“Should I take coenzyme Q10 with a statin?” This question often comes up in searches about coenzyme Q10, a molecule our body makes itself and which supplements offer in two forms: ubiquinone and ubiquinol. This guide compares the forms and explains what trials actually show, including the figures, limitations and precautions.
Key takeaways
- The body makes coenzyme Q10 through the same pathway as cholesterol; food supplies only 3 to 6mg per day.
- Ubiquinone and ubiquinol are two forms of the same molecule, which the body converts into each other; studies comparing their absorption disagree.
- Statins: a meta-analysis of 12 trials finds less muscle pain, while another, covering 7 trials, finds no benefit.
- No health claim is authorised for coenzyme Q10; seek medical advice if you take an anticoagulant or blood-pressure medicine.
What is coenzyme Q10?
Coenzyme Q10 is a fat-soluble molecule present in almost all our cells. Its name describes its structure: a quinone-type ring, the “Q”, and a chain of 10 units called isoprenes. It is not a vitamin: a healthy body makes it itself, from amino acids and mevalonate.
It exists in two forms: ubiquinone, the oxidised form, and ubiquinol, the reduced form, carrying two more electrons. The molecule constantly moves between these forms: this back-and-forth is what makes it work.
Mevalonate is also the starting point for cholesterol. By blocking an enzyme in this pathway, HMG-CoA reductase, statins slow the production of both cholesterol and coenzyme Q10, lowering the latter's blood level.
What does coenzyme Q10 do in the body?
Its first role takes place in mitochondria, the cells' power plants. In the respiratory chain, coenzyme Q10 picks up electrons from complexes I and II and delivers them to complex III. This flow helps produce ATP, the cell's energy molecule. Complex I receives its electrons from NADH, as explained in our article on the difference between NAD+ and NADH.
Its second role is antioxidant. As ubiquinol, it protects membranes and blood lipoproteins against fat oxidation and helps keep vitamins E and C in their active forms (see our feature on oxidative stress). Unlike water-soluble glutathione, it acts in the fatty parts of the cell.
Where is coenzyme Q10 found?
In the body, energy-demanding organs such as the heart, kidneys, liver and muscles contain the most, as does the pancreas; the lungs contain the least. Tissue levels fall with age, like NAD+ in some tissues, but the role of this decline in ageing remains debated.
From food, the average intake is only 3 to 6mg per day, mainly from meat. Fish, nuts and some oils are also good sources. Fruit, vegetables, cereals and dairy products contain just 0.01 to 0.3mg per 100 g. Clinical trials generally test 90 to 390mg per day, tens of times more.
Ubiquinone or ubiquinol: which form should you choose?
Since the body constantly converts one form into the other, the real question is absorption. Coenzyme Q10 circulates in the blood mainly as ubiquinol: around 85% of the total in participants in the first trial below. The small comparative studies disagree:
- In favour of ubiquinol: in 10 older men in a double-blind crossover trial, 200mg per day for 2 weeks increased blood coenzyme Q10 from 1.3 to 3.4 µmol/L with ubiquinol; the increase was not significant with ubiquinone.
- No clear winner: in 14 young adults, 7 products containing 100mg were tested in turn. Their absorption varied considerably; the two best were soft capsules, one containing ubiquinone and the other ubiquinol. Oil and excipients influenced the result, and differences between participants were substantial.
These studies measure a blood level, not a health benefit. The German Federal Institute for Risk Assessment (BfR) also considers that evidence is still lacking for a detailed assessment of the risks of each form.
| Criterion | Ubiquinone | Ubiquinol |
|---|---|---|
| Nature | Oxidised form | Reduced form |
| Role in the cell | Receives electrons | Donates them; antioxidant form |
| Share in blood | Minority | Around 85% |
| Compared absorption | Lower in one trial, equal in the other | Higher in one trial, equal in the other |
Why take it with a meal?
Because it is fat-soluble. Absorption is slow and limited: only a fraction of the dose reaches the blood, while the rest leaves in the stools. It is absorbed better with fat, and oil-based preparations are absorbed better than the purified molecule. This explains the interest in soft capsules, in which it is dissolved in oil.
Coenzyme Q10 and statins: what do meta-analyses say?
Since statins lower coenzyme Q10, taking it to ease the muscle pain they sometimes cause seems logical. Yet meta-analyses reach opposite conclusions:
- A favourable effect: in 2018, an analysis of 12 trials with 575 patients observed less muscle pain, weakness, cramps and fatigue with 100 to 600mg per day for 1 to 3 months. Creatine kinase, a marker of muscle injury, did not change, and results varied considerably between trials.
- No effect: in 2020, an analysis of 7 trials with 321 patients, all experiencing pain while taking a statin, found no benefit for pain or continued treatment.
Small trials and differences in patient selection may explain these discrepancies. Pain while taking a statin warrants a discussion with your doctor; never stop this treatment on your own.
Benefits attributed to coenzyme Q10: what do trials show?
Heart failure: a single trial requiring confirmation
In 420 patients with moderate to severe heart failure, 300mg per day was compared with a placebo for 2 years, in addition to usual treatment. The outcomes measured at 16 weeks did not change significantly. At 2 years, 15% of patients taking coenzyme Q10 had experienced a major cardiovascular event, compared with 26% taking placebo. This result rests on one trial, partly funded by a manufacturer. It needs confirmation and remains a research topic, not a treatment to administer to yourself.
Blood pressure: no clear effect according to the Cochrane review
The 2016 Cochrane review could pool only 2 trials with 50 participants with hypertension; a third was considered too biased. The 3.7 mmHg reduction in systolic pressure was not significant. With moderate-quality evidence, the authors concluded there was no clinically important effect on blood pressure. Hypertension requires medical follow-up.
Migraine: a slight effect in trials
A meta-analysis of 6 trials with 371 adults with migraine, taking 30 to 800mg per day for at least 6 weeks, observed an average of 1.5 fewer attacks per month than placebo. The evidence was of moderate quality, but there was no clear effect on pain intensity. Frequent migraines warrant medical follow-up.
Male fertility: results driven by combinations
A meta-analysis of 9 trials with 781 men with unexplained infertility measured higher sperm concentration (+10 million per mL) and slightly better motility (+5 percentage points) after 3 to 6 months or longer. Given alone at 100 to 200mg per day, coenzyme Q10 did not significantly improve these measures. The meta-analysis reported more pregnancies, but in only 2 trials testing combinations rich in carnitine. An effect on the couple's fertility is not established. Difficulty conceiving warrants a medical assessment of both partners.
Fatigue and exercise: inconsistent results
A meta-analysis of 13 trials with 1,126 participants over 4 to 24 weeks found a modest reduction in fatigue scores, more evident with higher doses and longer durations, but not significant in healthy people. For exercise, a meta-analysis of 24 trials in healthy adults concluded that coenzyme Q10 does increase its blood level, but improves performance only slightly and inconsistently, with low to very low-quality evidence.
Coenzyme Q10: what risks and contraindications apply?
Coenzyme Q10 is well tolerated: no serious toxicity has been reported. Up to 300mg per day, occasional digestive complaints such as nausea, heartburn and diarrhoea, and rare skin rashes, have been described. Well-conducted trials have used up to 1,200mg per day, but the BfR stresses that it is unknown whether adverse effects become more frequent above 300mg.
The main precautions concern interactions:
- Vitamin K antagonist anticoagulants, such as warfarin: coenzyme Q10 can reduce their effect. The BfR advises seeking medical advice before taking more than 100mg per day.
- Blood-pressure medicines: the interaction is poorly studied; the same advice applies above 100mg per day.
- Cancer treatment: do not take antioxidants without the treating team's agreement. In women receiving chemotherapy for breast cancer, antioxidants, including coenzyme Q10, were associated with a non-significant trend towards more recurrences.
What can a coenzyme Q10 supplement claim?
No health effect: no claim is authorised for coenzyme Q10 in the European Union. In 2010, EFSA examined applications concerning energy metabolism, blood pressure, protection against oxidation, cognitive function and endurance, among others, without considering any demonstrated.
Frequently asked questions
When should you take coenzyme Q10: morning or evening?
The meal matters more than the time. Since mild insomnia has been reported in some people from 100mg per day, taking it in the morning or at lunchtime is a cautious choice. At high doses, some trials divide the dose, as in the heart failure trial, with 3 doses of 100mg.
Does coenzyme Q10 lower cholesterol?
This is not demonstrated. It shares its production pathway with cholesterol and circulates with it in lipoproteins, but EFSA has recognised no effect of coenzyme Q10 on blood cholesterol. Our article on berberine reviews another molecule studied in this area.
Can you take coenzyme Q10 during pregnancy or breastfeeding?
Studies are lacking in pregnant and breastfeeding women, as well as children and adolescents. The BfR therefore recommends avoiding it or consulting a doctor first. In Germany, a 2014 decision allowing supplements up to 100mg per day required a warning directed at these groups.
Does coenzyme Q10 deficiency exist?
According to the BfR, no deficiency requiring treatment is known in the general population. However, rare primary deficiencies of genetic origin do exist and may affect the kidneys or nervous system. Blood testing is available, but values described as normal vary across studies, from 0.30 to 3.84 µg/mL.
