Coenzyme Q 10 Part Deux

Sorry for delaying in this post. I’ve been busy and not been able to get to the internet. Today I want to spend some time reviewing what depletes it and what types of supplementation can be used.

In the last post I put up a chart of CoQ10 reduction as one ages past the early 20’s.

Unfortunately ageing is inevitable. As you get older, your levels of the substance go down. Malnourishment will also speed that process along. Dr. Langsjoen discusses in the video linked from the first post about the need for folate, b vitamins 2, 3 6 and 12, pantothenic acid, vitamin c, tyrosine, methionine, Mg, and Se among others. If there is a deficiency in one or more of these, then coQ10 production could be impaired.

Drugs are going to be a big factor in depletion. Statins seem to be the most indicted when it comes to coQ10 depletion, but they aren’t the only ones. Tricyclic antidepressants are also offenders including;

Amitriptyline                 Clomipramine                   Doxepin                 Nortriptyline

Diabetic medications that raise insulin levels are offenders, namely;

glipizide          glyburide       tolbutamide

Blood pressure meds also lower coQ10 including

clonidine             atenolol                bisoprolol               labetalol                 metoprolol                    nadolol                pindolol                propranolol            hydralazine            hydrochlorothiazide, chlorothiazide         indapamide          metolazone

Gemfibrozil and statins that are for cholesterol lower coQ10.

Some others include chlorpromazine, fluphenazine and prochlorperazine.

Many people take these medications listed above, especially the statins and blood pressure medications. Some are even started in their 20’s. I know because I was started on simvstatin when I was 26. I took it for 2 years. I know others in their 20’s who are on blood pressure medications and/or statins as well because the numbers “are just high”. I find this rather disconcerting. Some people are actually lowering their coQ10 stores at ages when they are naturally their highest. I believe some doctors are unaware of the specifics when it comes to drugs that deplete coQ10 and the importance of resupplying the body.

Disease states such as congestive heart failure are also problematic. Many people are placed on drugs such as metoprolol, a beta blocker, which does seem to reduce mortality. Congestive heart failure is characterized by the heart not being able to pump sufficiently thereby causing problems with breathing, edema and other sequelae. The heart is literally in an energy crisis and many of the drugs used for blood pressure, cholesterol and in some cases diabetes actually cause longer term harm energetically. The underlying problem of getting the myocytes (heart cells) to produce energy is not addressed by many family docs and cardiologists, and even when it is with supplementation the amount being used may not be sufficient.


CoQ10 can be seen in many stores and online. It comes in many fancy packages and with many different claims. Some come in powder forms and others come in oil. Some are liquid preps and others are wafers. Traditionally I recommend to my patients to get the gel caps containing oil. Many times this oil is soybean because it is so cheap. I don’t recomment soy in any form unless it is fermented, soybean oil included. Look at the label if you want to get some. I know the amount is small in a gelcap, but if this is something your going to be taking long term, that amount will add up over time. I don’t know that it would technically be clinically significant, but I would stay away if possible.

CoQ10 also comes in the reduced form ubiquinol. Ubiquinol has been shown to abosrb better into the bloodstream than regular coQ1o or ubiquinone.1-3 Dr. Langsjoen has seen the benefit in patients that use ubiquinol over coQ10 in his clinical practice. Refer to the video that I posted last time for that story. It is also recommended that if taking regular coQ10, that it be done with a meal containing some fat so as to help the molecule into the blood. The main goal of supplementation is to raise blood levels so as to get more of the supplement into the cells where they are needed most. Blood levels of 4mcg/ml appears to be an effective treatment for heart failure per Dr. Langsjoen.4-6

CoQ10 may also be useful in treating neurodegenerative disorders like alzheimers. In a review of oxidative damage’s role in neurodegeneration, Beal discusses the potential role of substance like coQ10 can have on preventing or maybe treating this problem.7

Anecdotally I’ve talked to people at the pharmacy window who have told me it also seems to greatly improve muscle cramping. One lady said after a week of not taking it her cramps came back and she started it again. Within a week or so she said her cramps began to fade again. She is one of many who have reported this benefit. (I tell a lot of people to take CoQ10)


If coenzymeQ10 or ubiquinol is something you want to try then go for it. It does have a common side effect of nausea. Also it can interfere with warfarin binding to proteins in the blood, increasing the chance of bleeding for those patients. If you take warfarin, consult with a compentent doctor before supplementing. Ubiquinol appears to be the best absorbed so that is what I would recommend. For people using it as a preventative measure 50-100mg would probably be sufficient. For people with heart failure 200-300 mg divided twice daily or more may be required. It seems to depend more on the blood levels than the dose. For most of us, getting a coQ10 level measured may not be possible due to lack availability or money to pay. The supplement itself can be costly for some people, especially if you use ubiquinol rather than the less absorbable coQ10. If you have a doc or pharmacist who is knowledgable with this supplement, ask them for help. If they are unfamiliar, ask them to learn about it.

I think it important to note that it does take some time for coQ10 to begin working. It doesn’t start changing your life overnight so be patient.

There are other supplements that can be used to increase energy in the heart. I won’t be going over them in this post but would like to address them in future posts. A book that I would recommend is Reverse Heart Disease Now by James Roberts and Stephen Sinatra, two cardiologist who practice what they term integrative cariology. In the book they discuss the role of magnesium, l-carnitine, l-arginine and other supplements that can be used for the heart.

I want to express that I don’t receive any money from any company that makes any supplements or drugs. I believe CoQ10 and ubiquinol are great supplements and recommend them regularly.


The Brute

 1.  Hosoe K, Kitano M, Kishida H, et al. Study on safety and bioavailability of ubiquinol (Kaneka QH) after single and 4-week multiple oral administration to healthy volunteers. Regul Toxicol Pharmacol. 2007 Feb;47(1):19-28.

2.  Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol. 2002 Oct;59(10):1541-50.

3. Shults CW, Flint BM, Song D, Fontaine D. Pilot trial of high dosages of coenzyme Q10 in patients with Parkinson’s disease. Exp Neurol. 2004 Aug;188(2):491-4.

4.  Langsjoen PH, Langsjoen AM. Overview of the use of CoQ10 in cardiovascular disease. Biofactors. 1999;9(2-4):273-84.

5.  Langsjoen PH, Littarru GP, Silver MA. Role of concomitant coenzyme Q10 with statins for patients with hyperlipidemia.
Curr Topics Nutr Res.2005;3(3):149–58.

6.  Langsjoen PH, Langsjoen AM. Coenzyme Q10 in cardiovascular disease with emphasis on heart failure and myocardial ischaemia.
Asia Pacific Heart J. 1998;7(3):160-8.

7. Beal MF. Mitochondrial dysfunction and oxidative damage in Alzheimer’s and Parkinson’s diseases and coenzyme Q10 as a potential treatment. J Bioenerg Biomembr. 2004 Aug;36(4):381-6.

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.


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