Symptoms like muscle weakness, low energy levels and slow thinking are often vague and mostly dismissed as signs of getting old. What happens when all your blood reports come back normal? Chances are your doctor would ask you to live with these symptoms.
However, getting rid of these signs could be as simple as addressing CoQ10 deficiency. If nothing else seems to be working in improving your symptoms, you may have low CoQ10 levels.
So, what is CoQ10? CoQ10 or Coenzyme 10 is a vitamin like substance that helps the body make energy. It is naturally present in every cell of the body. That’s why it is also known as ubiquinone or ubiquinol as it is ‘ubiquitous’ - existing or being everywhere at the same time
CoQ10 is basically a co-enzyme that helps enzymes to do their job. An enzyme is a very small molecule that makes chemical reactions happen within the cells. Without an enzyme, a bio-chemical reaction would either occur at an exceptionally slow rate or wouldn’t take place at all. Coenzymes act as helper molecules in chemical reactions. Most coenzymes in the body are either vitamins or derived from vitamins. For example, most of the B vitamins work as coenzymes.
Coming back to CoQ10, what are the risk factors for developing CoQ10 deficiency? And what can you do to correct the deficiency? Before we discuss all these points, lets see how CoQ10 performs many important roles in the body that have wide-ranging effects on the body.
The role of CoQ10 in the body
CoQ10 helps in energy (ATP) production in the body and plays a unique role here. Simply put, no other molecule can replace CoQ10 in the process of energy production.
While all organs require energy to function, the energy demands of certain organs are higher than others. The majority of CoQ10 in the body is concentrated in the heart because of its extensive energy requirements. Other organs like the brain, skeletal muscles, liver, kidneys and lungs also have significantly high amounts of CoQ10. All these organs need substantial energy to function and have more mitochondria within their cells to provide an extra supply of energy. Therefore, having low levels of CoQ10 can affect the functions of many organs, especially the heart, brain, muscles and kidneys.
CoQ10 also functions as an anti-oxidant, a substance that scavenges free radicals and protects cells from oxidation and resulting damage. As an antioxidant, CoQ10 has many protective effects. For example, it inhibits oxidation of LDL cholesterol, which is one of the key processes in the development of atherosclerosis (build up of plaque within the arteries). Atherosclerosis can result in a higher risk of heart attack and stroke.
CoQ10 also recycles other anti-oxidants such as vitamins C and E. What does this mean? This is something to do with how an anti-oxidant works. It works by donating its extra electrons to free radicals, highly reactive, unstable molecules that are actively looking for electrons so as to gain stability. Free radicals are constantly attacking nearby stable molecules to snatch electrons and in doing so end up disturbing their chemical structure, function and stability. This is called oxidation and leads to oxidative damage.
Antioxidants, like CoQ10, keep a check on free radicals by offering extra electrons. This limits oxidative stress that can otherwise lead to cellular damage, unwanted immune responses and inflammation. Chronic inflammation is known to be the underlying mechanism of many diseases including heart disease, obesity, type 2 diabetes, cataracts, Alzheimer’s, Parkinson’s and cancer.
After an antioxidant has donated its spare electrons, it is transformed into a weak free radical itself. CoQ10 regenerates other antioxidants like vitamin C and vitamin E and brings them back to their initial working state after they have neutralized free radicals.
Signs of CoQ10 Deficiency
Most of the signs and symptoms of low CoQ10 levels revolve around the body’s reduced ability to make sufficient energy and fight oxidative damage.
- Muscle aches and pains
- Shortness of breath
- Memory issues
- Mental confusion
- Heart problems like chest pain, angina, arrhythmia and heart failure
- Gum disease
- Seizures (in severe deficiency)
However, these signs can also be caused by other conditions. That is why it can be a bit challenging to specifically trace all these symptoms to CoQ10 deficiency.
CoQ10 and treatment of chronic disease
CoQ10 supplements can improve mitochondrial functions, limit oxidative damage and control inflammation. As such, supplementation with CoQ10 has been found to beneficial in many health conditions including cardiovascular disease, metabolic syndrome, diabetes, muscular dystrophy, fibromyalgia, neurodegenerative disease, infertility, migraine and periodontal (gum) disease. Many of these health conditions stem from increased oxidative damage, uncontrolled inflammation and poor mitochondrial function (which leads to impaired production of energy within cells).
Studies show that CoQ10 supplements could be remarkably useful in the treatment and management of cardiovascular disease, especially in improving symptoms of heart failure.  As we also discussed above, your heart contains the bulk of total CoQ10 present in the body. As a hard-working muscle that beats non-stop, your heart requires extraordinary amounts of energy to keep going day and night.
Declining levels of CoQ10 impacts the strength and working of your heart muscle and can even lead to heart failure with symptoms like shortness of breath, fatigue and weakness. Similarly, you need healthy levels of CoQ10 in the body to maintain functions of other tissues and organs, including the brain and muscles. Since the brain also contains significantly high amounts of CoQ10, low levels cause symptoms like confusion and cloudy thinking.
Overall, CoQ10 helps to maintain cellular energy and mitochondrial function. It also fights free radicals known to cause oxidative damage and inflammation, that may lead to faster ageing and age-related diseases. In this capacity, CoQ10 supplements have shown immense benefits. For example, it helps to:
- Energize your heart muscle and help maintain its pumping action
- Improve symptoms like fatigue, pain and depression in people with fibromyalgia
- Improve exercise performance and reduce the risk of muscle damage
- Reduce the frequency and severity of migraines
- Ease muscle weakness and aching joints associated with prolonged use of statins
- Reduce inflammation in gum disease
- Improve fertility parameters in both men and women
Preliminary research shows that CoQ10 supplements may also help in improving immune functions in HIV/AIDS patients and improving exercise capacity and overall quality of life in people with muscular dystrophy. Initial research also looks promising in the role of CoQ10 slowing down the progression of dementia in patients with Alzheimer’s. However, more trials and studies are needed to conclude the positive role of CoQ10 supplements in all these chromic conditions.
What causes CoQ10 deficiency?
Your body produces CoQ10 on its own, but the levels begin to decline with age. You can get some amounts of CoQ10 from various foods, however, the amount is not sufficient to maintain healthy levels. Let’s look at various factors that can cause CoQ10 deficiency.
1. Diet lacing in CoQ10 rich foods: Organ meat like heart, liver and kidney and fish (especially sardines and mackerel) are excellent sources of CoQ10 in your diet. Peanuts, broccoli and cauliflower are also a reasonably good source of CoQ10. However, it is not always possible to include high sources of coenzyme Q10 in your daily diet. In addition, the current trend of consuming processed, ready to eat foods also limits the intake of CoQ10.
2. Age: It is a fact that you don’t make as much CoQ10 nowadays as you did in early adulthood. The levels naturally drop over time. Combine it with the fact that you often don’t get enough CoQ10 from your diet, and it is common to have CoQ10 deficiency with age.
3. Conditions that rob the body of CoQ10: Your body’s requirement of CoQ10 and other antioxidants increases during certain conditions, especially when there is increased oxidative damage and inflammation. This is the time when tissues require more than the available CoQ10 pool, leading to further deficiency. Low levels have been found in individuals with heart disease, heart failure, cancer, HIV/AIDS, Parkinson’s, gum disease, type 2 diabetes, muscular dystrophies, mitochondrial dysfunctions and other conditions. Other external factors that lower CoQ10 levels in your body include:
- Chronic stress
- Exposure to environmental toxins
- Use of certain drugs such as statins, beta blockers, antibiotics and certain antidepressant drugs known as tricyclic (TCAs).
5. Genetic factors: Certain genetic disorders can interfere with the production of CoQ10 and can even interrupt its functions in the body, leading to what is known as primary CoQ10 deficiency. This can cause poor muscle tone, intellectual disability, seizures and severe neurological symptoms.
Statins lowers CoQ10 levels
Statins are cholesterol-lowering drugs. They reduce cholesterol levels by blocking an enzyme pathway involved in the production of cholesterol. However, this pathway also produces CoQ10. Prolonged use of statins can reduce the overall levels of CoQ10 in the body. This results in symptoms like muscle fatigue, joint pain and injuries . This is obvious as CoQ10 is a critical ingredient in ATP production and its deficiency affects energy metabolism in muscles, resulting in all these symptoms.
In addition, CoQ10 supplements can effectively reduce muscle pain and other mild symptoms related to muscle health in people taking statins to manage their cholesterol levels.  
What can you do to improve your CoQ10 status?
While eating foods rich in CoQ10 helps, it may not be enough. In addition, most people today are not eating a well-balanced, healthy nutritious diet whether due to lack of time or easy availability of readymade food.
Using liposomal CoQ10 supplements is a great way of improving your levels. Liposomal technology ensures that CoQ10 is more available for the cells to use.
Always consult your doctor before taking CoQ10 supplements in any form. CoQ10 may interfere with some drugs such as diabetes drugs, blood thinners (warfarin) and drugs that lower blood pressure. CoQ10 may also interfere with the functioning of chemotherapy drugs such as daunorubicin and doxorubicin, making cancer treatment less effective. CoQ10 supplements are not recommended during pregnancy and breastfeeding. Its use should also be avoided in young children.
While CoQ10 supplements are generally considered quite safe to use in healthy adults, some people may experience mild gastrointestinal symptoms such as nausea, stomach upset and diarrhea. It may also cause other undesirable side effects like skin rashes.
Ubiquinone versus Ubiquinol: What form of CoQ10 to choose?
There is a lot of conflicting information surrounding what form of CoQ10 is better. It occurs in two forms; ubiquinone and ubiquinol. Is there something that makes one form better than the other? Is ubiquinol really better, as touted by many supplement companies?
Well, the fact is your body needs both forms of CoQ10 and is very much capable of converting one form into another when required. So, how does it work?
Ubiquinone: It is the oxidized form of CoQ10. In this form, CoQ10 works as a cofactor in ATP synthesis. You need ubiquinone to produce energy. Once utilized, it is quickly converted into ubiquinol to be used as an antioxidant.
Ubiquinol: It is the reduced form of CoQ10. In this form, CoQ10 works as a powerful antioxidant in the body. It protects the cell membranes and lipids, in particular, from the oxidative damage caused by free radicals. As an electron donor, ubiquinol helps to recycle ubiquinone and also other antioxidants like vitamins C and E. Once used as an antioxidant, it is quickly converted into ubiquinone to be used in energy synthesis.
In fact, the health benefits of ubiquinone are backed by years of clinical trials and research. For example, CoQ10 was used in the form of ubiquinone in the famous Q SYMBIO Trial. This study demonstrated the positive role of CoQ10 as an adjunct in improving the symptoms of heart failure and reducing the risk of events that could lead to hospitalization or urgent transplant.  On the other hand, ubiquinol only became available recently.
It really does not matter what form of CoQ10 you ingest. Both forms are rapidly converted into each other as per your body’s requirement and uses.
Since both forms of CoQ10 are equal, why not buy supplements in the form that is more affordable?
Given the ubiquinol form is rapidly oxidized, which makes it highly unstable, it is also more expensive to process and manufacture. This gives ubiquinone an edge.
- Mortensen SA et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Failure. 2014
- Mansi et al. Statins and Musculoskeletal Conditions, Arthropathies, and Injuries. JAMA Internal Medicine. 2013
- Caso G et al. Effect of coenzyme q10 on myopathic symptoms in patients treated with statins. American Journal of Cardiology. 2007 May 15;99(10):1409-12. Epub 2007 Apr 3.
- Skarlovnik et al. Coenzyme Q10 Supplementation Decreases Statin-Related Mild-to-Moderate Muscle Symptoms: A Randomized Clinical Study. Medical Science Monitor. 2014