There is a compound essential to animal life that is found in nearly all cells. This compound is called ubiquinone, or CoQ10. Being so ubiquitous, it was named as such. I’m sure that person thought they were so smart. Like the guy or gal who named the toaster.
CoQ10 is promoted widely in the supplement industry. Many non-supplement junkies are only minimally aware of it. Some use it without really knowing what for. “I heard it’s good for the heart/brain/insert organ here.” For me, it’s important that consumers know what it is and why many DON’T need it. For those who DO need it, it’s important to use it in the right forms and doses.
What CoQ10 Does In The Body
Simply put, CoQ10 is an important factor in energy production in every cell of the body. To understand it clearly, though, we need to understand also how it relates to the similarly named “ubiquinol” (you-bick-win-all).
Let’s pretend for a moment that the energy our bodies need to perform basic cellular functions is a tourist visiting Disneyland. Yes, another Nealism. They look like so:
Disney and The Mouse want that money. They get the money when the tourists are in the right spots of the park spending the money. Not in the parking lot. Not at the hotel. Especially not in areas that are off-limits. If they’re behind a fence somewhere, they’re going to get into chaos and probably break things.
We need a trolley to pick the people up and bring them to the areas they are needed. We need to bring people with money to the park, then ignore people with no money and get them out of our face until they save more dough. We have to monitor the areas tourists don’t belong and pick up stragglers quickly.
With that analogy, I’ve basically described the problem of oxidation and antioxidation, with further discussion in our previous blog about the topic.
CoQ10 is like our trolley. It has only 2 spots available for tourists with money. See the following artistic representation:
When the money is needed to make our body work, CoQ10 makes a delivery of tourists with money. After the delivery, the truck is empty, like so:
Here’s an important concept: the empty delivery truck is Ubiquinol. Ubiquinol and CoQ10 are the same thing; CoQ10 is the trolley WITH passengers while Ubiquinol is the trolley WITHOUT passengers.
Ubiquinol’s job is to drive around and pick up tourists from the WRONG locations and put it in the RIGHT ones. When Ubiquinol is full, it is now back to being Ubiquinone, or CoQ10.
To make this confusing, we often use the term CoQ10 to mostly refer to both CoQ10 and Ubiquinol. I’ll specify when I want to talk about the individual compounds, but otherwise it will be “CoQ10” = both from here out.
CoQ10 provides energy in the mitochondria (energy factory) of every cell in the body. Once the compounds used to produce energy have been used up, the “empty trolley” Ubiquinol scoops up and recycles oxidizing compounds, preventing oxidation and keeping the energy train (“cash flow”) going. Back and forth, forth and back.
Getting Enough CoQ10
CoQ10 and ubiquinol are found everywhere, but predominantly in organs and tissues that use and create the most energy. The big organs. Brain, liver, heart, lungs, kidney, pancreas. It goes without saying, we NEED to make sure we have enough CoQ10!
It should be noted that CoQ10 is not a vitamin. It is not an essential component that comes from OUTSIDE our body, it is made regularly BY our body. The best source of CoQ10 is us. Don’t start with cannibalism – I’m saying we don’t NEED to eat it or supplement it in a majority of cases.
Mostly we can create enough CoQ10 and Ubiquinol to meet demands. In some conditions, the process of creating CoQ10 diminishes. The most common condition is what scientists call “getting older.” As we age, our CoQ10 synthesis diminishes. This means older people may benefit from increasing their CoQ10 or Ubiquinol intake.
Here are some things that have been shown, at least loosely, to decrease CoQ10 synthesis, depleting vital organs of this powerful antioxidant:
- Age over 60 years
- Statin drugs – CoQ10 shares a synthesis pathway with cholesterol. Statins inhibit this pathway, decreasing CoQ10 levels and potentially increasing muscle aches, pains, and more
- Congestive heart failure
- Muscle diseases
- Parkinson’s disease
- HIV infection
- Migraines – via unknown mechansim
If you are a patient with one of the conditions above, CoQ10 supplementation may be warranted. Doses will vary based on the reason. Most people would start at about 100mg of Ubiquinol or 200mg of CoQ10. Otherwise, CoQ10 might be largely unnecessary.
There’s a genetic component to CoQ10 synthesis, but it’s something that affects almost none of us. Before all the MTHFR frauds are eventually exposed, I’m sure they’ll find some other fake genetic disorder to jump onto and promote their programs. Don’t let them tell you an online genetic test will show you have an inability to make CoQ10. First off, there’s a good chance you’d be literally dead waiting for those results, so supplements would be wasteful. Secondly, only 4 cases of genetic failure to synthesize have been reported in the literature. It’s not common.
How would you know you were CoQ10 deficient? You really don’t. There are no real tests to determine CoQ10 status. CoQ10 is found in cells in organs; very little CoQ10 is found in the blood. Blood tests for CoQ10 are available, but they are more of an indicator of supplementation and dietary intake, not for deficiency in your organs. Unless we are talking biopsies of specific tissues, we won’t really know if it is needed in a normal, healthy person.
Some of us do have issues that CoQ10 supplementation may support.
The data on benefits from increasing CoQ10 intake if you have one of these CoQ10-depleting conditions is spotty. There are some “mostly-positive” small studies, like heart failure, diabetes, and statin use. Many traditional practitioners may support use or even recommend it. I take a reserved approach with CoQ10 supplementation, recommending it only in a few circumstances. If someone wants to use CoQ10, we’ll ensure they’re getting the right dose and form of the supplement.
We take a “food first” mentality, though. Let’s discuss the dietary sources of CoQ10. Maybe that will do the trick!
Dietary Sources of CoQ10
Even though CoQ10 is NOT a vitamin, people may want to ramp up their intake of CoQ10-rich foods. It is such a vital compound, and there are things that can impact our CoQ10 levels like age, drugs, or disease. Makes sense?
To which I say, “Good luck!” CoQ10 and ubiquinol are found in foods, but in low, low amounts.
CoQ10 is richest in organ meats from cows, pork, and chicken. It is less concentrated in animal flesh, and the amount gained from chicken thighs, for example, is the same as you’d find in fish, nuts, and vegetables. Soybean, olive, and grapeseed oil are also rich in CoQ10 – all of which are great options for vegans or vegetarians looking to get extra CoQ10.
Here’s a chart:
“Well that doesn’t look so bad,” says the person in my head that contradicts everything I do. It should be noted those numbers are mg of CoQ10 per kilogram of food. That’s half a pound of beef heart to get 100mg of CoQ10, a standard recommended dose.
If you think that’s bad, let’s look at the Ubiquinol content of foods.
To get a dose of 100mg Ubiquinol, you need:
- 3.5 lbs of peanuts
- 20 6 ounce steaks
- 60 avocados (hipsters: do not attempt!)
- 50 cups of spinach
This is a long-winded way for me to say: the only issue with nutritional supplementation of CoQ10 is that it’s practically impossible to do.
If you want to increase your CoQ10, a supplement is a must.
CoQ10 and Ubiquinol Supplements
Let’s recap one important concept: CoQ10 and Ubiquinol are the same, fundamentally. When you take, make, or eat CoQ10, your Ubiquinol AND CoQ10 levels will increase. At any given time in the body, the total “pool” of CoQ10 and Ubiquinol is 20% CoQ10 (full trolley) and 80% Ubiquinol (empty trolley).
Most practitioners recommend CoQ10. We know more about CoQ10 supplements because CoQ10 was developed first, not because it is better. Ubiquinol, for many reasons, is superior, but it was difficult to stabilize when the supplements were first developed. Since then, we, of course, can stabilize it.
I recommend Ubiquinol over CoQ10 supplements. I always look for the more absorbable forms of nutrients when making recommendations. If they are the form the body uses the most of, that’s a definite plus.
Ubiquinol has 2x greater bioavailability and increases levels about 4x, where CoQ10 only increases 2x. This means you can take ½ the dose when you use Ubiquinol. If we want 100mg of CoQ10, you can use 50mg of Ubiquinol. The most recommended starting dose of Ubiquinol is 100mg, which is roughly equivalent to 200mg CoQ10.
We’ve decided we’ll be supplementing with AT LEAST 100mg of Ubiquinol. There are a few other factors that come into play when choosing a Ubiquinol supplement.
First, we have to understand that CoQ10 and Ubiquinol are naturally crystalline. They are not water-soluble. Large crystal compounds not mixing well with the water-rich environment of the stomach doesn’t make for good absorption. While Ubiquinol has higher bioavailability, we have to formulate the product to ensure it gets absorbed. This is a piece that is often neglected in supplement land. Though your product may say “Ubiquinol”, it is EXTREMELY difficult for a consumer to know if it is formulated properly.
I think it was Spider-Man’s Uncle who said, “With great ambiguity comes great marketing nonsense.” Every company now has their own spin on how their Ubiquinol and CoQ10 supplements are superior. I’m going to lightning round this, then give you the right answer on after:
- Crystal Free – Any form that dissolves the crystals so it is more absorbable than crystalized Ubiquinol.
- Liquid CoQ10 – Dry CoQ10 crystals are dissolved and usually combined with oil to enhance absorption. The manufacturer brags of higher bioavailability, but there is nothing peer reviewed to compare it.
- Water Soluble CoQ10 – They increase the surface area of powders and dissolve those into the water, which has a very minor effect.
- Nano Technology – Sounds fancy, but it’s just super small particles to help with absorption. It hasn’t been proven successful or superior; there are widely varying reports of quality.
- Oil – Dissolving the crystals in oils seems to have a 2x absorption compared to powder formulations.
The simple answer here is to look for these logos:
Kaneka is the Japanese company that developed CoQ10 initially and subsequently stabilized Ubiquinol. They have an established, respected, growing pool of data around their formulations. They use a little MCT oil in the formulation to further facilitate absorption, as these are fat-soluble compounds.
When it comes to CoQ10 and Ubiquinol supplements, I only recommend products that use Kaneka as a raw material supplier. It takes the guesswork out.
Are There Downsides to CoQ10?
All products that have any therapeutic effect in the body will always have some side effect or downside. We walk the Middle Path and know we take the good with the bad.
Side effects that have been reported include loss of appetite, heartburn, nausea, or diarrhea. This is normally at 1% or less incidence, so they are fairly rare.
CoQ10’s risk of drug interactions hasn’t been studied extensively. There are a handful of case reports floating around, specifically with warfarin. If you take warfarin, you should always be chatting with a doctor or pharmacist before starting any supplement.
The biggest downside is a financial one. Many people start taking this for no defined reason. Many people overpay. A solid majority of CoQ10 products are over $40. Our price on Ubiquinol 100 is pretty darn amazing – beating out even the biggest of online retailers. You shouldn’t pay more than $12-15 a month for Ubiquinol 100mg.
Ubiquinol and CoQ10 Are Important
It can’t be stated enough: the role of CoQ10 and Ubiquinol is essential to animal life. CoQ10 helps with energy formation and expenditure. When the tourist trolly is empty, CoQ10 as Ubiquinol is a powerful antioxidant, picking up the tourists and shuttling them to spend their hard-earned money.
Our organs with the highest energy requirements like the heart, brain, lungs, or liver, will have the highest concentrations of CoQ10. CoQ10 is not a vitamin but is synthesized by the body. Some conditions cause a decrease in CoQ10 production, so supplementation is the best way to go. Trying to get CoQ10 in your diet is a futile effort; most foods have very little CoQ10.
CoQ10 is a supplement that you only need if you really need it. Clear, right? CoQ10 isn’t something you take to optimize your wellness. Using it daily won’t ensure you’ll never have CoQ10-related problems. Use CoQ10 with the advice of an expert if you are on that list – on statins, diabetic, have migraines, etc – as there is reasonable data surrounding its use.
CoQ10 supplements can be misleading and confusing. It’s best to look for Kaneka brand raw materials as they have the most data supporting superior absorption. kip CoQ10 and instead use Ubiquinol at around half the dose of CoQ10. Don’t spend more than $15/month on Ubiquinol 100mg.
If you want to use Ubiquinol to support whatever you have going on, start at 100mg of Ubiquinol and talk to me to determine what dose you should be on based on your individual needs.
Hopefully, someday the knowledge of benefits of CoQ10 will be as ubiquitous as CoQ10 itself!
Just trying to keep it real…
Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth