Written by Helen Cooke, Helen Seers and the CAM-Cancer Consortium.
Updated September 21, 2011

Co-enzyme Q10

Abstract and key points

  • Coenzyme Q10 (CoQ10) is an organic compound produced by the body in small quantities.
  • No evidence exists to support CoQ10 working as an anti-cancer agent.
  • Weak evidence available that CoQ10 protects the heart from chemotherapy-induced toxicity.
  • Only minor side effects have been reported.

Coenzyme Q10 (CoQ10) is an organic compound, produced by the body in small quantities and used to assist the function of certain important enzymes within the cell. Produced commercially, CoQ10 is made by fermenting beets and sugar cane with yeast and is taken in supplement form.

In the context of cancer, CoQ10 is claimed to have three main possible benefits: a) possible anti-cancer effect, b) to protect the heart from toxic damage caused by chemotherapy drugs and c) to counteract chronic fatigue.

There is no evidence to support CoQ10 working as an anti-cancer agent although its use alongside other antioxidant supplements appears to show some anti-cancer benefit in preliminary trial.

There is some evidence that CoQ10 may protect the heart from chemotherapy-induced toxicity but the overall evidence from a systematic review and a small number of methodologically flawed clinical studies to support this protective property is weak.

Some fairly minor side effects have been reported, little however is known about its use alongside chemotherapeutic drugs, either in terms of safety or how it may affect the anti-tumour activity of these agents.

Citation Helen Cooke, Helen Seers, CAM-Cancer Consortium. Co-enzyme Q10 [online document]. http://www.cam-cancer.org/CAM-Summaries/Dietary-approaches/Co-enzyme-Q10. September 21, 2011.

