Evidence explainerCoQ10 (ubiquinol vs ubiquinone)
Ubiquinol vs Ubiquinone: Is the Pricier CoQ10 Worth It After 40?
Ubiquinol is marketed as the "active" CoQ10 your body struggles to make as you age. The headline comparison behind that claim involved 12 people. Here is what it showed.
Key takeaways
- In a 12-person study, 200 mg/day of ubiquinol raised plasma CoQ10 from 0.9 to 4.3 µg/mL, versus 0.9 to 2.5 µg/mL with ubiquinone, over 4 weeks [1].
- The study was not randomized: everyone took ubiquinone first, then ubiquinol after a 4-week washout [1].
- No trial in our sources shows ubiquinol produces better health outcomes than ubiquinone [1][2].
- The outcome trials (statin symptoms, blood pressure, heart failure) mostly do not state which form they used [3][4].
Safety at a glance
From our CoQ10 (ubiquinol vs ubiquinone) monograph. Published interactions and cautions only, each with its source.
Interactions
- Warfarin. NCCIH: CoQ10 may interact with the anticoagulant warfarin.[1]
- Insulin. NCCIH: CoQ10 may interact with insulin.[1]
- Some cancer treatments. NCCIH: CoQ10 may not be compatible with some types of cancer treatment.[1]
- Statins. A meta-analysis of 12 RCTs (n=1,776) found statins lowered circulating CoQ10, regardless of statin type, intensity or treatment length.[7]
Who should be careful
- People on warfarin or insulin. NCCIH lists possible interactions with warfarin and insulin; dose changes of those medicines may need monitoring.[1]
- People in cancer treatment. NCCIH notes CoQ10 may not be compatible with some cancer treatments.[1]
- Pregnancy and breastfeeding. Insufficient safety data in our sources.[1]
- Side effects. No serious side effects reported; mild insomnia or digestive upset may occur.[1]
The evidence, graded
Pulled from our monograph evidence tables. Grades follow our evidence-grading policy.
- Grade DImprovedBlood CoQ10 levels: ubiquinol vs ubiquinonePlasma total CoQ10 rose from 0.9 to 4.3 µg/mL with ubiquinol versus 0.9 to 2.5 µg/mL with ubiquinone; the increase was significantly larger with ubiquinol. No side effects noted.
- Grade CMixedMuscle symptoms in statin usersCoQ10 reduced muscle pain, weakness, cramps and tiredness scores versus placebo; creatine kinase did not change.
- Grade CImprovedLong-term clinical events (heart-failure trial)No change in the 16-week endpoints. At 2 years, major adverse cardiovascular events occurred in 15% vs 26% (HR 0.50); cardiovascular and all-cause mortality and heart-failure hospital stays were also lower.
Same molecule, two states
CoQ10 exists in an oxidized form, ubiquinone, and a reduced form, ubiquinol [1]. Supplements sell both, and ubiquinol usually costs more on the claim that it is absorbed better.
The comparison study
In 2014, 12 healthy volunteers took 200 mg/day of ubiquinone for 4 weeks, stopped for 4 weeks, then took 200 mg/day of ubiquinol for 4 weeks, in softgels with identical ingredients otherwise [1]. Plasma total CoQ10 rose from 0.9 to 2.5 µg/mL on ubiquinone and from 0.9 to 4.3 µg/mL on ubiquinol, a significantly larger increase [1]. No side effects were noted [1].
That is a real difference in blood levels. But the design had limits: tiny size, no randomization, and the same order for everyone [1]. We grade it D.
Do higher blood levels mean better results?
Not shown. The best-known CoQ10 outcome trial, Q-SYMBIO, gave 300 mg/day to 420 people with chronic heart failure on standard therapy and reported fewer major cardiovascular events at 2 years (15% vs 26%), but its abstract does not name the form, it has not been replicated, and it is a matter for a cardiologist [4][2].
The statin-muscle meta-analysis likewise does not specify form [3]. So if you choose ubiquinol, you are paying for higher blood levels, not for a proven better outcome.
How to choose
Either form raised blood CoQ10 in the comparison study [1]. If cost matters, ubiquinone is the form much of the older research grew up on; if you want the bigger blood-level bump, ubiquinol delivered it in one small study [1]. NCCIH lists interactions with warfarin and insulin regardless of form [2].
For the most common reason people in midlife reach for CoQ10, read CoQ10 with statins [3]. Creatine is another energy-related supplement with far stronger muscle data: creatine in midlife and beyond.
Keep reading
Full monographs
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- CoQ10 With Statins: Statins Do Lower It, but Does Taking It Ease Muscle Aches?
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References
- [1]Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clin Pharmacol Drug Dev, 2014.
- [2]Coenzyme Q10. National Center for Complementary and Integrative Health (NCCIH), 2019.
- [3]Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc, 2018.
- [4]The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail, 2014.