Sala Horowitz, Ph.D.

Coenzyme Q10 (CoQ10; also known as ubiquinone) is avitamin-like compound, synthesized by cells in mam-malian tissues to support energy production, that also

acts as an antioxidant. Because CoQ10 synthesis becomes lessefficient as people age, CoQ10 is thought to play a role inimmune-system modulation and disease. Certain medicationsand stress may deplete the body’s endogenous CoQ10 store fur-ther. A recent major clinical trial that evaluated CoQ10’s efficacyfor treating Parkinson’s disease found that CoQ10 was promisingfor treating the early stage of the disease.1

This article focuses primarily on research-based applications ofCoQ10 for treating Parkinson’s disease, cardiovascular disease,and cancer. Coverage also includes a brief survey of CoQ10 usesfor treating a broad range of health problems, from acquiredimmune-deficiency syndrome (AIDS) to periodontal disease, andfor improving general well-being, exercise capacity, and malefertility.

CoQ10 Sources, Research History, Biochemistry, and Physiologic Roles

First identified in 1940, CoQ10 (2,3 dimethyl-6-decaprenyl ben-zoquinone) was isolated from beef hearts in 1957 by FrederickCrane, M.D., of the University of Wisconsin–Madison.2 CoQ10occurs in small amounts in beef and eggs and, in lesser amounts,in beans, grains, spinach, and some oils.3 The chemical formulaof this fat-soluble compound was derived in 1958. The “10” in itsname refers to a portion of its chemical structure. Coenzymes aresmall molecules that facilitate the chemical reactions of enzymes.CoQ10 is vital for producing adenosine triphosphate (ATP) in thecellular electron transport chain.4,* CoQ10 supplements are man-ufactured by fermenting beets and sugar cane with special strainsof yeast.

In 1972, scientists first documented depressed CoQ10 levels inhuman cardiovascular disease. Based on preliminary evidence,the Japanese government approved CoQ10 for treating conges-tive heart failure in 1974. This supplement is also still a popularadjunctive therapy for that purpose in Europe and Russia. The

1978 award of a Nobel Prize for the discovery of CoQ10’s role incell energy transport prompted further interest and studies onthis vital coenzyme. According to the late Nobel Prize–winningscientist, Linus Pauling, Ph.D., CoQ10 supplements strengthenthe heart by increasing energy production in heart muscle cells,normalize blood pressure, optimize energy levels, and contributeto life extension.3

In the late 1980s, promotion of CoQ10 supplements in capsuleform began to reach health care professionals. In the 1990s, directmarketing to consumers began to people who presumably mightnot meet their CoQ10 requirements via biosynthesis and normaldietary intake of 5–10 mg per day, for improving immune andheart function, energy and lipid levels, and athletic performance.Normal blood levels of CoQ10 in humans have been variouslydefined as ranging from 0.30 to 3.84 mg/mL.5 There is evidencethat normal red blood cells may regulate their CoQ10 adequately,so supplements may have an impact mainly on pathologic condi-tions.6

Because CoQ10 is most concentrated in organs and tissues thatare highly active metabolically—including the heart, kidneys,liver, pancreas, and immune system—researchers began explor-ing the hypothesized role of CoQ10 in disease prevention. Casereports, uncontrolled clinical studies, and anecdotal reports havecentered on CoQ10 deficiency in patients with cancer and on thepresumed value of supplementation for treating tumors. In treat-ing patients with cancer who are undergoing conventional treat-ment, it is well-established that CoQ10 reduces the cardiotoxicityof such chemotherapy agents as Adriamycin (doxorubicin), thusconfirming laboratory studies that such agents’ antitumor activi-ty may be augmented by CoQ10.4

Evidence from animal studies suggests that analogues of CoQ10may function as antimetabolites to suppress cancer-cell growth.CoQ10 maintains cell integrity and acts as an antioxidant to preventthe free-radical damage to DNA and other cellular components that

111

Coenzyme Q10One Antioxidant, Many Promising Applications

*Several other naturally occurring forms of coenzyme Q have been iden-tified but CoQ10 is the predominant form found in mammals and theform that has been generally studied for its therapeutic applications.

