CoQ10 deficiency can be attributed to primary or secondary factors.[1]
A primary deficiency is a result of mutations in genes directly involved in the biosynthesis of CoQ10.[1]
A secondary deficiency can also stem from genetic mutations, but ones that affect genes not directly involved in CoQ10 synthesis, or it can be caused by non-genetic factors. For instance, the production of CoQ10 declines with age, peaking at 25 and decreasing by approximately 50% by the age of 65. Furthermore, certain health conditions, such as mitochondrial DNA depletion syndrome, phenylketonuria, mucopolysaccharidosis, cardiovascular disease, chronic kidney disease, type 2 diabetes[2], and metabolic syndrome, have been associated with lower CoQ10 levels.[1][3]
Finally, medications like statins (cholesterol-lowering drugs), amitriptyline (an antidepressant), and bisphosphonates (used in the treatment of osteoporosis), may interfere with CoQ10 production and reduce its levels when taken long-term.[PM