There are several reasons you may want to try a supplement of CoQ10. But with so many different formulations and dosages on the market, it can be a minefield working out what’s the best CoQ10 for you.
In this article we’ll look at what the science tells us are the most effective coenzyme Q10 formulations. We’ll also investigate the best ways to use this dietary supplement and some other nutrients that complement it.
Before going into detail on what’s the best CoQ10, let’s take an overview look at choosing and using this supplement:
The best CoQ10 supplements use ubiquinol, which research suggests is a more effectively absorbed form of CoQ10 than ubiquinone; these two are the most common forms of coenzyme Q10 supplements.
Because CoQ10 is oil soluble, you’ll also benefit from consuming it alongside dietary fat to ensure good absorption.
Try starting out with 200 mg of CoQ10 twice daily — you can adjust up or down to suit your needs later on.
Other antioxidants and anti-inflammatory compounds like vitamin E, curcumin, and selenium may work synergistically with CoQ10.
What Is CoQ10?
CoQ10 and coenzyme Q10 are the more common names for a substance known as ubiquinone, meaning “everywhere” (i.e. ubiquitous).
Everywhere is a clue to where CoQ10 is found — it’s in the mitochondria (energy production powerhouses) of all of our body’s cells, but most abundant in the cells of the very active organs like the heart, lungs, liver, kidneys, pancreas, and adrenal glands .
CoQ10 is involved in the chain of chemical reactions that generates adenosine triphosphate (ATP), the major currency of energy in our body. CoQ10 acts as a powerful antioxidant that protects and supports the mitochondria as they go about producing ATP. Without CoQ10, the level of ATP the mitochondria can produce drops, disrupting the availability of energy to key tissues and increasing the chance of disease.
Diseases and conditions that have been associated with reduced CoQ10 levels in the body are :
The body makes CoQ10 and it’s also found in foods — particularly meat, fish, nuts, seeds, and certain oils (soybean, corn, olive, and rapeseed). It’s also found in much lower levels in most dairy products, vegetables, fruits, and cereals .
Despite being so ubiquitous, the whole body contains only about 500-1,500 mg of CoQ10 (less than the weight of a jumbo paperclip), and levels decrease with age .
Which Form of CoQ10 Is Best Absorbed?
Most of the original research on CoQ10 supplementation was done using ubiquinone, but more recent studies suggest a different form called ubiquinol is better absorbed.
Ubiquinol has a slightly different chemical structure from ubiquinone but is still a naturally occurring active form found in the body. In fact, CoQ10 shifts back and forth between ubiquinone and ubiquinol as part of its activity within the mitochondria in cells.
Studies that suggest ubiquinol is a superior supplement include:
A 2014 clinical trial in which 12 healthy volunteers were given 200 mg per day of ubiquinol for four weeks, followed by a four-week period without supplementation and then another four weeks of taking ubiquinone. The results showed that both ubiquinol and ubiquinone were able to significantly raise CoQ10 levels, however ubiquinol was significantly more effective at increasing levels of CoQ10 in the blood, indicating superior bioavailability .
A 2018 study compared the ability of ubiquinol and ubiquinone to raise CoQ10 levels in healthy men over 55 years. The men were randomly assigned to receive 200 mg/day of either ubiquinol or ubiquinone for two weeks, followed by a fortnight with no supplementation and then the opposite supplement for two weeks. The results showed that ubiquinol significantly raised CoQ10 levels, while ubiquinone didn’t raise them as much .
That said, it’s not a totally cut-and-dried issue and not everyone who takes CoQ10 will definitely get greater benefit from ubiquinol. In the studies above, a minority of subjects responded better to ubiquinone and some people appeared not to absorb CoQ10 very well, regardless of the form used.
The bottom line is that more research is needed to determine what’s the best CoQ10 formulation , however, ubiquinol is where I would advise most patients interested in trying this supplement to start.
Add Fat for Maximal Uptake
Perhaps the most important thing you can do to ensure you get the best uptake of CoQ10 is to take the supplement with a meal that contains some healthy fat (e.g. nuts, coconut oil, or oily fish). This is because CoQ10 is a fat-soluble substance that will be absorbed better in the presence of oil or fat .
One study found that taking soft-gel capsules that combine CoQ10 with soy oil had better absorption than other CoQ10 supplements .
What’s the Best CoQ10 Dosage?
There’s not enough data to be definitive about a minimum or maximum effective dose of CoQ10. However, the average dose that has obtained therapeutic effects in studies is 400 mg (200 mg twice daily) .
Some studies have used doses up to 3,000 mg a day , but it would be wise to start much lower and increase slowly until you’ve settled on the minimum effective dose for your needs.
Side Effects and Contraindications
Since CoQ10 is produced naturally in the body, it’s usually well-tolerated. However some rare, mild side effects could include :
Some reports suggest CoQ10 may decrease the effectiveness of the blood-thinning drug warfarin . However, another study found no negative interaction between CoQ10 and this medication . If you’re considering taking CoQ10 and are currently on warfarin or other blood-thinning drugs, consult with your doctor in case extra monitoring of your blood might be needed.
What Is CoQ10 Good For?
People may take a coenzyme Q10 supplement for many reasons, but these are the health benefits and uses of the supplement that have the most scientific backing.
Support for Statin Users
Statin drugs, which are commonly prescribed to reduce the risk of cardiovascular disease, inhibit the activity of an enzyme (HMG-CoA reductase) that is needed for production of both cholesterol and CoQ10 [2, 9].
In other words, statins reduce both cholesterol and CoQ10 levels.
