Paging Dr. Frischer: CoQ10

I’m frequently asked about the supplement Coenzyme Q10 (CoQ10). It experienced a surge in popularity around 2009, when statins came into common use for the treatment of high cholesterol. 

While statins clearly decrease cholesterol levels and reduce the risk of heart disease, they also decrease the body’s level of CoQ10. 

Long before any scientific studies were published on any potential benefits or risks of CoQ10 supplements, statin users started taking CoQ10 to make up for that decrease.

Since then, claims about the benefits of CoQ10 have multiplied. Does it really lower blood pressure, reduce migraine headaches, improve symptoms of Parkinson’s disease and depression, stop dementia, and even slow the aging process? 

Is it beneficial for those with cancer, muscular dystrophy, and periodontal disease? Does it boost energy and speed recovery from exercise?

I am always skeptical when I see so many and such diverse claims.

CoQ10 was first recognized in the 1950s, when researchers in Great Britain carried out studies on cellular structure. Several companies now distribute it as a dietary supplement, which means that it is regulated as a food and not as a drug. 

Consequently, evaluation and FDA approval is not required before marketing, as long as no health claims are made about the supplement.

Coenzyme Q10 is, as its name indicates, a coenzyme, and coenzymes are similar to vitamins. They help enzymes work to digest food and perform other processes. The body manufactures it, and it is found in every cell, where it is utilized to produce energy needed for cell growth and maintenance. 

It is an antioxidant, which protects cell membranes and DNA from damage. The body produces less of it as we age. 

CoQ10 also exists in small amounts in a wide variety of foods, including organ meats like heart, liver, and kidney, as well as beef, soy, sardines, mackerel, and peanuts.
CoQ10 interacts with several important drugs, so caution is necessary:

■ CoQ10 can impact those who have bleeding disorders or who are taking drugs that increase the risk of bleeding. It reduces the effects of the blood thinner warfarin (Coumadin), and interacts with aspirin. CoQ10 should be discontinued one week prior to a surgery.

■ CoQ10 can lower blood pressure, which is especially relevant for those who are on blood pressure medication, as it could lower blood pressure to dangerous levels, leading to dizziness and fainting.

■ CoQ10 can lower blood sugar levels, so monitoring is necessary for diabetics, and for those taking other medications or supplements that may lower blood sugar.

Decisions to take supplements can be complex and overwhelming. I see patients who bring in bags full of different bottles. When I ask why they are taking each one, some admit that one was recommended by their hairdresser, and another by their brother-in-law. 

I urge my patients to limit their supplements to those with at least some science behind them, and with some potential benefit to their particular health issues. 

Of course, just because a well-controlled study has not been conducted yet doesn’t mean that the supplement is of no value. 

If you are considering using CoQ10 as a supplement, discuss it with your physician to determine whether it might be worthwhile.
