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CoQ10’s effects on fatigue, fertility, and the heart
Do you ever feel as if you don’t have enough energy? You’re not alone! Energy is not just a function of mood, positive thinking, or lack of sleep, although all those things play a role. Energy is, literally, the power to do work. Within the body, the power to do work is provided by a substance known as ATP (adenosine triphosphate),, which is produced when calories are burned. And the production of ATP requires Coenzyme Q10 (CoQ10).
When CoQ10 levels decline, so does the function of the mitochondria, and the energy for daily living declines as well.
A healthy person at rest produces their body weight in ATP each day! A large amount of ATP must be produced every second of every day, because ATP cannot be stored. ATP synthesis occurs in the mitochondria, the powerhouses within cells, and CoQ10 has both bioenergetic and antioxidant properties that keep the mitochondria running smoothly., When CoQ10 levels decline, so does the function of the mitochondria, and the energy for daily living has been shown to decline as well.,
“The flow of energy through mitochondria distinguishes the living person from the inert body; it enables mitochondrial functions required for life.” 
Certain rare mitochondrial disorders are associated with defects in CoQ10 synthesis, and can thus be corrected with supplemental CoQ10.,,, More commonly, CoQ10 deficiencies occur in the general population as a result of environmental toxins, poor diet, oxidative stress (which depletes CoQ10), exercise, and the natural aging process.,,, CoQ10 deficiency is also a secondary effect of cholesterol-lowering statin drugs, as is discussed below. But first, let’s take a look at the latest research on CoQ10 and fatigue, fertility, and the heart.
CoQ10 and fatigue
Low levels of CoQ10 are consistently associated with fatigue.
Chronic fatigue syndrome (CFS) is a debilitating condition that often goes undiagnosed. Although the average age of CFS onset is 33 years, the skeletal muscles of CFS patients show muscle damage and weakness similar to that seen in the elderly. Low serum CoQ10 levels are associated with CFS.,, Moreover, a review of the literature on fatigue, not limited to CFS, concluded that low levels of CoQ10 were consistently associated with fatigue.
According to several studies, supplementation with CoQ10 may ameliorate some CFS symptoms.,, One study evaluated the benefits of a combination of CoQ10 and nicotinamide adenine dinucleotide (NADH), a derivative of niacin (vitamin B3) that also participates in ATP production., Participants who took CoQ10 (200 mg per day) and NADH (20 mg per day) were found to have higher levels of ATP in their blood cells, and reported significantly less fatigue as compared to the placebo group.,
Low CoQ10 levels have also been reported in people with fibromyalgia (FM),, a disorder that affects up to 5% of the general population. FM is characterized by widespread musculoskeletal pain accompanied by fatigue, sleep disturbances, and other issues. Studies suggest that CoQ10 supplementation may help reduce some symptoms of FM.,, A randomized, placebo-controlled study evaluated the effects of 40 days of CoQ10 supplementation (300 mg per day) in 20 FM patients and found that CoQ10 supplementation was associated with a prominent reduction in pain, fatigue, and morning tiredness as compared with placebo.
CoQ10 and fertility
There is a correlation between the age-related decline in CoQ10 and the decline in fertility. In aging mice, supplementation with CoQ10 reverses most of these changes.
Female fertility is one of the first bodily functions affected by aging. Fertility begins to decline at age 32 and decreases more rapidly after age 37. Oocytes (eggs) depend on CoQ10 for energy and protection, and there is a correlation between the age-related decline in CoQ10 and the decline in fertility.,, In aging mice, supplementation with CoQ10 reverses most of these changes.
In women undergoing in vitro fertilization (IVF), CoQ10 levels in follicular fluids (the fluids that surround the egg) correlate with the chance for a successful pregnancy., These results have prompted studies of the effects of CoQ10 supplementation on IVF success. In one study, CoQ10 (200 mg per day) was associated with a significant increase in egg count and egg quality or grade, which is assessed by microscopy. In another study, women receiving CoQ10 supplements had twice as many retrieved oocytes per IVF cycle, along with a 50% higher fertilization rate, compared with a control group.
CoQ10 is necessary for energy production in sperm, and there is a correlation between CoQ10 levels and swimming ability.
Men (and women), take note: half of all infertility is attributable to the male partner. For successful fertilization, sperm must swim long distances through the thick, sticky fluid of the female reproductive tract to reach the egg., CoQ10 is necessary for energy production in sperm, and there is a correlation between CoQ10 levels and swimming ability!,,, In one study of male infertility, CoQ10 supplementation for 12 months improved sperm quantity and sperm motility (swimming) by 114% and 79%, respectively. The overall pregnancy rate in the supplemented men’s partners was a healthy 34%.
CoQ10 and heart health
The antioxidant function of CoQ10 helps protect the heart against damage.,,,, In addition to skeletal muscle, the striated muscle cells of the heart also contain high levels of mitochondria. Deficient levels of CoQ10 have been observed in individuals with congestive heart failure, angina pectoris, coronary artery disease, cardiomyopathy, and hypertension, as well as familial hypercholesterolemia, which raises the risk of early heart disease., CoQ10 supplementation has thus been suggested by some researchers as an adjunct to standard treatments for these conditions.,,
In heart attack patients, supplementation with CoQ10 (120 mg per day for 24 weeks) was associated with better heart function than that seen in the placebo group. In individuals with chronic heart failure, long-term supplementation with CoQ10 (100 mg three times daily for two years) was associated with a 40% decrease in mortality.
Along with protecting against cardiac damage, CoQ10 supplementation may improve blood lipid profiles, including a decrease in low density lipoprotein cholesterol (LDL-C), total cholesterol, and/or triglyceride levels.
Along with protecting against cardiac damage, CoQ10 supplementation may improve blood lipid profiles, including a decrease in low density lipoprotein cholesterol (LDL-C), total cholesterol, and/or triglyceride levels.,,,, CoQ10 also helps reduce the oxidation of LDL-C and levels of lipoprotein (a), which are factors that also contribute to cardiovascular disease.,
People with high cholesterol levels are typically treated with statin drugs, which reduce LDL-C. Although statin treatment is considered the standard of care, statins also reduce CoQ10, by blocking the enzyme that produces it as well. The reduction of CoQ10 may contribute to side effects known as “statin-associated muscle symptoms” (SAMS), which include muscle pain, cramping and weakness. Statin medications have been shown to potentially deplete CoQ10 by up to 40%. Several studies have shown a benefit of CoQ10 supplementation on SAMS,,, while others showed no effect.,
Finally, statins may increase the risk of new-onset diabetes mellitus (NODM), a rare but serious statin side effect.,, Very recent studies in animal models showed that the development of NODM could be prevented with CoQ10; human studies are needed to confirm these findings.
Although CoQ10 is made within the body, it declines with age and its levels are often not sufficient to support the body’s needs. Low levels of CoQ10 are common in people experiencing fatigue, muscle weakness, declining fertility, and/or heart problems. If any of these apply to you, seek the help of a qualified health professional, and consider supplementing with CoQ10!Click here to see References
 Bonora M, et al. ATP synthesis and storage. Purinergic Signal. 2012 Sep;8(3):343-57.
 Mendelsohn BA, et al. A high-throughput screen of real-time ATP levels in individual cells reveals mechanisms of energy failure. PLoS Biol. 2018 Aug 27;16(8):e2004624.
 Pizzorno J. Mitochondria—Fundamental to Life and Health. Integr Med (Encinitas). 2014 Apr;13(2):8-15.
 Acosta MJ, et al. Coenzyme Q biosynthesis in health and disease. Biochim Biophys Acta. 2016 Aug;1857(8):1079-85.
 Hernández-Camacho JD, et al. Coenzyme Q10 supplementation in aging and disease. Front Physiol. 2018 Feb 5;9:44.
 Andreani C, et al. Combination of Coenzyme Q10 intake and moderate physical activity counteracts mitochondrial dysfunctions in a SAMP8 mouse model. Oxid Med Cell Longev. 2018 Oct 24;2018:8936251.
