By Richard G. Boles, M.D.
Updated January 2020.
Overview: Coenzyme Q10 (CoQ10) is an essential electron carrier in the respiratory chain, where almost all of the energy for the body is produced. It also functions as an antioxidant, which protects the body from damage caused by harmful molecules. Many chronic conditions, especially those involving mitochondrial function, can increase the demand for CoQ10 in the body, leading to deficiency. Having been a mainstay of the mito-cocktail in the treatment of mitochondrial disease for decades, many physicians now recommend CoQ10 supplementation for a variety of different medical conditions. One study in children with autism reported that significant improvements were noted using CoQ10, including in communication and social skills as well as sleeping. However, the role of CoQ10 in the treatment of autism is mostly driven by its antioxidant properties in ameliorating an underlying metabolic, redox, or mitochondrial condition. CoQ10 is also sometimes recommended for treating a wide range of other conditions, especially heart disease and migraine. Given the above and its tolerability (side effects are rare and mild), many expert physicians recommend CoQ10 in their patients, especially in those with signs of mitochondrial dysfunction and/or manifestations of migraine or chronic pain.
Disclosure: This article is the product of the research, experiences, and opinions of the author. Dr. Boles has used CoQ10 supplementation has a key aspect of his medical practice since the early 1990s. Dr. Boles’ opinion of the clinical merits of CoQ10 supplementation was strong enough that NeuroNeeds® (a company he helped start and maintains a financial interest in) now markets its own brand of CoQ10 (ubiquinol form) called QNeeds®. Despite periodic updates, new CoQ10 products are a common occurrence in the market, and now all such products, new or otherwise, are known or have been evaluated by the author.
What Form of CoQ10 is Best? CoQ10 comes in two forms, ubiquinone, the oxidized form, and ubiquinol, the reduced antioxidant form. Both forms can easily be processed into the other by the body through either the loss or gain of electrons. Ubiquinone is the original and more clinically tested form, as well as the form that is in most dietary supplements. Many claim that ubiquinol has better gut absorption and that a much lower dose is required. One study demonstrated that a form of ubiquinol was absorbed five times better than a standard ubiquinone product (https://www.neuroneeds.com/wp-content/uploads/2019/08/CoQH_JFF-2009_KGK-STUDY.pdf). Additionally, ubiquinol likely has better penetration into brain, which is a good argument for the use of this form in the nutritional supplementation of individuals with autism and in any other condition involving the brain.
What Are Good Sources of CoQ10? Although CoQ10 is present in essentially all foods, the amounts are small and boosting CoQ10 levels is performed by dietary supplements. CoQ10 is not water soluble, and absorption from the intestines is difficult and highly dependent on the brand and form. There are many brands of CoQ10 on the market, yet in Dr. Boles’ experience most of them are poorly absorbed, in that even extremely high doses do not lead to desired blood levels. In Dr. Boles’ experience, some products result in improved blood levels and clinical effects than other products. In particular, ubiquinol consistently outperforms ubiquinone, and thus, Dr. Boles recommends that his patients take ubiquinol.
Adverse (Side) Effects: These are rare with CoQ10, mild, and reversible upon stopping/lowering the dose:
- A minority of individuals have sleep difficulty if CoQ10 is provided at bedtime, which generally responds to moving the dose earlier.
- A minority of individuals are “hyper-energized”, which generally responds to dose reduction, and/or the addition of “calming” supplements (for one suggestion, see https://www.neuroneeds.com/product/calmneeds).
How Do I Learn More? See what else Dr. Boles wrote regarding CoQ10, including references regarding treatment usage, at:
Read about the other 32 ingredients in, as well as what is not in, SpectrumNeeds® at:
The Caveats: The above are Dr. Boles’ general practice considerations that may or may not apply to any individual. More information is available on the NeuroNeeds.com website, including some of the literature that supports these suggestions. However, these suggestions are based also in large part on empirical clinical observation (what seems to work in Dr. Boles’ practice). Not all information is provided, or possibly could be, in the above summary. Note, that dosing information is provided per dose, with twice daily administration. The total daily dose is double the figures suggested above. Start low and work up to the desired dosing, and do not start two products at the same time. As always, consult your physician. In particular, dosing for infants to preschool children is more difficult, and should be provided by your physician.
Disclosure: Dr. Boles is the Chief Medical & Scientific Officer for NeuroNeeds LLC, the start-up company that makes SpectrumNeeds®, QNeeds®, and CalmNeeds®. As such, he may receive financial compensation based upon by efforts and/or the success of the company. You are under no obligation to purchase these or any products, whether recommended by Dr. Boles or another health care provider. As always, it is recommended that you contact your physician regarding these products and all other changes to disease management.