NICEVIVA
DRUG INTERACTION RECORDED 1 Prescription Drug Interaction(s) Reported — Review the pharmacokinetic interaction matrix below before use.
Pharmacokinetic Alert
MONOGRAPH SPEC LATEST 2026

Coenzyme Q10 (Ubiquinone)

ANTIOXIDANTS · Evidence Monograph

Coenzyme Q10 (Ubiquinone) is an evidence-graded antioxidants monograph evaluated across 16 peer-reviewed PubMed studies (4 meta-analyses, 0 systematic reviews, and 7 randomized controlled trials, encompassing n = 1,509 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for mitochondrial redox homeostasis, free-radical scavenging, and Nrf2/HO-1 signaling.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 16 Studies
Meta-Analyses · Reviews 4 Meta · 0 Systematic Reviews
Randomized Trials (RCT) 7 RCTs (6 Double-Blind)
Cumulative Participants n = 1,509
Reported Trial Dosages 20 mg · 20 mg/day · 600 mg
Trial Duration Range 27 months · 4 weeks · 6 months
Reading Time ~8 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for mitochondrial redox homeostasis, free-radical scavenging, and Nrf2/HO-1 signaling (supported by 16 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (20 mg · 20 mg/day · 600 mg) over a structured 27 months evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Stabilized Bioavailable Redox Formulation (e.g., Ubiquinol / R-ALA / Liposomal)
Acidic antioxidants (such as alpha-lipoic acid) irritate the esophagus when taken fasting; pair fat-soluble antioxidants with meals.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Sustained recovery and absence of post-dose heartburn.
Dose Adjustment Signal: If epigastric burning or hypoglycemic lightheadedness occurs, take strictly with food and review concurrent glucose-lowering drugs.
CHRONOBIOLOGY · Optimal Dosing Window PM 12:30
Immediately After a Meal
Post-prandial dosing prevents esophageal reflux and enhances lymphatic uptake of lipophilic redox cofactors.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
Primary antioxidants clinical efficacy (16 PubMed studies)
Quantitative biomarker & outcome analysis (10 studies with effect-size/sample data)
Randomized controlled trial verification (7 RCTs · 6 double-blind)
Systematic review & meta-analysis synthesis (4 meta-analyses · 0 reviews)
01

What Is Coenzyme Q10 (Ubiquinone) & Why Does Form Matter?

Coenzyme Q10 (Ubiquinone) is classified under ANTIOXIDANTS and has been investigated across 16 peer-reviewed PubMed publications for its role in mitochondrial redox homeostasis, free-radical scavenging, and Nrf2/HO-1 signaling.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (20 mg, 20 mg/day, 600 mg).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Coenzyme Q10 (Ubiquinone) frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (7 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Coenzyme Q10 (Ubiquinone) acts on pathways governing mitochondrial redox homeostasis, free-radical scavenging, and Nrf2/HO-1 signaling. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Acidic antioxidants (such as alpha-lipoic acid) irritate the esophagus when taken fasting; pair fat-soluble antioxidants with meals.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Coenzyme Q10 (Ubiquinone) an overall evidence rating of GRADE High (4.0 / 4.0) based on 16 PubMed studies: 4 meta-analyses, 0 systematic reviews, and 7 randomized controlled trials (6 double-blind, n = 1,509 total participants).

Representative peer-reviewed findings include: • PMID:25344142 (2015) — "Prophylactic treatment with coenzyme Q10 in patients undergoing cardiac surgery: could an antioxidant reduce complications? A systematic review and meta-analysis." (Since none of the clinical trials included in this review report any adverse effects associated to CoQ10 administration, and coenzyme Q10 has been demonstrated to be safe even at much higher doses in other studies, we conclude that CoQ10 should be considered as a prophylactic tre) • PMID:42074994 (2026) — "Non-Mineral Antioxidant Supplementation in Endometriosis: Biological Rationale, Clinical Evidence, and Therapeutic Implications-A Narrative Review." (Conclusions: Current evidence does not support the use of non-mineral antioxidant supplements as standalone therapy for endometriosis.) • PMID:41859772 (2026) — "Effects of Coenzyme Q10 Supplementation on Glycemic Control Biomarkers: An Umbrella Review of Meta-Analyses of Randomised Controlled Trials." (CONCLUSION: The present study suggests that CoQ10 supplementation may have a moderate beneficial effect on glycemic control in diabetic patients, though findings differ depending on analytic approach.)

Quantitative Clinical Effect-Size Distribution (Forest Plot)

Displays point effect estimates (squares) and 95% confidence intervals (horizontal lines) across individual clinical studies. Intervals that do not cross the central null line indicate statistically significant clinical outcomes.

Study (PMID · Year)SMD Effect Size & 95% CI DistributionEstimate (95% CI)PMID 416570172.71 (1.57–3.85)PMID 41294251-0.68 (-1.02–-0.33)-1.8Null (0)4.6Metric: SMD
05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Stabilized Bioavailable Redox Formulation (e.g., Ubiquinol / R-ALA / Liposomal). Acidic antioxidants (such as alpha-lipoic acid) irritate the esophagus when taken fasting; pair fat-soluble antioxidants with meals.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 20 mg · 20 mg/day · 600 mg · 100 mg over 27 months · 4 weeks · 6 months · 30 days. Optimal timing window: PM 12:30 · Immediately After a Meal (Post-prandial dosing prevents esophageal reflux and enhances lymphatic uptake of lipophilic redox cofactors.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Sustained recovery and absence of post-dose heartburn.

Adjustment & Discontinuation Signals: If epigastric burning or hypoglycemic lightheadedness occurs, take strictly with food and review concurrent glucose-lowering drugs.

07

Prescription Drug Interactions & Contraindications

• [MINOR] Statin (atorvastatin ): Pharmacokinetic or pharmacodynamic interaction reported in clinical literature (PMID:29020175). Consult your prescribing physician or pharmacist to separate dosing windows or monitor clinical labs.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 12:30 · Immediately After a Meal) with a full glass of water.
  • Stay within clinically studied daily dosages (20 mg · 20 mg/day · 600 mg) and re-evaluate efficacy after 27 months.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist before use if taking Statin (atorvastatin ).
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (16 Studies) · 10 Quantitative Analyses

01
META-ANALYSIS Interactive cardiovascular and thoracic surgery (2015) PMID: 25344142 ↗
Prophylactic treatment with coenzyme Q10 in patients undergoing cardiac surgery: could an antioxidant reduce complications? A systematic review and meta-analysis.
Clinical Trial Synthesis 2015 Meta-Analysis published in Interactive cardiovascular and thoracic surgery. Key conclusion: Since none of the clinical trials included in this review report any adverse effects associated to CoQ10 administration, and coenzyme Q10 has been demonstrated to be safe even at much higher doses in other studies, we conclude that CoQ10 should be considered as a prophylactic tre
View Original PubMed Abstract ↓

Coenzyme Q10 (CoQ10) is a lipid-soluble antioxidant that could have beneficial effects in patients undergoing cardiac surgery with cardiopulmonary bypass. There is no clear evidence about its clinical effects or a systematic review published yet. We aimed to conduct a systematic review and meta-analysis of the literature to elucidate the role of coenzyme Q10 in preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypass. We searched the PubMed Database using the following keywords: Coenzyme Q10, ubiquinone, ubiquinol, CoQ10, Heart Surgery, Cardiac surgery. Articles were systematically retrieved, selected, assessed and summarized for this review. We performed separate meta-analyses for different outcomes (inotropic drug requirements after surgery, incidence of ventricular arrhythmias and atrial fibrillation, cardiac index 24 h after surgery and hospital stay), estimating pooled odds ratios (ORs) or mean differences of the association of CoQ10 administration with the risk of these outcomes. Eight clinical trials met our inclusion criteria. Patients with CoQ10 treatment were significantly less likely to require inotropic drugs after surgery {OR [95% confidence interval (CI) 0.47 (0.27-0.81)]}, and to develop ventricular arrhythmias after surgery [OR (95% CI) 0.05 (0.01-0.31)]. However, CoQ10 treatment was not associated with Cardiac index 24 h after surgery [mean difference (95% CI) 0.06 (-0.30 to 0.43)], hospital stay (days) [mean difference (95% CI) -0.61 (-4.61 to 3.39)] and incidence of atrial fibrillation [OR (95% CI) 1.06 (0.19-6.04)]. Since none of the clinical trials included in this review report any adverse effects associated to CoQ10 administration, and coenzyme Q10 has been demonstrated to be safe even at much higher doses in other studies, we conclude that CoQ10 should be considered as a prophylactic treatment for preventing complications in patients undergoing cardiac surgery with cardiopulmonary bypass. However, better quality randomized, controlled trials are needed to clarify the role of CoQ10 in patients undergoing cardiac surgery with cardiopulmonary bypass. © The Author 2014. Published by Oxford University Press

