Coenzyme Q10 is a lipid-soluble antioxidant that is synthesized in the body and functions as a cofactor in ATP synthesis. It accepts and donates electrons during oxidative phosphorylation and also acts as an antioxidant. Due to its roles in energy production and antioxidant properties, Coenzyme Q10 supplementation has shown promise in treating cardiovascular diseases, neurodegenerative diseases, cancer, and diabetes, though more research is still needed to validate its therapeutic benefits.

1. By: Dr. Mohit Kulmi

2. • Coenzyme Q10 is a member of the ubiquinone family
of compounds.
• All animals and humans, can synthesize ubiquinones.
• The name ubiquinone refers to the ubiquitous
presence of these compounds in living organisms and
their chemical structure, which contains a functional
group known as a benzoquinone.

3. • Coenzyme Q10 is also a micronutrient.
• Coenzyme Q10 is soluble in lipids (fats) and is found
in virtually all cell membranes, as well as lipoproteins.
• The ability of the benzoquinone head group of
Coenzyme Q10 to accept and donate electrons is a
critical feature in its biochemical functions.
• Reduced form can act as an antioxidant. Rich sources
of dietary Coenzyme Q10 include mainly meat,
poultry, and fish.

4. • Other relatively rich sources include soybean and
canola oils, and nuts.
• Fruits, vegetables, eggs, and dairy products are
moderate sources of Coenzyme Q10 .
• Coenzyme Q10 was first isolated from beef heart
mitochondria by Dr. Frederick Crane in 1957.
• The precise chemical structure of Coenzyme Q10 was
determined by professor Karl Folkers and
collaborators in 1958.

5. The ubiquinone found in humans, ubidecaquinone or
Coenzyme Q10, has a "tail" of ten isoprene units (a
total of 50 carbon atoms) attached to its
benzoquinone "head“.
• The “Q” refers to the quinone chemical group and the
“10” refers to the 10 isoprenyl chemical subunits.
Also known as
• Ubidecarenone,
• Mitoquinone

6. Coenzyme Q10 can exist
in three states :
1. The fully reduced
ubiquinol form
(Coenzyme Q10 H2)
2. The radical
semiquinone
intermediate
(Coenzyme Q10 H·),
and
3. The fully oxidized
ubiquin one form
(Coenzyme Q10 ).

7. • Coenzyme Q10 is synthesized intracellularly using
tyrosine. This first step requires vitamin B6 as a
cofactor.
• Adequate vitamin B6 is essential for Coenzyme Q10
biosynthesis.
• Cells and tissues that are metabolically active have the
highest Coenzyme Q10 requirements (such as the
heart, immune system, and gingiva) and as such are
most susceptible to Coenzyme Q10 deficiency.

8. • Within the cell, coenzyme Q-10 is mostly present in
the mitochondria (inner membrane) (40-50%).
• The primary biochemical action of Coenzyme Q10 is
as a cofactor in the electron-transport chain.
• The conversion of energy from carbohydrates and fats
to ATP, requires the presence of Coenzyme Q10 in the
inner mitochondrial membrane.
Coenzyme Q10 :
• Accepts electrons from reducing equivalents and
• transfers them to electron acceptors.

10. • As an antioxidant and its role in ATP generation,
Coenzyme Q10 offers many therapeutic benefits.
• Coenzyme Q10 has been shown to help preserve
myocardial sodium-potassium ATPase activity and
stabilize myocardial calcium dependent ion channels.
• Since most cellular functions are dependent on an
adequate supply of ATP, Coenzyme Q10 is essential for
the health of virtually all human tissues and organs.

11. Lysosomal Function:
• Transports protons across lysosomal membranes,
• thus help to maintain the optimal pH for cellular
recycling.
Neutralize free-radicals:
– an effective lipid-soluble antioxidant
– continuously go through an oxidation-reduction
state

12. • Regenerate α-tocopherol from the α-tocopheroxyl
radical.
• Interact with dihydrolipoic acid.
– Dihydrolipoic acid reduces ubiquinone to
ubiquinol.
• Inhibit lipid peroxidation
– Occurs when cell membranes and low-density
lipoproteins (LDL) are oxidized.

13. Absorption:
• Same process as that of lipids.
• Absorption is lower on an empty stomach and higher
with foods, with high lipid content.
Distribution/Metabolism:
• Partitioned into various lipoproteins, with peak blood
levels occurring in 5 to 10 hours.
• Total body pool of Coenzyme Q10 is approx. 0.5 – 1.5
gms.
 Able to enter the brain.
Excretion:
• Elimination occurs through the bile, Elimination half-life
is 34 hours.

14. A Coenzyme Q10 deficiency could result from:
1. Impaired Coenzyme Q10 synthesis due to
nutritional deficiencies - such as vitamin B6
deficiency.
2. A genetic or acquired defect in Coenzyme Q10
synthesis or utilization.
3. Increased tissue needs resulting from a particular
illness.
4. Coenzyme Q10 levels decline with advancing age,
and this decline might contribute in part to some of
the manifestations of aging.

15. • Capsules,
• Chewable Tablets,
• Liquid softgel,
• Tablets,
• Can also be found in a number of skin products on the
market .

17. Typical dose for most conditions is 60-200 mg daily in
divided doses.
Some have experienced gastrointestinal symptoms:
• Nausea,
• Diarrhea,
• Appetite suppression,
• Heartburn, and
• Abdominal discomfort.

