Coenzyme Q₁₀

Coenzyme Q₁₀ (CoQ₁₀) is among the most widely used dietary and nutritional supplements on the market. CoQ₁₀ has several fundamental properties that may be beneficial in several clinical situations. This article reviews the pertinent chemical, metabolic, and physiologic properties of CoQ₁₀ and the scientific data and clinical trials that address its use in two common clinical settings: statin-associated myopathy syndrome (SAMS) and congestive heart failure (CHF). Although clinical trials of CoQ₁₀ in SAMS have conflicting conclusions, the weight of the evidence, as seen in meta-analyses, supports the use of CoQ₁₀ in SAMS overall. In CHF, there is a lack of large-scale randomized clinical trial data regarding the use of statins in patients receiving contemporary treatment. However, one relatively recent randomized clinical trial, Q-SYMBIO, suggests an adjunctive role for CoQ₁₀ in CHF. Recommendations regarding the use of CoQ₁₀ in these clinical situations are presented.