 Filler K, et al. Association of mitochondrial dysfunction and fatigue: a review of the literature. BBA Clin. 2014 Jun 1;1:12-23.
 Picard M, McEwen BS. Psychological stress and mitochondria: a systematic review. Psychosom Med. 2018 Feb/Mar;80(2):141-53.
 Hirano M, et al. CoQ(10) deficiencies and MNGIE: two treatable mitochondrial disorders. Biochim Biophys Acta. 2012 May;1820(5):625-31.
 García-Corzo L, et al. Ubiquinol-10 ameliorates mitochondrial encephalopathy associated with CoQ deficiency. Biochim Biophys Acta. 2014 Jul;1842(7):893-901.
 Neergheen V, et al. Coenzyme Q10 in the treatment of mitochondrial disease. Journal of Inborn Errors of Metabolism and Screening. 2017 May 18;5:2326409817707771.
 Parikh S, et al. Diagnosis and management of mitochondrial disease: a consensus statement from the Mitochondrial Medicine Society. Genet Med. 2015 Sep;17(9):689-701.
 Garrido-Maraver J, et al. Coenzyme q10 therapy. Mol Syndromol. 2014 Jul;5(3-4):187-97.
 Di Meo I, et al. Mitochondrial diseases caused by toxic compound accumulation: from etiopathology to therapeutic approaches. EMBO Mol Med. 2015 Oct;7(10):1257-66.
 Niklowitz P, et al. Coenzyme Q10 serum concentration and redox status in European adults: influence of age, sex, and lipoprotein concentration. J Clin Biochem Nutr. 2016 May;58(3):240-5.
 Pietrangelo T, et al. Old muscle in young body: an aphorism describing the Chronic Fatigue Syndrome. Eur J Transl Myol. 2018 Sep 7;28(3):7688.
 Ciregia F, et al. Bottom-up proteomics suggests an association between differential expression of mitochondrial proteins and chronic fatigue syndrome. Transl Psychiatry. 2016 Sep 27;6(9):e904.
 Tomas C, et al. Cellular bioenergetics is impaired in patients with chronic fatigue syndrome. PLoS One. 2017 Oct 24;12(10):e0186802.
 Fukuda S, et al. Ubiquinol‐10 supplementation improves autonomic nervous function and cognitive function in chronic fatigue syndrome. Biofactors. 2016 Jul 8;42(4):431-40.
 Castro-Marrero J, et al. Effect of coenzyme Q10 plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome – A randomized, controlled, double-blind trial. Clin Nutr. 2016 Aug;35(4):826-34.
 Castro-Marrero J, et al. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? Antioxid Redox Signal. 2015 Mar 10;22(8):679-85.
 Kaplon RE, et al. Vascular endothelial function and oxidative stress are related to dietary niacin intake among healthy middle-aged and older adults. J Appl Physiol (1985). 2014 Jan 15;116(2):156-63.
 Miyamae T, et al. Increased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation. Redox Rep. 2013;18(1):12-9.
 Alcocer-Gómez E, et al. Effect of coenzyme Q10 evaluated by 1990 and 2010 ACR Diagnostic Criteria for Fibromyalgia and SCL-90-R: four case reports and literature review. Nutrition. 2013 Nov-Dec;29(11-12):1422-5.
 DiPierro F, et al. Role for a water-soluble form of CoQ10 in female subjects affected by fibromyalgia. A preliminary study. Clin Exp Rheumatol. 2017 May-Jun;35 Suppl 105(3):20-7.
 Cordero MD, et al. Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal. 2013 Oct 20;19(12):1356-61.
 O’Connor KA, et al. Declining fecundity and ovarian ageing in natural fertility populations. Maturitas. 1998 Oct 12;30(2):127-36.
 May-Panloup P, et al. Low oocyte mitochondrial DNA content in ovarian insufficiency. Hum Reprod. 2005 Mar;20(3):593-7.
