CoQ10

Does it work? CoQ10 is an exciting route for migraine treatment that likely works best in people with mitochondrial dysfunction or increased need (which may be all migaineurs!).

How do I use it? Ubiquinol is the most easily absorbed form and doses between 150mg and 400mg appear to be most beneficial.

The Basics

CoQ10, also known as Coenzyme Q10, is a naturally occurring substance in your body that helps produce energy. It also acts as a powerful antioxidant and anti-inflammatory molecule, making it a hot topic for migraine research!

There is no recommended daily allowance for CoQ10, as most people produce enough on their own and it’s not widely found in food. That being said, research has shown that deficiency is possible and that migraineurs may need more CoQ10 than the average person. 

The Science: CoQ10 and Migraine

Coenzyme Q10 is, of course, a coenzyme! Coenzymes help enzymes do their job, which is to allow chemical reactions to occur in your body. Literally everything – from breaking down food, to creating DNA, to contacting your muscles – is made possible by a chemical reaction!

CoQ10 in particular sits within mitochondria, a teeny tiny organ inside virtually all of your cells. Inside the mitochondria, CoQ10 plays a role in the electron transport chain which allows your body to create raw energy from food (called ATP). Your body naturally produces CoQ10 and it exists as both ubiquinone (the oxidized form) and ubiquinol (the reduced form).

CoQ10 is crucial to proper mitochondrial functioning, and deficiencies have been shown to result in mitochondrial dysfunction and increased production of reactive oxygen species. These reactive oxygen species, also called free radicals, create inflammation and cause damage to your cells

CoQ10 acts as a powerful antioxidant that can reduce inflammation. Because of this, CoQ10 has been a popular focus of clinical trials looking to alleviate migraine symptoms.

A 2017 study looking at the effect of CoQ10 supplementation on adult migraine patients stated that, after 3 months of use:

The findings indicated a significant prophylactic effect resulting from CoQ10 that not only seems to reduce the frequency of headaches in migraineurs, but also renders their attacks shorter in duration, less severe and more tolerable. It was also observed to reduce symptoms of nausea, photophobia and phonophobia in these patients.
(Shoeibi et al, 2017)

AKA, CoQ10 was able to reduce migraine symptoms and frequency and improve nausea, sensitivity to light, and sensitivity to sound. 

Another study found that women who used a daily CoQ10 supplement had decreased levels of CGRP, the same substance that is the target of the new class of migraine drug CGRP-antagonists like Aimovig. 

Two other clinical trials as well as a review of current literature found similar results – that CoQ10 is able to reduce severity and frequency of migraine episodes with very few, if any, side effects. 

While this effect hasn’t been tested against a placebo (or sugar pill) yet, the results are certainly promising and the risks of taking this supplement appear to be very low if not nonexistent.

Signs of Deficiency

Coenzyme Q10 deficiencies are becoming more widely recognized as we research this supplement more. Deficiencies can result from certain genetic mutations, certain vitamin deficiencies (like B6), use of statins, and increased demand due to certain diseases. Deficiencies range in severity and can show up anytime throughout your lifespan.

Signs and symptoms of a CoQ10 deficiency include:

  • muscle weakness
  • problems with coordination
  • seizures
  • vision loss
  • involuntary muscle contractions

Even if you don’t have a true Coenzyme Q10 deficiency, you could very well still  benefit from supplementation. The studies mentioned previously were done on migraineurs with no diagnosed CoQ10 deficiency, so it appears that people with migraine may just benefit from higher doses of this coenzyme than the general population. 

There is also the possibility, of course, that people with migraine use more of this substance, or tend to produce less naturally. The verdict is still out!

CoQ10 From Food

While your body will ideally produce enough CoQ10 on its own, there are some food sources of CoQ10 such as:

  • organ meats
  • fish
  • dark leafy greens
  • fresh herbs
  • broccoli
  • peas
  • asparagus

You’ll notice many of these foods have something in common – they’re all GREEN! Foods that contain high amounts of chlorophyll (the natural chemical that gives plants a green color) tend to be higher in CoQ10. 

While looking to food first is always a good option, it may be hard to get enough CoQ10 from food alone if you are trying to consume therapeutic doses. This is where supplements come in handy!

CoQ10 Supplements

CoQ10 supplements come in two different forms: ubiquinone (the oxidized form) and ubiquinol (the reduced form). 

Almost all clinical trials and research studies use the ubiquinone form and have had pretty good success with it. This form must be processed (reduced) by your body in order to create ubiquinol, which is the more readily absorbed form. 

For most people, this isn’t a big deal! But there are some genetic mutations that can create a decreased ability to make this conversion. The question is, how do you know if you are one of these people?

My answer to this is that, rather than having expensive genetic testing done, you simply use the ubiquinol (better absorbed) form just in case. You body, whether you have a genetic mutation or not, will be able to use that form with no issues. 

One thing to note is that ubiquinol supplements are usually more expensive. If price is an issue, you can try the ubiquinone form first and see how you do with it – if you don’t notice any positive changes, you can always try the more expesive version later!

To find out which form a supplement comes in, look at the supplement facts on the back of the bottle (looks like a nutrition facts label). If it doesn’t specify a form, you can assume it’s ubiquinone. 

Common Usage

There’s no recommended daily amount of CoQ10, so we need to look to studies to see how much should be taken for migraine.

Most studies use anywhere between 150 mg and 400 mg of CoQ10 per day – that’s a big range! A good rule of thumb with this supplement is to go by the directions on the label and consult with your doctor or dietitian for the best dosage for you personally. You may find success starting with a smaller dosage (many supplements come in 100 mg or 200 mg) and increasing it if you notice no positive effects after a few months.

Side Effects and Warnings

Coenzyme Q10 has shown to be a very safe supplement and does not have a high likelihood of producing side effects when taken appropriately.

Potential, uncommon side effects of CoQ10 include:

  • Stomach pain
  • Loss of appetite
  • Nausea
  • Diarrhea
  • Headaches
  • Insomnia
  • Fatigue
  • Dizziness
  • Light sensitivity
  • Irritability

CoQ10 may reduce the effectiveness of certain blood clotting medications, so be sure to check with your doctor before starting this supplement especially if you are on a blood clotting medication.

Bottom Line

Coenzyme Q10 could be an important supplement for migraineurs, especially those with mitochondrial dysfunction or increased need. Ubiquinol is the most easily absorbed form of this ingredient and doses between 150mg and 400mg appear to be most beneficial.

References

Integrative and Functional Medical Nutrition Therapy – Noland, Drisko, and Wagner, 2020

Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers

Open Label Trial of Coenzyme Q10 as A Migraine Preventive 

Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial

Efficacy of coenzyme Q10 for the prevention of migraine in women: A randomized, double-blind, placebo-controlled study

Effect of coenzyme Q10 supplementation on clinical features of migraine: a systematic review and dose–response meta-analysis of randomized controlled trials

Primary coenzyme Q10 deficiency

Coenzyme q10 therapy

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