18. • There have been no reports of significant adverse side
effects of oral Coenzyme Q10 supplementation at
doses as high as 1,200 mg/day .
• These adverse effects may be minimized if daily doses
are divided into two or three doses.
• Because controlled safety studies in pregnant and
lactating women are not available, the use of
Coenzyme Q10 supplements by pregnant or breast-feeding
women should be avoided.

19. Warfarin:
• Concomitant use of warfarin (Coumadin) and
Coenzyme Q10 supplements has been reported to
decrease the anticoagulant effect of warfarin.
• If warfarin and Coenzyme Q10 are to be used
concomitantly, blood tests to assess clotting time
(prothrombin time; PT/INR) should be monitored
frequently, especially in the first two weeks.

20. HMG-CoA reductase inhibitors (statins):
• HMG-CoA reductase plays a critical role in the
regulation of cholesterol synthesis as well as
Coenzyme Q10 synthesis.
• Use of simvastatin ,pravastatin, lovastatin ,
rosuvastatin and atorvastatin has been shown to
decrease blood plasma levels of Coenzyme Q10 .
• Supplementing with Coenzyme Q10 is highly
recommended to prevent the myopathic side effects
associated with the statin drugs.

21. • Beta blockers - propranolol metoprolol,
• Phenothiazines and
• Tricyclic antidepressants have been shown to inhibit
Coenzyme Q10 -dependent enzymes.

22. Cardiovascular diseases:
• Numerous studies have investigated the benefit of
Coenzyme Q10 supplementation for improving
cardiovascular function via –
1. Enhanced energy production,
2. Improved contractility of cardiac muscle, and its
3. Potent antioxidant activity – particularly prevention
of LDL oxidation.

23. • A number of small intervention trials and a 2006
meta-analysis showed improvements in some cardiac
functions with supplemental administration of
Coenzyme Q10 in patients of CCF with significant,
improvement in left ventricular ejection fraction
along with conventional medical therapy.
• Pretreatment with Coenzyme Q10 provided some
benefit after CABG surgery .
• Coenzyme Q10 supplementation showed improved
exercise tolerance and reduced or delayed ECG
changes associated with myocardial ischemia.

24. Hypertension:
• Reduces blood levels of epinephrine and other
catecholamines – reduction of B.P. and protect the
vascular endothelium from free radical induced
damage.
Mitochondrial encephalomyopathies :
• Coenzyme Q10 supplementation has resulted in
clinical and metabolic improvement in some patients
with various types of mitochondrial
encephalomyopathies.

25. Cancer:
• Individuals with lung, pancreas, breast cancer ,
cervical intraepithelial neoplasia and cervical cancer
were more likely to have low plasma Coenzyme Q10
levels.
• Coenzyme Q10 supplementation may be beneficial as
an adjunct to conventional therapy for breast cancer.
• Coenzyme Q10 provides protection against
cardiotoxicity and liver toxicity in patients receiving
anthracycline chemotherapy drugs, doxorubicin.

26. Diabetes:
• Serum Coenzyme Q10 levels in type 2 diabetic
patients are often decreased and may be associated
with diabetic cardiomyopathy, reversible by
Coenzyme Q10 supplementation.
• Coenzyme Q10 shown to improve HBA1c .
Parkinson's disease :
• Coenzyme Q10 supplementation was associated with
slower deterioration of function in Parkinson's disease
patients compared to placebo.

27. Muscular Dystrophy:
• Deficiency of Coenzyme Q10 has been found in
muscle mitochondria of humans with muscular
dystrophy.
• Coenzyme Q10 treatment resulted in significant
improvements in cardiac output and stroke volume, as
well as increased physical well being.
Renal Failure:
• Coenzyme Q10 therapy reduced serum creatinine and
blood urea nitrogen (BUN) values and increased
creatinine clearance and urinary output in patients
with renal failure.

28. HIV/AIDS:
• Because Coenzyme Q10 enhances phagocytic activity
of macrophages and increases granulocyte
proliferation, its supplementation may be of benefit in
these patients.
• Coenzyme Q10’s antioxidant activity may also help
prevent AIDS-related diseases such as
cardiomyopathy and lipodystrophy that can be caused
by oxidative stress.

29. Other uses:
• Peridontal diseases,
• Radiation injuries,
• Gastric ulcers,
• Allergies,
• Migraine,
• Male infertility,
• Useful for weight loss in obese peoples.

30. • Coenzyme Q10 is an essential element of food that can
now be used medicinally to support the sick host in
conditions where nutritional depletion and cellular
dysfunction occur like cancer.
• Roles for Coenzyme Q10 supplementation in
cardiovascular diseases, neurodegenerative diseases,
cancer, and diabetes require further research.
• In keeping with the free radical theory of aging, these
antioxidant properties of Coenzyme Q10 have clear
implications in the slowing of aging and age related
degenerative diseases.

31. • Coenzyme Q10 is lipid-soluble antioxidant that is
synthesized in our bodies.
• It functions as a cofactor for ATP synthesis.
• It has antioxidants properties also.
• Helps in the prevention of lipid peroxidation and the
damage it causes.
• Due to its antioxidant properties it has a promising
role in the management of cardiovascular conditions,
neurodegenerative diseases, diabetes, mitochondrial
myopathies , HIV, Muscle dystrophies.
• Still more research and data is needed to validate its
definite beneficial effects in aforementioned
conditions.