Should you take coenzyme Q10 as you age?
There is no requirement to do so: the BfR considers that a healthy person eating a varied diet makes enough. A Swedish trial in around 440 older people combined 200mg of coenzyme Q10 with 200 µg of selenium for 4 years. The observed reduction in cardiovascular mortality cannot be attributed to coenzyme Q10 alone.
Coenzyme Q10 and diabetes: what precautions apply?
Coenzyme Q10 might reduce insulin requirements. If you use insulin, discuss it with your doctor and monitor your blood glucose. A 2015 meta-analysis of 7 trials in 356 people with diabetes found only a reduction in triglycerides; a 2026 analysis of 39 trials noted a slight reduction in fasting blood glucose, with very low-quality evidence.
Conclusion
Coenzyme Q10 is essential for mitochondria and membrane protection, but a healthy body can make it. Between the two forms, ubiquinol has no consistent advantage over well-formulated ubiquinone: oil, excipients and taking it with food matter as much as the form. Trials mainly involve people who are ill or receiving treatment, with modest or conflicting results. No health claim is authorised, and medical advice is essential if you take anticoagulants, blood-pressure medicines or cancer treatment.
Sources
- Hernández-Camacho JD et al. (2018). Coenzyme Q10 Supplementation in Aging and Disease. Frontiers in Physiology, 9, 44. doi:10.3389/fphys.2018.00044
- NIH, National Cancer Institute (2024). Coenzyme Q10 (PDQ) – Health Professional Version. PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, updated 31 October 2024. cancer.gov
- BfR, German Federal Institute for Risk Assessment (2023). Coenzym Q10: Was ist über gesundheitliche Risiken bekannt – und was nicht? [Coenzyme Q10: what is known, and what is not known, about health risks]. Questions and answers. bfr.bund.de
- Zhang Y et al. (2018). Ubiquinol is superior to ubiquinone to enhance Coenzyme Q10 status in older men. Food & Function, 9(11), 5653-5659. doi:10.1039/c8fo00971f
- López-Lluch G et al. (2019). Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition, 57, 133-140. doi:10.1016/j.nut.2018.05.020
- Qu H et al. (2018). Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. Journal of the American Heart Association, 7(19), e009835. doi:10.1161/JAHA.118.009835
- Kennedy C et al. (2020). Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis. Atherosclerosis, 299, 1-8. doi:10.1016/j.atherosclerosis.2020.03.006
- Mortensen SA et al. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC: Heart Failure, 2(6), 641-649. doi:10.1016/j.jchf.2014.06.008
- Ho MJ et al. (2016). Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database of Systematic Reviews, 3, CD007435. doi:10.1002/14651858.CD007435.pub3
- Sazali S et al. (2021). Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine—a meta-analysis. BMJ Open, 11(1), e039358. doi:10.1136/bmjopen-2020-039358
- Bakri S et al. (2026). Efficacy and Safety of Coenzyme Q10 in Idiopathic Male Infertility: A Systematic Review and Meta-Analysis of Randomized Trials. The World Journal of Men's Health, 44(4), 829-843. doi:10.5534/wjmh.250159
- Tsai IC et al. (2022). Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Pharmacology, 13, 883251. doi:10.3389/fphar.2022.883251
- Deng H et al. (2026). Coenzyme Q10 supplementation increases blood concentrations but shows limited and inconsistent effects on exercise performance: a systematic review and meta-analysis. British Journal of Nutrition, 135(7), 674-694. doi:10.1017/S0007114525106211
- EFSA Panel on Dietetic Products, Nutrition and Allergies (2010). Scientific Opinion on the substantiation of health claims related to coenzyme Q10 and contribution to normal energy-yielding metabolism (ID 1508, 1512, 1720, 1912, 4668), maintenance of normal blood pressure (ID 1509, 1721, 1911), protection of DNA, proteins and lipids from oxidative damage (ID 1510), contribution to normal cognitive function (ID 1511), maintenance of normal blood cholesterol concentrations (ID 1721) and increase in endurance capacity and/or endurance performance (ID 1913) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal, 8(10), 1793. doi:10.2903/j.efsa.2010.1793
- Collares LDN et al. (2026). The effects of coenzyme Q10 supplementation on glycemic control in diabetic and non-diabetic individuals: a systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition, 66(22), 4187-4209. doi:10.1080/10408398.2026.2624477
Food supplements do not replace a varied, balanced diet or a healthy lifestyle. Ask a healthcare professional for advice if you are taking medication, pregnant or breastfeeding.
