Coenzyme Q-10 (often abbreviated CoQ-10) is a supplement that can be bought over the counter at health stores or "on line".

Mechanism of Action: Coenzyme Q-10 plays a vital role in energy production, and it acts as an antioxidant.

Rationale for Use in Huntington's: Research studies have shown that Coenzyme Q-10 reduces brain injury in mouse models [Ferrante RJ 2002], and improves energy metabolism in Huntington's people [Koroshetz WJ 1997]. It also demonstrated a "trend" toward benefit in a large trial of Huntington's people which used 600 mg per day of Vitaline Coenzyme Q-10 [Huntington Study Group 2001]. A subsequent study in Parkinson's Disease suggested that higher dosages give greater benefit. [Shults CW 2004].

Dosage: Dosage determination is difficult for this product because bioavailability, or how much product is actually absorbed into blood, varies widely between products. Of preparations that are available, I recommend either Tischon's Q-gel or Vitaline. Q-gel is the best absorbed: 600 mg of Q-gel gives the same blood level as 1200 mg of Vitaline. At lower dosage, the Tischon product gave best mouse survival in a recent mouse study comparing Coenzyme Q-10 preparations [Smith KM 2006]; please note that Vitaline results were not reported in this study. The Huntington Study Group Coenzyme Q-10 human trial will be using 2400 mg of the Vitaline product.

"Statin" drugs that are used to decrease cholesterol deplete Coenzyme Q-10. Those on these drugs should consider higher dosage.

Contraindications: Coenzyme Q-10 has structural similarities to vitamin K and should be used with care in those on coumadin or warfarin blood thinners.

Side Effects: This drug can cause nausea, diarrhea, upset stomach and loss of appetite. Insomnia and liver enzyme elevations have been reported with higher dosages.

Sources: Consumer Lab (CL) is not helpful because only a few products have been tested (and reported) for bioavailability. Therefore the list is short.

  • Tischon/Epic for Health "ChewQ" Cost for 600 mg wafer, 1 or 2 per day, is $185 to $375 per month. Remember that 600 mg of Tischon is equal to 1200 mg of Vitaline. This dosage should be split into 3 or 4 times per day with meals. The product can be obtained from Tishcon's online store.
  • Vitaline Cost for 300 mg wafers, 4 or 8 per day (1200-2400 mg), is $260 to $520 per month. This dosage should be split into 3 or 4 times per day. The product can be obtained from Vitaline's online store.

References

Ferrante RJ, Andreassen OA, Dedeoglu A, Ferrante KL, Jenkins BG, Hersch SM, Beal MF. Therapeutic effects of coenzyme Q10 and remacemide in transgenic mouse models of Huntington's disease. J Neurosci. 2002 Mar 1;22(5):1592-9. PubMed abstract

Koroshetz WJ, Jenkins BG, Rosen BR, Beal MF. Energy metabolism defects in Huntington's disease and effects of coenzyme Q10. Ann Neurol. 1997 Feb;41(2):160-5. PubMed abstract

Huntington Study Group. A randomized, placebo-controlled trial of coenzyme Q10 and remacemide in Huntington's disease. Neurology. 2001 Aug 14;57(3):397-404. PubMed abstract

Shults CW, Flint Beal M, Song D, Fontaine D. Pilot trial of high dosages of coenzyme Q10 in patients with Parkinson's disease. Exp Neurol. 2004 Aug;188(2):491-4. PubMed abstract

Smith KM, Matson S, Matson WR, Cormier K, Del Signore SJ, Hagerty SW, Stack EC, Ryu H, Ferrante RJ. Dose ranging and efficacy study of high-dose coenzyme Q10 formulations in Huntington's disease mice. Biochim Biophys Acta. 2006 Jun;1762(6):616-26. Epub 2006 Apr 17. PubMed abstract