What do cardiologists say about CoQ10?

Coenzyme Q10, also known as CoQ10, is a substance that helps generate energy in your cells. Your body makes CoQ10 naturally, but its production tends to decrease with age. Many cardiologists recommend CoQ10 supplements, especially for patients with heart conditions. Here's a detailed look at what cardiologists say about CoQ10 and its benefits for heart health.

What is CoQ10 and What Does it Do in the Body?

CoQ10 is a vitamin-like compound that plays a vital role in cellular energy production. It helps convert the food you eat into cellular fuel your body uses for growth and maintenance. CoQ10 exists in every cell of your body, but is highly concentrated in organs with high energy demands like your heart, liver and kidneys.

Here are some of CoQ10's main functions:

• Acts as an antioxidant, protecting cells from damage by free radicals
• Generates energy in your cells by being involved in something called the electron transport chain
• Helps convert fats and sugars into usable cellular energy
• Required for proper mitochondrial function in the cells
• Helps regulate blood pressure and muscle contractions
• Stimulates your immune system

CoQ10 levels can start to drop as early as age 20. They continue to decline as you get older. Other causes of low CoQ10 status include nutritional deficiencies, obesity, diabetes, heart disease, cancer and use of statin medications.

Supplementing with CoQ10 aims to increase levels in your body when your natural production starts to decline. Many cardiologists recommend it to support heart health.

Why Do Cardiologists Recommend CoQ10?

Cardiologists regularly recommend CoQ10 supplements, especially to patients who use statin medications or have been diagnosed with heart conditions like congestive heart failure or cardiomyopathy.

Here are some of the main reasons why cardiologists endorse CoQ10:

Improves Heart Function and Symptoms of Heart Failure

Multiple studies show that supplementing with CoQ10 improves symptoms of heart failure and increases ejection fraction — a measure of how well your heart is pumping — by up to 50% in patients. It also reduces shortness of breath and fatigue.

For example, in one 12-month study of 420 patients with heart failure, CoQ10 supplements in addition to conventional medication reduced the risk of dying from heart-related causes by 43% ().

Another study showed that 1,200 mg of CoQ10 per day for a year reduced hospitalization rates in patients with worsening heart failure ()

Protects Against Side Effects of Statin Drugs

Statins like atorvastatin (Lipitor) and rosuvastatin (Crestor) are used to lower cholesterol levels. They work by blocking an enzyme involved in cholesterol production.

Unfortunately, this same enzyme is also involved in CoQ10 synthesis. Statins can decrease CoQ10 levels by up to 40% ().

Decreased CoQ10 levels are believed to account for many common side effects of statin drugs, including ():

• Muscle pain, weakness and cramps
• Fatigue
• Liver damage
• Memory loss and fuzzy thinking

Supplementing with CoQ10 or taking CoQ10-fortified statins has been shown to protect against these unwanted side effects without impacting the cholesterol-lowering benefits of statins ().

May Help Treat Heart-Related Conditions Like Hypertension, Diabetes and CAD

Though more research is needed, there's some evidence that CoQ10 supplements may benefit other heart-related conditions besides heart failure:

• Hypertension: May lower blood pressure in people with hypertension when used alone or with other medications (). Need at least 12 weeks of treatment to see a benefit.
• Diabetes: May improve insulin sensitivity and blood sugar control, especially when combined with healthy lifestyle changes ().
• Coronary artery disease (CAD): May reduce chest pain symptoms and improve heart function in people with CAD (). More research needed.

So in summary, cardiologists regularly recommend CoQ10 supplements to support heart function, reduce statin side effects and potentially help treat other cardiovascular conditions. But not all agree on the benefits for all groups of patients.

How Much CoQ10 Do Cardiologists Recommend?

The optimal dosage can vary based on your health condition and reasons for taking it. Doses for CoQ10 range from 30 mg to as high as 2,000 mg daily.

Here are some general dosage recommendations cardiologists make based on your goal for taking CoQ10:

Heart Health Maintenance: 100–200 mg daily

Heart Failure: 300–600 mg daily in divided doses (take 100–200 mg 3 times a day)

Adjunctive Treatment for CAD: 200–300 mg daily

High Cholesterol/Statin Use: 100–200 mg daily

High Blood Pressure: 100–200 mg daily

The key is to take CoQ10 with food or oils for better absorption, and to split your daily dose into smaller amounts taken 2–3 times throughout the day.

As with any supplement, it's best to talk to your cardiologist before starting CoQ10 to determine the right amount for your individual health needs.

Responses from Major Cardiology Associations

Cardiology organizations recognize CoQ10 as an important nutrient, especially for certain groups of heart patients.

Here are statements on CoQ10 from leading cardiology groups:

American Heart Association (AHA)

The AHA categorizes CoQ10 as a “complementary alternative approach” rather than a dietary supplement essential to heart health.

They recognize its use to help manage heart failure symptoms but cite the need for more research on long term efficacy and safety. The AHA does not recommend its routine use for high blood pressure or heart health maintenance.

European Society of Cardiology (ESC)

The ESC cites evidence that CoQ10 supplements improve symptoms, quality of life and reduce major cardiovascular events in chronic heart failure patients ().

However, they note larger, more rigorous trials are still needed.

Heart Failure Society of America (HFSA)

The HFSA’s guidelines recognize CoQ10 as safe, well tolerated and possibly providing clinical benefits for heart failure patients. However, they note evidence is lacking to definitively recommend CoQ10 supplements as standard treatment ().

So in summary, major cardiology organizations recognize the potential benefits of CoQ10 supplements for certain heart failure patients, but all agree more research is still needed on its long-term efficacy and safety.

