We’ve all heard the expression, “If it sounds too good to be true, it probably is.” Well, guess what, that’s not always true. Here’s one of my favorite counter-examples from the health world: CoQ10 supplementation.

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CoQ10 is a vitamin-like compound found in every cell in your body, essential for powering  it up. Fortunately, our bodies make it. Not so fortunately, our bodies don’t not make quite enough of it to power us through our whole lives as vigorously as we’d wish. And that’s where the supplements come in.

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In most cases, supplements only complement the nutrition that a good diet provides. But CoQ10 is something of a special case. Some foods are relatively rich in it but the amounts are still modest compared to what our bodies need. So, supplements are an effective and almost risk-free way to top off your energy tank and protect yourself against a range of diseases. It’s just one of those “most bang for your health buck” deals you simply can’t afford to pass up. Here’s a topline on all that CoQ10 goodness and what to do with it:

How does CoQ10  work?  

CoQ10 is all about energy. It’s an essential component in the complex chemical process that transforms the food we eat into the energy that our cells need to do their jobs, first and foremost, keeping us alive. Consequently, most of the CoQ10 in our bodies is found in the mitochondria, the power plants inside the cell which produce the energy we run on. But what makes CoQ10 truly cool, and such a great candidate to supplement, is that it’s also a powerful antioxidant. In other words, not only does it help pump out the energy but, as an antioxidant, it also helps to neutralize the waste products that come with the energy production. We’re talking here about the free radicals that generate inflammation and drive most, if not all, of our most serious chronic diseases. Think of CoQ10 as your super-capable best friend who shows up at your doorstep, cooks you a nutritious meal to keep you humming through the day …and then washes all the dishes!

But who really needs it?

We all do. The problem is, as we age, we lose energy. If we eat right and stay physically active and don’t let stress overwhelm us, the diminution may be subtle but it’s real. Our mitochondria decrease in number and efficiency, and our supply of CoQ10, that indispensable ingredient, drops as well. That’s why I recommend most of my patients over 40 add it to their good health armamentarium. That goes double for anyone who’s bothered by fatigue or is experiencing a slippage in their cardiovascular health and an increase in cardiovascular risk factors – blood pressure going up and the ratio of LDL (“bad”) cholesterol to HDL (“bad”) cholesterol headed in the wrong direction. Has medical science pinned down the exact relationship of CoQ10 to heart health? No. But we do know that people with healthy hearts have higher CoQ10 levels. And we know from the research that patients with heart failure -- a life-threatening weakening of the heart muscle that prevents the heart from pumping sufficient blood to the body – do better on CoQ10.

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If these readily-available supplements can improve the health of people with this worst-case heart condition, you can bet that the rest of us in middle age and beyond will get a significant health boost as well. Over the course of an lifetime, the heart beats more than 2 ½ billion times Adding a little extra fuel to the engine sounds like a good insurance policy to me.  

So, what’s the statin story?  

OK, suppose you are among an estimated 60% of older Americans on a statin drug to bring down your LDL and protect against heart attack and stroke. Here’s the rub. Mainstream medicine’s go-to cardiovascular system drug has the effect of reducing CoQ10 levels, in some cases, by as much as 40%, likely one cause of common statin side-effects like muscle soreness and muscle weakness. That’s a trade-off that makes me skeptical about the value of statins for most of my patients. But I will say this, with complete conviction. If you’re on a statin, make darn sure you’re also taking CoQ10 to counterbalance the effects of the pharmaceutical drug that’s supposed to be doing you so much good. There’s even reasonable evidence that the supplement can lower LDL (and blood pressure) numbers, without a Big Pharma assist.

What else can supplemental CoQ10 do?  

In a word, sorry, make that two words, almost everything. While the supplement’s effect on heart function has been the best studied, we do have good preliminary evidence that it may a boon to people with below-par metabolic health (that is, prediabetes and diabetes), which also helps drive heart problems.  [It’s a rat study, of course.] It can improve skin health (apply directly on the skin, in oil form); it may reduce migraine headache symptoms; there’s reason to believe it can protect brain and lung health. It’s even associated with a reduction in cancer risk and has been shown in one study to lower the incidence of cancer recurrence. Let’s just say, when you have a supplement that positively impacts the production of the energy, the energy that all of our cells, tissues and organs need to function, and helps out with the “garbage removal” (those free radicals), you cover a lot of health basis. In one meta-analysis, that is, a study analyzing a number of other studies, taking CoQ10 caused levels of the major markers that measure inflammation, the root cause of so much disease, to go down.  

What about exercise?

Maybe you’re asking yourself, if CoQ10 provides such an energy boost, wouldn’t the positive effects show up in exercise (or, as I like to think of it in broader terms, physical activity or movement)? The answer is yes. In a handful of admittedly smaller studies, administering the supplement improved athletic performance and reduced muscle fatigue.

What about diet?  

The fact is, you’re not going to completely optimize your CoQ10 levels by diet alone, but you can certainly help your cause by eating foods that are naturally rich in the compound. Leafy greens like spinach and cruciferous veggies like broccoli and cauliflower are good vegetable sources, as are legumes and nuts and seeds. But the mother lode here is organ meat (and please, make that meat organic/grass-fed) – the animals’ organs are high in the compound just like ours are. Two servings a week of beef or pork liver or hearts is a sensible recommendation. If that doesn’t sound appetizing, go with fish, the little ones. Mackerel, herring and anchovy are all great choices.

How to CoQ10 the right way.  

Discuss supplementation with your health care provider, and if they roll their eyes, think hard about finding a new one. But as a general recommendation, I usually suggest starting with 200-400 mgs daily for the first four weeks and then 200 mg a day after that to maintain healthy levels. If you’re on certain medications, statins especially, the intro dose might be higher (if you go too high, you’ll likely just excrete the excess). In any case, you should feel a positive effect within weeks. For some of my patients, it’s a matter of days. As always when it comes to supplements, go with quality. That means, liquid capsules of the ubiquinol form of CoQ10 -- professional-grade stuff from companies like Designs for Health, Thorne, Metagenics and Orthomolecular.