References

  1. Folkers, K, Osterborg, A, Nylander, M, Morita, M, & Mellstedt, H. Activities of vitamin Q10 in animal models and a serious deficiency in patients with cancer. Biochemical and Biophysical Research Communications. 1997; 234 (2): 296-9.
  2. Frei B, Kim MC, Ames BN. Ubiquinol-10 is an effective lipid-soluble antioxidant at physiological concentrations. Proceedings of the Natural Academy of Science.1990; 87(12):4879-83.
  3. Folkers, K, Shizukuishi, S, Takemura, K, Drzewoski, J, Richardson, P, Ellis, J, & Kuzell, WC. Increase in levels of IgG in serum of patients treated with coenzyme Q10. Research Communication in Chemical Patholology and Pharmacology. 1982; 38 (2): 335-8.
  4. Ernster, L, & Forsmark-Andrée, P. Ubiquinol: an endogenous antioxidant in aerobic organisms. Clinical Investigator. 1993; 71 (8 Suppl): S60-5.
  5. Lass A, Kwong L, Sohal RS. Mitochondrial coenzyme Q content and aging. Biofactors.1999; 9(2-4):199-205.
  6. Coenzyme Q10 PDQ. National Cancer Institute. [online]. 20011 [cited 20011 Aug 14]. Available from: URL http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/healthprofessional/allpages
  7. Jellin, JM., (Ed). Natural Medicines Comprehensive Database. 2003; Stockton, California: Therapeutic Research Faculty.
  8. Damkier A, Jensen AB, Rose C. Use of Q10 in cancer patients. Ugeskr Laeger. 1994, 7;156(6):813-8.
  9. Folkers, K. The potential of coenzyme Q 10 (NSC-140865) in cancer treatment. Cancer Chemotherapy Reports. 1974; 24 (4): 19-22.
  10. Folkers, K, Porter, TH, Bertino, JR, & Moroson, B. Inhibition of two human tumor cell lines by antimetabolites of coenzyme Q10. Research Communication in Chemical Pathology and Pharmacology. 1978; 19 (3): 485-90.
  11. Folkers, K, Brown, R, Judy, WV, & Morita, M. Survival of cancer patients on therapy with coenzyme Q10. Biochemical and Biophysical Research Communications. 1993; 192 (1): 241-5.
  12. Lockwood, K, Moesgaard, S, Hanioka, T, & Folkers, K. Apparent partial remission of breast cancer in 'high risk' patients supplemented with nutritional antioxidants, essential fatty acids and coenzyme Q10. Molecular Aspects of Medicine. 1994; 15 (Suppl): s231-40.
  13. Lockwood, K, Moesgaard, S, & Folkers, K. Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochemical and Biophysical Research Communications. 1994; 199 (3): 1504-8.
  14. Lockwood, K, Moesgaard, S, Yamamoto, T, & Folkers, K. Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases. Biochemical and Biophysical Research Communications. 1995; 212 (1): 172-7.
  15. Shinozawa, S, Gomita, Y, & Araki, Y. Protective effects of various drugs on adriamycin (doxorubicin)-induced toxicity and microsomal lipid peroxidation in mice and rats. Biological and Pharmaceutical Bulletin. 1993; 16 (11): 1114-7.
  16. Shaeffer, J, El-Mahdi. AM, & Nichols, RK. Coenzyme Q10 and adriamycin toxicity in mice. Research Communication in Chemical Patholology and Pharmacology. 1980; 29 (2): 309-15.
  17. Lund, EL, Quistorff, B, Spang-Thomsen, M, & Kristjansen, PE. Effect of radiation therapy on small-cell lung cancer is reduced by ubiquinone intake. Folia Microbiologica (Praha). 1998; 43 (5): 505-6.
  18. Roffe, L, Schmidt, K, & Ernst, E. Efficacy of coenzyme Q10 for improved tolerability of cancer treatments: a systematic review. Journal of Clinical Oncology. 2004; 1;22 (21): 4418-24.
  19. Takimoto, M, Sakurai, T, Kodama, K, Yokoi, H, Suzuki, Y, Enomoto, K, & Okada, N. Protective effect of CoQ10 administration on cardiac toxicity in FAC therapy. Gan To Kagaku Ryoho. 1982; 9(1): 116-21.
  20. Akihama, T, Nakamoto, Y, Shindo, T, Nakayama, Y, & Miura, A. Protective effects of coenzyme Q10 on the adverse reactions of anthracycline antibiotics: using double blind method--with special reference to hair loss] Gan To Kagaku Ryoho. 1983; 10(10): 2125-9.
  21. Okuma, K, Furuta, I, & Ota, K. Protective effect of coenzyme Q10 in cardiotoxicity induced by adriamycin. Gan To Kagaku Ryoho. 1984; 11(3): 502-8.
  22. Lucarelli, G, Angelucci, C, Giardini, G. et al. Ubidecarenone and toxic cardiopathy from antiblastic therapy with daunoblastine. Boll Chim Farm. 1986; 125: S34-S39.
  23. Iarussi, D, Auricchio, U, Agretto, A, Murano, A, Giuliano, M, Casale, F, Indolfi, P, & Iacono, A. Protective effect of coenzyme Q10 on anthracyclines cardiotoxicity: control study in children with acute lymphoblastic leukemia and non-Hodgkin lymphoma. Molecular Aspects of Medicine. 1994; 15 (Suppl): s207-12.
  24. Thibault, A, Samid, D, Tompkins, AC, Figg, WD, Cooper, MR, Hohl, RJ, Trepel, J, Liang, B, Patronas, N, Venzon, DJ, Reed, E, & Myers, CE. Phase 1 study of lovastatin, an inhibitor of the mevalonate pathway, in patients with cancer. Clinical Cancer Research. 1996; 2: 483-91.
  25. Villalba JM, Parrado C, Santos-Gonzalez M, Alcain FJ, Villalba JM, Parrado C et al. Therapeutic use of coenzyme Q10 and coenzyme Q10-related compounds and formulations. [Review] [211 refs]. Expert Opinion on Investigational Drugs 2010; 19(4):535-554.
  26. Baggio, E, Gandini, R, Plancher, AC, Passeri, M, & Carmosino, G. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Molecular Aspects of Medicine. 1994; 15 (Suppl): s287-94.
  27. Feigin, A, Kieburtz, K, Como, P, Hickey, C, Claude, K, Abwender, D, Zimmerman, C, Steinberg, K, & Shoulson, I. Assessment of coenzyme Q10 tolerability in Huntington's disease. Movement Disorders. 1996; 11 (3): 321-3.
  28. Pepping, J. Coenzyme Q10. American Journal of Health System-Pharmacy. 1999; 56 (6): 519-21.
  29. Ernst E, Pittler MH, Wider B, Boddy K. (Eds). The Desktop Guide to Complementary and Alternative Medicine. An Evidence-Based Approach. Edinburgh: Mosby, 2006.
  30. Overvad, K, Diamant, B, Holm, L, Holmer, G, Mortensen, SA, & Stender, S. Coenzyme Q10 in health and disease. European Journal of Clinical Nutrition. 1999; 53 (10): 764-70.
  31. ConsumerLab: Product review: Coenzyme Q10.. [online]. 20011 [cited 20011 Aug 14]. Available from: URL http://www.consumerlab.com/results/coq10.asp
  32. Borek, C. Dietary antioxidants and human cancer. Integrative Cancer Therapies. 2004; 3 (4), 333-341.
  33. Engelsen J, Nielsen JD, Hansen KF. Effect of Coenzyme Q10 and Ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo-controlled cross-over trial. Ugeskr Laeger. 2003, 28 ;165(18):1868-71.
  34. Kaikkonen, J, Nyyssonen, K, Tuomainen, TP, Ristonmaa, U, & Salonen, JT. Determinants of plasma coenzyme Q10 in humans. FEBS Letters. 1999; 443 (2): 163-6.
  35. Hoenjet KMJLF, Dagnelie PC, Delaere KPJ, Wijckmans NEG, Zambon JV, Oosterhof GON. Effect of a nutritional supplement containing vitamin E, selenium, vitamin c and coenzyme Q10 on serum PSA in patients with hormonally untreated carcinoma of the prostate: a randomised placebo-controlled study. Eur Urol. 2005 Apr;47(4):433-9; discussion 9-40.
  36. Premkumar VG, Yuvaraj S, Sathish S, Shanthi P, Sachdanandam P. Anti-angiogenic potential of CoenzymeQ10, riboflavin and niacin in breast cancer patients undergoing tamoxifen therapy. Vascul Pharmacol. 2008 Apr-Jun;48(4-6):191-201.
  37. Premkumar VG, Yuvaraj S, Shanthi P, Sachdanandam P. Co-enzyme Q10, riboflavin and niacin supplementation on alteration of DNA repair enzyme and DNA methylation in breast cancer patients undergoing tamoxifen therapy. Br J Nutr. 2008 Dec;100(6):1179-82.
  38. Premkumar VG, Yuvaraj S, Vijayasarathy K, Gangadaran SGD, Sachdanandam P. Effect of coenzyme Q10, riboflavin and niacin on serum CEA and CA 15-3 levels in breast cancer patients undergoing tamoxifen therapy. Biol Pharm Bull. 2007 Feb;30(2):367-70.
  39. Sachdanandam P. Antiangiogenic and hypolipidemic activity of coenzyme Q10 supplementation to breast cancer patients undergoing Tamoxifen therapy. Biofactors. 2008;32(1-4):151-9.
  40. Yuvaraj S, Premkumar VG, Vijayasarathy K, Gangadaran SGD, Sachdanandam P. Ameliorating effect of coenzyme Q10, riboflavin and niacin in tamoxifen-treated postmenopausal breast cancer patients with special reference to lipids and lipoproteins. Clin Biochem. 2007 Jun;40(9-10):623-8.
  41. Yuvaraj S, Premkumar VG, Vijayasarathy K, Gangadaran SGD, Sachdanandam P. Augmented antioxidant status in Tamoxifen treated postmenopausal women with breast cancer on co-administration with Coenzyme Q10, Niacin and Riboflavin. Cancer Chemother Pharmacol. 2008 May;61(6):933-41.
  42. Yuvaraj S, Premkumar VG, Shanthi P, Vijayasarathy K, Gangadaran SGD, Sachdanandam P. Effect of Coenzyme Q(10), Riboflavin and Niacin on Tamoxifen treated postmenopausal breast cancer women with special reference to blood chemistry profiles. Breast Cancer Res Treat. 2009 Mar;114(2):377-84.
  43. Perumal SS, Shanthi P, Sachdanandam P. Augmented efficacy of tamoxifen in rat breast tumorigenesis when gavaged along with riboflavin, niacin, and CoQ10: effects on lipid peroxidation and antioxidants in mitochondria. Chem Biol Interact. 2005 Feb 28;152(1):49-58.
  44. Perumal SS, Shanthi P, Sachdanandam P. Combined efficacy of tamoxifen and coenzyme Q10 on the status of lipid peroxidation and antioxidants in DMBA induced breast cancer. Mol Cell Biochem. 2005 May;273(1-2):151-60.
  45. Sakano K, Takahashi M, Kitano M, Sugimura T, Wakabayashi K. Suppression of azoxymethane-induced colonic premalignant lesion formation by coenzyme Q10 in rats. Asian Pac J Cancer Prev. 2006 Oct-Dec;7(4):599-603.
  46. Rusciani L, Proietti I, Paradisi A, Rusciani A, Guerriero G, Mammone A, et al. Recombinant interferon alpha-2b and coenzyme Q10 as a postsurgical adjuvant therapy for melanoma: a 3-year trial with recombinant interferon-alpha and 5-year follow-up. Melanoma Res. 2007 Jun;17(3):177-8
  47. Rusciani L, Proietti I, Rusciani A, Paradisi A, Sbordoni G, Alfano C, et al. Low plasma coenzyme Q10 levels as an independent prognostic factor for melanoma progression. J Am Acad Dermatol. 2006 Feb;54(2):234-41
  48. van Dalen EC, Caron HN, Dickinson HO, Kremer LC, van Dalen EC, Caron HN et al. Cardioprotective interventions for cancer patients receiving anthracyclines.[Update of Cochrane Database Syst Rev. 2008;(2):CD003917; PMID: 18425895]. Cochrane Database of Systematic Reviews 2011; 6:CD003917.
  49. Nicolson GL, Conklin KA. Reversing mitochondrial dysfunction, fatigue and the adverse effects of chemotherapy of metastatic disease by molecular replacement therapy. Clin Exp Metastasis. 2008;25(2):161-9.
  50. Coenzyme Q10 PDQ. Natural Standard Database. [online].2009 [cited 2009 May 31]. Available from URL http://www.naturalstandard.com/naturalstandard/monographinfo.asp?title=Coenzyme%20Q10&file=coenzymeq10
  51. Conklin, K. A. (2005). "Coenzyme q10 for prevention of anthracycline-induced cardiotoxicity." Integrative Cancer Therapies 4(2): 110-30.
  52. Bryant, J., J. Picot, et al. (2007)"Cardioprotection against the toxic effects of anthracyclines given to children with cancer: a systematic review." Health Technology Assessment (Winchester, England) 11(27): ii
  53. Hidaka, J, Fujii, K, et al. (2008) Safety assessment of Coenzyme Q10 (CoQ10). Biofactors 32(1-4): 499-508.
  54. Hathcock, J, Shao, (2006) A Risk Assessment for CoenzymeQ10(Ubiquinone). Regul Toxicol Pharm 45(3): 282-288.
  55. Chai W, Cooney RV, Franke AA, Shvetsov YB, Caberto CP, Wilkens LR et al. Plasma coenzyme Q10 levels and postmenopausal breast cancer risk: the multiethnic cohort study. Cancer Epidemiology, Biomarkers & Prevention 2010; 19(9):2351-2356.
  56. Cooney RV, Dai Q, Gao YT, Chow WH, Franke AA, Shu XO et al. Low plasma coenzyme q10 levels and breast cancer risk in chinese women. Cancer Epidemiology, Biomarkers & Prevention 2011; 20(6):1124-1130.
  57. Chai W, Cooney RV, Franke AA, Caberto CP, Wilkens LR, Le ML et al. Plasma coenzyme Q10 levels and prostate cancer risk: the multiethnic cohort study. Cancer Epidemiology, Biomarkers & Prevention 2011; 20(4):708-710.
  58. Chandran K, Aggarwal D, Migrino RQ, Joseph J, McAllister D, Konorev EA et al. Doxorubicin inactivates myocardial cytochrome c oxidase in rats: cardioprotection by Mito-Q. Biophysical Journal 2009; 96(4):1388-1398
  59. Fouad AA, Al-Sultan AI, Refaie SM, Yacoubi MT, Fouad AA, Al-Sultan AI et al. Coenzyme Q10 treatment ameliorates acute cisplatin nephrotoxicity in mice. Toxicology 2010; 274(1-3):49-56.
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