CoQ10, Fertility and PCOS #104

Should I be taking CoQ10?

Hello,

Please don’t freak out, but it’s already December 🎄. How is everyone feeling about approaching the end of the year? I am not feeling that Christmasy yet, but there is nothing Home Alone can’t fix.

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Today, we discuss another popular supplement in the PCOS space: CoQ10. This is often discussed to improve fertility and insulin resistance, but does it have scientific backing? What is even CoQ10?

What is CoQ10?

CoQ10, also known as Ubiquinone, is a vitamin-like molecule that helps convert food into energy. It is part of ATP production (energy) and is present in almost every cell in the body. We can get it from food, but our body produces most of it.

Besides helping glucose be transformed into energy, CoQ10 is a great antioxidant. Our bodies constantly create free radicals that need to be packaged and pushed out by antioxidants. Even the production of ATP (our energy molecule) produces free radicals. So, the body creates antioxidant molecules to deal with its own production of free radicals. Unfortunately, a higher insulin or testosterone environment will inevitably create more of these free radicals, which is why this molecule becomes beneficial for PCOS.

CoQ10 has also been shown to stop LDL cholesterol oxidation, one of the most dangerous processes for arteriosclerosis.

CoQ10 and PCOS

CoQ10 has piqued interest for PCOS. One meta-analysis showed that CoQ10 supplementation helped women reduce insulin resistance and cholesterol levels. For testosterone, the improvement was statistically significant but tiny.

Another randomised control trial studied the effect of CoQ10 in combination with Vitamin E and found an even more significant impact than CoQ10 alone. This is because these two molecules seem to be interlinked, and working together can amplify their effect. The dosage was 200 mg CoQ10 daily plus 400UI vitamin E for 8 weeks.

So, if insulin resistance worries you, this supplement has some potential.

CoQ10 and Fertility

Oxidative stress is the imbalance between free radicals and antioxidant defences. As mentioned above, the production of free radicals from the body’s processes surpasses that of antioxidants, tilting the balance towards higher free radicals. This is dangerous because free radicals are unstable molecules that damage our body’s functions.

When we want to conceive, our bodies must be stable because creating a human being is highly complex. I love our bodies.

A meta-analysis of the women undergoing IVF found a positive effect of CoQ10 on pregnancy rates overall: 28.8% vs. 14.1% pregnancy rate.

Looking a bit deeper, this looked at only two studies explicitly done on PCOS, of which one was retracted. I remain cautionary optimistic about this study because it has helped women without PCOS, but please bear in mind that it is not very solid evidence.

A lot of studies on fertility are done in IVF settings because it’s where it’s 1) easiest to get a pool of women who are unable to conceive and 2) have the ability to analyse things in detail as embryos and hormones are closely monitored and analysed.

I could not find any studies looking at natural conception. However, studies on women undergoing IVF suggest it can increase egg quality and protect it from oxidation.

I am unsure if this level of evidence justifies taking CoQ10 as a standard fertility supplement. However, levels of CoQ10 start decreasing with age. By 80 years old, we will have half the CoQ10 levels. Conceiving a bit later in life means we will operate with slightly lower levels, and supplementing could be beneficial.

Please consult a healthcare professional before taking supplementations, especially for fertility. Dosages, your current diet, your genetics, your past medical history, and your medication must all be considered before creating a supplement plan.

CoQ10 deficiency

You might wonder, how do I know if I produce enough CoQ10?

A blood test can be performed to check your CoQ10 levels. I would take this test if fatigue, muscle weakness, and concentration problems were present.

CoQ10 deficiency is rare. It’s caused by a genetic mutation that leads to quite severe symptoms. Because of its role in energy production, it affects the heart muscle, skeletal muscle, and brain function.

CoQ10 in food

Before we jump to pills and supplements, I would confidently say that trying to get CoQ10 from food is always a good idea. Because CoQ10 can be produced in the body without the need for external nutrients, there is no daily recommended dosage for it. However, adding to our CoQ10 pool is possible through:

• Organ meats (especially liver)

• Fatty fish (such as salmon and sardines)

• Beef and pork

• Chicken

• Nuts and seeds (particularly peanuts and sesame seeds)

To reiterate, please consult a healthcare professional before adventuring into taking supplements. It will pay off.

In The PCOS newsletter, we review PCOS supplements regularly. We have already discussed Inositol, NAC, Spearmint and many more. You can find them below:

Happy Sunday,

Francesca

Francesca is a Nutritional Therapist with years of experience managing PCOS symptoms. If you are interested in one-to-one consultations, you can book a free discovery call here.

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1. References

Elbohoty, S. B., Dawood, A. S., Dawood, A. S., & Elsayed, M. A. (2023). Does coenzyme Q10 improve ovulation and pregnancy rates in clomiphene citrate-resistant polycystic ovary syndrome? International Journal of Infertility & Fetal Medicine, 14(3), 133–138. https://doi.org/10.5005/jp-journals-10016-1327

Florou, P., Anagnostis, P., Theocharis, P., Chourdakis, M., & Goulis, D. G. (2020). Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. Journal of Assisted Reproduction and Genetics, 37(10), 2377–2387. https://doi.org/10.1007/s10815-020-01906-3

Hidaka, T., Fujii, K., Funahashi, I., Fukutomi, N., & Hosoe, K. (2008). Safety assessment of coenzyme Q₁₀ (CoQ₁₀). BioFactors (Oxford, England), 32(1–4), 199–208. https://doi.org/10.1002/biof.5520320124

Izadi, A., Ebrahimi, S., Shirzai, S., Taghizadeh, S., Parizad, M., Farzadi, L., & Pourghassem Gargari, B. (2018). Hormonal and metabolic effects of coenzyme Q10 and/or vitamin E in patients with polycystic ovary syndrome. The Journal of Clinical Endocrinology and Metabolism, 104(2), 319–327. https://doi.org/10.1210/jc.2018-01221

Xu, Y., Nisenblat, V., Lu, C., Li, R., Qiao, J., Zhen, X., & Wang, S. (2018). Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial. Reproductive Biology and Endocrinology: RB&E, 16(1). https://doi.org/10.1186/s12958-018-0343-0

Zhang, J., Xing, C., Zhao, H., & He, B. (2021). The effectiveness of coenzyme Q10, vitamin E, inositols, and vitamin D in improving the endocrine and metabolic profiles in women with polycystic ovary syndrome: a network Meta-analysis. Gynecological Endocrinology: The Official Journal of the International Society of Gynecological Endocrinology, 37(12), 1063–1071. https://doi.org/10.1080/09513590.2021.1926975

Zhang, T., He, Q., Xiu, H., Zhang, Z., Liu, Y., Chen, Z., & Hu, H. (2023). Efficacy and safety of coenzyme Q10 supplementation in the treatment of polycystic ovary syndrome: A systematic review and meta-analysis. Reproductive Sciences (Thousand Oaks, Calif.), 30(4), 1033–1048. https://doi.org/10.1007/s43032-022-01038-2

Disclaimer: We are all unique in our ways, so this information is for educational purposes only. In my communications, I summarise research data and bring my experience. This shouldn’t be viewed as medical advice at any point. Please consult your healthcare provider further about your health needs.