Chemical structure of coenzyme Q10 (2,3 dimethyl-6-decaprenyl benzo-quinone).

is thought to be a factor in cancer development. Accumulated datashow that this naturally occurring nutrient also enhances immunefunctioning, leading to higher antibody levels and greater T-cellactivity and resistance to infection, chemically-induced neoplasia,and cardiac toxicity from chemotherapeutic agents.5

A matter of continuing debate concerns whether the tendencyof certain drugs, such as the cholesterol-lowering statins, to com-promise CoQ10 levels is of clinical significance.7 Other drugs thatmay interact with and lower CoQ10 levels include oral agentsthat lower blood sugar (e.g., glyburide, tolazamide) and beta-blockers. CoQ10 can also reduce responsiveness to the anticoagu-lant drug warfarin and can decrease insulin requirements inindividuals with diabetes.5 (See Table 1.) There is some evidenceindicating that fermented soy foods potentiate the antioxidanteffect on lipoprotein of oral CoQ10 supplementation.8

In a study that investigated the behavior of antioxidants aspossible pro-oxidant agents in certain biologic conditions, a lowdose (10 mg) of CoQ10 administered in capsule and fluid multi-antioxidant formulas reduced oxidative stress and did not pro-mote pro-oxidant activity.9

Mild insomnia has been noted in some patients on dailyCoQ10 doses of 100 mg or higher and some subjects in clinicaltrials have experienced heartburn, nausea, headache, fatigue,dizziness, and photophobia. However, no associated serious livertoxicity has been reported.

CoQ10 Formulations

The most prevalent formulation of this supplement is in soft-gels containing CoQ10 suspended in soybean oil or vitamin E,generally sold in 10–100 mg capsules and in multiantioxidantformulations. The potency of CoQ10 products advertised on theInternet range from 30 to 200 mg. Other commercially availableforms of the supplement include powder-f il led capsules ,tablets, and topical cosmetic creams. Of 29 brands of CoQ10tested by the independent ConsumerLab.com laboratory (seebox entitled Resources), only one failed to meet this organiza-tion’s standards because the supplement contained only a smallpercentage of the claimed amount of CoQ10.10 In 1999, oneproduct the UbiQGel® softgel (Tishcon Corporation, Westbury,New York), was put on the U.S. Food and Drug Administra-tion’s list of orphan product designations as useful for treatingmitochondrial cytopathies.11

Prescribing CoQ10 for Preventive Medicine

Ray Sahelian, M.D., who has a private practice in Marina delRey, California, noted that the majority of his patients whotook CoQ10 for preventive nutrition reported improvementsin their energy levels and mental clarity. Dr. Sahelian noticedan energy boost with a dose as low as 30 mg. At a dose of 120

112 ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 2003

Table 1. Interactions Between Drugs and Coenzyme Q10 (CoQ10)

Drug class Effects

Antidepressants CoQ10 may be antagonized by tricyclic antidepressants.a,b

Beta blockers Beta blockers antagonize CoQ10.Cancer chemotherapy drugs The anticancer antibiotic drug, Adriamycin (doxorubicin), may deplete CoQ10 as a result of enzyme inhi-

bition; supplementation with CoQ10 may prevent cardiotoxicity associated with the use of this drug as well as doubling its antitumor effects.b,c

Cholesterol-lowering drugs HMG CoA reductase inhibitors inhibit the synthesis of ubiquinone, possibly resulting in significant alter-ations in cell-energy metabolism; CoQ10 supplementation prevents plasma and platelet ubiquinone reduction induced by HMG CoA reductase inhibitors; 100 mg/day has actually increased ubiquinone lev-els while individuals were using these drugs.d

Diabetes drugs The sulfonylurea drug, glyburide (Diabeta), inhibits the CoQ10 enzyme NADH oxidase; glyburide, aceto-hexamide (Dymelor), and tolazamide (Tolinase), can all lead to CoQ10 deficiency and their prolonged use may produce cardiac symptoms.e

L-Carnitine L-Carnitine works synergistically with CoQ10.f

Phenothiazines CoQ10 may be antagonized by phenothiazine.b

Vitamin E CoQ10 recycles the radical form of vitamin E back to alpha tocopherol.g

Warfarin Coumadin is apparently less effective when taken with CoQ10; warfarin should not be taken with CoQ10unless patient is specifically instructed to do so by a physician; however, if a patient is already taking both CoQ10 and warfarin at the same time, the patient should be advised to speak to a physician before dis-continuing the CoQ10 (common names of warfarin include Panwarfin, Coumadin, and Sofarin).

Excerpt reprinted, adapted, and updated with permission from ref. 34.aPretreatment with CoQ10 may prevent the cardiac toxicity associated with these drugs caused by their inhibition of this coenzyme’s activity in the heart; bKishi T, Makino K, OkamotoT, Kishi H, Folkers K. Inhibition of myocardial respiration by psychotherapeutic drugs and prevention by coenzymeQ. In: Yamamura Y, Folkers K, Ito Y, eds. Biomedical and Clinical Aspectsof Coenzyme Q, vol. 2. Amsterdam: Elsevier/North-Holland Biomedical Press, 1980:139–154; cIwamoto Y, Hansen IL, Porter TH, Folkers K. Inhibition of coenzyme Q10-enzymes,succinoxidase and NADH-oxidase, by adriamycin and other quinones having antitumor activity. Biochem Biophys Res Commun 1974;4;58:633–638; dBargossi AM, Grossi G, Fiorella PL,Gaddi A, Di Giulio R, Battino M. Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med. 1994;15(suppl):S187–S193; eKishi T, Kishi H, Watanabe T, Folkers K. Bioenergetics in clinical medicine: XI. Studies on coenzyme Q and diabetes mellitus. J Med 7:307–321, 1976; fBertelli A, Ronca G.Carnitine and coenzyme Q10: Biochemical properties and functions, synergism and complementary action [review]. Int J Tissue React 1990;12:183–186; gStoyanovsky DA, Osipov AN,Quinn PJ, Kagan VE. Ubiquinone-dependent recycling of vitamin E radicals by superoxide. Arch Biochem Biophys 1995;323:343–351.

HMG CoA = 3-hydroxy-3-methyl-glutaryl coenzyme A; NADH = reduced form of nicotinamide adenine dinucleotide.

mg, energy and moods were elevated in some patients evenmore but caffeine-like arousal and insomnia were also pro-duced. Consequently, Dr. Sahelian recommends a startingdosage of 10–30 mg per day as part of a long-term health regi-men, especially for vegetarians.

Because CoQ10 is chemically similar to vitamin K, Dr. Sahe-lian also advises patients who are taking prescription bloodthinners to avoid the nutrient or to take only minimal dosages.He observes that CoQ10’s mechanism of action appears to beinvolved in protecting arteries from forming plaques and help-ing to prevent other damage by preventing lipoprotein oxida-tion. For example, levels of CoQ10 have been shown to be lowerin patients with Parkinson’s disease and other neurodegenera-tive diseases.12

With rega rd to how CoQ10 shou ld be taken , Chr is D.Meletis, N.D., dean of naturopathic medicine and chief medi-cal officer, National College of Naturopathic Medicine inPortland, Oregon, said that his general rule is to take suchsupplements 2 hours before or after meals. If the supplementis taken too close together with food, the effects may be dif-fused.†

Research on Current Promoted Uses of CoQ10

Parkinson’s Disease and Other Neurologic DisordersAs Dr. Sahelian noted, the antioxidant-cum-mitochondrial

enhancer CoQ10 appears to play a protective role against theonset and/or progression of such neurodegenerative disorders asParkinson’s disease. While levodopa and other drugs can reduceParkinson’s disease symptoms, no treatment has yet been shownto slow the functional deterioration caused by the disease.Patients with Parkinson’s disease have shown reduced levels ofantioxidants and antioxidant enzymes.

According to the free-radical theory of disease, mitochondrialdysfunction, caused by oxidative stress and compromised ATPproduction, in conjunction with nutritional deficiencies andaging, may underlie the etiology of the symptoms of Parkinson’sdisease, chronic fatigue syndrome, and other debilitating ail-ments.13 Oxidative stress has also been implicated in amyotroph-ic lateral sclerosis, Huntington’s disease, and ischemic andhemorrhagic stroke.14

A recent multicenter, phase II study by the Parkinson StudyGroup (see box entitled Resources) was led by principal inves-tigator Clifford W. Shults, M.D., professor of neurosciences atthe University of California, San Diego (in La Jolla) and chiefof the neurology service at the Veterans Administration SanDiego Healthcare System. Dr. Shults was following up on pre-vious research that detected CoQ10 deficits in the mitochon-dria of patients with Parkinson’s disease and in animal models

of Parkinson’s disease thatwere amenable to reversalwith oral CoQ10.15

This randomized, parallelgroup, placebo-controlleds tu d y , sp on s o r ed b y theN a t i o n a l I n s t i t u t e s o fHealth’s National Institute ofNeurological Disorders andStroke, involved 80 patientswith early stage Parkinson’sdisease at ten sites nation-w ide . The pa t ients , a l l o fwhom exhibited the trade-mark Park inson ’s diseasesymptoms of tremors, rigidi-ty, and slowed movements,and were not taking medica-tion yet, were divided intothree treatment groups and acontrol group. Subjects in thetreatment groups receivedeither 300 mg per day, 600 mg day, or 1200 mg per day of CoQ10along with vitamin E.‡ Patients in the fourth group received amatching placebo with vitamin E alone.

Patients were evaluated at baseline, then every 4 months,for 16 months with standard measures. While they all experi-enced deterioration in their conditions during the course ofthe study, the group that received the highest CoQ10 doseexperienced the least decline (44 percent less than patients inthe placebo group) in mental and motor functioning. Patientswho received the lower doses showed incrementally greaterfunctional declines in performing basic daily activities but stillperformed better than the placebo group. All of the treatmentgroup patients showed significant increases of CoQ10 in theirblood and tolerated the CoQ10 well. The most serious side-effects, reported by a few patients, were sore throats and sinusor viral infections. A larger study is planned, which will alsoexamine whether CoQ10 had, in fact, reduced nerve-cell dam-age.1,16

Until such a definitive study is done, Dr. Shults cautioned that:“It would be premature to recommend that patients with Parkin-son’s disease take high doses of coenzyme Q10.”17

Based on his research on Parkinson’s disease, Kedar N. Prasad,Ph.D., a researcher at the University of Colorado Health SciencesCenter, Denver, had, in 1999, proposed using an antioxidant“cocktail” of 200 mg per day of CoQ10 plus daily doses of naturalbeta-carotene (30 mg), D-alpha tocopheryl succinate (600 interna-tional units), vitamin C (4 g), and selenium (200 mg) to treatParkinson’s disease.13 At doses greater than 300 mg per day,CoQ10 can elevate serum aminotransferases.13 These side-effects,of course, must be weighed against the adverse effects of thestandard agents to manage the progressive symptoms of Parkin-son’s disease: ( i .e . , ant ichol inergics and dopaminergics ,pramipexole dihydrochloride, ropinirole HCl, pergolide mesy-late, selegiline HCl, and entacapone).18

ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 2003 113

†Personal communication from Chris D. Meletis, N.D.‡The CoQ10 used in the tr ial was suppl ied by Vital ine Formula ,Wilsonville, Oregon. Dr. Shults is the co-inventor of this compound andco-owner of the pending patent application.

Clifford W. Shults, M.D., Universi-ty of California, San Diego (in LaJolla) and Veterans AdministrationSan Diego Healthcare System.

AIDS According to Mutter, CoQ10 has been seen to enhance immune

function in patients with AIDS but there does not seem to be a lotof literature on this effect.19

Alzheimer’s Disease Because of CoQ10’s neuroprotective role as demonstrated in

Parkinson’s disease, it is also believed to be potentially useful forpreventing Alzheimer’s disease–related memory loss. The recom-mended dosage is 100 mg per day and the precautions are thesame as for Parkinson’s disease noted above.20

Autoimmune AsthmaA study that found decreased concentrations of CoQ10 in the

blood of patients with autoimmune asthma supports the rationalefor supplementation, given extensive evidence linking CoQ10with amelioration of other autoimmune conditions.21

Heart Disease Prevention and Treatment CoQ10 is highly concentrated in heart muscle because of that

that organ’s high metabolic activity and functions as a lipid-solu-ble inhibitor of low-density lipoprotein and lipid peroxidation.

According to Sheldon Saul Hendler, Ph.D., M.D., clinical professorof medicine at the University of San Diego, much of the interest inCoQ10’s therapeutic value has focused on cardiovascular disease.3

This antioxidant coenzyme has been used in Japan and elsewherefor treating such cardiovascular-related conditions as angina pec-toris, arrhythmias, congestive heart failure, lipid disorders, hyper-tension, and cardiotoxicity associated with the anthracyclinefamily of chemotherapy drugs, which includes doxorubicin.19

In a study of patients who have had acute myocardial infarc-tion (AMI) with a comparable extent of cardiac disease, subjectswho were treated with 120 mg per day of CoQ10 for 28 days (N =73) experienced a marked reduction in total cardiac events (15percent in untreated subjects versus 30.9 percent in treated sub-jects) and a lessening in incidences of angina pectoris, totalarrhythmias, and poor left ventricular function compared to sub-jects in the placebo group (N = 71). Blood levels of antioxidants(vitamins A, E, and C and beta-carotene), which were lower ini-tially in the subjects postAMI, increased to a greater extent withCoQ10 intervention, while levels of lipid peroxides and otherindicators of oxidative stress were reduced. The investigatorsconcluded that CoQ10 can provide protective effects for patientswho experience AMI if the supplement administered within 3days of the onset of symptoms.22

Studies showing benefit have generally used doses of 100 or150 mg per day. To produce a protective effect, it has been rec-ommended that patients take 50–150 mg per day and doses usedfor treating hypertension are said to range from 75 to 360 mg perday to “maintain a level CoQ10 level of 2 m/mL.”2

In peripheral artery disease, the recommended dosage forCoQ10 is 100–300 mg per day, along with other antioxidants,namely: a-lipoic acid (20–50 mg per day); vitamin C (500 mg perday); vitamin E (400–800 international units per day).23

Because CoQ10 is thought to increase exercise capacity as wellas strengthening the heart, this supplement has been prescribedby some physicians for patients with mitral valve prolapse. Forpatients who have coronary bypass surgery, pretreatment withCoQ10 may play a protective role.3

CancerIn a survey of 1356 North American naturopathic physicians

by the Bastyr University Cancer Research Center, Kenmore,Washington, antioxidants, in general, were used by 84 percent ofsuch practitioners for treating patients who had breast cancerand CoQ10 was used by 34 percent of these practitioners.24

For treating breast cancer, the dosage reported in most studieshas been 90–300 mg per day.25 An uncontrolled Danish clinicalprotocol treated 32 patients with node-positive breast cancer. Thepatients were given 90 mg per day of CoQ10 plus other (unspeci-fied) supplements in conjunction with conventional therapy pro-tocols. All of the patients survived at for least 24 months and 6patients had partial tumor regression. Complete remissionsresulted in 2 patients who were treated later with 390 mg per dayof CoQ10.26 The antioxidant action of CoQ10 may counteractpro-oxidants that promote cancer pathogenesis. However, CoQ10deficiencies have been noted in both malignant and nonmalig-nant tumors.27

114 ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 2003

ResourcesOrganizations

Parkinson Study Group (PSG)University of Rochester1351 Mt. Hope Avenue, Suite 220Rochester, NY 14620Phone: (585) 275-2585Web site: www.parkinson-study-group.orgThe PSG is a non-profit group of health care providers from

North American medical centers dedicated to patient care andresearch on Parkinson’s disease. Note: This address is that of theinstitution of the current PSG chair, Ira Shoulson, M.D., professor ofneurology.