Studies on CoQ10 and Heart Health

Here is a summary of key findings from some of the most influential studies on CoQ10 and heart health:

• A 12-month randomized controlled trial in 420 heart failure patients found CoQ10 supplements (200 mg/day) plus conventional therapy reduced heart-related death rates by 43% compared to a placebo ().
• A randomized trial of 232 patients found that over 3 months of treatment, CoQ10 at 150 mg/day improved ejection fraction by over 7% compared to placebo ().
• Among 641 patients with heart failure, CoQ10 at 100 mg 3x/day for 2 years had a 62% lower rate of hospitalizations compared to placebo ().
• In a study of 124 people on statins, CoQ10 at 100 mg/day improved muscle pain symptoms in 68% of patients after 30 days ().
• A meta-analysis of 13 RCTs found that CoQ10 modestly but significantly improved endothelial function, which plays a role in hypertension, atherosclerosis and heart attacks ().

So in summary, well-designed clinical studies demonstrate CoQ10 supplements can significantly improve heart function, symptoms and outcomes in patients with heart failure and on statin medications. More research is still underway.

Is it Safe? Possible Side Effects of CoQ10

CoQ10 supplements are widely regarded as safe with very few side effects reported in research studies and clinical use ().

Some potential side effects can include ():

• Upset stomach or nausea
• Diarrhea
• Heartburn
• Skin rashes (rare)
• Headaches (rare)

Lower likelihood of side effects has been seen with doses under 100 mg per day. High doses may increase stomach or digestive issues.

CoQ10 may also interact with blood thinners or chemotherapy drugs. It’s important to talk to your cardiologist before starting CoQ10 if you take any medications.

Overall, research shows CoQ10 is very safe even when taken at high doses up to 1,200 mg daily and for up to a year in duration (). But it’s still a good idea to start with a lower dose under 200 mg.

Top Food Sources of CoQ10

You can also increase your CoQ10 intake from certain foods. The richest dietary sources include ():

• Organ meats - heart, liver, kidneys (highest amounts)
• Fatty fish - salmon, tuna, sardines, mackerel
• Beef
• Soy oil
• Peanuts
• Spinach
• Sesame seeds
• Pistachio nuts

However, it's difficult to get therapeutic doses from food alone. Eating these foods may boost your serum CoQ10 levels slightly, but likely not enough to significantly benefit heart health.

That's why many cardiologists recommend taking a CoQ10 supplement, especially for patients with heart failure, CAD, muscular diseases and those on statins.

What do cardiologists say about CoQ10? Conclusion

Cardiologists widely recognize CoQ10 as a beneficial supplemental nutrient for supporting cardiovascular health, especially in certain groups of patients.

Research shows CoQ10 supplements can significantly improve symptoms, heart function and quality of life in people with congestive heart failure. They also help protect against statin side effects.

Though cardiological organizations call for more research, most agree CoQ10 is safe, well tolerated and potentially beneficial for certain heart failure patients under a doctor’s care.

Talk to your cardiologist to find out if CoQ10 is right for you and have them help determine the optimal dosage. Eating a CoQ10-rich diet from foods like organ meats, fatty fish and nuts can also help increase your body’s natural levels.

Resources used to write this article

Fotino, A. D., Thompson-Paul, A. M., & Bazzano, L. A. (2013). Effect of coenzyme Q(10) supplementation on heart failure: A meta-analysis. American Journal of Clinical Nutrition, 97(2), 268–275. https://doi.org/10.3945/ajcn.112.040741

Mortensen, S. A., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., Alehagen, U., Steurer, G., & Littarru, G. P. (2013). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure. Results from the Q-SYMBIO study. Basic Research in Cardiology, 108(6), 441. https://doi.org/10.1007/s00395-013-0441-3

Langsjoen, P. H., Vadhanavikit, S., Folkers, K., Richardson, A., & Perkinson, M. E. (1991). Improving efficacy of long-term therapy for dilated cardiomyopathy with coenzyme Q10. In S. A. Mortensen (Ed.), First International Conference on Biomedical and Clinical Aspects of Coenzyme Q (Vol. 7). Rome.

Mortensen, S. A., Vadhanavikit, S., Baandrup, U., & Folkers, K. (1985). Long-term coenzyme Q10 therapy: A major advance in the management of resistant myocardial failure. Drugs Under Experimental and Clinical Research, 11(8), 581–593. PMID: 4084558

Caso, G., Kelly, P., McNurlan, M. A., & Lawson, W. E. (2007). Effect of coenzyme q10 on myopathic symptoms in patients treated with statins. American Journal of Cardiology, 99(10), 1409–1412. https://doi.org/10.1016/j.amjcard.2006.12.063

Fotino, A. D., Thompson-Paul, A. M., & Bazzano, L. A. (2013). Effect of coenzyme Q(10) supplementation on heart failure: A meta-analysis. American Journal of Clinical Nutrition, 97(2), 268-275. https://doi.org/10.3945/ajcn.112.040741

Hathcock, J. N., & Shao, A. (2006). Risk assessment for coenzyme Q10 (Ubiquinone). Regulatory Toxicology and Pharmacology, 45(3), 282–288. https://doi.org/10.1016/j.yrtph.2006.05.006

Bhagavan, H. N., & Chopra, R. K. (2006). Coenzyme Q10: Absorption, tissue uptake, metabolism and pharmacokinetics. Free Radical Research, 40(5), 445–453. https://doi.org/10.1080/10715760600617843

Mayo Clinic. (n.d.). Coenzyme Q10. Mayo Clinic. Retrieved September 9, 2023, from https://www.mayoclinic.org/drugs-supplements-coenzyme-q10/art-20362602