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ConsumerLab.com Answers
Question: What is the difference between CoQ10 and ubiquinol?
Answer: Only after you take CoQ10 does your body convert it to the active form, ubiquinol. Taking 100 mg of ubiquinol (sometimes labeled as CoQH-10 or CoQH2-10) compared to 100 mg of CoQ10 (known as ubiquinone), may yield a bit more active compound in your body. In short, you may be able to take a little less ubiquinol than CoQ10 to get the same result.
However, more important than whether you take CoQ10 or ubiquinol is that fact that both are fat-soluble compounds, so to significantly improve their absorption, it is important to take them with a fatty meal or in a formula that contains fats or other solubility enhancers.
More information about CoQ10 and ubiquinol and their solubility-enhanced formulas is found in the CoQ10 and Ubiquinol Supplements Review, which includes our test results and quality ratings of dozens of products, as well as ingredient and price comparisons. See the CoQ10 and Ubiquinol Supplements Review now >>
ConsumerLab.com Answers
Question: Are supplements which claim increased absorption or improved bioavailability telling the truth? Is it worth paying more for these? Are there concerns?
Answer:
It is true that some supplements contain special ingredients, or enhancers, which can improve the absorption or bioavailability (amount of ingredient circulating in your blood) of certain supplements, such as CoQ10, curcumin, milk thistle, green tea, grape seed, ginkgo, and resveratrol. Enhancers typically act in the gut to either improve solubility or reduce the amount of enzymatic breakdown which occurs there. By allowing you to absorb more active ingredient, the supplement may be more potent, meaning that a smaller dose may be used. At the same time, enhancers may increase the absorption or otherwise interact with other supplements or drugs which you take, so it is important to use caution.
The four main types of enhancers currently found in supplements are emulsifying agents, like lecithin; self-emulsifying systems, which involve an oil; phytosomes made from phosphatidylcholine; and enzyme inhibitors, like black pepper extract. Liposomes and nanoparticles have also shown promise for improving absorption. Pros and cons of these enhancers, and the types of ingredients with which they may be useful, are discussed below (and in many of ConsumerLab.com's Product Reviews). See the full answer >> >>
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Question: When taking a statin drug like Lipitor or Crestor, are there supplements I should avoid, or be taking?
Answer: Atorvastatin (Lipitor), rosuvastatin (Crestor), and other cholesterol-lowering statin drugs can be affected by taking supplements and can affect your ability to absorb certain vitamins and minerals. Certain herbal supplements, such as St. John's wort, may decrease blood levels of some statin drugs, and when taken with atorvastatin, may actually result in increased cholesterol levels. Certain forms of magnesium may also decrease blood levels of statin drugs -- particularly Crestor. Red yeast rice, which contains a naturally occurring statin, should not be combined with prescription statin drugs without medical supervision.
Berberine should be avoided or used with caution when taking certain statin drugs, such as lovastatin (Mevacor) and rosuvastatin (Crestor).
Some fruit juices can also be a problem, particularly grapefruit juice, which impairs the body's normal breakdown of certain statins, allowing them to build up to potentially excessive levels in the blood. Since the effects of grapefruit juice may last as long as 3 days, it should be avoided if you are taking atorvastatin (Lipitor), lovastatin (Mevacor, Altoprev) or simvastatin (Zocor). However, some other statins do not seem to be affected by grapefruit juice, including pravastatin (Pravachol), fluvastatin (Lescol) and rosuvastatin (Crestor).
On the other hand, CoQ10 and fish oil may offer particular benefits to people on statin drugs.
These interactions are explained in the Statin Drugs article, which is part of the extensive Drug Interactions section of our website (where you can look up interaction for other drugs you may be taking), and in other reports (linked to above) on ConsumerLab.com.
Question: Your CoQ10 review says that water-soluble formulas do not have to be taken with fats or oils. That appeals to me because it is more convenient not to have to take it with food. Yet I've found that the directions for all of the reviewed water-soluble brands say to take with a meal/food. Please advise.
Answer: CoQ10 and ubiquinol are fat-soluble molecules and are best absorbed with fats or oils, which is why it is good to take them with the largest meal of the day. (The same holds true with fat soluble vitamins, like vitamin D). However, water-soluble formulations of CoQ10 and ubiquinol have been developed which don't require fats or oils and can significantly increase the amounts of CoQ10 and ubiquinol in the bloodstream. Nevertheless, it is still best to take these solubilized formulas with food. Why? Food slows down the transit time through the small intestine, which is where CoQ10 and ubiquinol (and all vitamins and minerals) are absorbed. Longer time in the intestine creates more opportunity for absorption. So, in short, even with water-soluble formulas, it's best to take CoQ10 and ubiquinol with food. In addition to food, water-soluble formulations of CoQ10 and ubiquinol should, obviously, also be taken with water.
See our tests of CoQ10 and ubiquinol supplements, including those with water-soluble formulations, and learn more about these products in the CoQ10 and Ubiquinol Supplements Review>>
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Question: I take insulin (Humalog) for diabetes. Are there supplements which could affect my blood sugar levels, and how much insulin I need to take?
Answer: A number of supplements may affect blood sugar levels typically reducing them and require you to, therefore, reduce your dose of insulin (sold as Humalog, Humulin, Iletin, Lantus, Levemir, Novolin, Novolog, Velosulin, etc.).
The supplements which may have this effect include aloe, chromium, ginseng, and CoQ10, and there is weaker evidence for about 30 others. See the list of these supplements and get more information in the Insulin article, which is part of the extensive Drug Interactions section of our website (where you can also look up supplement interactions for other drugs you may be taking).
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Question: Do any supplements really help with brain function, like memory and cognition?
Answer: There are a few supplements which may provide modest benefit with memory and cognition in certain people: These are fish oil, certain B vitamins, cocoa flavanols, curcumin (from turmeric), huperzine A, vinpocetine, and acetyl-L-carnitine. CoQ10 may help improve statin drug side-effects, including memory loss. However, be aware that some proprietary formulas which contain some of these ingredients, such as Procera AVH, may promise more of a benefit than clinical evidence suggests.
Certain forms of choline may be help improve short-term memory and attention in older adults, or improve cognition in people with mild to moderate Alzheimer's disease, while other forms of choline have not been found to have a benefit.
In girls deficient in iron, iron supplementation may improve learning and memory.
Although green tea has been touted for improving brain function, this effect is not well established. Other supplements touted for brain function, such as Gingko biloba and vitamin E have, by and large, not been found to be helpful.
You can read more about the potential memory and cognition benefits of these supplements by using the links above. Also see ConsumerLab.com's Encyclopedia article about Enhancing Memory and Mental Function.
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Question: Which supplements have been shown to be helpful for autism?
Multivitamins and minerals -- These are one of the most widely recommended supplements by physicians for children with autism. One randomized, double-blind, placebo-controlled study involving 141 children and adults with autism found supplementation with a specially formulated liquid multivitamin/mineral (see ingredients and amounts here) which also contained CoQ10, MSM and N-acetylcysteine (NAC), improved the nutritional and metabolic status of children with autism, and significantly reduced symptoms such as hyperactivity and tantrums (Adams, BMC Pediatrics 2011). The supplement was given in three equal doses at breakfast, lunch and dinner. For more about multivitamins, including our most recent product tests and reviews, see the Multivitamin Supplements Review >>
Melatonin -- Many children with autism have difficulty falling asleep or staying asleep. In fact, an estimated 50% to 80% of children with autism spectrum disorders may suffer from sleep difficulties or insomnia (Malow, J Autism Dev Disord 2013). Several studies have found individuals with autism to have lower levels of melatonin or melatonin metabolites than those without autism (Rossignol, Dev Med Child Neurol 2011). An analysis of 18 studies of people with autism (mostly children between the ages of 2- 18, although two studies included individuals over the age of 18) found that melatonin supplementation (in doses ranging from 0.75 mg to 25 mg daily) significantly improved the time it took to fall asleep and sleep duration, and, in some individuals, also improved daytime behavior (Rossignol, Dev Med Child Neurol 2011). Another study also found that a daily dose of 1 mg or 3 mg of melatonin improved sleep latency in children with autism spectrum disorder (Malow, J Autism Dev Disord 2013). For more about melatonin, including our most recent product tests and reviews, see the Melatonin Supplements Review >>
Probiotics -- Children with autism can experience significantly more gastrointestinal symptoms, including diarrhea, constipation and abdominal pain, than others (McElhanon, Pediatrics 2014), and probiotics may be helpful for some of these symptoms.
Because abnormal gut microbiota and gastrointestinal dysfunction in children with autism has also been associated with increased irritability, tantrums, aggressive behavior and sleep disturbances, researchers have proposed further study of the use of probiotics (Critchfield, Gastroenterol Res Pract 2011). One interesting, preliminary animal study found a specific bacterial strain, Bacteroides fragilis, improved gut permeability and autism-like behaviors in mice (Hsiao, Cell 2013). For more information about specific strains used to reduce abdominal pain, and our most recent product tests and reviews, see the Probiotic Supplements Review>>
N-acetylcysteine (NAC) -- This amino acid has been found to reduce irritability, but not other symptoms, in children with autism (Hardan, Biol Psychiatry 2012) and in children taking risperidone (an atypical antipsychotic drug sometimes prescribed for people with autism) (Ghanizadeh, BMC Psychiatry 2013). The dose in these studies ranged from 900 mg to 2,700 mg daily, which was generally well tolerated. For more about NAC and our tests of products, see the N-Acetylcysteine Supplements Review >>.
L-carnosine -- An 800 mg daily dose of L-carnosine for 8 weeks in children with autism was found to significantly improve scores on the Gilliam Autism Rating Scale in a small clinical study (Chez, J Child Neurol 2002).
L-carnitine -- One preliminary clinical trial found that L-carnitine, taken daily (50 mg per kg bodyweight) as a liquid supplement, significantly improved clinical measures of autism spectrum disorder in children (Geier, Med Sci Monit 2011).
Ubiquinol -- Some research on autism has proposed oxidative stress as a potential cause of neuronal dysfunction and clinical symptoms in autism (Gvozdjakova, Oxid Med Cell Longev 2014). Ubiquinol, which is the active form of CoQ10, taken at 50 mg twice per day, at morning and lunchtime, for three months, was found to improve communication, sleep, and decrease food rejection in a small study of children with autism, based on parental reports (Gvozdjakova, Oxid Med Cell Longev 2014). The authors noted that in the first days of supplementation, a small subset of children had increased anger, hyperactivity or sleep disturbance, which was managed by modifying the timing of the doses to morning and evening. For more about ubiquinol, including our most recent product tests and reviews, see the CoQ10 & Ubiquinol Supplements Review>>
A preliminary study among young children with autism found that high-dose vitamin D reduced autism symptoms from moderate to mild. For more details, and our tests of products, see the Vitamin D Supplements Review >>
Vitamin C -- One small study found significant improvements in behavior in autistic children who received a high dose of vitamin C (8,000 mg per 70 kg of body weight) daily when compared to placebo. (Dolske, Prog Neuropsychopharmacol Biol Psychiatry 1993). It is important to note, however, that taking such a large dose of vitamin C may cause diarrhea in some people. For more about Vitamin C, including our most recent product tests and reviews, see the Vitamin C Supplements Review >>
See ConsumerLab.com’s Encyclopedia article on Autism for more information about supplements that may or may not be helpful.
