What does the research show about coenzyme q10?

Coenzyme Q10

Four meta-analyses of CoQ10 for statin muscle pain disagree, two finding no benefit and two a reduction. In heart failure, pooled trials report lower mortality and hospitalization, with the largest trial funded by a CoQ10 maker. Systolic pressure fell about 3 mmHg. Semen quality improved in infertile men. Exercise performance did not change. A warfarin trial found no dose change.

Add to Bio HackChecked 2026-11-12

Status: Dietary supplement in the US.
Also called: CoQ10, ubiquinone, ubiquinol, ubidecarenone, coenzyme Q
Taken for: statin muscle pain, heart failure, heart health, blood pressure, migraine, energy, fatigue, exercise performance, recovery, fertility, skin aging, wrinkles, gum disease, periodontitis

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help5

StrongShown to raise sperm count and motility in men with unexplained infertility. Reviews disagree on sperm concentration and on the size of the effect.
ModerateShown to lower deaths and heart failure hospitalizations in people with heart failure on standard therapy. The largest trial was funded by a CoQ10 maker.
ModerateShown to lower systolic blood pressure by about 3.4 mmHg in adults. Diastolic pressure did not change, and no change was seen in people with diabetes.
ModerateShown to reduce migraine frequency and attack duration in adults with migraine, across 6 small studies. Severity did not change.
LimitedSmall trials found one water-soluble CoQ10 reduced wrinkles and improved smoothness over 12 weeks. Hydration and dermis thickness did not change.

Reported risks1

LimitedOne small trial found 100 mg a day did not change INR or warfarin dose in 24 people on stable warfarin. Earlier case reports described a reduced response.How often is not known

What people take it for, and what was found

Shown to help5

Moderate

Heart failure

Shown to lower deaths and heart failure hospitalizations in people with heart failure on standard therapy. The largest trial was funded by a CoQ10 maker.

The numbers and sources

Effect: Across 33 RCTs, CoQ10 was associated with lower all-cause mortality (RR 0.64, 95% CI 0.48 to 0.85, moderate quality) and hospitalization for heart failure (RR 0.50), and 31.7 m more on the 6-minute walk test [6]. In Q-SYMBIO, 420 patients on 100 mg three times a day for 2 years had fewer major cardiovascular events (15% versus 26%, HR 0.50, 95% CI 0.32 to 0.80) and lower all-cause mortality (10% versus 18%). Short-term endpoints at 16 weeks did not change [7].
Population: Patients with heart failure on standard therapy [6][7].
Sources: [6], [7]
Caveats: Q-SYMBIO was funded by Kaneka Corp., a CoQ10 manufacturer, and the International Coenzyme Q10 Association [7]. Several pooled outcomes were rated low quality [6].

Moderate

Blood pressure

Shown to lower systolic blood pressure by about 3.4 mmHg in adults. Diastolic pressure did not change, and no change was seen in people with diabetes.

The numbers and sources

Effect: Across 45 RCTs, CoQ10 lowered systolic pressure by 3.44 mmHg (95% CI -5.13 to -1.55). Diastolic pressure and heart rate did not change significantly [8].
Population: Adults in 48 effect sizes [8].
Sources: [8]
Caveats: Larger reductions in subgroups with lower doses and longer trials [8]. In 20 RCTs in people with prediabetes or type 2 diabetes, systolic and diastolic pressure did not change [9].

Moderate

Migraine frequency

Shown to reduce migraine frequency and attack duration in adults with migraine, across 6 small studies. Severity did not change.

The numbers and sources

Effect: Across 6 studies (371 participants), CoQ10 reduced migraine frequency (MD -1.52, 95% CI -2.40 to -0.65) and attack duration (MD -0.19). Severity did not change [10].
Population: Adults with migraine [10].
Sources: [10]
Caveats: Small trials. Frequency units vary between trials.

StrongStudied in men

Male fertility and semen quality

Shown to raise sperm count and motility in men with unexplained infertility. Reviews disagree on sperm concentration and on the size of the effect.

The numbers and sources

Effect: In 9 studies (781 men) with idiopathic infertility, CoQ10 raised sperm concentration by 10.22 million/mL (95% CI 3.51 to 16.93) and total motility by 4.95 percentage points (95% CI 1.15 to 8.75), and raised the odds of clinical pregnancy (OR 6.02, 95% CI 1.97 to 18.41) [21]. In 8 RCTs (877 men), total sperm count, total and progressive motility and normal morphology were higher on CoQ10, and sperm concentration and semen volume did not change [22]. A network meta-analysis of 16 studies in men with unexplained infertility found CoQ10 improved sperm concentration over placebo [23].
Population: Men with idiopathic or unexplained infertility [21][23]; men in RCTs of semen quality [22].
Sources: [21], [22], [23]
Caveats: One review reported standardized mean differences as large as 13.38, several times the 2.98 reported by the network meta-analysis [23], with significant heterogeneity between studies [22]. The pregnancy interval is wide [21]. The reviews disagree on sperm concentration [21][22].

Limited

Wrinkles and skin smoothness, oral

Small trials found one water-soluble CoQ10 reduced wrinkles and improved smoothness over 12 weeks. Hydration and dermis thickness did not change.

The numbers and sources

Effect: In 33 healthy adults, 50 or 150 mg a day of a water-soluble CoQ10 (Q10Vital) for 12 weeks reduced wrinkles and microrelief lines, improved smoothness and limited the seasonal decline in skin viscoelasticity against placebo. Skin hydration and dermis thickness did not change significantly [25]. In 34 women aged 40 to 65, a liquid supplement of the same CoQ10 with collagen for 12 weeks raised dermis density, reduced periorbital wrinkle area and total wrinkle score, and improved smoothness against placebo. Hydration, dermis thickness, transepidermal water loss and viscoelasticity did not change significantly [26].
Population: 33 healthy adults [25]; 34 healthy women, 17 per group [26].
Sources: [25], [26]
Caveats: Two small trials of one CoQ10 form, sharing authors. The second combined CoQ10 with collagen, so CoQ10's share of the effect is unknown [26].

Mixed results5

Moderate

Statin-associated muscle pain

Mixed results: two reviews found no benefit for statin muscle pain, including one limited to diagnosed statin myalgia, while two others found less pain.

The numbers and sources

Effect: Statin therapy lowered plasma CoQ10 by 0.44 μmol/L across 8 placebo-controlled arms [1]. For muscle pain, a 2015 meta-analysis of 6 RCTs found no significant effect (SMD -0.53, 95% CI -1.33 to 0.28) and no change in creatine kinase [2]. A 2020 meta-analysis of 7 RCTs (321 patients) found no benefit for myalgia (WMD -0.42, 95% CI -1.47 to 0.62) and no change in staying on statins (RR 0.99) [3]. A 2018 meta-analysis of 12 RCTs (575 patients) found less muscle pain (WMD -1.60, 95% CI -1.75 to -1.44), weakness and cramps [4]. A 2025 meta-analysis of 7 RCTs (389 patients) found less pain intensity (WMD -0.96, 95% CI -1.88 to -0.03) [5].
Population: Adults taking statins, many with muscle symptoms [2][3][4]. The 2025 review covered 100 to 600 mg a day for 30 to 90 days [5].
Sources: [1], [2], [3], [4], [5]
Caveats: The four reviews pool overlapping small trials with different inclusion rules and reach opposite conclusions. The review restricted to patients with diagnosed statin myalgia found no benefit [3]. Creatine kinase did not change in any of them [2][4].

Moderate

Muscle damage markers after exercise

Mixed results: two reviews found lower creatine kinase and malondialdehyde in athletes after exercise, while a 2026 review found no change.

