CoQ10

Summary:
Coenzyme Q10 is a mitochondrial cofactor that supports ATP production and antioxidant defense. It may reduce migraine frequency through improved cellular energy metabolism.

Biological Plausibility

CoQ10 improves mitochondrial respiration and reduces oxidative stress—both important in migraine. CoQ10 deficiency has been documented in people with migraine, especially children and women with hormonal migraines.

Evidence

RCTs show modest reductions in migraine frequency with 100–300 mg/day. Pediatric and adult studies both support benefit, especially in combination with other nutraceuticals.

Effect Size

1–2 fewer migraine days/month. 30–50% response rate in open-label and controlled trials.

⚠️ Risk

Minimal. Occasional GI upset, especially at higher doses. Better absorbed in oil-based softgel form.

Cost

$$

Scores

  • Benefit: 3
  • Burden: 3
  • Ratio: 1.0

Clinical Takeaways

  • Best results at 100–300 mg/day in divided doses.
  • Consider using with magnesium and riboflavin.
  • Good choice for those with low mitochondrial resilience.

Key References

  • Hershey AD, et al. *Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine.* Headache. 2007.
  • Sandor PS, et al. *Coenzyme Q10 for migraine prophylaxis: a randomized controlled trial.* Cephalalgia. 2005.
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