CoQ10 acts as a non-enzymatic endogenous antioxidant,[1] exerting its effects by increasing the production of key antioxidants (e.g., SOD) and by inhibiting lipid peroxyl radicals, thereby reducing lipid peroxidation levels.[2] Additionally, CoQ10 serves as a cofactor in the mitochondrial electron transport chain, transporting electrons from complex I and II to complex III to synthesize ATP, and reducing the production of superoxide (a free radical).[3] Furthermore, CoQ10 appears to regenerate α-tocopherol (vitamin E’s active metabolite) from its radical state back to its antioxidative state.[4][3] Finally, another potential mechanism observed in vitro and in animal studies is the activation of nuclear factor erythroid 2-related factor 2 (Nrf-2), which regulates the cellular response to oxidative stress. However, more research is needed to verify this mechanism of action.[3]
CoQ10 appears to improve glycemic control in individuals affected by type 2 diabetes (characterized by elevated oxidative stress and abnormalities in mitochondrial function), thanks to its antioxidant activity.[5][6]
CoQ10 may improve the lipid profile through several potential mechanisms. In vitro studies showed that exposure of endothelial cells to CoQ10 was linked to downregulation of lectin-like oxLDL receptor (LOX-1), to which oxidized LDL (oxLDL) bind causing an increase in reactive oxygen species (ROS) levels, and stimulation of 5’ adenosine monophosphate-activated protein kinase (AMPK), which regulates mitochondrial ROS production and oxidative stress resistance.[7][8] Furthermore, CoQ10 may increase fatty acid oxidation, therefore reducing the level of free fatty acids in mitochondria,[9] and it may decrease triglyceride levels by increasing lipolysis.[8]