2014

Clinical applications of coenzyme Q10

Garrido-Maraver J, Cordero MD, Oropesa-Ávila M, Vega AF, de la Mata M, Pavón AD, Alcocer-Gómez E, Calero CP, Paz MV, Alanis M, de Lavera I, Cotán D, Sánchez-Alcázar JA

Published in Frontiers in Bioscience

Abstract

Comprehensive review of CoQ10's critical role in mitochondrial function, energy production, and its decline with aging.

Methodology

Review of CoQ10 biochemistry and clinical use, covering its role in mitochondrial electron transport, antioxidant activity, gene expression effects, and trial evidence across primary CoQ10 deficiency, mitochondrial disease, heart failure, neurodegeneration and statin myopathy.

Key Findings

CoQ10 functions both as a mitochondrial electron and proton carrier and as a lipid-soluble antioxidant, and it influences expression of genes involved in cell signalling and inflammation. Endogenous CoQ10 declines with age and with statin therapy. Supplementation is clearly effective in primary CoQ10 deficiency and secondary mitochondrial disorders. Evidence in heart failure is supportive but was not definitive at the time of review, and results in neurodegenerative disease have been largely disappointing. Bioavailability is poor and formulation-dependent.

Conclusions

CoQ10 has established benefit in primary CoQ10 deficiency and mitochondrial disease, plausible benefit in heart failure, and weak evidence elsewhere. Absorption limitations mean formulation and dosing matter substantially.

Limitations

Narrative review without systematic search or quantitative synthesis; conflates strong evidence in rare genetic deficiency with weaker evidence in common conditions; predates several later large trials, and plasma CoQ10 levels correlate poorly with tissue levels.