Some of my patients take Coenzyme Q10 and they ask my opinion if this is a good supplement
to help their chronic pain. Today, I ll review the scientific
evidence of CoQ10 for pain and I ll give you my honest opinion if it works or not.
So, let s talk about CoQ10 today
Coenzyme Q10, or ubiquinone, is a vitamin-like substance, involved in the energy sources for
all the cells in the human body. Our body produces our own CoQ10, and it
is present in small, but adequate amounts, in our everyday diet. The natural sources of CoQ10 are
cold-water fish, meats, vegetable oils, whole grains and some fruits like avocado.
There are claims that people need a higher amount of CoQ10 to fix some health problems,
and they would need to take supplements which contain a much higher amount than what is found
in a regular healthy diet. Let s check if that is supported by scientific evidence or not.
I will only review the topics related to chronic pain.
I ll start by reviewing the scientific studies of CoQ10 for migraine prevention:
There are two studies showing that about half the patients benefitted
from a decrease in their migraines of around 50% after they used daily CoQ10 for 3 months.
CoQ10 supplements reduced both the severity and frequency of attacks.
A further study showed that it seemed to work well in children and adolescents.
A recent clinical practice guideline prepared in Canada by the Alberta Doctors recommend CoQ10
for the prevention of migraine in adults, but they acknowledge that this recommendation is based on
low-quality evidence and mostly on expert opinion. This Canadian Headache guideline
recommends using supplements of 100 mg three times daily, for a total of 300 mg per day.
If the person wants to find out if this works for their migraine,
they need to take daily for 3 months and chart their progress on a migraine diary.
If they don t see any benefit in the number of migraine attacks after 3 months,
then they should stop taking this supplement. That is why it is important to keep a diary and compare
the number of days that they had a migraine attack before and after the 3 months trial.
The second indication of CoQ10 is for muscle pain caused by cholesterol-lowering
drugs. These are medications called statins, and examples are atorvastatin and simvastatin.
The medical term for this painful condition is statin-induced myopathy.
This myopathy is caused by mitochondrial dysfunction due to lack of CoQ10. People who
are treated with statins have a 16 to 49% reduction in their blood levels of CoQ10,
and we know that supplementation with CoQ10 maintains a normal blood level.
You may be asking, why don t we just measure the amount of CoQ10 in the blood?
There is no use in testing the amount of CoQ10 in the blood, we don t do that because the levels of
this substance in the blood are not indicative of how much CoQ10 there is inside of the cells.
A recent meta-analysis published in 2021 included 8 studies in which 472 patients
with statin-induced myopathy were treated with oral CoQ10 or placebo. The authors
found no difference between CoQ10 and placebo. Despite these negative conclusions, there are
still some clinicians who recommend patients to take CoQ10 supplements to avoid muscle pain caused
by cholesterol-lowering drugs. I personally do not recommend it, but if the patient wants to try
for 3 months to find if their pain is reduced with this supplement, then it is fine with me. I tell
them that it is important they continue taking their statin medication, which is so important to
maintain their cholesterol levels in the normal range and avoid cardiovascular complications.
Is there a risk if I take too much Coenzyme Q10? While we still do not know the ideal daily dose,
the studies have used doses of CoQ10 ranging from 50 milligrams to 1,200 milligrams in adults,
split into 3 doses per day. A typical daily dose is 100 milligrams to 200 milligrams.
Co-enzyme Q10 seems remarkably free from side effects even when high doses are used.
There are minimal gastro-intestinal upset like stomach pain, diarrhea,
nausea, burning sensation in the mouth or loss of appetite.
People with chronic diseases such as heart failure, kidney, liver problems, or diabetes
should be cautious of using this supplement. CoQ10 may lower blood sugar levels and blood pressure.
So, it is not recommended to take if the person has a history of low blood pressure.
People taking thyroid medications, blood thinners or chemotherapy should check with their doctors
before using CoQ10 supplements. Given the lack of evidence about its safety,
CoQ10 supplements are not recommended for children or for women who are pregnant or breastfeeding.
What is a good brand of Coenzyme Q10? When you buy supplements, any type of supplements,
remember that they are not regulated the same way that medicines are, so they may say
that they contain certain quantities of substances but that is not accurate.
Manufacturers of natural health products can sell a product and claim health benefits without
having to obtain the same supporting evidence that would be needed if it were sold as a drug.
It is always a good idea to talk to your pharmacist to check if the source of CoQ10
is from a reputable manufacturer. Please, don t forget that this
video is for educational purposes only. If you have a condition that needs medical advice,
please talk to your doctor. And if there is an emergency,
go to the nearest emergency department. Below this video, in the description, there is
a link to a document that you can download and it summarizes all the content of this video.
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Goodbye