ConsumerLab.com Answers
Question: I take warfarin (Coumadin), an anticoagulant drug. Are there supplements I should avoid, or be taking, due to this drug?
Answer: Yes, the effectiveness of warfarin (Coumadin), anisindione (Miradon) and other anticoagulant drugs prescribed to help prevent blood clots can be impacted by taking supplements. This is discussed in detail in the Warfarin article, which is part of the extensive Drug Interactions section of our website (where you can look up interactions for other drugs you may be taking).
Examples of supplements which may increase warfarin’s blood-thinning effect (and, consequently, the risk of abnormal bleeding) are garlic, gingko and curcumin. Examples of supplements which may reduce warfarin’s ability to thin the blood include vitamin K, ginseng, St. John’s wort, and, in very high doses, green tea. CoQ10 is chemically similar to vitamin K2 and may also decrease the effects of warfarin, although the evidence for this is mixed. Because it can be affected by a large number of herbs, supplements and foods, it's important to consult your physician before taking any supplement with warfarin.
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Question: How do I choose the best CoQ10 supplement?
Answer: As shown in the Review of CoQ10 Supplements, we have found that most (but not all) CoQ10 products contain what they claim. However, it's important to note that some are formulated to enhance absorption, allowing you to take a smaller dose, e.g., half the dose (see the "Absorption, Formulation and Dose" section of the report). This should be considered when choosing a product, selecting an appropriate dose, and comparing prices. To get the best value among "CL Approved" CoQ10 supplements, see the "Cost" section of the report.
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Question: What is PQQ? Does it help with aging and memory? Is it similar to CoQ10?
Answer: Both PQQ (Pyrroloquinoline quinone) and CoQ10 (ubiquinone) are antioxidant compounds used by the body, but they differ in many ways and, unlike CoQ10, which has been extensively researched in well-controlled clinical studies, only a few, small and relatively short clinical studies have been conducted with PQQ. See the Full Answer for more about PQQ >>
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Question: Do I need to divide my daily 300 mg dose of CoQ10 into smaller doses, or can I take it all at once?
Answer: If the total daily dose exceeds 100 mg, it is better to take CoQ10 in two or three smaller doses, rather than in one large dose. Be aware that more moderate doses of CoQ10 (e.g. 100 mg per day) have been more helpful than higher doses in some situations, so be sure you really need 300 mg per day. Also, keep in mind that CoQ10 is best absorbed when taken with a meal that contains some fat or oils - with the exception of water-soluble formulas, which do not need to be taken with fat. For more about dosage and absorption of CoQ10 -- including absorption enhancers, as well as our tests of popular supplements, see the CoQ10 & Ubiquinol Supplements Review >>
ConsumerLab.com Answers
Question: Do any supplements help with migraines?
Answer: There is evidence that magnesium, CoQ10 and riboflavin (B2) may help to reduce the frequency or severity of migraine headaches. The amino acid 5-HTPmay also reduce frequency, although the evidence is mixed.
Some herbal supplements, such as butterbur and feverfew may also be helpful. One preliminary study suggests gingermay help reduce the severity of migraine headaches. However, be aware that taking St. John's wort with migraine medications or the painkiller tramadol can cause adverse effects.
One clinical study found that a DAO (diamine oxidase) supplement reduced the duration of migraine attacks by 30%, but did not reduce pain or frequency.
For more information, see the article about Migraine in our Encyclopedia, and also use links above.
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Question: I have low blood pressure. Are there any supplements I should avoid?
Answer: Certain supplements can cause decreases in blood pressure and should be used with caution if you already have low blood pressure. These are melatonin, arginine and large doses of magnesium. Calcium may also cause a very small decrease in blood pressure. Preliminary studies have found black cohosh may lower blood pressure in animals, but it is unclear whether it has this effect in people.
There are also a number of supplements that have been shown to lower blood pressure in people with hypertension (high blood pressure). These include CoQ10, fish oil and omega-3 fatty acids, garlic, potassium, flaxseed, certain strains of probiotics, and green coffee bean extract. While much of the evidence for these is focused on people with high blood pressure, they could potentially lower blood pressure in others. So, if you take one of these supplements and find your low blood pressure becomes even lower, try eliminating the supplement and see if your blood pressure improves.
Note that sexual enhancement supplements with undeclared drugs, such as sildenafil (Viagra) or tadalafil (Cialis) may also lower blood pressure (see the list of Recalls and Warnings for supplements found to contain these drugs).
For more about using these supplements, including the evidence, potential side effects, and our tests of products, use on the links above.
ConsumerLab.com Answers
Question: Is there a lab test that can measure CoQ10 in the blood? Can it help to determine the dosage I should take for a certain condition, like heart failure?
