranted, but because of its low toxicity it may be appropriate to recommend coenzyme Q10 to select patients as an adjunct to conventional treatment.
CoQ 10 and Improvement of Energy
CoQ10 plays a role in “mitochondrial ATP synthesis”, which involves the conversion of raw energy from foods (carbohydrates and fats) into the form of energy that our cells use called adenosine triphosphate (ATP). This pathway needs coenzyme Q in the inner mitochondrial membrane. Molyneux et al., (2008) reports that CoQ10 accepts electrons during fatty acid and glucose metabolism and then transfers them to electron acceptors.
Khakh et al., (2009) further explains that this process of providing ATP is significant to every cell in the human body, and CoQ10 is needed to do its job. Additionally, Lee et al., (2011) is of the view that CoQ10 aids in fatigue connected to exercise. The study which is a double-blind, placebo-controlled study in humans has shown improvements in exercise-related fatigue when participants were supplemented with CoQ10 (at dosages between 100–300 milligrams per day) ( Mizuno et al. 2007; Gökbel et al.2010). Glover et al., (2010) also found 1,200 mg of CoQ10 per day for 60 days very beneficial.
CoQ10, PH Level
Schwalfenberg (2012) argued that diseases develop more easily in environments that have to work harder to maintain proper pH levels. CoQ 10 helps to maintain normal PH levels in the body. This, in addition to its major antioxidant capacity, may be one reason that cancer risk may be associated with low CoQ10 levels. CoQ 10 also deals with the side effects of conventional cancer treatment. A study by Conklin, (2005) found that supplementing with CoQ10 during cancer treatment may help to increase the cancer-killing potential of these medications (like doxorubicin and daunorubicin ). There is also evidence that CoQ10 can protect the heart from DNA damage that can sometimes occur from high doses of chemotherapy medications.
Another prospective study by Lockwood et al., (1994) found that COQ10 may slow or reverse the spread of breast cancer in high-risk patients within three months. A recent commentary in PDQ Integrative, Alternative, and Complementary Therapies Editorial Board (2021) also found that CoQ10 may play a role in the prevention of cervical cancer as low levels were found in these patients.
Another study by Hertz and Lister (2009) also found that CoQ10 may improve survival rates in end-stage cancers. The interesting thing is that, these studies are far from hard proof, but they are encouraging beginnings to the thought that CoQ10 supplementation may help improve survival with certain cancers.
Rusciani et al., (2007) in their study indicated that supplementing with CoQ10 may help reduce the chance of cancer recurrence.
CoQ10 and Cognitive Health
Isobe et al., (2009) found that people with cognitive disorders tend to have reduced levels of CoQ10 in their blood. This was also demonstrated in a previous study by Wadsworth et al., (2008) which found that CoQ10 may slow the progression of Alzheimer’s and Parkinson’s disease.
Other studies have found positive effects of CoQ10 on Parkinson disease. For instance, Shults et al., (2002) randomized, placebo-controlled trial which evaluated the efficacy of 300, 600 or 1,200 milligrams a day given to 80 people with early Parkinson’s disease found good results. Negative results were however reported in some studies (Storch et al. 2007; NINDS NET-PD Investigators, 2007;) leading to cancellation of the trial.
Six studies ( Lewin and Lavon ,1997; Safarinejad, 2009; Nadjarzadeh, 2011; Safarinejad, 2010;
Lafuente et al., 2013; Ahmadi et al., 2016) found that CoQ10 can help improve fertility issues in men. In clinical trials, they found that supplementation with Coenzyme Q10 significantly:
- Improves sperm motility (movement)
- Increases fertilization rates
- Boosts sperm count
- Improves sperm morphology (size/form)
- Increases antioxidants in seminal plasma
- Aids in treatment of asthenozoospermia (diagnostically low sperm motility)
- Improves symptoms of Peyronie’s disease (a serious male infertility disease)
CoQ 10 and Fibromyalgia
Several clinical trials (Cordero et al., 2011; Cordero et al., 2012; Cordero et al., 2013; Miyamae et al., 2013) and case reports have found that CoQ10 may be a powerful natural method of treating fibromyalgia symptoms . In adults, the dosage was typically 300 milligrams per day, while one study on juvenile fibromyalgia focused on a 100 milligram dose.
