Herbs & Supplements

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Although coenzyme Q-10 is available mainly as a dietary supplement, specific coenzyme Q-10 products have been given orphan drug status in the United States. An orphan drug has received approval from the U.S. Food and Drug Administration (FDA) because it shows effectiveness for treating severe or uncommon diseases that usually have few other treatment options. In the United States, designated coenzyme Q-10 products are used to treat relatively rare, inherited defects in mitochondria, which are tiny structures within body cells. Because mitochondria are responsible for energy production by each cell, many of them are found in cells that use lots of energy--such as muscle cells. Cells that use little energy have few mitochondria. If mitochondria do not function properly, progressively worsening symptoms that may include muscle weakness, nerve damage, seizures, stroke-like episodes, and eventually death may result. Although coenzyme Q-10 seems to be an effective treatment to prevent, delay, or decrease the symptoms of inherited mitochondrial defects in some individuals, it may take 6 months or longer to produce a noticeable response.

Low levels of natural coenzyme Q-10 have been observed in individuals with other muscle-wasting diseases (conditions that result in decreased muscle size and efficiency). Therefore, coenzyme Q-10 is being studied as a possible treatment for conditions, such as Parkinson's disease (PD) that affect muscle function. Coenzyme Q-10's possible energy-enhancing effects may prevent the deterioration of muscle activity. Additionally, in animal and human studies, increasing amounts of coenzyme Q-10 also seemed to increase levels of a neurotransmitter known as dopamine. Neurotransmitters are chemicals that carry messages from nerve cells to other cells. Individuals with PD generally have low dopamine levels, so raising dopamine may lessen their PD symptoms. Coenzyme Q-10 may also reduce other factors, such as inflammation and damage by oxygen free radicals, that may cause or worsen PD. Despite its potential for PD, a recent well-controlled study of 131 individuals with moderate PD found no benefit from adding coenzyme Q-10 to treatment with conventional drugs. Studies are also inconclusive for coenzyme Q-10's possible effectiveness for other muscle-wasting conditions, including amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), Huntington's disease (HD), and muscular dystrophy (MD). While these conditions may have a connection to low coenzyme Q-10 levels, it is not known if the decreased levels of coenzyme Q-10 contribute to the conditions or result from them. Much more research is needed in these areas.

In other countries, coenzyme Q-10 is used widely to treat heart conditions--particularly heart failure (HF), but also angina, heart rhythm disorders, and high blood pressure. Heart failure was formerly called congestive heart failure (CHF). In Japan, coenzyme Q-10 has been prescribed for treating HF since 1974. In several published studies of individuals with HF, taking coenzyme Q-10 has generally reduced symptoms such as shortness of breath, sleep problems, and swelling that are associated with HF. It is believed that coenzyme Q-10 may increase energy production in the heart muscle, which may cause the heart to beat with more force. However, results from other human studies contradict these findings, with little or no improvement seen in the actual pumping action of the heart or in the individual's ability to perform everyday tasks. The best overall results occurred for individuals who took coenzyme Q-10 along with other prescription drugs for HF.

Even though coenzyme Q-10 may not affect heart function directly, it does appear to promote relaxation in both arteries and veins. Therefore, taking it may help relieve angina and reduce high blood pressure. In a recent study, a small number of heart patients who received coenzyme Q-10 and other antioxidants along with moderate exercise and stress-reduction counseling for about a month before heart surgery, generally recovered physical and emotional activity faster than patients who had no supplements, exercise, or counseling. Coenzyme Q-10 cannot replace prescription medications, however, and it may interfere with their effects. A doctor should be consulted before coenzyme Q-10 is started to treat HF or any other heart condition.

Based on results from several studies, coenzyme Q-10 appears to be safe for helping to treat heart diseases in individuals with diabetes; but whether it affects blood sugar levels is not known conclusively. Results from some studies may show a small decrease in blood sugar levels when coenzyme Q-10 is taken by individuals with diabetes, but other studies have found no effects on insulin production or utilization. Coenzyme Q-10 may be slightly effective for individuals with an uncommon inherited type of diabetes known as maternally inherited diabetes mellitus and deafness (MIDD).

As an antioxidant, coenzyme Q-10 may also have potential as an anticancer and immune-stimulating agent. Antioxidants are thought to protect body cells from damage caused by a chemical process called oxidation. Oxygen free radicals, natural chemicals that may also suppress immune function, are produced during oxidation. In one study, coenzyme Q-10 levels were found to be low in women who have cancer of the cervix or who have conditions that may lead to cervical cancer. As shown in case reports of women with breast cancer, supplementing prescription cancer treatments with coenzyme Q-10 may have helped to slow or stop the cancer from growing. In some cases, the spread of cancer to other parts of the body appeared to be prevented. Separate studies of people living with AIDS, may show that the numbers of certain white blood cells reached levels that are more nearly normal when coenzyme Q-10 was taken. In general, white blood cells, especially the kind known as T cells, are responsible for attacking abnormal substances--such as the HIV virus. This apparent strengthening of the immune system may help prevent and treat AIDS and other infectious diseases. The antioxidant effects of coenzyme Q-10 may also protect the liver from some of the damage caused by certain drugs, chemicals, or chronic alcohol abuse. One review of previous studies found that coenzyme Q-10 may help to protect the hearts of children who receive certain cancer drugs that can cause heart damage. Some additional evidence from recent studies may also show that coenzyme Q-10 has potential to prevent or lessen the severity of migraine headaches. All these possible effects need further study to prove or disprove them.

Coenzyme Q-10 has also been used, both topically and orally, to treat periodontal (gum) disease. Increasing levels of coenzyme Q-10, which are usually low in individuals with gum disease, appeared to improve symptoms such as looseness and inflammation of the teeth in small studies of individuals with gum disease that is related to low coenzyme Q-10 levels. These studies were conducted nearly 30 years ago, though; and research that is more recent has failed to show a definite effect on periodontal disease from coenzyme Q-10 supplementation.