CoQ10 dosage in capsule or softgel, 30 mg, 60 mg, safety and risks, does it help with hypertension or blood pressure, what about congestive heart failure?

March 28 2014

Dosage
CoQ10 is available in a variety of dosages ranging from 10 mg to 300 mg per capsule, but most commonly in 30, 50, and 60 mg. High doses are not needed, and may even be unhelpful or detrimental. We have had reports of fatigue when taking dosages above 100 mg. Just as we discovered that high doses of vitamin E, generally over 400 units, are not beneficial, or even potentially harmful, we may eventually discover the same about CoQ10. Try to limit your dosage to 50 mg or maximum 100 mg a day, unless for the temporary treatment of a medical condition. It is best taken in the morning, before or with breakfast.

CoQ10 is a naturally occurring nutrient found in each cell of the body. It was first identified by University of Wisconsin researchers in 1957. In addition to playing a significant role in the energy system of each of our cells, it is a good antioxidant. Many who take this supplement notice that this nutrient enhances energy and mental clarity. Alpha Lipoic Acid is another excellent antioxidant that can be taken in dosages less than 50 mg two or three times a week with a low dose of the coenzyme supplement.

What foods contain CoQ10?
This nutrient
is found in foods, particularly in fish and meats, and small amounts are found in nuts. There is little or none in grains, vegetables or fruits. Hence, some vegetarians and particularly vegans may not get adequate amounts of this nutrient, although, fortunately, the body is able to synthesize it when dietary sources are not adequate. Dietary intake is about 2 to 5 mg per day.

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For which conditions is it of benefit?
Studies with CoQ10 have mostly focused on its role in improving certain types of cardiovascular diseases, including congestive heart failure and hypertension. However, It may also benefit those with diabetes and Parkinson's disease.
Those on a vegetarian diet should consider taking a supplement. The benefits of this supplement in reducing blood pressure are not significant and cannot be relied on. There are more effective natural ways to treating hypertension. Idebenone is a synthetic analogue of coenzyme Q10.

Q. I asked my cardiologist if I should take CoQ10 and his response was that there was not enough history/research for him to suggest it. When I asked if it was ok to take, he didn’t say it would be harmful but avoided saying anything more.

Cholesterol and high lipids

Individuals on cholesterol medicines of the statin class such as Lipitor, Zocor, and others, may consider taking CoQ10 supplements since statins decrease blood levels. Some doctors are routinely advising their patients on statin drugs to take small amounts.

 

Coumadin or warfarin blood thinning medication
If i am on Coumadin for a long term (many years and the tests show it is still there) blood clot in my hip would coq10 be dangerous?
   We are not aware of any major role of CoQ10 in blood clotting or interaction with Coumadin, however this is the decision of your doctor to make.

 

Diabetes

CoQ10 may be beneficial in diabetics. It helps improve the function of endothelial cells lining blood vessels and may slightly help with blood sugar control.

Energy
Many people who take CoQ10 notice an increase in energy. But some are under the misconception that the more they take, the healthier they will be. Taking too high a dose may interfere with sleep and cause fatigue. Carnitine is a nutrient that increases energy levels.

Heart Attacks

In a small trial of patients with new myocardial infarction, CoQ10 -- used in addition to aspirin and cholesterol-lowering drugs -- decreased the likelihood of further cardiac events for at least one year after the heart attack.

 

Heart Failure

A study in patients with heart failure showed improvement in functional status, clinical symptoms, and quality of life in end stage heart failure patients who were placed on CoQ10. Hawthorn is an herb used for heart failure.

 

Heart palpitations, rhythm abnormalities
Q. Is the use of Q10 in cases of abnormal heart rhythm beneficial?
   A. There are several types of abnormal heart rhythms, including atrial fibrillation, premature ventricular contractions, sinus arrhythmia, etc. Each of them may have a different cause. As a general rule, we find fish oils and eating cold water fish to be more beneficial for abnormal heart rhythms. We have not seen much studies regarding the role of CoQ10 in arrhythmia control, but fish oils have been studied more extensively.

 

Ginkgo biloba
A Human trial shows Co Q10 and Ginkgo biloba do not influence the clinical effect of warfarin.