02
CLINICAL STUDY Nutrients (2026) PMID: 42074994 ↗
Non-Mineral Antioxidant Supplementation in Endometriosis: Biological Rationale, Clinical Evidence, and Therapeutic Implications-A Narrative Review.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in Nutrients. Key conclusion: Conclusions: Current evidence does not support the use of non-mineral antioxidant supplements as standalone therapy for endometriosis.
View Original PubMed Abstract ↓

Background/Objectives: Oxidative stress plays an important role in the pathophysiology of endometriosis, contributing to inflammation, immune dysregulation, and lesion progression. This has led to growing interest in antioxidant-based strategies as potential supportive interventions. Methods: A literature search was conducted using PubMed, Scopus, and Web of Science databases, covering studies published from database inception until the end of January 2026. The review focused on clinically relevant endpoints, including pain intensity, markers of inflammation and oxidative stress, reproductive parameters, and quality of life. Results: Among the analyzed interventions, the most consistent clinical effects were observed with melatonin, with randomized controlled trials indicating a moderate reduction in pain. N-acetylcysteine shows potentially beneficial effects; however, the available clinical data remain limited and heterogeneous. For other supplements, the evidence is inconsistent or insufficient to support clear clinical conclusions, and in many cases relies on indirect or mechanistic findings rather than well-established clinical outcomes. Conclusions: Current evidence does not support the use of non-mineral antioxidant supplements as standalone therapy for endometriosis. They may be considered as adjunctive strategies, although their clinical effectiveness remains uncertain and requires confirmation in well-designed randomized clinical trials.

03
RANDOMIZED TRIAL (RCT) Endocrinology, diabetes & metabolism (2026) PMID: 41859772 ↗
Effects of Coenzyme Q10 Supplementation on Glycemic Control Biomarkers: An Umbrella Review of Meta-Analyses of Randomised Controlled Trials.
Clinical Trial Synthesis 2026 Meta-Analysis published in Endocrinology, diabetes & metabolism. Key conclusion: CONCLUSION: The present study suggests that CoQ10 supplementation may have a moderate beneficial effect on glycemic control in diabetic patients, though findings differ depending on analytic approach.
View Original PubMed Abstract ↓

BACKGROUND: Several meta-analyses suggest that Coenzyme Q10 (CoQ10) supplementation is associated with glycemic control; however, findings about fasting blood glucose (FBG) and haemoglobin A1c (HbA1c) remain inconsistent across studies. Accordingly, this study aimed to synthesise the results to present a firm conclusion in relation to the efficacy of CoQ10 on glycemic control. METHODS: A systematic search was conducted to find meta-analyses of randomised controlled trials using PubMed, Scopus, Web of Science and the Cochrane Database of Systematic Reviews from inception to March 6, 2025. Also, the methodological quality of included studies was evaluated using the AMSTAR2 tool. RESULTS: In total, eight meta-analyses were included in this umbrella systematic review and meta-analysis. Pooled analysis using standardized mean difference analysis demonstrated that CoQ10 is associated with decreased FBG. While it didn't exert any significant changes on the HbA1c, HOMA-IR, and insulin levels. In addition, the combined effect of CoQ10 using weighted mean difference analysis revealed that CoQ10 is able to decrease the FBG (5.04 mg/dL), HbA1c (0.17%), HOMA-IR (0.72), and insulin (1.32 μIU/mL) levels significantly. CONCLUSION: The present study suggests that CoQ10 supplementation may have a moderate beneficial effect on glycemic control in diabetic patients, though findings differ depending on analytic approach. © 2026 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

04
RANDOMIZED TRIAL (RCT) Clinical pharmacology in drug development (2026) PMID: 41789786 ↗
A Randomized, Double-Blind, Two-Treatment, Two-Period, Crossover Study Investigating the Systemic Bioavailability of a Novel Cocrystal Ubiquinol Formulation Compared with a Ubiquinone Formulation in Healthy Adults.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in Clinical pharmacology in drug development. Key conclusion: Coenzyme Q10 (CoQ10) is a naturally occurring biochemical cofactor found in all human cell membranes in two interconvertible forms: oxidized ubiquinone and reduced ubiquinol.
View Original PubMed Abstract ↓

Coenzyme Q10 (CoQ10) is a naturally occurring biochemical cofactor found in all human cell membranes in two interconvertible forms: oxidized ubiquinone and reduced ubiquinol. Clinical studies indicate that different CoQ10 formulations have different absorption rates, highlighting research comparing their systemic bioavailability. This study compared the oral bioavailability of cocrystal formulation soft gels (test product), a novel ubiquinol formulation, and ubiquinone formulation (reference product) in a randomized, double-blind, two-period crossover study with 12 healthy subjects under fasting conditions. The secondary objective of this study was to evaluate the safety and tolerability of the ubiquinol formulation. The pharmacokinetic analyses indicated that the test ubiquinol formulation demonstrated substantially higher relative systemic bioavailability compared with the ubiquinone reference. The geometric mean ratios (test/reference) for baseline-corrected peak plasma concentration (Cmax) and area under the curve from zero to last quantifiable time (AUC0-t) were 2.20 and 2.01, respectively, with 90% confidence intervals of 1.59-3.04 and 1.51-2.70. The geometric mean ratio for AUC from time zero to infinity (AUC0-∞) was 3.43 (90% CI: 1.47-8.00). No adverse events were reported in this small pilot study for either of the formulations. These findings demonstrate that ubiquinol has a better systemic bioavailability than ubiquinone, supporting the novel formulation's potential as a promising alternative to traditional CoQ10 supplements. © 2026 Credevo Pte. Ltd. Cocrystal Health Industry Co., Ltd and The Author(s). Clinical Pharmacology in Drug Development published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.

05
CLINICAL STUDY The Journal of physiology (2026) PMID: 41733122 ↗
Translational studies of chronic supplementation with a mitochondria-targeted antioxidant to improve physical function with ageing.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in The Journal of physiology involving n = 22 participants. Key conclusion: Here, we determined the efficacy of the mitochondria-targeted antioxidant MitoQ for improving multiple domains of physical function, first in old mice and then in high-functioning older adults in a randomized, placebo-controlled, cross-over design clinical trial.
View Original PubMed Abstract ↓

Declines in physical function with advancing age increase the risk of functional limitations and chronic disease. Excess mitochondrial reactive oxygen species (mitoROS)-related oxidative stress is linked to physical dysfunction with ageing, but the effects of therapies targeting excess mitoROS on age-associated physical dysfunction are unclear. Here, we determined the efficacy of the mitochondria-targeted antioxidant MitoQ for improving multiple domains of physical function, first in old mice and then in high-functioning older adults in a randomized, placebo-controlled, cross-over design clinical trial. In old male C57BL6/N mice (N = 22-26; 27 months), we found that 4 weeks of treatment with MitoQ (250 µm in the drinking water) attenuated the age-related decline in grip strength, co-ordination, and endurance without effects in young mice (N = 18-20; 6 months). The effects of MitoQ in old mice were accompanied by lower levels of skeletal muscle mitochondria-specific superoxide production and markers of mitoROS-related oxidative stress (i.e. phosphorylated SHC adaptor protein 1, isoform p66) and inflammation (i.e. interleukin-6, tumour necrosis factor-alpha, interferon-gamma). In the clinical trial, we did not observe convincing effects of 6 weeks of MitoQ (20 mg day-1) treatment on physical function in healthy older adults (N = 18; aged 60-79 years). However, exploratory subgroup analyses suggest possible effects of MitoQ on peak leg extension power and grip strength in participants ≥70 years of age. Our findings provide preclinical, proof-of-concept evidence for targeting excess mitoROS with MitoQ to reverse physical dysfunction with ageing. Although the effects of MitoQ did not directly translate to high functioning older adults, our initial observations suggest MitoQ may have greater efficacy in older, more physically frail individuals. KEY POINTS: Excess mitochondrial reactive oxygen species (mitoROS)-related oxidative stress is linked to physical dysfunction with ageing, but the effects of therapies targeting excess mitoROS on age-associated physical dysfunction are unclear. In old mice, chronic supplementation with the mitochondria-targeted antioxidant Mito

06
META-ANALYSIS The Journal of international medical research (2026) PMID: 41657017 ↗
Effects of coenzyme Q10 analogs on oxidative stress, muscle, and metabolism after exercise: A meta-analysis and systematic review.
Clinical Trial Synthesis 2026 Meta-Analysis published in The Journal of international medical research involving n = 433 participants; statistical significance reported at p = 0.00001 (SMD 2.71). Key conclusion: The metabolism-related blood lactate and maximal oxygen uptake levels were not affected by coenzyme Q10 (standardized mean difference: -0.68, 95% confidence interval: -1.89 to 0.53, p = 0.271; standardized mean difference: -0.156, 95% confidence interval: -0.79 to 0.478, p = 0.63
View Original PubMed Abstract ↓

ObjectiveThis study aimed to investigate whether coenzyme Q10 is effective in preventing exercise-induced oxidative stress and muscle damage.MethodsFourteen randomized controlled studies examining the effects of supplementation with coenzyme Q10 analogs on postexercise oxidative stress and muscle damage were identified through searches in literature databases, including PubMed, the Cochrane Library, Embase, and Web of Science, and then the quality of the included studies was assessed. Quantitative and qualitative analyses were performed.ResultsThe study screened 14 randomized controlled trials that included a total of 433 subjects. The results demonstrated that oral coenzyme Q10 elevated blood coenzyme Q10 concentration (standardized mean difference: 2.710, 95% confidence interval: 1.57-3.85, p < 0.00001) and reduced blood malondialdehyde concentration (standardized mean difference: -0.289, 95% confidence interval: -0.541 to -0.038, p = 0.024). Additionally, oral coenzyme Q10 was found to reduce blood creatine kinase values (standardized mean difference: -1.532, 95% confidence interval: -2.856 to -0.209, p = 0.023), suggesting a potential protective effect on skeletal muscle. The metabolism-related blood lactate and maximal oxygen uptake levels were not affected by coenzyme Q10 (standardized mean difference: -0.68, 95% confidence interval: -1.89 to 0.53, p = 0.271; standardized mean difference: -0.156, 95% confidence interval: -0.79 to 0.478, p = 0.630).ConclusionsCoenzyme Q10 may reduce exercise-induced oxidative stress on blood malondialdehyde and exert a protective effect on muscle; however, no effect was observed from the anaerobic and aerobic metabolism of the organism.

07
CLINICAL STUDY Nutrients (2025) PMID: 41470903 ↗
Effects of Coenzyme Q10 Supplementation on Physical Function Adaptations to High-Intensity Interval Training in Older Adults.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Nutrients involving n = 38 participants; statistical significance reported at p = 0.05. Key conclusion: Conclusion: While CoQ10 supplementation enhanced improvements in lower-body strength and power, as indicated by the greater gains in 5XSST and 30CST performance compared to the placebo, no between-group differences were observed in TUG, grip strength, or other functional outcomes
View Original PubMed Abstract ↓

