CoQ10 vs Ubiquinol vs Ubiquinone: The Difference and Studies?

The antioxidant CoQ10, commonly referred to as coenzyme Q10, is one of the most well-liked dietary supplements for cardiovascular health in both the conventional medicine realm and the alternative or complementary medicine realm. It has also been linked in studies to regulating blood sugar, boosting fertility, preventing cancer, and even reducing migraines.

Coq10 Supplement Market size was valued at USD 614.3 Million in 2024 and is projected to reach USD 852.53 Million by 2030, growing at a CAGR (compound annual growth rate) of 5.1% during the forecast period 2024-2030. (R)

As you age, your body produces less CoQ10. In addition, it has been discovered that statin users and patients with specific diseases, such type 2 diabetes mellitus (T2DM), have lower amounts of CoQ10. Restoring CoQ10 levels in T2DM patients may reduce oxidative stress, protect mitochondrial function, and ultimately result in better glycemic control.

CoQ10 supplements may also help atrial fibrillation (a-fib), nonalcoholic fatty liver disease (NAFLD), insulin resistance, heart failure, cancer and migraines (R).

We've seen a piqued interest in coenzyme Q10, with people curious about its use in both topical products and oral supplements. But with curiosity comes questions and confusion.

In the case of coenzyme Q10, that confusion usually comes down to its types and names: Why do you sometimes see coenzyme Q10 as ubiquinol—or even ubiquinone? Well, we're here to explain the difference.  

What is Coenzyme Q10?

CoQ10 is a coenzyme, meaning it helps enhance the actions of key enzymes in the body. CoQ10 is a unique coenzyme in that it's also a fat-soluble antioxidant found in almost every cell of your body. It comes in two forms—ubiquinone and ubiquinol—and your body produces the compound naturally, although your levels do drop as you get older.

Antioxidants are substances that help neutralize free radicals, which are unstable molecules that can be natural byproducts of many cellular reactions (think our immune cells responding to an invader), as well as things like internal stressors, UV exposure, and pollution.

"People often ask how many antioxidants you should be using regularly; the answer is: the more the better," says board-certified dermatologist Rachel Nazarian, M.D., of Schweiger Dermatology Group about the role of antioxidants in the body. "The more you can help neutralize unstable molecules caused by free radical formation, the longer you can salvage the health of your cells and skin. There's really no limit to how much you can protect and repair your body!"

And all antioxidants come with their own set of benefits and specialized focus areas for health. CoQ10, in particular, plays several critical roles in the body. The below is not an exhaustive list—for that please check out MindBodyGreen's guide to CoQ10—but it can give you a good indication of what you can expect if you decide to take it via supplementation or topical products.

Its primary role in the body is to support energy production. It's specifically used in the mitochondria, or "powerhouse" of the cells, where CoQ10 transports electrons in your mitochondrial pathways, which in turn produces energy (i.e., ATP energy from the carbohydrates, protein, and fats we consume daily). Because this happens in every cell in the human body, CoQ10 supports overall health, too.

Like all antioxidants, it fights free radicals. But it's not just any antioxidant. In fact, it's the only fat-soluble antioxidant naturally made by the human body. Additionally, it also helps protect against lipid peroxidation, a process by which free radicals break down lipids in cell membranes. Finally, it helps regenerate other antioxidants in the body, supporting the free-radical-neutralizing power of other antioxidants you are ingesting or using.

It also supports skin health, thanks to its antioxidant and energy-promotion abilities. When used via topicals, research has found that topical CoQ10 can significantly decrease facial wrinkles. And a clinical trial found that CoQ10 supplements reduce the appearance of wrinkles and lines while enhancing skin smoothness.

What is Ubiquinol?

The difference in the two types of CoQ10 comes down to molecular structure—specifically, ubiquinol contains a hydrogen bond, whereas ubiquinone has been oxidized (the hydrogen bond has been removed).

Ubiquinol is the form of coenzyme Q10 that is considered to be the "active" form of the antioxidant, as it is the bioactive form that's utilized in the body. Because it is the active form, it does not need any additional conversion steps to be used by the cells.

Both are present in your body, and your body actually converts the two back and forth naturally as required by cellular pathways. However, ubiquinol is the most prevalent form, accounting for 90% of the CoQ10 in the blood.

As mbg's vice president of scientific affairs Ashley Jordan Ferira, Ph.D., RDN, explains, "CoQ10 is found ubiquitously—hence the name, ubiquinol, the active form of CoQ10—in every cell of your body." Ferira adds, "In your cells' mitochondria, ubiquinol is a vital part of cellular energy production from nutrition we consume daily. A real multitasker, ubiquinol is also a powerhouse antioxidant."

What is Ubiquinone?