Infertility treatment and how to improve fertility
Coenzyme Q10 and male infertility.
J Endocrinol Invest. 2009.
Coenzyme Q10 is present in well measurable levels in human seminal fluid, where it probably exerts important metabolic and antioxidant functions. Alterations of CoQ10 content were also shown in conditions associated with male infertility, such as asthenozoospermia and varicocele. We therefore evaluated CoQ10 concentration and distribution between seminal plasma and spermatozoa in varicocele, before and after surgical treatment, and in infertile patients after rh-FSH therapy. The exogenous administration of CoQ10 increases both ubiquinone and ubiquinol levels in semen and can be effective in improving sperm kinetic features in patients affected by idiopathic asthenozoospermia.

Kidney disease
My mum is a renal patient and has haemodialysis 3 x week. Does COQ10 get metabolised by the kidneys or liver and in particular, would it get dialysed out? What is the half-life?
   CoQ10 has a long half life. Those who have renal conditions may wish to take no more than 30 mg a few times a week unless closely monitored by a doctor. It is metabolized in almost every cell of the body.

Peyronie's disease
I have a 90 degree curvature in my penis due to Peyronie's disease, will CoQ 10 supplement help?
   We have not seen such research and doubt it would be helpful.

Warfarin, drug interactions with prescription medications
The administration of CoQ10 and warfarin does not significantly affect the anticoagulant effect of warfarin in rats.

How does it work?
Cells break down sugars, fats, and amino acids to make energy. Small enclosures within cells that make this energy are called mitochondria. CoQ10 exists naturally in our mitochondria and carries electrons involved in energy metabolism. It is essential in the production of adenosine triphosphate (ATP), the basic energy molecule of each cell.
   In the bloodstream, it is mainly transported by lipoproteins such as LDL (low-density lipoprotein) and HDL (high-density lipoprotein). It is thought that CoQ10 is one of the first antioxidants to be depleted when LDL is subjected to oxidation. Hence, it is an important nutrient that prevents the oxidation of lipoproteins, thus potentially reducing the risk of arteries from forming plaques and getting damaged. In healthy individuals, it is found in high concentrations in the heart, kidneys, and liver.

CoQ10 side effects, safety, risks, and cautions, overdosage, toxicity
CoQ10 side effects on high doses can induce restlessness and insomnia. No major safety issues have been mentioned in research studies.
Long term side effects of high dose use are not clear at this time.
Overdosing could lead to irritability, restlessness, insomnia, and nausea.

I have been taking 200 mg per day for about 2 months now. I have developed a persistent cough that I cannot get rid of. I also have acid reflux and am coughing up a lot of mucus as well. Is it causing this problem?
   It's not easy to say without doing a full exam and review of medical history, but we have not such reactions reported to us yet.

I am a 40 year old female. I have been taking coenzyme q10 30mg for the last one yr. Recently I upped the dosage to 50mg. After about a week, I started experiencing insomnia. However I did not relate it to intake of Coenzyme 10 till I had already taken the supplement for a month. It has been 10 days since I stopped taking it. However my symptoms have not gone. I am still experiencing insomnia and high energy. Do you know how long it can take before the effects go away completely ?I've had cfs for about 4 years, and I have been taking 150mg of CoQ10 for over 6 months, but hadn't quite realised the potential link between the insomnia that struck me sometime after upping my dose. I have trialed not taking it for a couple days before, but noticed no improvement in my sleep so I assumed it wasn't the Q10. My question is: assuming the insomnia is related to CoQ10, how long could it take before this side effect of insomnia should go away, if I stop taking it? Would it more likely be days, weeks or months? The reason I ask, is so that I have some idea of how long to trial taking it.
   Each person is different but it may take a few weeks in some people. It is a good idea to stop all supplements along with any form of caffeine. Outdoor light exposure and outdoor physical activity will help with sleep.

Recommendations and review
CoQ10 is probably beneficial in cardiovascular conditions such as heart disease and this nutrient will likely be found to play some positive role in cognitive or neurodegenerative disorders, but more studies are needed. In the meantime, it would seem appropriate to supplement with this nutrient as part of a long-term health regimen, particularly for those with cardiovascular conditions. Long-term therapy with 10 to 50 mg seems to be a reasonable option for many individuals.