 Meldrum DR, et al. Aging and the environment affect gamete and embryo potential: can we intervene? Fertil Steril. 2016 Mar;105(3):548-59.
 Ben-Meir A, et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. 2015 Oct;14(5):887-95.
 Turi A, et al. Coenzyme Q10 content in follicular fluid and its relationship with oocyte fertilization and embryo grading. Arch Gynecol Obstet. 2012 Apr;285(4):1173-6.
 Akarsu S, et al. The association between coenzyme Q10 concentrations in follicular fluid with embryo morphokinetics and pregnancy rate in assisted reproductive techniques. J Assist Reprod Genet. 2017 May;34(5):599-605.
 Giannubilo SR, et al. CoQ10 supplementation in patients undergoing IVF-ET: the relationship with follicular fluid content and oocyte maturity. Antioxidants (Basel). 2018 Oct 13;7(10):141.
 Xu Y, et al. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial. Reprod Biol Endocrinol. 2018 Mar 27;16(1):29.
 Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci. 2015 Oct-Dec;8(4):191-6.
 Eamer L, et al. Microfluidic assessment of swimming media for motility-based sperm selection. Biomicrofluidics. 2015 Aug 4;9(4):044113.
 Ishikawa Y, et al. Surfing and swimming of ejaculated sperm in the mouse oviduct. Biol Reprod. 2016 Apr;94(4):89.
 Nadjarzadeh A, et al. Effect of Coenzyme Q10 supplementation on antioxidant enzymes activity and oxidative stress of seminal plasma: a double-blind randomised clinical trial. Andrologia. 2014 Mar;46(2):177-83.
 Alleva R, et al. The protective role of ubiquinol-10 against formation of lipid hydroperoxides in human seminal fluid. Mol Aspects Med. 1997;18 Suppl:S221-8.
 Mancini A, Balercia G. Coenzyme Q(10) in male infertility: physiopathology and therapy. Biofactors. 2011 Sep-Oct;37(5):374-80.
 Lafuente R, et al. Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet. 2013 Sep;30(9):1147-56.
 Thakur AS, et al. Effect of ubiquinol therapy on sperm parameters and serum testosterone levels in oligoasthenozoospermic infertile men. J Clin Diagn Res. 2015 Sep;9(9):BC01-3.
 Safarinejad MR. The effect of coenzyme Q₁₀ supplementation on partner pregnancy rate in infertile men with idiopathic oligoasthenoteratozoospermia: an open-label prospective study. Int Urol Nephrol. 2012 Jun;44(3):689-700.
 Zhang X, et al. Coenzyme Q10 protects against hyperlipidemia-induced cardiac damage in apolipoprotein E-deficient mice. Lipids Health Dis. 2018 Dec 8;17(1):279.
 Chapidze G, et al. Prevention of coronary atherosclerosis by the use of combination therapy with antioxidant coenzyme Q10 and statins. Georgian Med News. 2005 Jan;(118):20-5.
 Gao L, et al. Effects of coenzyme Q10 on vascular endothelial function in humans: a meta-analysis of randomized controlled trials. Atherosclerosis. 2012 Apr;221(2):311-6.
 Genova ML, et al. Mitochondrial production of oxygen radical species and the role of Coenzyme Q as an antioxidant. Exp Biol Med (Maywood). 2003 May;228(5):506-13.
 Singh RB, et al. Coenzyme Q10 modulates remodeling possibly by decreasing angiotensin-converting enzyme in patients with acute coronary syndrome. Antioxidants (Basel). 2018 Jul 25;7(8):99.
 Boengler K, et al. Mitochondria and ageing: role in heart, skeletal muscle and adipose tissue. J Cachexia Sarcopenia Muscle. 2017 Jun;8(3):349-369.
 Yang YK, et al. Coenzyme Q10 treatment of cardiovascular disorders of ageing including heart failure, hypertension and endothelial dysfunction. Clin Chim Acta. 2015 Oct 23;450:83-9.