CoQ 10 and the lungs
A study by Gvozdjáková et al., (2005) showed that supplementing with CoQ10 reduced inflammation in individuals who had asthma, as well as their need for steroid medications to treat it. An earlier study by Gazdík et al., (2002) also found that people suffering from lung conditions have lower levels of CoQ10.
CoQ 10 and Diabetes
One study by Amin et al., (2014) showed that CoQ10 improves insulin sensitivity and regulates blood sugar levels. Two studies (Eriksson et al., 1999; El-ghoroury et al., 2009) also showed that CoQ10 increases concentrations in the blood by three times in people with diabetes who typically show low levels of this compound. A retrospective study by Zahedi et al., (2014) further found that those with type 2 diabetes who take CoQ10 for 12 weeks significantly reduced their fasting blood sugar levels and hemoglobin A1C. Finally, Abdali et al., (2015) reports that CoQ10 averts diabetes by stimulating the breakdown of fats and reducing the accumulation of fat cells that could lead to obesity or type 2 diabetes.
CoQ10 and Headache
A study by Sándor et al., (2005) found that those who took CoQ10 were three times more likely than a placebo group to reduce the number of migraines in 42 people. Fast-forward, one large study by Hershey et al., (2007) found that 1,550 people with low CoQ10 levels experienced fewer and less severe headaches after treatment with CoQ10. Shoeibi et al., (2017) concluded that CoQ10 could also prevent migraines and not only treat it.
CoQ10 and Skin Health
Knott et al., (2015) study found that applying CoQ10 straight to the skin can reduce the damage from internal and external agents by increasing energy production in skin cells and promoting antioxidant protection. This is not new as one study by Hoppe et al., (1999) affirmed this position and found that CoQ10 on the skin reduces oxidative damage caused by UV rays and even decreases the depth of wrinkles. Finally, Rusciani et al., (2007) study found that those lacking CoQ10 are likely to develop skin cancer.
CoQ10 Food Sources
A study by Weber et al., (1997) found that CoQ10 is absorbed in capsule form or through foods. Hence, the following foods contain CoQ10:
- Organ meats: Heart, liver and kidney
- Some muscle meats: Pork, beef and chicken
- Fatty fish: Trout, herring, mackerel and sardine
- Vegetables: Spinach, cauliflower and broccoli
- Fruits: Oranges and strawberries
- Legumes: Soybeans, lentils and peanuts
- Nuts and seeds: Sesame seeds and pistachios
- Oils: Soybean and canola oil
CoQ10 supplement Dosage
An article by Griffin (2021) recommends 50–1,200 milligrams per day. Most supplements fall within the 100–200 milligram range. Alternatively, 90 milligrams up to 1,200 milligrams is also acceptable. This larger dose has typically been used only to study the neurological benefits of CoQ10. Most successful studies have used between 100–300 milligrams (Levy, 2019).
COQ10; Time to take
Levy (2019) explains that, CoQ10 can be taken any time that is most convenient. It is however best to take CoQ10 with a meal containing fat, since it is fat soluble. If you take a CoQ10 dosage that exceeds 100 mg per day, it is best to split the doses into two or three smaller servings, which will help with absorption. Levy (2019) further notes: “There is some evidence that taking CoQ10 at night may help with the body’s ability to use it, so a good option is taking it with dinner. However, some people report having difficulty falling asleep when they take CoQ10 close to bed time, so this comes down to individual preference”.
Griffin (2021) notes the following side effects:
- Upper abdominal pain
- Loss of appetite
- Light sensitivity
- From studies, CoQ10 improves heart and brain health, lowers sugar level, slows aging and fighs cancer.
- CoQ10 foods include meat, fish, nuts, seeds, veggies and eggs. However, our ability to produce and use it decreases significantly with age.
- CoQ10 supplement dosages range between 30—1,200 milligrams/daily. The typically recommended dosage is between 100-200 milligrams each day for most conditions.
The writer is a Professor of Naturopathic Healthcare and President of Nyarkotey University College of Holistic Medicine & Technology (NUCHMT)/African Naturopathic Foundation .E-mail: [email protected] .
- Lewin A, Lavon H. The effect of coenzyme Q10 on sperm motility and function. Mol Aspects Med. 1997;18 Suppl:S213-9. doi: 10.1016/s0098-2997(97)00036-8. PMID: 9266524.
- Safarinejad MR. Efficacy of coenzyme Q10 on semen parameters, sperm function and reproductive hormones in infertile men. J Urol. 2009 Jul;182(1):237-48. doi: 10.1016/j.juro.2009.02.121. Epub 2009 May 17. PMID: 19447425.
- Nadjarzadeh A, Sadeghi MR, Amirjannati N, Vafa MR, Motevalian SA, Gohari MR, Akhondi MA, Yavari P, Shidfar F. Coenzyme Q10 improves seminal oxidative defense but does not affect on semen parameters in idiopathic oligoasthenoteratozoospermia: a randomized double-blind, placebo controlled trial. J Endocrinol Invest. 2011 Sep;34(8):e224-8. doi: 10.3275/7572. Epub 2011 Mar 7. PMID: 21399391.
- Safarinejad MR. Safety and efficacy of coenzyme Q10 supplementation in early chronic Peyronie's disease: a double-blind, placebo-controlled randomized study. Int J Impot Res. 2010 Sep-Oct;22(5):298-309. doi: 10.1038/ijir.2010.20. Epub 2010 Aug 19. PMID: 20720560.
- Ahmadi S, Bashiri R, Ghadiri-Anari A, Nadjarzadeh A. Antioxidant supplements and semen parameters: An evidence based review. Int J Reprod Biomed. 2016 Dec;14(12):729-736. PMID: 28066832; PMCID: PMC5203687.
- Lafuente R, González-Comadrán M, Solà I, López G, Brassesco M, Carreras R, Checa MA. Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet. 2013 Sep;30(9):1147-56. doi: 10.1007/s10815-013-0047-5. Epub 2013 Aug 3. PMID: 23912751; PMCID: PMC3800531.
- Cordero MD, Cano-García FJ, Alcocer-Gómez E, De Miguel M, Sánchez-Alcázar JA. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement. PLoS One. 2012;7(4):e35677. doi: 10.1371/journal.pone.0035677. Epub 2012 Apr 19. PMID: 22532869; PMCID: PMC3330812.
- Cordero MD, Alcocer-Gómez E, de Miguel M, Cano-García FJ, Luque CM, Fernández-Riejo P, Fernández AM, Sánchez-Alcazar JA. Coenzyme Q(10): a novel therapeutic approach for Fibromyalgia? case series with 5 patients. Mitochondrion. 2011 Jul;11(4):623-5. doi: 10.1016/j.mito.2011.03.122. Epub 2011 Apr 7. PMID: 21496502.
- Cordero MD, Alcocer-Gómez E, de Miguel M, Culic O, Carrión AM, Alvarez-Suarez JM, Bullón P, Battino M, Fernández-Rodríguez A, Sánchez-Alcazar JA. Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal. 2013 Oct 20;19(12):1356-61. doi: 10.1089/ars.2013.5260. Epub 2013 Apr 6. PMID: 23458405.
- Miyamae T, Seki M, Naga T, Uchino S, Asazuma H, Yoshida T, Iizuka Y, Kikuchi M, Imagawa T, Natsumeda Y, Yokota S, Yamamoto Y. Increased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation. Redox Rep. 2013;18(1):12-9. doi: 10.1179/1351000212Y.0000000036. PMID: 23394493; PMCID: PMC6837523.
- Gvozdjáková A, Kucharská J, Bartkovjaková M, Gazdíková K, Gazdík FE. Coenzyme Q10 supplementation reduces corticosteroids dosage in patients with bronchial asthma. Biofactors. 2005;25(1-4):235-40. doi: 10.1002/biof.5520250129. PMID: 16873952.
- Gazdík F, Gvozdjáková A, Nádvorníková R, Repická L, Jahnová E, Kucharská J, Piják MR, Gazdíková K. Decreased levels of coenzyme Q(10) in patients with bronchial asthma. Allergy. 2002 Sep;57(9):811-4. doi: 10.1034/j.1398-9995.2002.23747.x. PMID: 12169177.