Answer: Yes, several well-known, national chain laboratories offer a test that measures CoQ10 levels in the blood. Although this test does not measure CoQ10 levels in heart tissue itself (which will differ from blood levels), it can reveal if you are below the normal range, and help your health care provider determine an appropriate dose for your condition, as well as monitor your response to certain drugs, like statins (which can lower blood levels of CoQ10). For more about this test, including the normal range for blood levels of CoQ10, see the CoQ10 and Ubiquinol Supplements Review >>
ConsumerLab.com Answers
Question: Does taking natural versus synthetic CoQ10 make a difference? How do you know which product is natural or synthetic?
Answer: As explained in the "Synthetic vs. Natural" section of the CoQ10 and Ubiquinol Supplements Review, naturally formed CoQ10 is 100% in the "trans" isomer form. Synthetically formed material is also predominantly in the "trans" form with a small amount in the "cis" form. Since the fermentation process using bacteria or yeast is much cheaper than chemical synthesis and provides 100% natural (trans) CoQ10, most, but not all, CoQ10 found in the marketplace today is made by a fermentation process.
Question: Could my CoQ10 supplement be making me nauseous?
Answer: Yes. Although CoQ10 is generally well-tolerated, it can cause gastrointestinal symptoms such as nausea and diarrhea in a small percentage of people. Ways to minimize these effects, and information about other potential side-effects, are found in the CoQ10 and Ubiquinol Supplements Review.
Question: Is it worth paying more for "pharmaceutical grade" CoQ10? What about "natural" or "live source" CoQ10?
Answer: CoQ10 is not sold in the U.S. as a prescription drug, so no CoQ10 can technically be "pharmaceutical grade." There is no reason to pay more if you see this meaningless term. However, a manufacturer is allowed to claim that its CoQ10 meets the standard set by U.S. Pharmacopeial Convention (USP), which is the same standard ConsumerLab.com applies in its testing of CoQ10 supplements for Approval (See CoQ10 Supplements Review for approval status by product).
Terms like "natural" or "live source" on a CoQ10 supplement label simply mean that it contains the natural form of CoQ10, as opposed to the synthetic form. You may also see the term "yeast fermentation" or "natural fermentation" on the label of supplements that contain the natural form. However, nearly all CoQ10 supplements contain the natural form because the fermentation process is actually much less expensive than the process used to create synthetic CoQ10. In fact, many products using the natural form don't even list the form. Again, you don't need to pay more if you see "natural" or "live source." You can read more about the natural and synthetic forms of CoQ10 here.
Answer: MitoQ (by MitoQ Limited) is a form of CoQ10 promoted as a "more effective" antioxidant than regular CoQ10 because it is shown to be absorbed by the mitochondria of cells - where many oxidative reactions take place. It also appears to achieve higher levels in the blood compared to regular CoQ10 - although a number of formulations of CoQ10 also offer enhanced absorption over regular CoQ10. More information about MitoQ and other CoQ10 formulations is found in the CoQ10 and Ubiquinol Supplements Review >>
ConsumerLab.com Answers
Question: I take ubiquinol to replenish CoQ10 depleted by my statin. I also take curcumin (from turmeric). Since they both manage free radicals, do I need to take the curcumin?
Answer: Although both curcumin and ubiquinol (the activate form of CoQ10) have antioxidant properties, they have very different effects in the body, as is the case with other antioxidants, such as vitamin E and vitamin C. So taking one will not achieve all the things accomplished by the other.
CoQ10 is used for energy production within cells, and levels in the body can be lowered by statin drugs. Some, but not all, evidence suggests taking CoQ10 may help reduce certain side effects of statin drugs, such as muscle pain. Curcumin, on the other hand, has anti-inflammatory effects, which may be helpful for conditions such as arthritis or muscle-soreness after exercise, but it is not known to increase energy production in cells, or reduce statin-related muscle pain.
Question: Do any supplements help with gum disease or periodontitis?
Answer: Several different types of supplements may be helpful in improving gum disease and/or periodontitis -- the inflammation around the teeth causing pocketing -- such as DHA from algal oil, gamma-linolenic acid (GLA), lycopene, green tea, cranberry extract, and a certain type of probiotic. For details, including dosage, see the full answer >>
Also see the Encyclopedia article about Periodontal Disease for additional information.
Question: Is it safe to take CoQ10 while taking blood thinners like warfarin or Plavix (clopidogrel)?
Answer: CoQ10 may interfere with warfarin treatment, although the evidence is mixed. There are some reports suggesting that CoQ10 decreases the effectiveness of warfarin (Coumadin), which could necessitate an increase in warfarin dosage. On the other hand, there's a study which suggests the opposite (that CoQ10 may increase the risk of bleeding when on warfarin). And another study suggests no effect so long as your INR (bleeding time) is stable. To play it safe, consult with your doctor about using CoQ10 with warfarin.
However, it's not clear whether it CoQ10 affects Plavix treatment. For more information, see the Cautions and Concerns section of the CoQ10 and Ubiquinol Supplements Review >>
Question: Which supplements can help to lower blood pressure?
Answer: There are many supplements, including CoQ10, fish oil, curcumin, certain probiotics, cinnamon and others, which may lower blood pressure. However, if you already take medication to lower blood pressure, always consult your physician before using these supplements, as they may lower your blood pressure too much, or interfere in some other way with your current medication. Be aware that a number of supplements can increase blood pressure. Sign in to see the full answer >>
See the Encyclopedia article about Hypertension for more information.
Question: I take a supplement containing a "proprietary formula" which lists many ingredients. Can ConsumerLab test the contents so I'll know the amounts of each ingredient?
Answer: ConsumerLab.com has long cautioned against purchasing supplements with proprietary formulas and typically does not test them. We may, however, check listed amounts of other key, individually listed ingredients in the same supplement. In some cases, we have found high levels of contaminants which, we suspect, originated from ingredients in a proprietary formula.
The major problem with "proprietary formulas," as well as with proprietary "blends" and "complexes," is that they permit manufacturers to withhold important information about what's really in a product. The company only has to list the total amount of formula, not the amount of each ingredient in the formula. The formula's ingredients only have to be listed in weight order, i.e., based on their relative contribution to the weight of the formula. Furthermore, the formula may change over time without you necessarily knowing.
Proprietary formulas are often developed around an expensive ingredient, like CoQ10, because this allows a company to use less of the expensive ingredient, creating a formula in which the expensive ingredient is just a small part of the formula. We have seen this with ingredients such as chondroitin in joint supplements, and SAMe. We also see proprietary formulas marketed for uses such as cognitive enhancement, nerve pain, or weight loss where a company may try to impress the consumer with a laundry list of ingredients having only shreds of evidence relating to the intended use. In most cases, the formulas themselves have not been clinically tested.
Question: Are CoQ10 and ubiquinol safe to take for a long period of time? Should I give it a rest period?
Answer: Studies with CoQ10 have not shown serious adverse effects at moderate doses even when taken for several years — although it may be best to divide the dose over the course of the day. However, be aware that CoQ10 and ubiquinol may affect your response to certain medications. For more details, see the "Concerns and Cautions" section of the CoQ10 and Ubiquinol Supplements Review >>
Question: Are there negative interactions between the following supplements I take twice each day, as well as 60 mg of beta-sitosterol with dinner: Vitamin C (500 mg), CoQ10 (100 mg), grape seed extract (100 mg), fish oil (500 mg), vitamin D3/calcium/magnesium/zinc (200 IU/333 mg/113 mg/5mg)?
Answer: You may want to cut back on the vitamin C. The required daily intake is not even 100 mg and if you already get that, taking another 500 mg or 1,000 mg may actually reverse vitamin C's ability to reduce the risk of cataracts, as noted in the Vitamin C Supplements Review.
The amounts of the other supplements you take are generally safe and are at doses which may be helpful -- depending on your health conditions. It is also good that you have broken up your intake of calcium over the day, since you can't absorb more than 500 mg at a time, as discussed in the Calcium Supplement Review.
If you have high blood pressure, be aware that one study found the combination of vitamin C and OPCs (the active component of grape seed extract) to increase blood pressure (as noted in the Safety Issues section of the article on OPCs).
The beta-sitosterol which you take is at a dose which may help with symptoms of an enlarged prostate. Be aware that beta-sitosterol is also used at a much higher dose for lowering cholesterol (by competing with cholesterol for absorption in the gut) and, at this higher dose, you would not want to take it at the same time you take the fat-soluble supplements -- vitamin D and CoQ10, both of which are best taken with a meal containing some fat.
If you take also take prescription medications, be sure to look up the supplements with which they may interact using our Drug Interactions information.
Note: ConsumerLab.com staff is not able to regularly respond to requests from members to evaluate their supplement regimens. However, it tries to do so from time-to-time and often responds to questions of more general interest, such as those below.
Question: What is "nano" CoQ10? Is it better than other CoQ10 formulations?
Answer: Nano formulations of CoQ10, such as NanoCoQ10, NanoCell-Q and VesiSorb CoQ10, involve microencapsulating tiny amounts of CoQ10 in various substances which supposedly make CoQ10 more dispersible in water and enhance its absorption. Unfortunately, the evidence supporting these nano formulations is not strong and is based on small, company-funded studies -- some of which do not appear to have been published. For more about this, see the "Absorption, Formulation and Dose" section of the CoQ10 and Ubiquinol Supplements Review >>
Question: Which supplements can help lower or control my blood sugar?
Answer: Many different supplements may help lower or control blood sugar in people with prediabetes or type 2 diabetes who experience hyperglycemia (when blood glucose rises higher than normal). These supplements are discussed below. More details about each, including dosage, drug interactions, potential side effects, and ConsumerLab.com's reviews of products on the market, can be found by clicking on the links.
Due to the seriousness of hyperglycemia, it is important to consult with your physician regarding use of these supplements.
Cinnamon supplements may modestly improve blood sugar in people with type 2 diabetes whose blood sugar is not well controlled with medication. In addition, one small study found that a branded cinnamon extract reduced fasting blood sugar by an average of about 10 mg/dL in prediabetic men and women with metabolic syndrome. Keep in mind, however, that only certain varieties of cinnamon have been shown to have this effect, and long-term safety studies have not been conducted.
Curcumin (from turmeric) may improve blood sugar levels, according to preliminary studies, and one study found curcumin to dramatically lower the chances of prediabetes in middle-aged, slightly overweight men and women with somewhat higher than normal blood sugar levels.
Alpha lipoic acid may improve insulin sensitivity and blood sugar control in people with type 2 diabetes, although it may only slightly reduce levels of glycosylated hemoglobin (HbA1c).
Chromium picolinate may help some people with type 2 diabetes decrease fasting blood glucose levels as well as levels of insulin and glycosylated hemoglobin (HbA1c). However, be aware that high doses may worsen insulin sensitivity in healthy people who are not obese or diabetic.
Having adequate blood levels of vitamin D may reduce the risk of insulin resistance in people who are obese. There is some evidence that a certain blood level of vitamin D is needed for normal glucose metabolism in women who are overweight and obese (but not diabetic), but it is not clear whether any further benefit is gained with higher blood levels.
In healthy people, consuming a moderate amount of olive oil with a meal has been shown to reduce increases in blood sugar after the meal compared to the same meal consumed with corn oil. In people with type 1 or type 2 diabetes, olive oil may improve glucose metabolism.
Increasing dietary fiber, especially insoluble fiber from cereal and grains, is associated with a reduced risk of diabetes and has been shown to reduce fasting blood glucose and modestly lower HbA1c in people with type 2 diabetes (Martin, J Nutr 2008; Post,J Am Board Fam Med 2012). In people with type 1 diabetes, 50 grams of dietary fiber per day has been shown to significantly improve blood sugar control and reduce hypoglycemic events (Giacco, Diabetes Care 2000). The American Dietetic Association states that "diets providing 30 to 50 g fiber per day from whole food sources consistently produce lower serum glucose levels compared to a low-fiber diet. Fiber supplements providing doses of 10 to 29 g/day may have some benefit in terms of glycemic control." (Slavin, J Am Diet Assoc 2008). Although ConsumerLab.com has not tested fiber products, we have produced a webinar about that provides more information.
Ginseng, both American and Korean Red ginseng (from Panax ginseng), may reduce blood sugar levels in people with diabetes, according to preliminary research.
Drinking whey protein before a high glycemic meal may help to lessen increases in blood sugar after the meal in people with well-controlled type 2 diabetes.
Silymarin, a component of milk thistle, may decrease blood sugar and hemoglobin A1c in people with type 2 diabetes, and reduce insulin resistance in people with coexisting diabetes and alcoholic cirrhosis.
Inulin, a type of prebiotic, may improve measures of blood sugar control in women with type 2 diabetes, although it did not improve blood sugar levels or insulin resistance in a study of prediabetic men and women.
Berberine (a compound found in plants such as barberry, Oregon grape and goldenseal) may reduce blood sugar levels in people with metabolic syndrome or type 2 diabetes, according to a few small studies.
Fenugreek may help to lower blood sugar, according to preliminary studies, and one study found fenugreek extract to significantly improve some measures of blood sugar control and insulin response in people with type 2 diabetes.
White mulberry (Moruns alba or Morus indica) has been traditionally used in Asia to help treat type 2 diabetes, and there is some preliminary evidence to support this use. Mulberry leaf extract (species not given) may lessen increases in blood sugar after ingestion of table sugar in healthy people and people with type 2 diabetes (Mudra, Diabetes Care 2007). Among people with type 2 diabetes, taking 1 gram of powdered white mulberry leaf three times daily (after breakfast, lunch and dinner) for four weeks was found to lower fasting blood sugar by 27%, while taking 5 mg of the anti-diabetes drug glibenclamide lowered fasting blood sugar by only 8% (Andallu, Clin Chim Acta 2001).
There is mixed evidence as to whether CoQ10 may lower blood sugar. To be safe, people with diabetes or who take medication to lower blood sugar should consult a physician before using.
Preliminary evidence suggests certain other supplements, including aloe, ashwagandha, ginkgo, green coffee bean extract, glucosamine, black cohosh, rhodiola, reishi mushroom and tart cherry juice may lower blood sugar. While there is not enough clinical research to support the use of these supplements for this purpose, it's important to keep this in mind, as they could enhance the blood sugar lowering effect of other supplements or medications you may be taking.
There are a few supplements which may worsen blood sugar control or insulin sensitivity in certain people: excessive amounts of niacin may elevate blood sugar levels, and prescription digestive enzymesmay cause an increase or decrease in blood sugar levels in people with exocrine pancreatic insufficiency. CLA (conjugated linoleic acid), a popular supplement for slimming, may worsen blood sugar control in diabetics and in obese people without diabetes.
Although fish oil does not appear to adversely affect blood sugar levels in people with diabetes, one study reported that a large daily dose of krill oil (providing a modest amount of EPA and DHA) reduced insulin sensitivity in overweight, middle-aged men by about 27% -- which could potentially increase the risk of diabetes.
Also note that high doses of vitamin C may increase blood sugar or interfere with certain blood sugar tests.
Question: I've heard it's best to take fat-soluble supplements, like CoQ10, curcumin, and vitamin D, with fats or oils to increase absorption. Would taking them with a fish oil capsule be enough?
Answer: The amount of fat in a fish oil supplement is only about 1 gram. While that might help a little, studies which have shown increased absorption of fat-soluble vitamins have involved taking them with foods or meals containing fats. Most meals provide at least 5 grams of fat (the amount of fat in a single egg, for instance), while a tuna wrap with mayo can have 40 grams.
In the case of vitamin D, taking it with a meal has increased absorption by 32% to 57% compared to taking it with just water. The bigger (and fattier) the meal, the better — at least for absorption!
Of course, you can also purchase special formulations of some fat-soluble vitamins and other supplements which enhance their absorption — in some cases, even more than taking them with fats. These are described in our reviews of CoQ10, curcumin and vitamin D. Other supplement ingredients which are fat soluble and are best absorbed with fats are vitamin A, vitamin E, and vitamin K, as well as astaxanthin and boswellia (and its key component AKBA).
Question: Which supplements help to improve energy and decrease fatigue?
