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Coenzyme Q10 and endurance performance: grade C

Limited evidence. Direction: No effect.

C Limited

Educational guidance, not medical advice

Why this grade

Rubric condition met: Mixed small trials and a null pooled VO2max estimate; not N because no meta-analysis of performance outcomes in healthy adults and no 2 adequately sized null RCTs, so C with direction none

A 2026 meta-analysis of 14 RCTs (433 subjects) found no effect on VO2max or blood lactate, though creatine kinase fell. A small trial with 9 people per group found less anaerobic improvement with CoQ10 than placebo, and a 12-week trial in 40 older adults found no change in VO2max or physical performance. A systematic review in athletes concluded anaerobic performance improved, while another called the data inconclusive. EFSA found the endurance claim not substantiated.

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)1995200520152025Meta-analysisSystematic reviewRCTControlled trialTalebi 2024, 2024: meta-analysis, n = 830, result not recordedZhang 2026, 2026: meta-analysis, n = 433, result not recordedSchm 2026, 2026: RCT, n = 40, result not recordedMalm 1997, 1997: controlled trial, n = 18, result not recordedFernandes 2023, 2023: systematic review, n not recorded, result not recordedDrobnic 2022, 2022: systematic review, n not recorded, result not recorded
each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.
Show the numbers
StudyYearDesignParticipantsResult
Malm 19971997controlled trial18result not recorded
Drobnic 20222022systematic reviewnot recordedresult not recorded
Fernandes 20232023systematic reviewnot recordedresult not recorded
Talebi 20242024meta-analysis830result not recorded
Schm 20262026RCT40result not recorded
Zhang 20262026meta-analysis433result not recorded

Coenzyme Q10 Supplementation in Athletes: A Systematic Review.

Fernandes MSS, Fidelis DEDS, Aidar FJ. Coenzyme Q10 Supplementation in Athletes: A Systematic Review Nutrients, 2023. PMID 37764774

Result not recorded
Design
Systematic review of 16 studies (PROSPERO CRD42022357750)
Population
Athletes aged 17 and older
Funding
Funding: not stated in the PubMed or Crossref record; full text not read. COI: authors declare none.

Coenzyme Q(10) Supplementation and Its Impact on Exercise and Sport Performance in Humans: A Recovery or a Performance-Enhancing Molecule?

Drobnic F, Lizarraga MA, Caballero-García A. Coenzyme Q(10) Supplementation and Its Impact on Exercise and Sport Performance in Humans: A Recovery or a Performance-Enhancing Molecule? Nutrients, 2022. PMID 35565783

Result not recorded
Design
Systematic review
Population
Physically active people and athletes of different ages and fitness levels
Funding
Funding: not stated in the PubMed or Crossref record; full text not read. COI: authors declare none.

Coenzyme Q10 supplementation raises plasma levels without improving mitochondrial function in older adults.

Schmücker M, Tranberg C, Borch J. Coenzyme Q10 supplementation raises plasma levels without improving mitochondrial function in older adults Geroscience, 2026. PMID 41604113

Result not recorded
Design
12-week double-blind randomized placebo-controlled trial
Sample
n = 40
Population
Robust community-dwelling older adults (mean age 74)
Funding
Nordea-fonden (Crossref funder record)

Effects of ubiquinone-10 supplementation and high intensity training on physical performance in humans.

Malm C, Svensson M, Ekblom B. Effects of ubiquinone-10 supplementation and high intensity training on physical performance in humans Acta Physiol Scand, 1997. PMID 9401591

Result not recorded
Design
Placebo-controlled trial, 22 days (9 per group)
Sample
n = 18
Population
Human volunteers (9 per group) doing high-intensity anaerobic training; sex and health status not stated in the abstract
Funding
Funding: not stated in the PubMed or Crossref record; full text not read.

The effects of coenzyme Q10 supplementation on biomarkers of exercise-induced muscle damage, physical performance, and oxidative stress: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Talebi S, Pourgharib Shahi MH, Zeraattalab-Motlagh S. The effects of coenzyme Q10 supplementation on biomarkers of exercise-induced muscle damage, physical performance, and oxidative stress: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials Clin Nutr ESPEN, 2024. PMID 38479900

Result not recorded
Design
GRADE-assessed systematic review and dose-response meta-analysis of 28 RCTs
Sample
n = 830
Population
Adults in exercise trials, mostly conducted in Asia
Funding
Funding: not stated in the PubMed or Crossref record; full text not read. COI: authors declare none.

Effects of coenzyme Q10 analogs on oxidative stress, muscle, and metabolism after exercise: A meta-analysis and systematic review.

Zhang Y, He Y, Ma M. Effects of coenzyme Q10 analogs on oxidative stress, muscle, and metabolism after exercise: A meta-analysis and systematic review J Int Med Res, 2026. PMID 41657017

Result not recorded
Design
Meta-analysis and systematic review of 14 RCTs
Sample
n = 433
Population
Exercise trials (population details not given in the abstract)
Funding
Funding: not stated in the PubMed or Crossref record; full text not read. COI: authors declare none.

Search and history

Search (): (coenzyme Q10[ti] OR CoQ10[ti] OR ubiquinol[ti]) AND (exercise[tiab] OR performance[tiab] OR athletes[tiab]) AND (meta-analysis[pt] OR systematic review[pt])

  • Graded C (proposed): Proposed in the monograph draft
  • C to C (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page