- Amin MM, Asaad GF, Abdel Salam RM, El-Abhar HS, Arbid MS. Novel CoQ10 antidiabetic mechanisms underlie its positive effect: modulation of insulin and adiponectine receptors, Tyrosine kinase, PI3K, glucose transporters, sRAGE and visfatin in insulin resistant/diabetic rats. PLoS One. 2014 Feb 20;9(2):e89169. doi: 10.1371/journal.pone.0089169. PMID: 24586567; PMCID: PMC3930675.
- El-ghoroury EA, Raslan HM, Badawy EA, El-Saaid GS, Agybi MH, Siam I, Salem SI. Malondialdehyde and coenzyme Q10 in platelets and serum in type 2 diabetes mellitus: correlation with glycemic control. Blood Coagul Fibrinolysis. 2009 Jun;20(4):248-51. doi: 10.1097/mbc.0b013e3283254549. PMID: 19530339.
- Eriksson JG, Forsén TJ, Mortensen SA, Rohde M. The effect of coenzyme Q10 administration on metabolic control in patients with type 2 diabetes mellitus. Biofactors. 1999;9(2-4):315-8. doi: 10.1002/biof.5520090229. PMID: 10416046.
- Zahedi H, Eghtesadi S, Seifirad S, Rezaee N, Shidfar F, Heydari I, Golestan B, Jazayeri S. Effects of CoQ10 Supplementation on Lipid Profiles and Glycemic Control in Patients with Type 2 Diabetes: a randomized, double blind, placebo-controlled trial. J Diabetes Metab Disord. 2014 Jul 25;13:81. doi: 10.1186/s40200-014-0081-6. PMID: 26413493; PMCID: PMC4583053.
- Abdali D, Samson SE, Grover AK. How effective are antioxidant supplements in obesity and diabetes? Med Princ Pract. 2015;24(3):201-15. doi: 10.1159/000375305. Epub 2015 Mar 14. PMID: 25791371; PMCID: PMC5588240.
- Sándor PS, Di Clemente L, Coppola G, Saenger U, Fumal A, Magis D, Seidel L, Agosti RM, Schoenen J. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology. 2005 Feb 22;64(4):713-5. doi: 10.1212/01.WNL.0000151975.03598.ED. PMID: 15728298.
- Hershey AD, Powers SW, Vockell AL, Lecates SL, Ellinor PL, Segers A, Burdine D, Manning P, Kabbouche MA. Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache. 2007 Jan;47(1):73-80. doi: 10.1111/j.1526-4610.2007.00652.x. PMID: 17355497.
- Shoeibi A, Olfati N, Soltani Sabi M, Salehi M, Mali S, Akbari Oryani M. Effectiveness of coenzyme Q10 in prophylactic treatment of migraine headache: an open-label, add-on, controlled trial. Acta Neurol Belg. 2017 Mar;117(1):103-109. doi: 10.1007/s13760-016-0697-z. Epub 2016 Sep 26. PMID: 27670440.
- Knott A, Achterberg V, Smuda C, Mielke H, Sperling G, Dunckelmann K, Vogelsang A, Krüger A, Schwengler H, Behtash M, Kristof S, Diekmann H, Eisenberg T, Berroth A, Hildebrand J, Siegner R, Winnefeld M, Teuber F, Fey S, Möbius J, Retzer D, Burkhardt T, Lüttke J, Blatt T. Topical treatment with coenzyme Q10-containing formulas improves skin's Q10 level and provides antioxidative effects. Biofactors. 2015 Nov-Dec;41(6):383-90. doi: 10.1002/biof.1239. Epub 2015 Dec 9. PMID: 26648450; PMCID: PMC4737275.
- Hoppe U, Bergemann J, Diembeck W, Ennen J, Gohla S, Harris I, Jacob J, Kielholz J, Mei W, Pollet D, Schachtschabel D, Sauermann G, Schreiner V, Stäb F, Steckel F. Coenzyme Q10, a cutaneous antioxidant and energizer. Biofactors. 1999;9(2-4):371-8. doi: 10.1002/biof.5520090238. PMID: 10416055.
- Rusciani L, Proietti I, Rusciani A, Paradisi A, Sbordoni G, Alfano C, Panunzi S, De Gaetano A, Lippa S. Low plasma coenzyme Q10 levels as an independent prognostic factor for melanoma progression. J Am Acad Dermatol. 2006 Feb;54(2):234-41. doi: 10.1016/j.jaad.2005.08.031. Epub 2005 Dec 27. PMID: 16443053.
- Morgan Griffin(2021) Coenzyme Q10: CoQ10. https://www.webmd.com/diet/supplement-guide-coenzymeq10-coq10#1-3
- Amoah A.G.B. Kallen C(2000) Aetiology of Heart Failure as Seen from a National Cardiac Referral Centre in Africa. Cardiology ; 93:11–18
- Bosu WK. Epidemic of Hypertension in Ghana: A systematic Review. BMC Public Health 2010;10:418. [ PMC free article ] [ PubMed ] [ Google Scholar ] [ Ref list ]
- Sanuade OA, Kushitor MK, Awuah RB, et al Lay knowledge of cardiovascular disease and risk factors in three communities in Accra, Ghana: a cross-sectional survey BMJ Open 2021;11:e049451. doi: 10.1136/bmjopen-2021-049451
- COQ 10. https://lpi.oregonstate.edu/mic/dietary-factors/coenzyme-Q10
- Vaduganathan M, Butler J, Pitt B, Gheorghiade M. Contemporary Drug Development in Heart Failure: Call for Hemodynamically Neutral Therapies. Circ Heart Fail. 2015 Jul;8(4):826-31. doi: 10.1161/CIRCHEARTFAILURE.115.002271. PMID: 26199309.
- Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014 Dec;2(6):641-9. doi: 10.1016/j.jchf.2014.06.008. Epub 2014 Oct 1. PMID: 25282031.
- Morisco C, Trimarco B, Condorelli M. Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Investig. 1993;71(8 Suppl):S134-6. doi: 10.1007/BF00226854. PMID: 8241697.
- DiNicolantonio JJ, Bhutani J, McCarty MF, O'Keefe JH. Coenzyme Q10 for the treatment of heart failure: a review of the literature. Open Heart. 2015 Oct 19;2(1):e000326. doi: 10.1136/openhrt-2015-000326. PMID: 26512330; PMCID: PMC4620231.
- Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy: a systematic review. J Am Coll Cardiol. 2007 Jun 12;49(23):2231-7. doi: 10.1016/j.jacc.2007.02.049. PMID: 17560286.
- Watts GF, Playford DA, Croft KD, Ward NC, Mori TA, Burke V. Coenzyme Q(10) improves endothelial dysfunction of the brachial artery in Type II diabetes mellitus. Diabetologia. 2002 Mar;45(3):420-6. doi: 10.1007/s00125-001-0760-y. PMID: 11914748.
- Fumagalli S, Fattirolli F, Guarducci L, Cellai T, Baldasseroni S, Tarantini F, Di Bari M, Masotti G, Marchionni N. Coenzyme Q10 terclatrate and creatine in chronic heart failure: a randomized, placebo-controlled, double-blind study. Clin Cardiol. 2011 Apr;34(4):211-7. doi: 10.1002/clc.20846. PMID: 21462215; PMCID: PMC6652705.
- Glover EI, Martin J, Maher A, Thornhill RE, Moran GR, Tarnopolsky MA. A randomized trial of coenzyme Q10 in mitochondrial disorders. Muscle Nerve. 2010 Nov;42(5):739-48. doi: 10.1002/mus.21758. PMID: 20886510.
- Sarter, Barbara(2002) Coenzyme Q10 and Cardiovascular Disease: A Review. Alternative Medicines For Cardiovascular Diseases.
- Molyneux, S. L., Young, J. M., Florkowski, C. M., Lever, M., & George, P. M. (2008). Coenzyme Q10: is there a clinical role and a case for measurement?. The Clinical biochemist. Reviews, 29(2), 71–82.
- Khakh, B. S., & Burnstock, G. (2009). The double life of ATP. Scientific American, 301(6), 84–92. https://doi.org/10.1038/scientificamerican1209-84
- Lee YJ, Cho WJ, Kim JK, Lee DC. Effects of coenzyme Q10 on arterial stiffness, metabolic parameters, and fatigue in obese subjects: a double-blind randomized controlled study. J Med Food. 2011 Apr;14(4):386-90. doi: 10.1089/jmf.2010.1202. Epub 2011 Mar 3. PMID: 21370966.