BC Cancer Agency (BCCA)Suite 400, East Tower555 West 12th AvenueVancouver, British Columbia V57Z 3X7Phone: +1 (604) 877-6000 Fax: +1 (604) 877-6146Web site: www.bccancer.bc.caAs part of the Provincial Health Services Authority, the BCCA

provides comprehensive cancer care, support services, andinformation primarily for British Columbian healthcare professionalsand residents. The organization’s Web site states that the agencybelieves that there is a role for such ACM therapies in improvingpatients quality of life, and therefore, it provides objectiveinformation on supplements such as CoQ10.

Web sitewww.consumerlab.com

ConsumerLab.com is an independent laboratory that tests andreports on over-the-counter wellness and nutrition products to helphealth care professionals and consumers evaluate such products asdietary supplements, including information on the accuracy of theclaims and amounts of ingredients printed on the labels of theseproducts.

No toxicity or interference with conventional treatment wasobserved; in fact, CoQ10 has been used to mitigate the cardiotoxi-city of chemotherapy. Dr. Meletis noted that 50 mg day has beenused for treating doxorubicin-related cardiotoxicity. James S.Gordon, M.D., who was the first chair of the advisory council ofthe National Institute’s of Health National Office of Complemen-tary and Alternative Medicine, recommends CoQ10 as an adjuncttherapy because of its antioxidant and immune-enhancingeffects.28 Andrew Weil, M.D., chair of the University of ArizonaProgram in Integrative Medicine, Tucson, Arizona, recommendsthat patients who undergo chemotherapy take 300 mg per day ofCoQ10.4

However, it has not been proven that CoQ10 is effective as acancer treatment by itself.

Another caveat is that CoQ10 can reduce the response to sin-gle-dose tumor irradiation in xenotransplanted human small-celllung cancer tumors. The magnitude of this adverse effect, whichis dose-dependent, may justify a warning against concurrent useof CoQ10 during radiotherapy in such patients. A few studieshave also raised the possibility that CoQ10 may not stop, or mayeven promote, the growth of cancer cells.4 As of the end of 2002,no clinical drug researchers had filed the prerequisite Investiga-tional New Drug application with the Food and Drug Adminis-tration to study CoQ10 as a treatment for cancer.5

Diabetes A recent Australian study found that a total of 200 mg per day

of CoQ10, taken for 12 weeks improved glycemic control andblood pressure in patients with type 2 diabetes. The researchersnoted that the supplement produced a threefold increase inCoQ10 concentrations in the subjects and that its main effect wasto decrease systolic and diastolic blood pressure and HbA(1c)levels significantly.29

Mitochondrial DisordersAs noted above, a specific CoQ10 formulation (UbiQGel)

has Food and Drug Administration orphan drug status fortreating mitochondrial disorders,11 including Kearns-Sayresyndrome and myoclonic epilepsy with lactic acidosis andstroke-l ike episodes. Cit ing this orphan drug status, Dr.Meletis notes that this brand of CoQ10 appears to reduce thesymptoms of some patients with such genetic or acquired dis-orders if patients are given the supplement for 6 months.Quinones such as CoQ10 are the only agents that have provenefficacy for supportive management of mitochondrial respira-tory-chain defects.30

Muscle DisordersThe recommended dosage is 60 mg twice per day for treating

multiple sclerosis, the most common cause of chronic neurologicdisability in young adults.31 Veteran CoQ10 researcher Karl Folk-ers, Ph.D., and his colleagues at the University of Texas at Austin,recommend that patients who have muscle dystrophies (e.g.,Duchenne disease) should be treated with a minimum of 100 mgper day.3 According to Dr. Meletis, CoQ10 is also efficacious forpreventing statin-induced myopathy.

