Coenzyme Q-10 is a non-prescription dietary supplement that can be bought across the counter at health stores or pharmacies. It is a natural nutrient made in the human body. It is also found in meat and seafood.

Co-Q10 plays a vital role in mitochondrial ATP (energy) production. It acts as a free radical scavenging agent or "antioxidant."

Research studies have shown that CoQ-10 reduces brain injury and improves HD symptoms in the mouse models (Ferrante et al. 2002), and improves energy metabolism in Huntington’s people (Koroshetz et al. 1997). It also demonstrated a “trend” toward benefit in a large trial of Huntington’s people that used 600 mg/day Vitaline CoQ-10 (HS Group 2001). A subsequent study in Parkinson’s disease suggested that 1200 mg/day dosing gives greater benefit. Doses of 1800 and 2400 achieve significantly higher blood levels (Shults et al. 2004). It has been shown to increase brain levels of ATP, and to decrease biomarkers of oxidative injury in the mouse model (Smith et al. 2006).

Further, there is evidence that CoQ10 levels are decreased in Huntington’s people as the disease progresses (Muller, et al 2004). For those who are on “statin” drugs to lower cholesterol, there is evidence that this drug depletes CoQ10 levels.

Dosage determination is difficult for this product because bioavailability, or how much product is actually absorbed into blood, of each supplement varies widely. Because bioavailability is so varied, recommended "dosage" depends on the product. I recommend the equivalent dosage of 1200 to 1800 mg/24 hrs of the Vitaline product (used in Shults dosage study). Tishcon-manufactured CoQ-10 has higher bioavailability. Only 600 to 900 mg/24 hrs is needed to reach equivalent blood levels of absorbed CoQ-10. At lower dosage, the Tischon product (Vitaline was not reported) gave best mouse survival in a recent mouse study comparing CoQ-10 preparations (Smith et al. 2006). The Huntington Study Group CoQ-10 human trial will be using 2400 mg of the Vitaline product.

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

ConsumerLab (CL) is not helpful on this supplement, because only a few products have been tested (and reported) for bioavailability. Therefore its "list" is short.

• Vitaline 300 mg wafers: 4 or 8 per day (1200-2400mg), $260 to $520/month. (www.vitalinecoq10.com )
• Tischon/Epic for Health “ChewQ” 600 mg wafer, 1 or 2 per day $185 to $375 per month. (www.qgel.com )

Side effects include nausea, diarrhea, upset stomach and loss of appetite. Insomnia and liver enzyme elevations have been reported with higher dosages.

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

• Andrich, J., C. Saft, M. Gerlach, B. Schneider, A. Arz, W. Kuhn and T. Muller (2004). "Coenzyme Q10 serum levels in Huntington's disease." J Neural Transm Suppl(68): 111-6.
• Ferrante, R. J., O. A. Andreassen, A. Dedeoglu, K. L. Ferrante, B. G. Jenkins, S. M. Hersch and M. F. Beal (2002). "Therapeutic effects of coenzyme Q10 and remacemide in transgenic mouse models of Huntington's disease." J Neurosci Mar 1;22(5):1592-9.
• Group, H. S. (2001). "A randomized, placebo-controlled trial of coenzyme Q10 and remacemide in Huntington's disease." Neurology 57(3): 397-404.
• Koroshetz, W. J., B. G. Jenkins, B. R. Rosen and M. F. Beal (1997). "Energy metabolism defects in Huntington's disease and effects of coenzyme Q10." Ann Neurol 41(2): 160-5.
• Shults, C. W., M. Flint Beal, D. Song and D. Fontaine (2004). "Pilot trial of high dosages of coenzyme Q10 in patients with Parkinson's disease." Exp Neurol 188(2): 491-4.
• Smith, K. M., Matson, S., Matson. W.R., Cormier, C., Del Signore, S. J., Hagerty, S. W., Stack, E. C., Ryu, and R. J. Ferrante. "Dose ranging and efficacy study of high-dose coenzyme Q10 formulations in Huntington's disease mice." Biochimica et Biophysica Acta 2006 Apr 17 (Epub ahead of print)