CoQ10
What is CoQ10?
Coenzyme Q10 (CoQ10) [pronounced Co-Q-Ten] is an antioxidant that assists in energy production in our cells, heart health, and mitochondrial disease. In relation to autism, research has shown that supplementation with CoQ10 can improve symptoms of mitochondrial dysfunction.
Antioxidants are molecules that help to fight or neutralize free radicals produced within our bodies. As our bodies break down food and react to our environment, free radical waste products are produced.
When there are too many free radicals and not enough antioxidants, oxidative stress can occur which damages our cells, DNA, and organs. Oxidative stress has been linked to accelerated aging, many diseases, and autism. [1] In short, antioxidants help to keep our bodies well and healthy.
Research suggests that oxidative stress (and CoQ10 oxidation rates) among those with autism is higher than typically developing children. [10]
CoQ10 is also known as ubiquinone, semiquinone, and ubiquinol. All of these names refer to different forms of the same molecule. Our bodies convert CoQ10 to ubiquinol because ubiquinol is the active form of the nutrient.
Young, healthy bodies have an easier time making this conversion. [2,3]
While CoQ10 is the form found in food, ubiquinol can be taken in supplement form and is more readily absorbed by the body.
CoQ10 has shown the most promise in studies related to heart health.
In relation to autism, research has shown that supplementation with CoQ10 can improve symptoms of mitochondrial disease. [2]
Mitochondrial dysfunction often co-occurs with autism and several studies suggest CoQ10 provides clinical improvements among children with ASD who also have mitochondrial dysfunction. [2, 7]
Recommended Intake
Research suggests that adults need 500mg/day of CoQ10. [6]
There is no recommended daily intake for adults for CoQ10, but studies estimate that 3-5 mg/day from food is adequate to meet needs. [2,6]
There is no recommended daily intake for children for CoQ10, though most supplement manufacturers dose 1-30 mg/per kilogram/ per day for infants, and no more than 180-200 mg per day for older children.
For those that have low blood levels of CoQ10, 60-100 mg per day is typically sufficient to raise levels to the normal range.
One study showed that high-dose coenzyme Q(10) (10 mg/kg/day) is well-absorbed and well-tolerated by most children with Down Syndrome. [18]
Deficiency
Signs of CoQ10 deficiency are apparent with changes in the heart, kidneys, and muscles. A person may experience muscle weakness or problems with coordination and balance. The deficient person may have seizures, hypotonia (low muscle tone), loss of sight or hearing, abnormal eye movements, involuntary muscle contractions, nephrotic syndrome, and hypertrophic cardiomyopathy. [4,5]
Normal blood levels for CoQ10 are 0.8–1.2 mg/L. [5]
It is not known whether blood levels accurately reflect levels of other tissues, so sometimes urine or tissue samples are taken to determine CoQ10 levels. Typical reference ranges for skeletal muscle and fibroblasts CoQ10 status are 140–580 pmol/mg and 39–75 pmol/mg, respectively. [6]
A host of neurodegenerative disorders are associated with low CoQ10, including Down Syndrome. [2,16]
A deficiency in vitamin B6 may result in a CoQ10 deficiency because B6 is necessary for the body to produce CoQ10.
The use of cholesterol-lowering statin drugs and genetic defects can contribute to CoQ10 deficiency. [2]
One small study found that children with recurrent food intolerance and allergies may acquire CoQ10 deficiency over time. [14]
Toxicity
Studies support that oral supplementation is safe and well-tolerated, even up to doses of 2400mg/day in adults. [2]
The tolerable upper limit for children is not defined though one study safely used a dose of 60mg/day. [11]
Supplementation does not impair the body’s own production of CoQ10 and only mild gastrointestinal side effects, primarily nausea was reported. [2]
Supplements
CoQ10 absorption is slow and occurs in the small intestine.[2]
An optimal plasma level or supplement dose required to elicit a clinical benefit is unknown and may be dependent upon the organ affected.[17]
Ubiquinol is the form that is best absorbed.
The absorption of CoQ10 can be increased if taken with food that contains fat.
Adults with mitochondrial disease are often supplemented with upwards of 1200-3000mg/day of CoQ10 or ubiquinol. [2,5]
For children, doses between 5 and 10 mg/kg/day of ubiquinol are recommended.[2]
Supplementation does increase blood concentrations of CoQ10 but the amount that reaches the tissues/organs is not fully understood. [2]
Examples
Chewable’s/Gummies
Liquid
Note: All supplements are linked to Amazon for convenience, however, buying supplements on Amazon does not guarantee quality, as there are many “unverified resellers” selling nutrition supplements. To buy supplements that are verified to be sent directly to the consumer, you can create an account on the Autism Dietitian FullScript and search for the respective supplement under “Catalog”.
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
CoQ10 & Autism in the Research
Ubiquinol supportive therapy improved symptoms in children with autism, as communication with parents (in 12%), verbal communication (in 21%), playing games of children (in 42%), sleeping (in 34%), and food rejection (in 17%), with CoQ10−TOTAL plasma level above 2.5 μmol/L. [9]
CoQ10 supportive therapy after three months (daily dose of 60 mg (30mg twice/day)) improved oxidative stress in the children with ASD. High doses of CoQ10 can improve gastrointestinal problems and sleep disorders in children with ASDs with an increase in the CoQ10 of the serum. [11]
CoQ and melatonin protect against propionic acid neurotoxicity because both stimulate the expression of antioxidant and detoxification genes. These two antioxidants also keep production of free radical reactive oxygen species under control. CoQ and melatonin can be suggested as nutritional supplements that might be helpful in the early intervention of neurodevelopmental disorders [12]
Melatonin and coenzyme Q10 were effective in restoring normal level of most of the impaired fatty acids in propionic acid-intoxicated rats which could help suggest both as supplements to ameliorate the autistic features induced in rat pups.[8]
Current meta-analysis shows that CoQ10 supplementation significantly increased the levels of total antioxidant capacity and antioxidant enzymes (superoxide dismutase, glutathione peroxidase and catalase) and reduced malondialdehyde levels. [15]
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[1] Neha K, Haider MR, Pathak A, Yar MS. Medicinal prospects of antioxidants: A review. Eur J Med Chem. 2019;178:687-704. doi:10.1016/j.ejmech.2019.06.010
[2] Barcelos IP, Haas RH. CoQ10 and Aging. Biology (Basel). 2019;8(2):E28.
[3] Martin R. How is Ubiquinol Different from Conventional CoQ10? Ubiquinol.org. https://ubiquinol.org/ubiquinol-vs-coq10. Published May 21, 2021. Accessed August 12, 2021.
[4] Primary coenzyme Q10 deficiency: MedlinePlus Genetics. MedlinePlus. https://medlineplus.gov/genetics/condition/primary-coenzyme-q10-deficiency/. Published August 18, 2020. Accessed August 12, 2021.
[5] Manzar H, Abdulhussein D, Yap TE, Cordeiro MF. Cellular Consequences of Coenzyme Q10 Deficiency in Neurodegeneration of the Retina and Brain. Int J Mol Sci. 2020;21(23):E9299.
[6] Hargreaves I, Heaton RA, Mantle D. Disorders of Human Coenzyme Q10 Metabolism: An Overview. Int J Mol Sci. 2020;21(18):E6695.
[7]Rossignol DA, Frye RE. Mitochondrial dysfunction in autism spectrum disorders: a systematic review and meta-analysis. Mol Psychiatry. 2012;17(3):290-314.
[8] El-Ansary A, Al-Ghamdi M, Bhat RS, Al-Daihan S, Al-Ayadhi L. Potency of pre-post treatment of coenzyme Q10 and melatonin supplement in ameliorating the impaired fatty acid profile in rodent model of autism. Food Nutr Res. 2016;60:28127.
[9] Broekemeier KM, Dempsey ME, Pfeiffer DR. Cyclosporin A is a potent inhibitor of the inner membrane permeability transition in liver mitochondria. J Biol Chem. 1989;264(14):7826-30.
[10] Hirayama A, Wakusawa K, Fujioka T, et al. Simultaneous evaluation of antioxidative serum profiles facilitates the diagnostic screening of autism spectrum disorder in under-6-year-old children. Sci Rep. 2020;10(1):20602.
[11] Mousavinejad E, Ghaffari MA, Riahi F, Hajmohammadi M, Tiznobeyk Z, Mousavinejad M. Coenzyme Q10 supplementation reduces oxidative stress and decreases antioxidant enzyme activity in children with autism spectrum disorders. Psychiatry Res. 2018;265:62-9.
[12] Al-Ghamdi M, Al-Ayadhi L, El-Ansary A. Selected biomarkers as predictive tools in testing efficacy of melatonin and coenzyme Q on propionic acid - induced neurotoxicity in rodent model of autism. BMC Neurosci. 2014;15:34.
[13] Simani L, Rezaei O, Ryan F, et al. Coenzyme Q10 Insufficiency Contributes to the Duration and Frequency of Seizures in Epileptic Patients. Basic Clin Neurosci. 2020;11(6):765-71.
[14] Miles MV, Putnam PE, Miles L, et al. Acquired coenzyme Q10 deficiency in children with recurrent food intolerance and allergies. Mitochondrion. 2011;11(1):127-35.
[15] Sangsefidi ZS, Yaghoubi F, Hajiahmadi S, Hosseinzadeh M. The effect of coenzyme Q10 supplementation on oxidative stress: A systematic review and meta-analysis of randomized controlled clinical trials. Food Sci Nutr. 2020;8(4):1766-76.
[16] Zaki ME, El-Bassyouni HT, Tosson AM, Youness E, Hussein J. Coenzyme Q10 and pro-inflammatory markers in children with Down syndrome: clinical and biochemical aspects. J Pediatr (Rio J). 2017;93(1):100-4.
[17] Neergheen V, Chalasani A, Wainwright L, et al. Coenzyme Q10 in the Treatment of Mitochondrial Disease. Journal of Inborn Errors of Metabolism and Screening. 2017;5:232640981770777.
[18] Miles MV, Patterson BJ, Schapiro MB, Hickey FJ, Chalfonte-Evans M, Horn PS, Hotze SL. Coenzyme Q10 absorption and tolerance in children with Down syndrome: a dose-ranging trial. Pediatr Neurol. 2006 Jul;35(1):30-7. doi: 10.1016/j.pediatrneurol.2005.11.004. PMID: 16814082.