Answer: Getting adequate sleep, eating a healthy, well-balanced diet, and regular exercise are the best ways to maintain your energy. However, we all have times when we could benefit from an energy boost. (If you are frequently tired, be sure to consult your physician about potential causes, as discussed below).
Certain supplements may help increase energy and decrease fatigue.
CoQ10, which plays a role in energy production in cells, has been shown to decrease fatigue in people with conditions such as heart failure and Gulf War Illness. One small study suggested it may increase self-assessed "vitality" in older adults. (Be aware that taking CoQ10 in the evening can cause insomnia in some people).
Curcumin (from turmeric) has been shown to reduce fatigue in older men and women using a particular branded formula.
Ashwagandha may reduce fatigue in middle-aged adults with moderate to severe anxiety.
Cocoa flavanols may help reduce self-reported mental fatigue in healthy adults, according to one study.
Ginseng is a popular ingredient in supplements promoted for increasing energy and vitality. Although there is little evidence to support this effect in healthy people, there is some evidence it may increase energy in people with cancer-related fatigue.
Carnitine may help reduce fatigue in older men with symptoms of sexual dysfunction, depression and fatigue.
B vitaminsare involved in the metabolism of food to release energy, and deficiency in vitamin B-12 is known to cause fatigue. However, if you already get an adequate amount of the B vitamins in your diet and are not deficient in them, supplementing with additional amounts of B vitamins is not known to improve performance. Be aware that energy drinks often contain much higher doses of B vitamins than needed — sometimes amounts above tolerable limits. Energy drinks also commonly contain significant amounts of caffeine or ingredients which naturally contain caffeine such as guarana and cola nut. Although caffeine does not actually provide energy, it acts as a stimulant and can reduce fatigue. Be aware that energy drinks can increase blood pressure, and stroke and liver injury have been reported in people consuming certain energy drinks.
Energy bars, or nutrition bars, can be a good source of real energy (calories), especially if you are on the go and haven't had a chance to eat a real meal, and also provide vitamins and minerals. It's important to choose carefully as some are high in sugar, or contain sugar substitutes that may upset your stomach. Some also contain caffeine.
Supplements that provide iodine, such as kelp supplements and potassium iodide, are often promoted to increase energy. However, there is little evidence for this effect unless they are being used to treat hypothyroidism due to iodine deficiency.
Rhodiola rosea and maca supplements are sometimes promoted to increase energy or reduce fatigue, however, there is not enough evidence to support these supplements for this use.
Iron deficiency can cause fatigue. Consequently, correcting iron deficiency with iron supplementation can reduce related fatigue. Interestingly, iron supplementation has even been shown to reduce fatigue in women who are not anemic but have ferritin levels in the lower end of normal range.
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Product Review:CoQ10 and Ubiquinol Supplements Review
Initial Posting: 12/16/16 Last Update: 3/14/17
Choose the Best CoQ10 or Ubiquinol Supplement -- and Save Money!
Products Vary in Quality, Absorption, and Cost
Find Out Now If Yours Passed or Failed!
Alphabetical list of CoQ10 and ubiquinol supplements in report
21st Century CoQ-10
Member's Mark (Sam's Club) CoQ-10
Solgar Ubiquinol
Berkley & Jensen [BJ's] CoQ10
Nature's Bounty Co Q-10 100 mg
Spring Valley [Walmart] CoQ10 200 mg
ChewQ
Nature's Bounty Co Q-10 200 mg
Spring Valley (Walmart) CoQ10
CVS Pharmacy CoQ10
NOW CoQ10
Stop Aging Now Max Q10 Ultra
CVS/Pharmacy Health CoQ-10 200 mg
NutriGold CoQ10 Gold
Swanson Ultra CoQ10
Doctor's Best High Absorption CoQ10
PacificCoast NutriLabs (PCNL) CoQ10 Platinum
Trader Joe's Co Enzyme Q 10
Doctor's Best VESIsorb
PipingRock.com Advanced Ubiquinol
USANA CoQuinone 30
Dr. Mercola Ubiquinol
Pure Encapsulations Ubiquinol-QH
Vitacost Ubiquinol CoQH
Finest Nutrition (Walgreens) Co Q-10
Puritan's Pride CO Q-10 100 mg
Vitafusion CoQ10
Finest Nutrition [Walgreens] Co Q-10 300 mg
Puritan's Pride CO Q-10 200 mg
Vitamin World Co Q-10 100 mg
Garden of Life RAW CoQ10
Puritan's Pride Ubiquinol
Vitamin World Co Q-10 200 mg
GNC CoQ-10 100 mg
QGel Mega 100 Coenzyme Q10
Vitamin World Ubiquinol
GNC CoQ-10 200 mg
Qunol Liquid CoQ10
Viva Labs CoQ10
Healthy Origins Ubiquinol
Qunol Mega CoQ10
Webber Naturals CoenzymeQ10 200 mg
Jarrow Formulas Ubiquinol QH-Gummies
Qunol Ultra CoQ10
Well at Walgreens CoQ-10
Kirkland Signature CoQ10 (Costco)
Shaklee CoQHeart
Xymogen CoQmax CF
Maxi Health Maxi Co-200 Maxicaps
Make sure the CoQ10 or ubiquinol supplement you take passed our test and is right for you!
Isn't your health worth it?
CoQ10 and its activated form, ubiquinol, are among the most popular supplements in the U.S. They may be useful in treating congestive heart failure and preliminary evidence suggests other uses including improving "vitality," reversing side-effects of "statin" drugs, and preventing migraine headaches.
But choosing the best CoQ10 or ubiquinol product can be difficult. Among the 43 products tested in this Review alone, the suggested daily serving size ranged from 30 mg to 400 mg and many of the CoQ10 and ubiquinol products reviewed included "solubility enhancers" which may significantly increase absorption but can also cause side-effects of which you need to be aware. In an addition, our tests revealed that one product contained less CoQ10 than claimed -- just 78% of the amount listed on the label.
Among the products which passed our tests and were CL Approved, we found that you can pay as little as 7 cents (or over $2) per 100 mg of CoQ10. The cost to get the same amount of ubiquinol, which tends to be a more expensive ingredient, ranged from 27 cents to $1.16. You can save a lot of money by choosing the right supplement!
You must join to get the full test results for CoQ10 and ubiquinol supplements along with ConsumerLab.com recommendations and quality ratings. You will get results for 18 CoQ10 and ubiquinol supplements selected by ConsumerLab.com and for 25 others which passed testing in our voluntary Quality Certification Program, as well as information about six products that are very similar to ones that passed our tests.
In this comprehensive review, you'll discover:
Which CoQ10 and ubiquinol supplements failed testing and which passed
CL's Top Picks, representing the best CoQ10 and ubiquinol supplements at lowest cost
Which supplements have special ingredients which may increase their absorption (such as polysorbate 80) and/or bioavailability (such as black pepper extract) — and the pros and cons of these formulas
CoQ10 and ubiquinol dosing for treating specific conditions
How to take CoQ10 and ubiquinol to reduce side-effects and enhance absorption
CoQ10 side-effects, drug interactions, and cautions
ConsumerLab.com Answers -- for CoQ10 and Ubiquinol Supplements Review
Question: What is the difference between CoQ10 and ubiquinol? Get the answer >>
Question: Are supplements which claim increased absorption or improved bioavailability telling the truth? Is it worth paying more for these? Are there concerns? Get the answer >>
Question: When taking a statin drug like Lipitor or Crestor, are there supplements I should avoid, or be taking? Get the answer >>
Question: Your CoQ10 review says that water-soluble formulas do not have to be taken with fats or oils. That appeals to me because it is more convenient not to have to take it with food. Yet I've found that the directions for all of the reviewed water-soluble brands say to take with a meal/food. Please advise. Get the answer >>
Question: I take insulin (Humalog) for diabetes. Are there supplements which could affect my blood sugar levels, and how much insulin I need to take? Get the answer >>
Question: Do any supplements really help with brain function, like memory and cognition? Get the answer >>
Question: Which supplements have been shown to be helpful for autism? Get the answer >>
Question: I take warfarin (Coumadin), an anticoagulant drug. Are there supplements I should avoid, or be taking, due to this drug? Get the answer >>
Question: How do I choose the best CoQ10 supplement? Get the answer >>
Question: What is PQQ? Does it help with aging and memory? Is it similar to CoQ10? Get the answer >>
Question: Do I need to divide my daily 300 mg dose of CoQ10 into smaller doses, or can I take it all at once? Get the answer >>
Question: I have low blood pressure. Are there any supplements I should avoid? Get the answer >>
Question: Is there a lab test that can measure CoQ10 in the blood? Can it help to determine the dosage I should take for a certain condition, like heart failure? Get the answer >>
Question: Does taking natural versus synthetic CoQ10 make a difference? How do you know which product is natural or synthetic? Get the answer >>
Question: Could my CoQ10 supplement be causing my insomnia? Get the answer >>
Question: Could my CoQ10 supplement be making me nauseous? Get the answer >>
Question: Is it worth paying more for "pharmaceutical grade" CoQ10? What about "natural" or "live source" CoQ10? Get the answer >>
Question: I take ubiquinol to replenish CoQ10 depleted by my statin. I also take curcumin (from turmeric). Since they both manage free radicals, do I need to take the curcumin? Get the answer >>
Question: Do any supplements help with gum disease or periodontitis? Get the answer >>
Question: Do any supplements help for tinnitus? Is it true that some supplements can cause tinnitus? Get the answer >>
Question: Is it safe to take CoQ10 while taking blood thinners like warfarin or Plavix (clopidogrel)? Get the answer >>
Question: Which supplements can help to lower blood pressure? Get the answer >>
Question: I take a supplement containing a "proprietary formula" which lists many ingredients. Can ConsumerLab test the contents so I'll know the amounts of each ingredient? Get the answer >>
Question: Are CoQ10 and ubiquinol safe to take for a long period of time? Should I give it a rest period? Get the answer >>
Question: Are there negative interactions between the following supplements I take twice each day, as well as 60 mg of beta-sitosterol with dinner: Vitamin C (500 mg), CoQ10 (100 mg), grape seed extract (100 mg), fish oil (500 mg), vitamin D3/calcium/magnesium/zinc (200 IU/333 mg/113 mg/5mg)? Get the answer >>
Question: What is "nano" CoQ10? Is it better than other CoQ10 formulations? Get the answer >>
Question: Which supplements can help lower or control my blood sugar? Get the answer >>
Question: I've heard it's best to take fat-soluble supplements, like CoQ10, curcumin, and vitamin D, with fats or oils to increase absorption. Would taking them with a fish oil capsule be enough? Get the answer >>
Question: Which supplements help to improve energy and decrease fatigue? Get the answer >>