Objectives: This study investigated whether CoQ10 supplementation enhances physical adaptations to high-intensity interval training (HIIT) in muscular strength, power, and physical function in older adults. Method: In a double-blind, randomized controlled trial, 38 adults aged 65-75 were assigned to either a CoQ10 (Females: 8; Males: 11) or placebo (Females: 8; Males: 11) group and completed an 8-week supervised HIIT program. Lower- and upper-body strength (30s 5-repetition chair stand [5XSST], chair standing [30CST], handgrip strength [HGR/L]), balance (single-leg stand [SLS], timed up and go [TUG]), mobility (25-foot walk [25FW]), and aerobic endurance (6-minute walk [6MWT]) were assessed pre- and post-intervention. Results: The CoQ10 group demonstrated significantly greater improvements in 5XSST and 30CST compared to the placebo group (p < 0.05). Both groups showed significant within-group improvements in right and left handgrip strength, SLS, 6MWT, and TUG (all p < 0.001), with no significant between-group differences observed for these outcomes (p > 0.05). No adverse events were reported. Conclusion: While CoQ10 supplementation enhanced improvements in lower-body strength and power, as indicated by the greater gains in 5XSST and 30CST performance compared to the placebo, no between-group differences were observed in TUG, grip strength, or other functional outcomes. This suggests that the performance-related effects of CoQ10 may be more specific to muscular power output and fatigue resistance, rather than general mobility or balance-related tasks. These findings highlight the potential of CoQ10 as a targeted adjunct in exercise for supporting lower-body function and physical performance in older adults.

08
RANDOMIZED TRIAL (RCT) BMC sports science, medicine & rehabilitation (2025) PMID: 41361495 ↗
Short-term CoQ10 supplementation reduces markers of cardiac stress in soccer players following heavy exercise: A randomized double-blind placebo-controlled trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in BMC sports science, medicine & rehabilitation; statistical significance reported at p = 0.003. Key conclusion: These findings suggest potential associations with reduced cardiac stress responses to exercise, but further studies are required to confirm the clinical significance and long-term effects of CoQ10 supplementation on cardiovascular health in athletes.
View Original PubMed Abstract ↓

BACKGROUND: Coenzyme Q10 (CoQ10), a vital mitochondrial antioxidant, may enhance cardiovascular recovery and delay fatigue in athletes. This double-blind, randomized, placebo-controlled trial investigated CoQ10's effects on cardiac stress markers and exercise performance in 16 professional soccer players. METHODS: Participants received either CoQ10 (n = 8) or placebo (n = 8) for 30 days and completed exhaustive aerobic cycling tests pre- and post-supplementation. Blood samples were collected at six time points to analyze GDF-15, NT-proBNP, and hs-TnT levels. RESULTS: In the CoQ10 group, GDF-15 rose post-exercise (PreEx1-PostEx1: +8.84%, p = 0.003; PreEx2-PostEx2: +5.37%, p = 0.001) but declined by 24 h post-Ex1 (- 5.28%, p = 0.003) and 24 h post-Ex2 (-6.62%, p = 0.001) compared to post-Ex1 & post-Ex2, respectively. NT-proBNP increased post-Ex1 (19.66%, p = 0.001), post-Ex2 (12.09%, p = 0.001) but decreased in 24 h-Ex1 (- 20.28%, p = 0.001), 24 h-Ex2 (-20.83%, p = 0.001) compared to post-Ex1&Ex2, respectively. Following a 31.18% increase post-Ex1, a smaller 23.65% increase was observed post-Ex2 in hs-TnT levels, however, decreases of -19.57 and - 32.20% were observed 24 h- postEx1&Ex2 compared to post-Ex1&Ex2, (p = 0.001 for all). Time to fatigue (TTF) improved post-supplementation (- 0.5%, p = 0.002), whereas the placebo showed no change (- 0.08%, p = 0.793). CONCLUSIONS: CoQ10 supplementation significantly reduced post-exercise cardiac stress markers (GDF-15, NT-proBNP, hs-TnT) and improved TTF in athletes. These findings suggest potential associations with reduced cardiac stress responses to exercise, but further studies are required to confirm the clinical significance and long-term effects of CoQ10 supplementation on cardiovascular health in athletes. TRIAL REGISTRATION: not applicable. © 2026. The Author(s).

