A little bit about coQ10

CoQ10 is an important essential enzyme in the body that participates in energy movement via the electron transport chain, partakes in production of building blocks for DNA, and also acts as an antioxidant in cellular membranes (Casagrande et al., 2018; Fischer et al., 2011; Medline Plus, 2017; Xie et al., 2022). For humans, CoQ10 is at its greatest concentration around age 20 when it starts to decline; this decline varies for each individual based upon a number of factors including but not limited to: metabolic syndrome, Alzheimer’s disease, vitamin A deficiency, medication usage, oxidative and physiological stress, and GI absorption issues (Casagrande et al., 2018). It is often prescribed to support cardiometabolic function. For intake, CoQ10 can be obtained from dietary sources, however very little (less than 10%) is actually absorbed from these sources and this absorption is influenced further by the underlying health of the individual, especially in regard to their digestive system (Casagrande et al., 2018; Xie et al., 2022). This warrants the need for supplementation in most cases but especially in those at greatest risk for accelerated decline (Casagrande et al., 2018; Xie et al., 2022). The most bioavailable CoQ10 supplement is the solubilized form of ubiquinol, those with greatest declines should consider this form over others (Casagrande et al. 2018).
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In general, 22-400 mg/day of CoQ10 supplementation is considered safe, but even in clinical trials with high dosing, the adverse effects seen were not significant enough to stop usage, therefore 100 mg/day is definitely considered an acceptable dosage for adult patients (Casagrande et al., 2018; Xie et al., 2022). Conversely, for some individuals 100mg/day may not be enough due to genetic variations, challenges with absorption, certain disease states, age, medication usage, general health, inflammation levels, and stress load; even the mitochondrial size can influence needs (Casagrande et al., 2018; Fischer et al., 2011; MedlinePlus, 2017; Xie et al., 2022). Serum levels may be needed for individualized dosing, but due to the inevitable decline of this enzyme and the relative safety of supplementation, even without lab draws, it is appropriate to recommend all adults over age 20 take a supplement form of at least 100mg/day (Casagrande et al., 2018; Xie et al., 2022). It is important to note that extremely high doses may be recommended for individuals with genetic variants, but genetic testing should be done when at all possible to confirm this need (Xie et al., 2022).


References
 
Casagrande, D., Jordao, A. A., & Waib, P. H. (2018). Mechanisms of action and effects of the administration of Coenzyme Q10 on metabolic syndrome. Journal of Nutrition & Intermediary Metabolism, 13, 26–32. https://doi.org/10.1016/j.jnim.2018.08.002
 
Deichmann, R., Lavie, C., & Andrews, S. (2010). Coenzyme q10 and statin-induced mitochondrial dysfunction. The Ochsner journal, 10(1), 16–21.
 
Fischer, A., Schmelzer, C., Rimbach, G., Niklowitz, P., Menke, T., & Döring, F. (2011). Association between genetic variants in the Coenzyme Q10 metabolism and Coenzyme Q10 status in humans. BMC Research Notes, 4(1), 1–7. https://doi.org/10.1186/1756-0500-4-245
 
MedlinePlus. (2017, April 1). COQ2 gene. MedlinePlus. https://medlineplus.gov/genetics/gene/coq2/
 
Xie, J., Jiang, J., & Guo, Q. (2022). Primary Coenzyme Q10 deficiency-7 and pathogenic COQ4 variants: Clinical presentation, biochemical analyses, and treatment. Frontiers in Genetics, 12(776807), 1–18. https://doi.org/10.3389/fgene.2021.776807