- Mizuno K, Tanaka M, Nozaki S, Mizuma H, Ataka S, Tahara T, Sugino T, Shirai T, Kajimoto Y, Kuratsune H, Kajimoto O, Watanabe Y. Antifatigue effects of coenzyme Q10 during physical fatigue. Nutrition. 2008 Apr;24(4):293-9. doi: 10.1016/j.nut.2007.12.007. Epub 2008 Feb 13. Erratum in: Nutrition. 2008 Jun;24(6):616. PMID: 18272335.
- Gökbel H, Gül I, Belviranl M, Okudan N. The effects of coenzyme Q10 supplementation on performance during repeated bouts of supramaximal exercise in sedentary men. J Strength Cond Res. 2010 Jan;24(1):97-102. doi: 10.1519/JSC.0b013e3181a61a50. PMID: 19644406.
- Schwalfenberg G. K. (2012). The alkaline diet: is there evidence that an alkaline pH diet benefits health?. Journal of environmental and public health, 2012, 727630. https://doi.org/10.1155/2012/727630
- Kenneth A. Conklin (2005) Coenzyme Q10 for Prevention of Anthracycline-Induced Cardiotoxicity. Integrative Cancer Therapies. https://doi.org/10.1177/1534735405276191
- Hertz N, Lister R. Improved Survival in Patients with End-Stage Cancer Treated with Coenzyme Q10 and other Antioxidants: A Pilot Study. Journal of International Medical Research. December 2009:1961-1971. doi: 10.1177/147323000903700634
- Rusciani L, Proietti I, Paradisi A, Rusciani A, Guerriero G, Mammone A, De Gaetano A, Lippa S. Recombinant interferon alpha-2b and coenzyme Q10 as a postsurgical adjuvant therapy for melanoma: a 3-year trial with recombinant interferon-alpha and 5-year follow-up. Melanoma Res. 2007 Jun;17(3):177-83. doi: 10.1097/CMR.0b013e32818867a0. PMID: 17505263.
- Wadsworth TL, Bishop JA, Pappu AS, Woltjer RL, Quinn JF. Evaluation of coenzyme Q as an antioxidant strategy for Alzheimer's disease. J Alzheimers Dis. 2008 Jun;14(2):225-34. doi: 10.3233/jad-2008-14210. PMID: 18560133; PMCID: PMC2931577.
- Isobe C, Abe T, Terayama Y. Levels of reduced and oxidized coenzyme Q-10 and 8-hydroxy-2'-deoxyguanosine in the cerebrospinal fluid of patients with living Parkinson's disease demonstrate that mitochondrial oxidative damage and/or oxidative DNA damage contributes to the neurodegenerative process. Neurosci Lett. 2010 Jan 18;469(1):159-63. doi: 10.1016/j.neulet.2009.11.065. Epub 2009 Nov 26. PMID: 19944739.
- Shults CW, Oakes D, Kieburtz K, Beal MF, Haas R, Plumb S, Juncos JL, Nutt J, Shoulson I, Carter J, Kompoliti K, Perlmutter JS, Reich S, Stern M, Watts RL, Kurlan R, Molho E, Harrison M, Lew M; Parkinson Study Group. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol. 2002 Oct;59(10):1541-50. doi: 10.1001/archneur.59.10.1541. PMID: 12374491.
- Storch A, Jost WH, Vieregge P, Spiegel J, Greulich W, Durner J, Müller T, Kupsch A, Henningsen H, Oertel WH, Fuchs G, Kuhn W, Niklowitz P, Koch R, Herting B, Reichmann H; German Coenzyme Q(10) Study Group. Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q(10) in Parkinson disease. Arch Neurol. 2007 Jul;64(7):938-44. doi: 10.1001/archneur.64.7.nct60005. Epub 2007 May 14. PMID: 17502459.
- NINDS NET-PD Investigators. A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease. Neurology. 2007 Jan 2;68(1):20-8. doi: 10.1212/01.wnl.0000250355.28474.8e. PMID: 17200487.