Periodontal Disease A deficiency of CoQ10 has been found in gingival biopsy tis-

sue from patients with advanced periodontal disease. A coupleof small-sample studies (one open-labeled and the other dou-ble-blinded) resulted in improvement from baseline. The exper-imental group in the latter study applied 25 mg of CoQ10topically twice per day for 3 weeks.2 Dramatic improvementswith CoQ10 were found in patients who could no longer eatsolid food because of the severity of their gum disorders. Aftertaking the supplement, patients were able to resume eatingsolid foods.3

Male InfertilityIn its role as an antioxidant, CoQ10 acts to prevent damage

caused by lipid oxidation in sperm-cell membranes and, thus, ispivotal to sperm motility. In a small-scale, uncontrolled studyof men whose sperm produced low in vitro fertilization rates,supplementation with 60 mg per day of CoQ10 for a mean of103 days resulted in significantly higher fertilization rates.2

F rom the i r ev a lua t i on o f th e semina l f l u id o f 7 7 men ,researchers at Catholic University in Rome, Italy, suggest thatassessing CoQ10 levels could be a valuable way of assessingand treating infertile men. Not only does CoQ10 have an inti-mate link to sperm viability but these researchers’ data revealthat CoQ10 levels are inversely related to such pathophysiolo-gies as varicocele, a condition in which there are distendedveins in the scrotum.3

Dermatologic/Cosmetologic ApplicationsInternet sites tout various topical antiwrinkle cream products

containing CoQ10, often along with other ingredients such asvitamin E, lavender floral water, or shea butter. One of the fewstudies on the efficacy of topical CoQ10 preparations for derma-tologic purposes was conducted on experimenta l animals.Because CoQ10, applied in an olive oil suspension, readily pene-trated the animals’ epidermis, the investigators concluded thatCoQ10 may be a good pharmacologic tool for such uses.32 Topi-cal application of CoQ10 may reduce wrinkle depth and oxida-tive DNA damage caused by ultraviolet A-radiation.2

ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 2003 115

Recommended ReadingProfessional literature

Mutter KL. Prescribing antioxidants [chapter]In: Integrative MedicineEdited by David Rakel Philadelphia: Saunders, 2003

Schults CW, et al., Effects of coenzyme 10 in early Parkinson’s disease: Evidence of slowing of the functional decline. Arch Neurol 2002;59(10):1541–1550

For professionals and their patientsMind Boosters: A Guide to Natural Supplements That Enhance Your Mind,

Memory, and MoodBy Ray Sahelian, M.D.New York: St. Martin’s Griffin, 2000

Conclusions

Research suggests strongly that aging and disease reduce thebody’s levels of CoQ10 and using supplements containing thisagent may raise the levels of this beneficial cell constituent insuch patients. Low-dose supplementation might therefore beconsidered as a preventive form of “health insurance.” To date,the majority of the research on CoQ10’s therapeutic potential hasfocused on Parkinson’s disease, cancer, and heart disease. GivenCoQ10’s central role in cell-energy production and the supple-ment’s demonstrated ability to brake progressive deterioration offunctioning in Parkinson’s disease, the usefulness of supplemen-tal CoQ10 in the other applications discussed also merits contin-ued investigation.

One nurse–practitioner who headed one of the multicenterParkinson’s disease study sites at Oregon Health & Science Uni-versity, Portland, Oregon, noted: “I’m very excited about theresults of this study” but “[y]ou can’t really say this is real untilyou go out and do this study with a larger group.”33

Further study of this coenzyme should also be pursued, givenits low toxicity and ability to ameliorate some of the serious side-effects of cancer chemotherapy. The jury is still out on CoQ10 sup-plementation for general health enhancement but recent researchresults will undoubtedly magnify scientific interest in, and con-sumer demand for, this supplement. n

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