CoQ10: Ubiquinone vs Ubiquinol

Written by Dr. Jewel Alfoure, ND

What is CoQ10?

Q10 is a naturally-occurring enzyme that plays an important role in the production of energy in all body cells (apart from mature red blood cells). It is found in all tissues of the body, but its concentration is highest in mitochondria-rich organs including the heart, liver, and kidney. (1)

The human body naturally produces coenzyme Q10 and converts it to the form that it requires at any given time. However, the levels of this important compound decline with age. Some studies indicate a decline in production in age groups as early as 21 years old. Most research on CoQ10 has used the form of ubiquinone. (2)

Ubiquinol is the reduced, active form of CoQ10 and many hypothesize that it provides better efficacy, though clinical research demonstrates a different trend. Studies shows that that there is no statistical significance in the absorption of ubiquinol vs ubiquinone. Additionally, most of the impressive medical findings attributed to CoQ10 has been concluded from clinical trials using the ubiquinone form. (3)

What are The Different Forms of CoQ10?

CoQ10 can exist in three oxidation states. The first is ubiquinol, the completely reduced form. The second is an unstable radical semiquinone intermediate, and the third is a completely oxidized ubiquinone (CoQ10). (4)

Ubiquinone is the lipid-soluble form and is synthesized naturally in the body from basic building blocks like amino acids and fatty acids. It plays a key role in cellular energy production as well as several other biological processes. The absorption of the lipid-soluble form of CoQ 10 is more difficult as it requires a high efficiency lipid breakdown and absorption system.(5,6)

Ubiquinol is a water-soluble form and is found in some of our foods. Some claim that the water-soluble form has better bio-availability and, thus, is likely to work better in the body. Naturally, it would make sense to assume that a water-soluble form of CoQ10 has better bioavailability. After all, a water-soluble compound does not rely on the capacity to absorb fats (a complex process) to facilitate the success of nutrient absorption (7). 

Reviewing studies that compared the bio-availability of ubiquinone and ubiquinol shows that the absorbability was equal, but one study demonstrated a higher absorbability with the consumption of the ubiquinone form, while the other demonstrated a higher absorbability with the consumption of the ubiquinol form. (8,9,10)

Knowing that the highest-quality trials demonstrating CoQ10 efficacy were all conducted on the ubiquinone form, it would make more sense to attempt to improve the absorption of the active, most abundantly studied form of CoQ10.(11)

A CoQ10 in ubiquinone form that has the bio-availability advantage of a water-soluble CoQ10 is the best way to follow evidence-based medicine and address the issue of CoQ10s’ limited absorbability. (12)

Food Sources of CoQ10

As CoQ10 plays an important role in energy production, helping to turn nutrients into usable energy for the body, foods that are high in CoQ10 tend to be foods that are also rich in nutrients. 

Some of the most abundant sources of CoQ10 include foods like fatty fish, organ meats like liver and kidney, and nuts and seeds like walnuts and flaxseeds. 

CoQ10 can also be found in vegetables like broccoli, spinach and cauliflower. Though such sources are much poorer than animal tissues. (13)

Types of CoQ10 Supplements

Ubiquinone, more commonly known as CoQ10, is a powerful antioxidant that plays an essential role in supporting cardiovascular health. The cardiovascular benefits of supplementing with this important nutrient include improved quality of life, enhanced cardiovascular function and reduced mortality from heart disease.

Furthermore, research has shown that ubiquinone may help to prevent a wide range of cardiovascular events, including heart attacks, strokes, and angina. 

Overall, for anyone who wants to protect their heart health and improve their overall quality of life, it is clear that ubiquinone is an important supplement to consider. (14)

The Role of CoQ10 in The Body

Ubiquinone help to maintain a proper lipid profile by preventing lipid oxidation; it also helps to promote efficient cardiovascular health by regulating blood pressure and mitigating the accumulation of plaque in the arteries. 

Studies have shown that ubiquinone has numerous beneficial effects on health and may be a promising, potentially effective treatment for preventing atherosclerosis and other heart conditions.(15)

Coenzyme Q10 has been shown to be beneficial for kidney health, fertility, and beauty enhancement. The antioxidant properties of ubiquinone help to protect cells from damage and improve skin elasticity. The compound also helps to increase energy levels and improve circulation. Therefore, ubiquinone supplementation may be beneficial for those seeking to maintain good health as they age. (16)

The best way to obtain coenzyme Q10 is through dietary sources such as organ meats, salmon, and nuts. However, supplements are also available for those who are unable to get enough of the compound through diet alone, those who have poorer digestion/ absorption and those who have their CoQ10 stores continuously depleted.

Pharmaceuticals That Deplete CoQ10

Pharmaceuticals that deplete coenzyme Q 10 include statins, beta blockers, macrolides, and certain cancer treatments.

Statins are cholesterol-lowering drugs that work by inhibiting the enzyme HMG-CoA reductase, which is needed for the production of coenzyme Q 10 .(17)

Beta-blockers are used to treat hypertension and heart conditions by blocking the action of adrenaline. Evidence points towards the depletion of CoQ10 with beta-blocker use. On the other hand, macrolides are a class of antibiotics that includes erythromycin and clarithromycin. Though very different in indications, they also play a role at depleting CoQ10. 

Cancer treatments such as chemotherapy and radiation can also deplete levels of coenzyme Q10 . It is important to note that though some leukemia patients are shown to improve with coenzyme Q10 supplementation, some studies demonstrate negative findings when coenzyme Q10 is supplemented during cancer therapy (18, 19). Thus, it is very important to ensure that you consult a regulated healthcare provider who is well versed in coenzyme Q10 supplementation. (20)

While many may have encountered the information about coenzyme Q10 being an important supplement to combine with cholesterol-lowering medications, many may not know that cholesterol-lowering medications are only one class of drugs that deplete coenzyme Q10. Click here for a more detailed list of the medications that can deplete CoQ 10. While these drugs may be necessary for treating certain conditions, it is important to be aware of the potential side effect of coenzyme Q10 depletion. Supplementation with coenzyme Q10 may be recommended for patients taking these medications.

Conclusion

CoQ10 is an important nutrient for overall health, especially as we age. While getting CoQ10 from food is ideal, for some people it’s necessary to supplement with CoQ10 in order to maintain optimal health. If you are elderly or taking medications that actively deplete your CoQ10 levels, ask your doctor to test your levels and see if supplementation would be a good idea for you. Supplementing with CoQ10 has been shown to improve heart health, lipid profile, cognitive function, vitality, and physical appearance.