Absorption
Effect on absorption and oxidative stress of different oral CoQ10 dosages and intake strategy in healthy men.
Biofactors. 2005. Halberg Hospital and Research Institute, Moradabad, India.
In a randomized, double blind, placebo controlled trial 60 healthy men, aged 18-55 years, were supplemented with various dosages and dose strategies of coenzyme CoQ10 soft oil capsules (Myoqinon 100 mg, Pharma Nord, Denmark) or crystalline 100 mg powder capsules or placebo. After 20 days blood levels were compared and oxidative load parameters, malondialdehyde (MDA) and thiobarbituric acid reactive substances (TBARS) were monitored to evaluate bioequivalence. All the subjects were advised to take the capsules with meals. Blood samples were collected after 12 hours of overnight fasting at baseline and after 20 days of administration. Serum concentrations of CoQ10 (average for groups) increased significantly 3-10 fold in the intervention groups compared with the placebo group. Serum response was improved with a divided dose strategy. After 20 days intervention in the 200 mg group TBARS and MDA decreased, but the decrease was only significant for MDA. All supplementations increased serum levels. CoQ10 dissolved in an oil matrix was more effective than the same amount of crystalline CoQ10 in raising serum levels. 200 mg of oil/soft gel formulation caused a larger increase in CoQ10 serum levels than did 100 mg. Divided dosages (2 x 100 mg) of CoQ10 caused a larger increase in serum levels than a single dose of 200 mg.

I am considering buying your Coenzyme Q10 supplement but am concerned about absorbency. I ran across this graph on the Internet and was wondering if you knew where your version falls in this graph? It seems that the last four versions have completely different results, and I just don't want to waste my money on something that might not even be working in my system.
Compressed Tablets 0-3
Hardshell Caps (powder-filled) 0-3
Softgel Caps (oil suspension) 0-3
Chewable wafers 0-5
ChewQ wafers 75-80
Hydro-Q-Sorb (powder) 75-100
Q-Gel (softgel caps) 90-100
Q-Nol (softgel caps) 90-100
Liquid Q (Liquisorb) (aqueous nanodispersion)100 percent
    We have not seen studies in human comparing all the absorption rates of various types and the same time. Although some preparations that have oil immersion may be absorbed better, the differences are not too great and the chart shown above is misleading and you should request proof of a published study where the same group of humans were given the various forms at different times. To improve absorption of regular CoQ10 products that are in capsule form, one can consume them with food that has some fat or oil. One can improve absorption by taking the supplement twice a day instead of once daily.

 

Questions
Q. I feel confused with a newsletter I received today, which, among other things, refers to the positive qualities of CoQ10. Quote: CoQ10 is the single most important nutrient you can give you body. Your very life depends on it! To get that kind of protection, you need high-quality CoQ10 that’s easy to absorb. But reliable CoQ10 is hard to find… You can be certain PRIMAL FORCE CoQ10 has the highest potency of any CoQ10 available. In fact, it’s 3 TIMES more absorbable than “ordinary” CoQ10. Here’s why… Warning: Most CoQ10 Supplements are a Waste of Your Money! CoQ10 is so important; CoQ10 pills have sprung up everywhere. You might think the cheapest one is the best bargain. But in reality, they’re virtually worthless. For starters, the cheap stuff is synthetic. It’s not real CoQ10. It’s manufactured to look like CoQ10, but your body sees it as a “foreign substance” and will pass it the next time you go to the bathroom. And then there’s the “powder problem”… Most of the CoQ10 made today is in a powdered form before they put it into that pill or capsule. (PRIMAL FORCE CoQ10 is a patented liquid gel.) The majority of this CoQ10 is NEVER absorbed by your body. Check out this graph: Adapted from a 2004 study by Soft Gel Technologies, Inc. My PRIMAL FORCE CoQ10 is PROVEN 3 TIMES MORE ABSORBABLE than the typical powder form. And that means 3 times more in your blood and tissues!  For CoQ10 to be effective, it has to get into your blood and stay there. Only by raising your blood levels – and keeping them high – does CoQ10 have a chance to work its way into your organs where it performs its miracles. If the CoQ10 you’re using is never absorbed, it’s a complete waste! What’s worse, you’ll THINK that it’s doing something for you… When in fact, your body is still crying out for the CoQ10 it craves! So far, the Japanese process for making CoQ10 is the only tested, proven and reliable way to create the CoQ10 your body can actually use. Their patented system makes “bio-identical” CoQ10. This is exactly the same as the CoQ10 your body makes. Only CoQ10 using this system and giving it to you in a hyper-soluble liquid gel cap – can dramatically raise your blood levels of CoQ10. By special arrangement, you now have a reliable source of the world’s most potent and most bio-available CoQ10. Straight from Japan.
   A. One of the first ways to spot a scam in the nutritional field is when they claim their product is the best on the market. This type of misleading statements have been going on in the health industry as far back as we can remember.

Q. I am a vegetarian and take a statin drug for cholesterol. Physician Formulas advertises CoQ10 100 mg. For me the conflicting statements are as follows: CoQ10 is available in a variety of dosages ranging from 10 mg to 300 mg per capsule. I personally believe that high doses are not needed, and may even be unhelpful or detrimental. Just as we recently discovered that high doses of vitamin E, generally over 400 units, are not beneficial, or even potentially harmful, we may eventually discover the same about CoQ10. I would not feel comfortable recommending to my patients to take more than 50 mg or maximum 100 mg of CoQ10 a day, unless for the temporary treatment of a medical condition. The 100-mg dose of CoQ10, though, is too much since I feel too energetic and alert even in late evening when I want to slow down and get ready for sleep. I usually do not recommend more than 20 to 60 mg of CoQ10 on a long-term basis without medical supervision. Q. Do you think those taking statin drugs should take CoQ10? A. To be on the safe side, 50 mg CoQ10 can be taken a few times a week by those on statin drugs.
   So I am curious why Dr. Ray Sahelian says to take it daily and then only a few times a week. Then other times he admits that he lays off the supplements and herbs but not for how long. I have not done any other research into this area other than his. My family also has a history of high blood pressure, heart attacks, diabetes, and strokes but so far I have not had any symptoms. I get checked regularly for the diabetes and heart conditions. With palms folded^ Reverend, a Buddhist Monk.
   A. Since there is not enough human research with CoQ10, Dr. Ray Sahelian does not have a very strong opinion on the ideal daily CoQ10 dose. He understands that different people need different dosages. Some do well with no CoQ10, others may need 30 mg a day, still others 50 mg, and some patients may temporarily benefit from 100 mg of CoQ10 or more. There are no firm guidelines, the research with CoQ10 is not advanced enough to have a specific dosage that is good, hence the variations and fluctuations in thinking.

CoQ10: absorption, tissue uptake, metabolism and pharmacokinetics.
Free Radic Res. 2006. Tishcon Corporation, Westbury, NY 11590, USA.
Available data on the absorption, metabolism and pharmacokinetics of coenzyme CoQ10 are reviewed. Because of its hydrophobicity and large molecular weight, absorption of dietary CoQ10 is slow and limited. In the case of dietary supplements, solubilized CoQ10 formulations show enhanced bioavailability. The T(max) is around 6 h, with an elimination half-life of about 33 h. The reference intervals for plasma CoQ10 range from 0.40 to 1.91 micromol/l in healthy adults. With CoQ10 supplements there is reasonable correlation between increase in plasma CoQ10 and ingested dose up to a certain point. Animal data show that CoQ10 in large doses is taken up by all tissues including heart and brain mitochondria. This has implications for therapeutic applications in human diseases, and there is evidence for its beneficial effect in cardiovascular and neurodegenerative diseases.

Combining with dietary supplements, interactions
Q. Can a person take CoQ10 with Passion Rx?
   A. Both CoQ10 and Passion Rx have energizing properties, but if a low dose is used, such as a third of Passion Rx and 30 mg or less of CoQ10, it may be okay. Higher doses could lead to overstimulation.

Q. I have a friend that is so afraid to take supplements that when ever I give her a couple tablets to try, she always tells me they upset her stomach and then she admits she is afraid what they are going to do to her body. So I got her some Q10, 30mg caps and she took one for two days and then flushed the rest down the toilet as she was afraid her doctor would find out she was taking them and she would get into trouble. Then when she started feeling bad again, I told her to try a multi vitamin, she bought some but was sure after one tablet she was having heart problems from the vitamins, so I told her to ask her doctor for a prescription of which were prenatal vitamins which she took successfully and felt that they were helping her and she continues to take them! Funny how some people fear anything unless its given to them by their doctors.

Q. Can a normal healthy person start taking CoQ10 with his or her diet on regular basis like other multi Vitamins without any harm full side effect. Other hand if your body don't need CoQ10 but you are taking and it won't hurt your body or do any damage.
   A. There is no easy answer to this. Some people may benefit from taking CoQ10, others may not. Much depends on a person's diet and metabolism. If a person wants to take CoQ10, 30 mg a few times a week could offer benefits without any foreseeable side effects.

Q. I read with avid interest your comments on CoQ10.This is my first time at your site and found it very interesting and informative. I have quite an opposite reaction to CoQ10 and whatever the dose I take, it makes me sleepy. I like the benefits though so I still take it. No matter how alert or active I feel, once I take the 50 or 100mg dose, I sleep off in 10mins or less. For me, it's basically a sleeping pill; but then I have to add caffeine does not give me insomnia either. Is it me then?
   A. Almost everyone notices being more energetic after taking CoQ10, however there are individuals who have uncommon reactions to supplements and medicines.

Q. You seem to be pretty critical of high dose CoQ10. I took a Spectracell test that revealed I am functionally deficient in CoQ10. I do not take statins. What is someone who is CoQ10 deficient to do in terms of supplementation when the SpectraCell test shows a low CoQ10?
   A. We are not convinced a Spectracell test is an effective way to determine CoQ10 deficiency. If blood tests do show CoQ10 deficiency, one can increase food intake that has CoQ10 or take a 30 mg CoQ10 supplement. It would be best to confirm CoQ10 blood levels with another doctor and with another type of blood test. If deficient, you can ask your doctor to read the page on CoQ10 and guide you as to proper dosage. We wish you well. 

Q. I have recently started taking a herbal blend containing L Argenine, Damiama, tongkat ali, Ginkgo and Ginseng. I also take a multiple, calcium, mag and zinc fish oil and CO Q10 supplement. Is it OK to take all this at the same time or will it be dangerous to take the COQ10 supplement at the same time as the new herbal supplement?
   A. Much depends on your overall health and the dosages of the supplements being taken. Each person has a different response and no generalizations can be given. It is best to first learn how each supplement is making you feel by itself before combining.

Does 100 mg CoQ10 product contain any Vitamin E or Vitamin E equivalents? My heart doctor said recent studies have shown that Vitamin E is bad for the heart, etc., so I stopped taking it on his advise. Is your 100 mg CoQ10 product water soluble or only fat soluble? Apparently, if the kind of CoQ10 is in the form that is not water soluble but only fat soluble, then much of it will not be absorbed in the body. Perhaps in this case, one could take a higher dosage of the fat-only soluble type to get the same affect as taking a lower dosage water-soluble type. I take 80 mg of Lipitor daily, so I'm depleting my CoQ10 in my body. I'll need to take a higher dosage of CoQ10 to replace what I am depleting, especially if the type of CoQ10 is NOT water soluble.
   When coq10 is taken with a meal, such as breakfast, it is absorbed quite well since there is fat in the meal. Studies with vitamin E and heart have not been conclusive, and it is possible that very high doses may not be heart healthy, but we are talking about more than 200 units. Most CoQ10 supplements have only a few mg of vitamin E. Our CoQ10 product does not have vitamin E.

