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Effects of Coenzyme Q10 Supplementation on Muscle Health and Physical Capacity in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Xundian Liu, Jinxuan Bao, Zhuoxuan Yu, Wende Zheng, Yaxuan Huang, Yifan Zhang, Xiuying Jiang
Antioxidants (Basel) 2026 15(10):1219

Bibliography

DOI
10.3390/antiox15101219
Funding
Fundamental Research Funds for the Central Universities, grants 2026KYPT05 and 2026KYPT06.
Competing interests
The authors declared no conflicts of interest.

Study snapshot

DesignSystematic review and meta-analysis of randomized controlled trials
ModelAdults in trials with study-level mean or median age ≥40 years, spanning healthy and clinical populations
Sample33 RCTs; 3,317 randomized participants; 21 trials contributed to quantitative meta-analysis
InterventionOral CoQ10 supplementation versus placebo, no supplementation, or an otherwise equivalent control for at least 2 weeks
DurationIncluded randomized trials lasted at least 2 weeks; durations varied across studies
EndpointsRelative VO2peak/VO2max; 6-minute walk distance; Exercise duration; Handgrip strength; Lower-limb strength; Chair-rise performance; Muscle or lean-tissue quantity; Disease-specific motor and functional outcomes; GRADE certainty

What the study showed, in plain terms

This September 2026 systematic review examined whether oral CoQ10 improves muscle health and physical capacity in middle-aged and older adults. Thirty-three randomized trials involving 3,317 participants were included, with 21 contributing to meta-analysis.

The pooled estimate for relative VO2peak/VO2max was small and imprecise: +0.73 mL/kg/min (95% CI -0.07 to 1.54) across five studies and 172 participants. Evidence for walking capacity, exercise duration, handgrip, lower-limb strength, chair-rise performance and muscle/lean-tissue quantity was also uncertain and generally compatible with no clinically meaningful benefit.

The review therefore provides an important boundary for 'energy' and healthy-aging claims: CoQ10 has a clear role in mitochondrial bioenergetics, but current randomized evidence does not establish that supplementation improves aerobic capacity, muscle health or physical function in adults aged roughly 40 and older.

Key findings

Relative VO2peak/VO2max: 5 studies, n=172; MD +0.73 mL/kg/min, 95% CI -0.07 to 1.54; I²=0%; low-certainty evidence and compatible with no benefit.

Primary pooled estimates for 6-minute walk distance, handgrip strength, lower-limb strength, chair-rise performance, exercise duration and muscle/lean-tissue quantity were uncertain and did not establish clinically meaningful benefit.

Sensitivity analyses incorporating assumption-dependent estimates did not materially change the overall interpretation.

Evidence certainty was low or very low across all key outcomes.

The authors concluded that current evidence does not support routine CoQ10 supplementation solely to improve muscle health or physical capacity in middle-aged and older adults.

What this study can and cannot tell us

Only 21 of 33 included trials could contribute to quantitative meta-analysis, reflecting incomplete or incompatible reporting across the literature.

Many individual outcomes were informed by few participants; the relative VO2 analysis, for example, included only 172 participants.

Populations, doses, formulations, disease states, treatment durations and physical-function tests varied substantially, limiting generalizability of any single pooled estimate.

GRADE certainty was low or very low for all key outcomes, so the appropriate conclusion is absence of established clinically meaningful benefit rather than proof that no individual population can benefit.

Editorial review

Reviewed by the Biohack Blueprint research team

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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