The numbers and sources

Effect: In 17 trials (440 athletes), CoQ10 lowered creatine kinase by 71.81 IU/L (95% CI -124.33 to -19.3), lactate dehydrogenase by 69.99 IU/L and the oxidative stress marker malondialdehyde by 0.61 µmol/L. Total antioxidant capacity did not change [15]. In 14 RCTs (433 participants), creatine kinase fell (SMD -1.532, 95% CI -2.856 to -0.209) and malondialdehyde fell (SMD -0.289) [13]. A 2026 review of athlete trials found malondialdehyde unchanged in its primary analysis (SMD -0.96, 95% CI -2.07 to 0.15, I² 73%), and creatine kinase, IL-6 and total antioxidant capacity unchanged [12].
Population: Athletes [12][15]; exercising adults [13].
Sources: [15], [13], [12]
Caveats: Sources disagree on creatine kinase. Evidence quality was low to very low [15]. These are blood markers, not measured recovery or performance.

Moderate

Periodontitis, oral CoQ10 added to dental treatment

Mixed results: one review found slightly shallower gum pockets with 120 mg a day added to dental cleaning, while others found no clear effect.

The numbers and sources

Effect: In a systematic review of 10 RCTs, the six oral trials of 120 mg a day alongside scaling and root planing found probing depth 0.41 mm lower (95% CI 0.02 to 0.80) and clinical attachment gain 0.52 mm greater (95% CI 0.26 to 0.78) than controls after 12 weeks [16]. A 2023 review of 5 systemic and 12 local CoQ10 RCTs found heterogeneous protocols, low reporting quality and high or unclear risk of bias. About half the trials reported group differences in pocket depth, and the authors concluded no statement on effectiveness was possible [17]. An umbrella meta-analysis of 14 meta-analyses of antioxidants, CoQ10 among them, found no significant pooled change in probing depth (ES 0.064, 95% CI -0.341 to 0.468) or attachment level, and less bleeding on probing (ES 0.57, 95% CI 0.44 to 0.69) [18].
Population: Adults with periodontitis receiving nonsurgical periodontal therapy [16][17]; meta-analyses of human studies [18].
Sources: [16], [17], [18]
Caveats: Certainty was very low [16]. The reviews disagree, and the umbrella review pooled several antioxidants, so it does not isolate CoQ10 [18].

Moderate

Periodontitis, CoQ10 gel in the gums (topical)

Mixed results: one review found less plaque, bleeding and pocket depth with CoQ10 gel, while a later review of 4 trials found no effect.

The numbers and sources

Effect: Across 11 trials, CoQ10 lowered plaque index (SMD -0.64, 95% CI -1.03 to -0.26), bleeding index (SMD -1.05), pocket depth (SMD -0.96, 95% CI -1.35 to -0.58), clinical attachment level (SMD -0.73) and gingival index (SMD -0.63). Effects were stronger when placed in the gum pocket than on the gum surface [19]. In a 2025 review, four trials of local CoQ10 (one topical, three in the pocket) showed no significant effect on probing depth or attachment gain [16].
Population: Adults with periodontitis in controlled trials [19][16].
Sources: [19], [16]
Caveats: Heterogeneity was high (I² 72.8% to 89.5%), and studies at high risk of bias reported larger effects than studies at unclear risk [19]. The two reviews disagree.

LimitedStudied in women

IVF outcomes in women with poor ovarian response

One trial found CoQ10 with folic acid raised egg counts in 100 women with poor ovarian response, but pregnancy rates did not differ.

The numbers and sources

Effect: In 100 women with poor ovarian response, CoQ10 plus folic acid before and during an ICSI cycle raised oocyte count and antral follicle count against folic acid alone. Chemical and clinical pregnancy rates did not differ [24].
Population: 100 women classified as poor ovarian responders [24].
Sources: [24]
Caveats: One trial without a placebo. Pregnancy rates did not differ [24].

Not shown to help3

Strong

Exercise performance

Not shown to improve VO2 max or exercise performance in athletes or healthy adults, though it raised blood CoQ10.

The numbers and sources

Effect: Across 24 studies, CoQ10 consistently raised blood CoQ10. Performance effects were small and inconsistent. A small chronic benefit was no longer stable after outliers were removed, and acute dosing showed no benefit [11]. In athletes, VO2max did not change (7 studies, SMD 0.03, 95% CI -0.32 to 0.39), nor did anaerobic threshold [12]. Across 14 RCTs (433 participants), VO2max and blood lactate did not change [13]. In 33 trials (3,317 participants) in adults aged 40 and over, VO2peak rose 0.73 mL/kg/min (95% CI -0.07 to 1.54), compatible with no benefit, and estimates for walking distance, grip and leg strength, chair rises and lean mass were uncertain [14].
Population: Healthy adults in randomized trials [11]; athletes and trained people [12]; exercising adults [13]; middle-aged and older adults [14].
Sources: [11], [12], [13], [14]
Caveats: Certainty was very low to low [11][14]. Risk of bias raised some concerns in 23 of 24 athlete studies [12].

Limited

Fatigue

Limited evidence: 2 trials in people with depression found no difference in fatigue from control.

The numbers and sources

Effect: In 2 trials in people with depression, fatigue did not differ from control (SMD -0.33, 95% CI -1.38 to 0.72, I² 89%) [20].
Population: Patients with depression, alone or with multiple sclerosis, breast cancer or polycystic ovary syndrome [20].
Sources: [20]
Caveats: Two trials with high heterogeneity. No review of fatigue in healthy people was located.

Limited

Sunburn sensitivity, oral

One small trial found 12 weeks of CoQ10 did not change the UV dose that causes sunburn in 33 healthy adults.

The numbers and sources

Effect: In 33 healthy adults, 12 weeks of 50 or 150 mg a day of CoQ10 did not significantly change the minimal erythema dose, the UV dose that causes sunburn [25]. A systematic review of 47 photoprotection studies found the weakest evidence for isolated vitamin or CoQ10 supplements [27].
Population: 33 healthy adults [25]; human studies [27].
Sources: [25], [27]
Caveats: One small trial measured sunburn sensitivity directly [25].

Doses studied

Statin trials used 100 to 600 mg a day for 30 to 90 days [5]. Q-SYMBIO used 100 mg three times a day for 2 years [7]. The warfarin trial used 100 mg a day for 4 weeks [28]. Blood pressure reductions were larger below 200 mg a day in subgroup analysis [8]. Oral periodontal trials used 120 mg a day [16]. The skin trials used 50 or 150 mg a day for 12 weeks [25].

Risks

Mixed results1

LimitedHow often is not known

Interaction with warfarin

One small trial found 100 mg a day did not change INR or warfarin dose in 24 people on stable warfarin. Earlier case reports described a reduced response.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: In a randomized, double-blind crossover trial, 24 outpatients on stable warfarin took CoQ10 100 mg a day, ginkgo or placebo for 4 weeks each. INR stayed stable, and the mean weekly warfarin dose did not change (CoQ10 36.5 mg, placebo 36.0 mg) [28][29].
Population: 14 women and 10 men, median age 64.5 [28].
Sources: [28], [29]
Caveats: One small trial at one dose. The trial abstract cites earlier case reports of a reduced warfarin response with CoQ10 [28]. Numbers come from the trial's Danish-language report.

Checked, no increase found1

Moderate

Adverse effects in trials

No major adverse effects were reported across 33 heart failure trials, and infertility trials reported none or mild, short-lived effects.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: The 33-trial heart failure meta-analysis reported no major adverse effects with CoQ10 [6]. In the male infertility review, 3 studies reported no adverse effects and 1 reported mild, transient side effects [21].
Population: Patients with heart failure [6]; men with infertility [21].
Sources: [6], [21]
Caveats: Adverse event counts were not given in the abstract.

Claims tested and not found

That CoQ10 relieves diagnosed statin myalgia. In patients with statin-associated myalgia, pain did not differ from placebo (WMD -0.42, 95% CI -1.47 to 0.62) [3].
That CoQ10 improves exercise performance. Effects were small and inconsistent, and not stable after outlier removal [11]. VO2max did not change in athletes [12] or in adults aged 40 and over [14].
That oral CoQ10 protects skin from sunburn. The minimal erythema dose did not change significantly over 12 weeks [25].

Sources

Banach M, Serban C, Ursoniu S, et al. Statin therapy and plasma coenzyme Q10 concentrations: A systematic review and meta-analysis of placebo-controlled trials. Pharmacological Research. 2015. https://doi.org/10.1016/j.phrs.2015.07.008
Banach M, Serban C, Sahebkar A, et al. Effects of Coenzyme Q10 on Statin-Induced Myopathy. Mayo Clinic Proceedings. 2015. https://doi.org/10.1016/j.mayocp.2014.08.021
Kennedy C, Köller Y, Surkova E. Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis. Atherosclerosis. 2020. https://doi.org/10.1016/j.atherosclerosis.2020.03.006
Qu H, Guo M, Chai H, et al. Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. Journal of the American Heart Association. 2018. https://doi.org/10.1161/jaha.118.009835
Kovacic S, Habicht SD, Eckert GP. Effects of coenzyme Q10 supplementation on myopathy in statin-treated patients: a systematic review and meta-analysis. Journal of Nutritional Science. 2025. https://doi.org/10.1017/jns.2025.10043
Xu J, Xiang L, Yin X, et al. Efficacy and safety of coenzyme Q10 in heart failure: a meta-analysis of randomized controlled trials. BMC Cardiovascular Disorders. 2024. https://doi.org/10.1186/s12872-024-04232-z
Mortensen SA, Rosenfeldt F, Kumar A, et al. 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. 2014. https://doi.org/10.1016/j.jchf.2014.06.008
Karimi M, Pirzad S, Hooshmand F, et al. Effects of coenzyme Q10 administration on blood pressure and heart rate in adults: A systematic review and meta-analysis of randomized controlled trials. International Journal of Cardiology Cardiovascular Risk and Prevention. 2025. https://doi.org/10.1016/j.ijcrp.2025.200424
Rezagholizadeh F, Rezvani S, Oskouie FH, et al. The effect of CoQ10 supplementation on cardiovascular risk factors in patients with prediabetes and type 2 diabetes mellitus: a grade-assessed systematic review and dose-response meta-analysis. BMC Pharmacology and Toxicology. 2026. https://doi.org/10.1186/s40360-025-01002-1
Sazali S, Badrin S, Norhayati MN, et al. Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine: a meta-analysis. BMJ Open. 2021. https://doi.org/10.1136/bmjopen-2020-039358
Deng H, Song T, Yin M, et al. 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. 2025. https://doi.org/10.1017/s0007114525106211
Lu S, Zhong W, Wang H. The effects of coenzyme Q10 supplementation on exercise-induced oxidative stress and related physiological outcomes in athletes: a systematic review and meta-analysis. 3 Biotech. 2026. https://doi.org/10.1007/s13205-026-05076-4
Zhang Y, He Y, Ma M, et al. Effects of coenzyme Q10 analogs on oxidative stress, muscle, and metabolism after exercise: A meta-analysis and systematic review. Journal of International Medical Research. 2026. https://doi.org/10.1177/03000605251411151
Liu X, Bao J, Yu Z, et al. Effects of Coenzyme Q10 Supplementation on Muscle Health and Physical Capacity in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Antioxidants. 2026. https://doi.org/10.3390/antiox15101219
Qu H, Qu Y. Can coenzyme Q10 supplementation reduce exercise-induced muscle damage and oxidative stress in athletes? A systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2025. https://doi.org/10.1016/j.ctcp.2025.102001
Fernandez MDS, Martins TM, Meza-Mauricio J, et al. Clinical efficacy of adjunctive use of coenzyme Q10 in non-surgical periodontal treatment: A systematic review. European Journal of Oral Sciences. 2025. https://doi.org/10.1111/eos.70002
Merle CL, Lenzen C, Schmalz G, Ziebolz D. Systematic Review on Protocols of Coenzyme Q10 Supplementation in Non-Surgical Periodontitis Therapy. Nutrients. 2023. https://doi.org/10.3390/nu15071585
Tang Z, Deng Y, Guo G. Efficacy of antioxidants supplementation as an adjunct to non-surgical periodontal therapy: an umbrella meta-analysis. Odontology. 2026. https://doi.org/10.1007/s10266-026-01546-6
Rasoolzadeh EA, Shidfar F, Rasoolzadeh RA, Hezaveh ZS. The effect of coenzyme Q10 on periodontitis: a systematic review and meta-analysis of clinical trials. Journal of Evidence-Based Dental Practice. 2022. https://doi.org/10.1016/j.jebdp.2022.101710
Magalhães PLM, da Silva AMP, Maximiano MLB, et al. Effects of Coenzyme Q10 Supplementation on Depressive Symptoms and Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Psychopharmacology. 2025. https://doi.org/10.1097/jcp.0000000000002112
Bakri S, Saleh R, Cayan S, et al. 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. 2026. https://doi.org/10.5534/wjmh.250159
Akhigbe TM, Fidelis FB, Adekunle AO, et al. Does coenzyme Q10 improve semen quality and circulating testosterone level? a systematic review and meta-analysis of randomized controlled trials. Frontiers in Pharmacology. 2025. https://doi.org/10.3389/fphar.2024.1497930
Niu C, Lu X, Xie Y, et al. Effects of Carnitine and Coenzyme Q10 on Sperm Quality and Pregnancy Rates in Men with Unexplained Infertility: A Systematic Review and Network Meta-Analysis. Reproductive Sciences. 2025. https://doi.org/10.1007/s43032-025-01958-9
Abdelrahman MA, Gamal M, Salem SA, et al. Coenzyme Q10 Impact on Ovarian Reserve Measures and the Intra-Cytoplasmic Sperm Injection (ICSI) Outcomes in Women with Poor Ovarian Response: A Randomized Controlled Study. Drug Design, Development and Therapy. 2026. https://doi.org/10.2147/dddt.s583321
Žmitek K, Pogačnik T, Mervic L, et al. The effect of dietary intake of coenzyme Q10 on skin parameters and condition: Results of a randomised, placebo-controlled, double-blind study. BioFactors. 2017. https://doi.org/10.1002/biof.1316
Žmitek K, Žmitek J, Rogl Butina M, Pogačnik T. Effects of a Combination of Water-Soluble Coenzyme Q10 and Collagen on Skin Parameters and Condition: Results of a Randomised, Placebo-Controlled, Double-Blind Study. Nutrients. 2020. https://doi.org/10.3390/nu12030618
Natarelli N, Aflatooni S, Stankiewicz K, et al. Oral Supplements and Photoprotection: A Systematic Review. Journal of Medicinal Food. 2025. https://pubmed.ncbi.nlm.nih.gov/39804624/
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. Ugeskrift for Laeger. 2003. https://pubmed.ncbi.nlm.nih.gov/12772396/
Engelsen J, Nielsen JD, Winther K. Effect of Coenzyme Q10 and Ginkgo biloba on Warfarin Dosage in Stable, Long-term Warfarin Treated Outpatients. A Randomised, Double Blind, Placebo-crossover Trial. Thrombosis and Haemostasis. 2002. https://doi.org/10.1055/s-0037-1613135

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