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Coenzyme Q10 supplementation increases blood concentrations but shows limited and inconsistent effects on exercise performance: a systematic review and meta-analysis

Hengzhi Deng, Tianyu Song, Mingyue Yin, Kai Xu, Yuming Zhong, Norsyazmi Bin Mohd, Mohamed Nashrudin Bin Naharudin, Ashril Yusof, Xiaohan Fan
British Journal of Nutrition 2025 Online ahead of print:1-21

Bibliography

PubMed
PMID 41457257
DOI
10.1017/S0007114525106211
Funding
No specific funding statement was identified in the accessible publication record reviewed for this audit.
Competing interests
No specific competing-interest statement was identified in the accessible publication record reviewed for this audit.

Study snapshot

DesignSystematic review and meta-analysis of randomized studies; six databases searched through November 2025; three-level meta-analytic models, RoB2 risk-of-bias assessment and GRADE certainty evaluation.
ModelHealthy adults in acute and chronic CoQ10 exercise/performance studies.
Sample24 randomized studies.
InterventionCoQ10 supplementation versus placebo/control; formulations, doses and durations varied across studies.
DurationVaried across included studies; acute and chronic supplementation trials were analyzed separately.
EndpointsCirculating CoQ10; Aerobic endurance/performance; Anaerobic performance; Strength; Subjective fatigue; Dose-response and duration-response analyses

What the study showed, in plain terms

This 2025 systematic review is the most useful high-level check on claims that CoQ10 is an exercise-performance supplement. Across 24 randomized studies, supplementation reliably increased circulating CoQ10 concentrations.

Performance results were much less convincing. Chronic supplementation showed a small benefit in the primary model, but the estimate was sensitive to outliers and weakened or disappeared in sensitivity analyses. Acute supplementation produced no meaningful performance advantage. Aerobic-endurance signals were the most promising but also became borderline after influential studies were removed; anaerobic performance and strength changed little.

Subjective fatigue showed a more suggestive pattern than objective performance. The review rated the certainty of performance evidence from very low to low because of heterogeneity, moderate-to-high risk of bias and unstable estimates. The strongest conclusion is therefore biochemical: CoQ10 raises blood CoQ10; a reliable ergogenic effect has not been established.

Key findings

  • Circulating CoQ10 increased consistently across supplementation studies.
  • Chronic supplementation produced only a small performance signal in the primary analysis, and that result was unstable after outlier/influence analyses.
  • Acute CoQ10 supplementation did not meaningfully improve performance.
  • Aerobic-endurance effects were more favorable than anaerobic or strength outcomes but were sensitive to influential studies.
  • No stable dose-response or duration-response relationship was established for performance outcomes.
  • Overall GRADE certainty for performance outcomes was very low to low.

What this study can and cannot tell us

  • Substantial heterogeneity across populations, formulations, training status, doses, durations and performance tests.
  • Several pooled effects were outlier-sensitive and changed materially in sensitivity analyses.
  • Moderate-to-high risk of bias in parts of the evidence base contributed to very-low/low GRADE certainty.
  • Higher circulating CoQ10 is a pharmacodynamic result and should not be described as proof of improved athletic performance.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology