Written by Mario Rottorf, Helen Cooke and the CAM-Cancer Consortium.
Updated June 21, 2016

Coenzyme Q10

What is it?

Description

CoQ10 is a naturally produced molecule found in the membranes of nearly all of the body’s cells. Particularly high concentrations are located in the inner mitochondrial membrane, although it is also found in the membranes of peroxisomes and lysosomes 1

Scientific/common names

CoQ10 is structurally related to Vitamins K and E. The molecule structure is 1,4-benzoquinone, which has a characteristic isoprenoid tail.  The structure is what gives CoQ10 its name: the “Q” refers to the molecule’s quinone structure and the “10“ to the lipophilic isoprenoid chain of 10 subunits 2. The name “ubiquinone” is often used to describe CoQ10; the term is taken from the ubiquity of the substance in a number of natural foods and in the human body as well as its quinone structure 3. CoQ10 is also known as Vitamin Q10, ubidecarenon, mitoquinone, adelir, heartcin, neuquinone, and taidecanone.

Ingredients

CoQ10 naturally occurs in meat, fatty fish (such as sardines and mackerel), eggs, whole-grain cereals, rice, soya products, nuts, and vegetables (especially broccoli and spinach) 1.

Application and dosage

The mean amount of CoQ10 obtained from the diet is a mere 3-10mg/d, and the body meets any additional need for CoQ10 by means of endogenous synthesis from precursors of cholesterol biosynthesis. As a result, in healthy individuals there is generally no CoQ10 deficiency 4-5, 44-45. The reference range of the CoQ10 concentration in serum/whole blood lies between 600-1000µg/l 6.

CoQ10 is sold as a dietary supplement and usually taken orally as a capsule or tablet. It can also be administered intravenously. Due to its lipophilic nature, CoQ10 is absorbed more effectively when taken with high-fat foods. Consequently, intravenous CoQ10 is available as lipid preparations 2. Dosages of 50-3000 mg/day are used in clinical studies.

History

CoQ10 was first isolated in 1957 and then described as a benzoquinone structure one year later [7;8]. Commercially produced CoQ10 is made by microbial fermentation processes 9.

Several studies conducted since the 1960s have determined lower serum concentrations of CoQ10 in a variety of cancers (including breast, lung, prostate and colon). This led to increasing interest in CoQ10 as a potential agent in cancer prevention 2. Furthermore, there have been anecdotal reports of CoQ10 playing a part in the remission of breast cancer and regression of metastases 10-11.

Claims of efficacy / mechanisms of action / alleged indication

Dietary supplementation of CoQ10 is said to prevent the development or progression of cancer. The data from epidemiological studies, however, are not consistent. They show an inverse relationship between serum CoQ10 levels and the risk of disease / progression of breast cancer, multiple myelomas and malignant melanoma 7;12;13. At the same time, they also indicate that higher CoQ10 levels in post-menopausal women may be associated with a greater risk of breast cancer 14. A possible explanation for the latter may be that high concentrations of CoQ10 can have pro-oxidative effects on tissue 15. CoQ10 is said to lower the cardiotoxic effects of certain chemotherapy drugs and mitigate the extent of chronic fatigue syndrome.

As a carrier molecule, CoQ10 has a critical function in the mitochondrial respiratory chain and the related production of oxidative energy. In addition, CoQ10’s antioxidant and immunomodulatory mechanisms of action have been hypothesized on the basis of experimental and epidemiological data:

  • In one clinical study, lower serum cytokine levels were reported in breast cancer patients who received CoQ10 supplements 16.
  • Older studies show that in comparison with placebo, CoQ10 produces greater increases in antibody titres of healthy volunteers who were recently vaccinated against HBV 17;18. A trial among healthy volunteers showed that CoQ10 can cause a significant increase in the CD4/CD8 cell ratio 19.
  • CoQ10 is a major endogenous antioxidant 20 which counteracts the oxidation of proteins, lipids and DNA 3. Its protective effects against free radicals may involve stabilizing the cell membrane 2.
  • One trial in breast cancer patients indicated evidence of lower concentrations of matrix metalloproteases in those who took CoQ10 16.
  • In one animal study on hepatocellular cancer, CoQ10 stabilised the concentration of antioxidative enzymes and lowered the TNF-alpha levels as well as reducing the activity of NO synthase and cyclooxygenase-2.
  • Data from animal studies suggest that CoQ10 can protect against anthracycline-induced cardiotoxicity and nephrotoxicity 15;21-23 as well as cisplatin-induced nephrotoxicity 24 and neurotoxicity 1.
  • Preclinical data from a study of healthy volunteers shows evidence that CoQ10 has positive effects on physical performance and subjective symptoms of fatigue both during and after physical exertion 32. It is postulated that the molecular mechanism of action here is caused by CoQ10 supplementation compensating for mitochondrial dysfunction, which can take place in severe chronic diseases and may be a contributing factor to chronic fatigue syndrome 25;26.

Prevalence

According to an EU-wide survey of nearly 300 breast cancer patients, some 4-5% of this cohort took CoQ10 as a complementary treatment 27

Legal issues

CoQ10 is classified as a nutraceutical and may be sold as such. Suppliers may therefore only advertise in terms of its health-improving benefits and are not allowed to make claims of medical efficacy 28. Since the 1970s, CoQ10 has been marketed in Japan for treating cardiovascular disease 29.

Costs and expenditure

CoQ10 costs between €10 - 35 for 60 capsules (with doses ranging from 10 - 100 mg per capsule).

Citation

Mario Rottorf, Helen Cooke, CAM-Cancer Consortium. Coenzyme Q10 [online document]. http://cam-cancer.org/The-Summaries/Dietary-approaches/Coenzyme-Q10. June 21, 2016.

Document history

Revised in September 2016 by Mario Rottorf and Helen Cooke
Assessed as up to date in April 2014 by Barbara Wider.
Revised and updated in December 2012 by Helen Cooke.
Fully revised and updated in September 2011 by Helen Cooke.
Fully revised and updated in August 2009 by Helen Cooke.
First published in 2005, authored by Helen Seers and Helen Cooke.

References

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