Both ubiquinol and ubiquinone are forms of CoQ10 (coenzyme Q10), act as an antioxidant, substances that may shield your cells from free radicals, which have been linked to heart disease, cancer, and other diseases.

The main differences between ubiquinol and ubiquinone is that ubiquinol is the reduced form of CoQ10, whereas ubiquinone is the oxidized form. Therefore, ubiquinone has more electrons than the ubiquinol. In your body, this conversion occurs thousands of times every second inside your mitochondria.

The flipping back and forth between these two molecular forms is part of the process that transforms food into energy. Ubiquinol production ramps up from early childhood until your mid- to late 20s. By the time you hit 30, it begins to decline. Young people are able to use CoQ10 supplements quite well, but older people do better with ubiquinol, as it’s more readily absorbed.

To revisit the structural differences between the two forms: ubiquinol (the active form) contains a hydrogen bond, and ubiquinone has been oxidized therefore removing the hydrogen bond. Ubiquinone must be converted to ubiquinol (add a hydrogen bond) in the body before it can perform its functions.

However, because it is the oxidized form, it's also much more stable in specific formats—specifically, ubiquinone comes in handy in certain emulsions and topical formulations.

Ubiquinone vs Ubiquinol

Ubiquinol (CoQH2) May Be More Bioavailable Than Ubiquinone (CoQ10)

The ability of a medicine or other substance to be absorbed and used by the body is referred to as bioavailability. According to some researches, ubiquinol is more bioavailable. However, the study is still inconsistent.

A study (2018) aimed to compare the effectiveness between ubiquinone and ubiquinol to enhance the CoQ10 status in older men suggests that ubiquinol supplement are more effective than ubiquinone supplement.

However, another study found no significant differences between ubiquinone capsules and ubiquinol capsules in the redox status of the absorbed CoQ10, which indicates that CoQ10 appears in blood almost exclusively as ubiquinol, even if consumed as ubiquinone.

Ubiquinol is More Expensive and Less Stable Than Ubiquinone

Ubiquinol cost more to manufacture than ubiquinone, therefore, they are more expensive for consumers and researchers. Moreover, ubiquinol is less stable than ubiquinone, biochemically speaking.

CoQ10 vs Ubiquinol in Lowering Heart-Related Deaths

A 2023 scientific review of 28 studies found that CoQ10 is more effective than its reduced form, ubiquinol, in reducing deaths related to heart diseases. Participants who took CoQ10 supplements showed significantly lower rates of cardiovascular mortality compared to those who took ubiquinol.

CoQ10 enhances mitochondrial function, which is crucial for energy production in heart cells. By improving how mitochondria operate, CoQ10 ensures that the heart muscle gets the energy it needs to pump blood efficiently. This improvement in energy production directly contributes to better heart health and reduced mortality rates.

Moreover, CoQ10 is more stable and bioavailable than ubiquinol. This means that CoQ10 is easier for the body to absorb and use effectively. Higher bioavailability ensures that more of the supplement reaches the heart cells where it is needed most, providing greater benefits.

Long-term studies have shown that the positive effects of CoQ10 persist over time, offering sustained protection against heart failure. In contrast, ubiquinol does not demonstrate the same level of long-term benefits, making CoQ10 the preferred choice for ongoing heart health management.

CoQ10 supplementation is particularly important if you’re on a statin drug. Statins block HMG coenzyme A reductase in your liver, which is how they reduce cholesterol. But this is also the same enzyme that makes CoQ10, making deficiency highly likely. Statin-induced CoQ10 deficiency is in many cases responsible for the myopathic side effects attributed to these drugs (i.e., side effects involving loss of muscle control).

Read More: CoQ10 vs Ubiquinol in Heart Health Battle

CoQ10 (Ubiquinone) vs Ubiquinol for Supplements

You'll see both forms show up in supplements and topicals. 

Interestingly, in a surprising reversal of long-held beliefs, a 2023 scientific review of 28 studies suggests that CoQ10 (ubiquinone) is more effective for heart health than its reduced form, ubiquinol. For years, health experts and supplement manufacturers have advocated for ubiquinol, claiming its superior bioavailability made it the obvious choice for those seeking cardiovascular benefits.

Their recommendation seemed logical: since ubiquinol is the active form of CoQ10 in the body, taking it directly should provide better results. However, emerging evidence challenges this conventional wisdom, indicating that the body may actually use standard CoQ10 more effectively for cardiac function. As noted by the authors, "Improved water solubility and limited understanding of CoQ10 and CoQH2 absorption and transfer mechanisms have led to misleading interpretations, favoring CoQH2 as the more bioactive form."

This finding not only questions our understanding of CoQ10 supplementation but also highlights how assumptions about bioavailability don't always translate to real-world therapeutic benefits. 

CoQ10 vs Ubiquinol for Topicals

Given the nature of topical formulations, cosmetic chemists normally use the more stable version, ubiquinone (CoQ10).

Because skin care topicals contain multiple ingredients, preservative systems for aqueous formulas, and are often readily exposed to air, they need more stabilized actives; otherwise, the ingredient's efficacy will be reduced when it comes in contact with other ingredients, water, and oxygen.

Other Differences

Ubiquinone = oxidized CoQ10 = yellow
Ubiquinol = reduced CoQ10 = white

In contrast to ubiquinone, which has a characteristic yellowish color, ubiquinol is essentially white. As soon as ubiquinol is exposed to oxygen, it transforms back into ubiquinone, which is its oxidized (and yellow) form.

Optimizing Your Heart Health with CoQ10

Your body can naturally make CoQ10, but genetic alterations in metabolism, poor diet, oxidative stress, chronic conditions and aging can all interfere with CoQ10 production and lead to CoQ10 deficiency. Statin drugs can also deplete CoQ10.

If you’re new to CoQ10 supplementation, an initial dose of 200 to 300 mg per day is recommended. After about three weeks, when plasma levels typically reach their optimal plateau, you can transition to a maintenance dose of 100 mg daily, which is sufficient for most healthy individuals. 

However, if you maintain an active lifestyle, exercise frequently, or experience high stress levels, you might benefit from continuing with 200 to 300 mg daily.

Special consideration must be given to certain health conditions. Those taking statin medications should supplement with at least 100 to 200 mg of CoQ10 daily, and possibly more. Similarly, individuals managing chronic conditions such as heart disease, diabetes, ALS, chronic fatigue, or autism may require higher doses. Ideally, you’ll want to work with your physician to determine your ideal dose.

For optimal absorption, split your daily dose into two or three portions rather than taking it all at once, and take it with a healthy source of fat since CoQ10 is fat-soluble. While these guidelines provide a general framework, working with an integrative physician can help determine the most appropriate dosage for your specific needs.

Additionally, given the varying quality of supplements available in the market, it's crucial to select a CoQ10 product specifically formulated for maximum absorption and bioavailability.

CoQ10 Outshines Ubiquinol in Enhancing Heart Health

CoQ10 significantly reduces heart-related deaths more effectively than Ubiquinol. Studies demonstrate that individuals taking CoQ10 supplements experience lower rates of cardiovascular mortality due to improved mitochondrial function and efficient energy production in heart cells.

The stability and bioavailability of CoQ10 ensure it is easily absorbed and utilized by the body. This higher bioavailability allows more of the supplement to reach heart cells, providing consistent and long-lasting benefits that surpass those of Ubiquinol.

CoQ10 plays a crucial role in the early recovery of cardiac function after a myocardial infarction. It reduces inflammation by inhibiting specific immune cells and inflammatory pathways, which helps preserve heart tissue and improves overall heart health following a heart attack.

Intravenous administration of CoQ10 offers rapid elevation of its levels in vital organs during emergency ischemic conditions. This swift delivery protects the heart muscle, reduces the size of damaged areas, and supports better long-term recovery, making CoQ10 an essential treatment option in acute medical settings.

Incorporating CoQ10 into your daily routine can optimize heart health. By selecting a high-quality supplement, determining the appropriate dosage based on age, and maintaining consistent supplementation, you can enhance energy production, boost immune responses, and protect your heart from damage.

CoQ10 Safety and Side Effects

At typical doses, CoQ10 and ubiquinol appear to be generally safe, even when taken daily for several years. Gastrointestinal side effects may occur but can be minimized by breaking up the dose throughout the day, although it may interfere with sleep if taken before bed. CoQ10 may interact with certain drugs, including blood thinners and diabetes medications. 

Conclusion

There are many benefits to adding the antioxidant to your routine (from smooth skin to ATP energy production). But understanding how to best utilize CoQ10 in your daily routine comes down to understanding the intended use (topical and/or supplementation) and key differences in its two types: ubiquinol (CoQH2) and ubiquinone (CoQ10).

CoQ10 may interact with certain drugs, including blood thinners and diabetes medications. Ideally, you’ll want to work with your doctor to determine your ideal dose or whether CoQ10 is right for you.

Best Ubiquinone Supplements - Online Buying Guide

1. Ubiquinone Softgels 100mg | Nutrigenomic Naturals Coenzyme Q10 Ubiquinone 100mg

2. Ubiquinone Softgels 200mg | Zebora CoQ10-200mg-Softgels with PQQ, BioPerine & Omega-3

3. Ubiquinone Capsules 400mg | ASquared Nutrition CoQ10 400mg Max Strength

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