09
RANDOMIZED TRIAL (RCT) Contemporary clinical trials (2026) PMID: 41325897 ↗
Assessment of a novel functional food modulating the microbiota-inflammation-brain axis in patients with heart failure and/or /atrial fibrillation patients (the AMBROSIA study): Protocol for a randomized controlled trial.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in Contemporary clinical trials involving n = 60 participants. Key conclusion: CONCLUSION: By integrating cutting-edge omics tools and a multidimensional nutritional strategy, AMBROSIA aims to uncover mechanisms driving undernutrition and identify biomarkers to support personalized interventions for older patients with AF and HF.
View Original PubMed Abstract ↓

BACKGROUND AND AIMS: Atrial fibrillation (AF), heart failure (HF), and undernutrition represent a complex triad with major clinical and socioeconomic consequences in older adults, often predisposing to frailty. Undernutrition often remains underdiagnosed due to a reliance on weight-based measures and limited awareness of inflammation-related cachexia. The AMBROSIA study aims to fill these gaps by exploring the response of the microbiota-inflammation-brain axis to a targeted, fortified food product-based intervention, with comprehensive outcome assessments, alongside mechanistic/exploratory -omics analyses and gut microbiota (GM) functional profiling. METHODS AND RESULTS: This single-center, prospective, parallel-group randomized controlled trial aims to enroll 120 older adults with confirmed AF and/or HF. Participants will be randomized 1:1 into an intervention group (n = 60) or control group (n = 60). All participants receive individualized dietary counseling; the intervention group additionally consumes one AMBROSIA nutritional bar daily for six months. The bar contains hydrolyzed proteins, inulin, CoQ₁₀, and probiotics (L. rhamnosus IMC 501® and L. paracasei IMC 502®) in a flavonoid-rich chocolate matrix. Clinical, cognitive, and nutritional data, along with blood, saliva, urine, and stool samples, will be collected at baseline, 3, and 6 months. The primary endpoint is the change in skeletal muscle mass, physical function and frailty, while secondary endpoints include changes in nutritional status, inflammation, GM, metabolomics, and quality of life. CONCLUSION: By integrating cutting-edge omics tools and a multidimensional nutritional strategy, AMBROSIA aims to uncover mechanisms driving undernutrition and identify biomarkers to support personalized interventions for older patients with AF and HF.

10
CLINICAL STUDY Redox biology (2025) PMID: 41308251 ↗
MitoQ supplementation does not impact redox responses to acute exercise in skeletal muscle of older individuals.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Redox biology. Key conclusion: MitoQ supplementation reduced mitochondrial H2O2 emission capacity in skeletal muscle but did not impact mitochondrial respiration, H2O2 emission in the presence of ADP, or the sensitivity for ADP to stimulate respiration (apparent Km) and attenuate H2O2 emission (apparent IC50).
View Original PubMed Abstract ↓

Ageing is associated with attenuated exercise responses in skeletal muscle, which may be related to a failure of muscle redox signalling. The attenuation of redox responses to exercise in aged muscle has been linked to perturbations in redox homeostasis induced by age-related increases in mitochondrial oxidative stress. Accordingly, we investigated the effects of supplementation with the mitochondria-targeted antioxidant MitoQ on mitochondrial bioenergetics and H2O2 emission as well as acute exercise-induced redox responses in skeletal muscle of older individuals. In a randomised, double-blind, placebo-controlled, parallel design, 10 males and 12 females aged 65-80 years were randomised to receive either MitoQ (20 mg/day) or a placebo for 12 weeks before completing a single bout of exercise. Vastus lateralis muscle biopsies were collected before supplementation and before, immediately post- and 4 h post-exercise. MitoQ supplementation reduced mitochondrial H2O2 emission capacity in skeletal muscle but did not impact mitochondrial respiration, H2O2 emission in the presence of ADP, or the sensitivity for ADP to stimulate respiration (apparent Km) and attenuate H2O2 emission (apparent IC50). Acute exercise-induced peroxiredoxin oxidation in skeletal muscle was not altered by MitoQ supplementation. Similarly, MitoQ had no effect on the phosphorylation of several redox-sensitive protein kinases (AMPK, p38 MAPK, and ERK1/2) or the upregulation of mitochondrial and antioxidant genes following exercise. Collectively, these findings indicate that MitoQ supplementation did not influence the basal myocellular redox state or redox responses to exercise in skeletal muscle of older individuals.

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