There are conflicting views as to whether low CoQ10 levels contribute to the muscle cramping and pain experienced by 10-15% of patients taking statins [2, 9, 10].
One systematic review and meta-analysis concluded that CoQ10 supplementation improved statin-associated muscle symptoms (SAMS) , while another found that it did not .
Either way, CoQ10 supplementation would still seem like a good idea for patients on statins to replenish levels depleted by these drugs. We often advise it for patients on statins, particularly if they’re experiencing fatigue and muscle side effects.
Help for Migraines
The biggest review of trials (371 patients and six students) examining the effectiveness of CoQ10 for migraine headaches found that CoQ10 significantly reduced the duration and frequency of migraines compared with the control group .
Better Outcome for Heart Failure Patients
Two separate systematic reviews/meta-analyses both concluded that CoQ10 supplementation is associated with a reduced risk of death from any cause in heart failure patients [14, 15].
Additionally, CoQ10 appeared to be safe and improve the cost-effectiveness of heart failure treatment.
A further review found CoQ10 also improved exercise capacity in heart disease patients, compared to placebo .
Fewer Depressive Symptoms
One randomized clinical trial examined the effect of eight weeks of CoQ10 supplementation (200 mg/day) in 89 patients, and the results showed that CoQ10 significantly improved depression in patients with bipolar disorder, compared to placebo .
Improved PCOS Symptoms
In a review that looked at which nutritional agents could improve hormonal and metabolic health in women with PCOS (polycystic ovary syndrome), CoQ10 supplementation was associated with significant improvements in testosterone, fasting insulin levels, fasting glucose, insulin resistance, triglycerides, and total cholesterol, compared to placebo .
CoQ10 combined with vitamin E appeared to be more effective than CoQ10 alone for improving testosterone and insulin resistance.
Better Blood Sugar Control
In a review of studies exploring the effects of CoQ10 on type 2 diabetes, the supplement significantly improved two markers of blood sugar control (hemoglobin A1c and fasting blood glucose). HDL cholesterol also improved compared to controls .
Improved blood sugar control and inflammation has also been noted in people with metabolic syndrome .
Improved Fibromyalgia Symptoms
Three small trials that explored the effects of CoQ10 on fibromyalgia noted :
300 mg per day of CoQ10 for 40 days significantly improved depression scores compared to placebo.
The same dosage improved pain by 56%, number of tender points by 44%, and overall fibromyalgia severity by 52%.
400 mg per day of CoQ10 for six months significantly improved physical pain scores compared to placebo.
Other Potential Benefits
Weaker or less-comprehensive evidence suggests a possible role of CoQ10 in:
Reducing inflammation and oxidative stress in various diseases, including chronic kidney disease [22, 23, 24, 25]
Improving systolic (but not diastolic) blood pressure 
Improving levels of liver enzymes and inflammation in non-alcoholic fatty liver 
Given CoQ10 helps produce ATP within our mitochondria, it’s logical to expect it might improve energy levels. In practice though, the research regarding CoQ10 supplementation for fatigue is mixed, and the effectiveness of CoQ10 may be dependent on the population involved.
CoQ10 has shown to be helpful for fatigue in the following situations and diseases :
End-stage heart failure
It’s unlikely that CoQ10 will turbo boost your energy levels if you’re healthy. In three out of four studies that looked at the effect of CoQ10 on energy levels in healthy adults there was no effect , and in the fourth, improvements were small and temporary .
Nutrients That Complement CoQ10
What’s the best CoQ10 supplement for your needs can’t be answered fully without also considering the compounds that may work alongside CoQ10 to improve its benefits. In some instances, supplementing CoQ10 along with other compounds that have anti-inflammatory and/or antioxidant properties may yield better results than CoQ10 alone.
Vitamin E, curcumin, fish oil, selenium, and NADH are the nutrients that have been noted to work in synergy with CoQ10. (NADH is short for nicotinamide adenine dinucleotide, a derivative of vitamin B3).
Here’s a summary of some situations in which CoQ10 works better with other nutrients.
Works Better For
CoQ10 + Vitamin E
PCOS (polycystic ovary syndrome)
More effective at improving testosterone levels and insulin resistance in PCOS patients than CoQ10 alone .
CoQ10 + NADH
Chronic Fatigue Syndrome/MS
Fatigue symptoms didn’t improve with CoQ10 supplementation alone, but did so significantly when CoQ10 and NADH were taken in combination .
CoQ10 + Curcumin
Reduces the frequency, severity, and duration of migraine more effectively than CoQ10 alone, curcumin alone, or placebo .
CoQ10 + Omega-3 Fish Oils
CoQ10 alone had no effect on blood pressure in chronic kidney disease patients. However, CoQ10 and fish oil together significantly reduced systolic blood pressure .
CoQ10 + Selenium
Fighting inflammation and oxidative stress
Selenium optimized the anti-inflammatory and antioxidant functions of CoQ10 and together the two nutrients improved mitochondrial function in critically ill patients .
Choosing CoQ10 Doesn’t Have to Be Complicated
Arming yourself with the know-how from this article will allow you to get optimal benefits from a CoQ10 supplement and work out what’s the best CoQ10 for you. For most people, the key points are to opt for a ubiquinol supplement and take it with a fat-containing meal to ensure optimal absorption. Suitable dosages can vary, but starting in the 200-400 mg/day range is about right.
Working with an experienced functional health practitioner can help you develop a more targeted way to find the treatments for health conditions such as low energy, migraines, and heart conditions (or any of the other reasons you might be seeking out CoQ10 supplements). If this is of interest to you, please contact us at the Ruscio Institute for Functional Medicine and we would be happy to assist.
The Ruscio Institute has also developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.
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