 Suárez-Rivero JM, et al. Intracellular cholesterol accumulation and coenzyme Q10 deficiency in Familial Hypercholesterolemia. Biochim Biophys Acta Mol Basis Dis. 2018 Dec;1864(12):3697-3713.
 Singh RB, et al. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther. 1998 Sep;12(4):347-53.
 Mortenson 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 Fail. 2014 Dec;2(6):641-9.
 Jafari M, et al. Coenzyme Q10 in the treatment of heart failure: a systematic review of systematic reviews. Indian Heart J. 2018 Jul;70 Suppl 1:S111-7.
 Zhang P, et al. Treatment of coenzyme Q10 for 24 weeks improves lipid and glycemic profile in dyslipidemic individuals. J Clin Lipidol. 2018 Mar-Apr;12(2):417-27.
 Sharifi N, et al. The effects of coenzyme Q10 supplementation on lipid profiles among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials. Curr Pharm Des. 2018;24(23):2729-42.
 Jorat MV, et al. The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Lipids Health Dis. 2018 Oct 9;17(1):230.
 Huang H, et al. Effects of coenzyme Q10 on cardiovascular and metabolic biomarkers in overweight and obese patients with type 2 diabetes mellitus: a pooled analysis. Diabetes Metab Syndr Obes. 2018 Nov 29;11:875-86.
 Mohseni M, et al. Effects of coenzyme q10 supplementation on serum lipoproteins, plasma fibrinogen, and blood pressure in patients with hyperlipidemia and myocardial infarction. Iran Red Crescent Med J. 2014 Oct 5;16(10):e16433.
 Thomas SR, et al. Inhibition of LDL oxidation by ubiquinol-10. A protective mechanism for coenzyme Q in atherogenesis? Mol Aspects Med. 1997;18 Suppl:S85-103.
 Singh RB, Niaz MA. Serum concentration of lipoprotein(a) decreases on treatment with hydrosoluble coenzyme Q10 in patients with coronary artery disease: discovery of a new role. Int J Cardiol. 1999 Jan;68(1):23-9.
 Oesterle A, et al. Pleiotropic effects of statins on the cardiovascular system. Circ Res. 2017 Jan 6;120(1):229-43.
 Qu H, et al. The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials. Eur J Med Res. 2018 Nov 10;23(1):57.
 Thompson PD, et al. Statin-associated side effects. J Am Coll Cardiol. 2016 May 24;67(20):2395-2410.
 Ghirlanda G, et al. Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study. J Clin Pharmacol. 1993 Mar;33(3):226-9.
 Caso G, et al. Effect of coenzyme q10 on myopathic symptoms in patients treated with statins. Am J Cardiol. 2007 May 15;99(10):1409-12.
 Kiesewetter H, Coenzyme Q10 deficiency. Dtsch Arztebl Int. 2016 May 13;113(19):344-5.
 Skarlovnik A, et al. Coenzyme Q10 supplementation decreases statin-related mild-to-moderate muscle symptoms: a randomized clinical study. Med Sci Monit. 2014 Nov 6;20:2183-8.
 Young JM, et al. Effect of coenzyme Q(10) supplementation on simvastatin-induced myalgia. Am J Cardiol. 2007 Nov 1;100(9):1400-3.
 Taylor BA, et al. A randomized trial of coenzyme Q10 in patients with confirmed statin myopathy. Atherosclerosis. 2015 Feb;238(2):329-35.
 Kamran H, et al. Statins and new-onset diabetes in cardiovascular and kidney disease cohorts: a meta-analysis. Cardiorenal Med. 2018;8(2):105-12.
 Chrysant SG. New onset diabetes mellitus induced by statins: current evidence. Postgrad Med. 2017 May;129(4):430-5.
 Maki KC, et al. Statin use and risk for type 2 diabetes: what clinicians should know. Postgrad Med. 2018 Mar;130(2):166-72.
 Lorza-Gil E, et al. Coenzyme Q10 protects against β-cell toxicity induced by pravastatin treatment of hypercholesterolemia. J Cell Physiol. 2018 Dec 7. [In Press]
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Marina MacDonald, MS, PhD
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