As those of you who closely follow heath and fitness know, Coenzyme Q10 has long been the talk of the town, online. Frequent claims have been made that it prolongs life and prevents age-related decline in humans. It has also been used in “treating” and in “preventing” atherosclerosis (buildup of plaque in arteries), myocardial infarction (“heart attack”), hypertension (“high blood pressure”), cancer, etc.,etc.  In this current segment, Spanking FIT examines the widely  made claim that Coenzyme Q10 dietary supplementation specifically enhances athletic performance; but, first we explain what it is and how it works in our bodies:

What is Coenzyme Q10 and what exactly does it do?

Accorded to the highly regarded Linus Pauling Institute Micronutrient Information Center, Coenzyme Q10 or Co Q10 for short, is a fat-soluble substance obtained to a certain degree in our diets, but primarily synthesized in the body. Fat-soluble means that it is absorbed in fat globules and stored in body tissues. The fact that our bodies synthesize it attests to the common fallacy of labeling it “a vitamin“. It is also a member of the “ubiquinone family” of compounds which serve as electron carriers between flavoproteins (involved in D.N.A. repair and apoptosis) and in cellular respiration. They are called ubiquinone because they are widespread or ubiquitous throughout the body. CoQ10 is required for mitochondrial A.T.P. synthesis and also functions as an antioxidant. It’s A.T.P. that provides energy for movement of our skeletal muscles and; hence, is responsible for athletic performance. It also provides energy for the neural activity in our brains.  Since CoQ10 is present everywhere in our cells and is essential for energy production, the theory naturally arises that dietary supplementation with it may increase blood plasma levels and eventually this extra amount may work its way into muscle tissue leading to enhanced performance in sports, exercise, and athletics.  Here’s what the “experts” have to say about this theory:

There is insufficient scientific evidence to support the claim that dietary supplementation with CoQ10 enhances athletic performance (the “Nay-sayers”)

Among the most prominent nay-sayers is the Linus Pauling Institute, itself. Here’s what they say on their website: “there is little evidence that it (CoQ10) improves athletic performance in healthy individuals. At least seven placebo-controlled trials have examined the effects of 100-150 mg. daily of supplementation from 3-8 weeks on physical performance on untrained men. Most found no significant differences between groups taking it and groups taking placebo (“sugar pill”) with respect to measures of athletic performance.” Although they state “at least seven”, they actually cited five references only. Among them is “Effect of ubidecarenone oral treatment on aerobic power in middle-aged trained subjects” by A. Bonetti, et al. This study used 28 healthy male cyclists who received dietary supplementation for eight weeks. In all fairness to  CoQ10 supplementation advocates , the researchers did report a statistically significant 4% increase in maximum cycling workload for the CoQ10 users.

Another “nay-sayer” is the equally well-respected webmed.com website. Under “uses for CoQ10 as a supplement” they label it as “likely ineffective” for athletic performance, and say that “insufficient evidence” exists for using it even as a treatment for  “fatigue”.

There is sufficient scientific evidence to support the claim that dietary supplementation with CoQ10 enhances athletic performance (the “Yay-sayers”)

Literally hundreds of “health practitioners” advocate using CoQ10 to increase energy and enhance performance. Here are the results of Spanking FIT’s extensive search for serious research  supporting the CoQ10-enhanced performance hypothesis. We have listed them in order of importance, following our judgement.

(1) “Ubiquinol supplementation enhances peak power production in trained athletes: a double-blind placebo controlled study” by A. Dietmar, et al published in Journal of the International Society of Sports Nutrition; 2013, 10:24.

This study, in our opinion, has so far made the strongest case that CoQ 10 dietary supplementation actually works. It is surprising that the above-mentioned nay-sayers  overlooked it. Researchers at the Olympic Support Center  in Rhein-Ruhr Germany took a sample of 100 well-trained athletes and randomly divided  them into  two groups of fifty each: placebo/ control, or CoQ10 in Ubiquinol form. Ubiquinol is an electron-rich (reduced) form of CoQ10 that may exhibit greater bio-availability taken orally than the other forms (See: “Study on safety and bio-availability of Ubiquinol (Kaneka QH)” by K. Hosoe, et al. in Regulatory Toxicology & Pharmacology 47 (1): 19-28). They then made comparisons in athletic performance using a “maximum power output test” on a cycling ergometer. Measurements were taken after the treatment group had ingested 300 mg. per day Ubiquinol for six weeks, and were  in Watts per Kilogram of body weight(W/kg.).  Both groups trained intensively throughout this period in preparation for the London 2012 Olympic games. A statistically significant mean difference between the before and after performance differences of the two groups was detected of 0.08 W/ kg. Keep in mind that the maximum power output expected for the average Tour de France participant is about 6.7 W/ kg., so that the detected difference provides only about a 1.2% performance edge.  Nevertheless, the study authors vigorously maintain that “this can make a very significant difference for elite athletes.” (By comparison, there have been as high as 5 % performance increases reported for caffeine users. (See: “Enhancement of 2,000-m rowing performance after caffeine ingestion” by C.R. Bruce et al. in Medicine & Science in Sports & Exercise; 2000, 32: 1958-1963) Caffeine, once banned by the World Antidoping Agency (W.A.D.A.), is presently allowed. Ubiquinol is not banned either, yet). The research study’s authors strongly criticize previous studies that have been inconclusive by stating that “inadequate doses” of CoQ10 were used especially for individuals not deficient in it. (Remember that the work cited by the “nay-sayers” made use of 100-150 per day supplement only, while this German study used 300 mg. per day.) Dedicated readers may recall that Spanking FIT has previously noted how  common it is for nutritional supplements to be discounted only to discover that inadequate dosages of it were administered during testing (For example, see “Male with Low T? Try Nude Sunbathing“; Spanking FIT, Dec. 2014 for a similar problem that we encountered in the vitamin D /cancer debate).