Dr. Donsbach sells a liposomal product, vitamin C and CoQ10 claiming it is like taking it intravenously. He also states that when other products are taken one gets very little benefit, say 10-30% of dosage. Liposomal yields a much higher dose from little. An ex: 1 oz. of coq 10 yields 83 mg where if one took 100 mg of a regular coq 10 they may get 10-30 mgs. Also 1 oz. of his vit c yields 1667 mgs of vitamin c !! Are you familiar with Liposomal ? Is it worth the extra dollars, seems like it is if what Dr. Donsbach states is true, though if so, it may be cheaper.
    Taking a CoQ10 supplement with food allows it to mix with fat and absorb well. We have not seen any evidence that taking a liposomal CoQ10 is any healthier than taking a regular CoQ10 capsule. However, there are many different viewpoints on this topic.

I am sensitive to doses and I have found, in the past, that the usual market doses are too strong for me. For example, I use to take Co-enzyme Q10 30 mg everyday but found after a few days it was too stimulating. So I resorted to taking it every second day but I would prefer taking a smaller dose, say 10 mg, everyday. The same thing with R Alpha Lipoic acid. I would like trying a dose of about 5 mg to begin with but the smallest dose available is 50 mg. Can the capsule be emptied into a container with, say orange juice, and mixed and consume a prescribed fraction of that juice each day. Or will putting these supplements into a juice and leaving in the refrigerator for a few days destroy the supplement? Can you give me guidance on how to lower the dosage for both Co-enzyme Q10 and R Alpha Lipoic acid.
    Yes, it is certainly okay to open a capsule of a supplement and use a portion. I would say for most supplements it should not be a problem to keep them a few days in juice in the refrigerator although I would prefer not much longer. Another option is to open a capsule, pour out some of it, and then close the capsule again. Many capsules can be opened by twisting and pulling on each end. I encourage people who are sensitive to open capsules or break tablets and use smaller amounts. One of the most important things to know about taking medication or supplement pills is that there is a wide range of dosages that are appropriate. For instance, we have had feedback from Passion Rx users that a third of a capsule works for some people whereas others say they need a capsule and a half or two capsules to notice an effect.

I am a 31 year old Male Aussie Expat who is currently living in Qatar. I have been using CoQ10 for several years and currently take 200mg a day. I use the CoQ10 for arrhythmias and HOCM. I have noticed wonders in terms of the change in my heart function, I have less episodes of arrhythmias and feel a lot fitter and healthier.
I do notice there is a difference of CoQ10 between brands. I use one from GNC which seems to be more effective. When I take other ones I automatically notice a difference. There are a few side effects, I do notice mild insomnia and been a bit restless, however compared to the side effects of beta blockers (which is the other alternative) they are quite minimal. I get blood tests every three months to check on things, the only change I have noticed is enzymes in my liver seem a bit higher but not abnormal. Just wanted to give my feed back! Cheers

Is it true that if a cap of COq10 is opened and it is bright orange, it is already oxidized and will not perform the healthful effects intended? Therefore one should take ubiquinol if one is over 25 yrs. of age.
    We don't have any reason to believe it will not be effective, and a person's age should not be a major factor in deciding which form of coq10 to take.

I am taking "Chews for Health". Dr. Friedman's 1-800-213-0512. Are they as good for you as the radio advertisements say? Also I am thinking of ordering CoQ10 Max that I have been hearing about on the radio. What do you know of this. The tel. no. is 1-800-727-2001. Also I am thinking of ordering "Cal Mag" tel. no. 1-800-572-1076 for sleep and other things calcium is good for. Would you please give me your opinion of these three supplements. I am generally in good health. don't take any drugs and don't have health issues. I Take supplements for prevention.
    We prefer not to comment on products made by other companies.

Is there any difference between "crystal free" coQ-10 and one that is not? Please explain.
    This term was searched in Medline, the online science research database, and no such term came up. We suspect it is a term made up by a company and has no real meaning.

I am a 30 year old female who suffers from migraines for the pass 10 years. I am also a new mother who is tired all the time. I wanted to know if there is a difference in taking TOCOQ10 vs COQ10. I plan on taking 30 mg of it. I also plan on taking New Chapters Organic Woman daily multivitamin, Migrelief and I wanted to add another nutrient that would increase energy, as well as be beneficial to the deduction of my migraines. Do you think 30 mg is best for me and if so, which one? I'm very overwhlemed by all of the information out there and it's becoming a hard decision to make. Any information that you can pass along to me would be very appreciated.