Here’s the real problem with this particular study: The work was funded by Kaneka Pharma of Japan, the world’s largest supplier of Ubiquinol and holder of its patent. Hence, an appearance of a conflict of interest exists.

(2) “Coenzyme Q intake elevates the mitochondrial and tissue levels of CoQ and alpha-tocopherol in young mice” by S. Kamzalov, et al. in Journal of Nutrition; 2003, 133:3175-3180.

Number two on our list of best supporting research is this animal study that was conducted at University of Southern California (U.S.C.) You may recall that, according to geneticists, we share over eighty percent of our genes with the humble mouse.  A randomized experiment was conducted whereby a sample of 36 mice were randomly assigned to control, low dose, or high dose CoQ10 daily ingestion groups, for an eleven week period. After that time, the mice were asphyxiated and the quantity of CoQ10 present in their plasma, brain, and skeletal muscle tissue was determined. The researchers applied statistical analysis of variance techniques (ANOVA) to the data, and discovered significant differences between the three groups with respect to quantity of CoQ10 present in skeletal muscle tissue.  Recall that CoQ10 contained in muscle cell mitochondria is responsible for movement, so that athletic performance depends on it. Spanking FIT performed an independent Bonferroni test on their data presented in Table 1 of paper and was able to confirm that even the low dose seems to have succeeded in significantly raising the amount of CoQ10 in mouse muscle tissue by about 77% on average! Here’s the catch:  the quantity investigators administered to the mice is equivalent to giving more than 13,000 mg. of CoQ10 per day to an average American male. Since Ubiquinol usually comes in 100 mg. caplets, that same male would have to “pop” around 130 caplets per day to receive the equivalent dose! In conclusion, although this study demonstrates that CoQ10 may have performance enhancing potential in humans, it does not firmly establish that it may be used for that purpose at more moderate and practical dose levels, in our opinion.

(3) “Effects of acute and 14 day CoQ10 supplementation on exercise performance in both trained and untrained individuals” by M. Cooke et al. in Journal International Society of Sports Nutrition; March 2008.

A randomized double blind experiment was conducted to test the CoQ10/ athletic performance hypothesis by using 22 trained and 19 untrained males and females. Levels of coenzyme Q10 present were measured in both subject blood plasma and muscle tissue at baseline, 48 hours later before exercise, following exercise after “acute” CoQ10 ingestion,  again following exercise after 14 days of daily CoQ10 ingestion.  The athletes in the “treatment” group received 200 mg. of a “fast melt” form of CoQ10. 2-way repeated measures ANOVA was performed on exhaustion time during an aerobic power index test, and it was noted that a statistically significant interaction term was obtained. The analysts cited this as evidence of CoQ10’s effectiveness. Upon careful inspection of their results, we noted that the placebo group actually performed better after both treatments (the placebo group was also better at baseline). A preferred analytical approach, in our opinion, would have been to calculate exhaustion time differences between baseline and end-time for both the placebo and treatment groups and perform relevant tests of differences in the means using a standard t-test.

In comparing concentrations of CoQ10 in muscle tissue, the researchers did just what we suggested above. Although an upward trend was uncovered for the treatment group, it was not statistically significant and so, therefore, no definite conclusion can be drawn from it.

To Qo10 or Not to CoQ10? That is the question

It is apparent that from a scientific perspective, the jury is still out on the importance of Ubiquinol or Coenzyme Q10 as a dietary supplement for improving athletic performance or personal health and fitness. (Just as the military often serves as a testing ground for commercial products, so does the world of sports). It is also the case that many potential users of it refrain from doing so due to its prohibitively high price. Since my personal philosophy is ” good health is priceless”, I decided to ingest 100 mg. daily CoQ10 in Ubiquinol form upon commencing research about it. As warned in Spanking FIT‘s “About Us” category, case example evidence is never strong enough in medical science to prove any claim. Nevertheless, I think I have detected about a 12-25% personal increase in anaerobic exercise performance, which really is incredible if due to CoQ10 supplementation.    Also, after decades of listening to composers like Boccherini and Brahms only, last weekend I  actually “rocked out” to an old Fleetwood Mac album. Try it yourself.  Here’s the album: