【一次看懂】輔酶Q10功效、副作用完整攻略！
你有想過，我們身體是如何將血液中的葡萄糖轉化成能量嗎？
原來，我們身體需要借助氧氣，透過有氧呼吸將葡萄糖分解來產生能量，而輔酶Q10（Coenzyme Q10 / CoQ10）正是有氧呼吸過程中其中一種重要的還原劑／抗氧化劑。
這也是為甚麼我們常常將輔酶Q10與「產生能量」和「抗氧化」拉上關係，那麼到底坊間所指，輔酶Q10能幫助心血管問題和生育能力的說法是否有科學根據呢？
就讓我們繼續看下去吧！
輔酶Q10（CoQ10）的功效
輔酶Q10（CoQ10）可以改善高血壓嗎？
2007年1Rosenfeldt FL, Haas SJ, Krum H, Hadj A, Ng K, Leong J-Y, et al. Coenzyme Q10 in the treatment of hypertension: A meta-analysis of the clinical trials. Journal of Human Hypertension [Internet]. 2007;21(4):297–306. Available from: Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials | Journal of Human Hypertension (nature.com)和2018年2Tabrizi R, Akbari M, Sharifi N, Lankarani KB, Moosazadeh M, Kolahdooz F, et al. The effects of coenzyme Q10 supplementation on blood pressures among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials. High Blood Pressure & Cardiovascular Prevention [Internet]. 2018;25(1):41–50. Available from: The Effects of Coenzyme Q10 Supplementation on Blood Pressures Among Patients with Metabolic Diseases: A Systematic Review and Meta-analysis of Randomized Controlled Trials | SpringerLink的兩份文獻回顧均發現，每天補充輔酶Q10有助令收縮壓（上壓）下降約16.6 mmHg，而舒張壓（下壓）則會降低約8.2 mmHg，而普遍研究中可以見到輔酶Q10對上壓的改善相較對下壓的改善更加明顯。
輔酶Q10（CoQ10）可以改善血脂／膽固醇問題嗎？
臨床研究發現3Jorat MV, Tabrizi R, Mirhosseini N, Lankarani KB, Akbari M, Heydari ST, et al. The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: A systematic review and meta-analysis of randomized controlled trials. Lipids in Health and Disease [Internet]. 2018;17(1). Available from: The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials | Lipids in Health and Disease | Full Text (biomedcentral.com)4Mohseni M, Vafa MR, Hajimiresmail SJ, Zarrati M, Rahimi Forushani A, Bitarafan V, et al. Effects of coenzyme Q10 supplementation on serum lipoproteins, plasma fibrinogen, and blood pressure in patients with hyperlipidemia and myocardial infarction. Iranian Red Crescent Medical Journal [Internet]. 2014;16(10). Available from: Effects of Coenzyme Q10 Supplementation on Serum Lipoproteins, Plasma Fibrinogen, and Blood Pressure in Patients With Hyperlipidemia and Myocardial Infarction - PMC (nih.gov)5Shidfar F, Mohseni M, Hajimiresmail SJ, Forushani AR, Vafa M, Zarrati M. Beneficial effects of coenzyme Q10 supplementation on lipid profile and intereukin-6 and intercellular adhesion molecule-1 reduction, preliminary results of a double-blind trial in acute myocardial infarction. International Journal of Preventive Medicine [Internet]. 2015;6(1):73. Available from: Beneficial Effects of Coenzyme Q10 Supplementation on Lipid Profile and Intereukin-6 and Intercellular Adhesion Molecule-1 Reduction, Preliminary Results of a Double-blind Trial in Acute Myocardial Infarction - PMC (nih.gov)6Lee Y-J, Cho W-J, Kim J-K, Lee D-C. Effects of coenzyme Q10 on arterial stiffness, metabolic parameters, and fatigue in obese subjects: A double-blind randomized controlled study. Journal of Medicinal Food [Internet]. 2011;14(4):386–90. Available from: Effects of Coenzyme Q10 on Arterial Stiffness, Metabolic Parameters, and Fatigue in Obese Subjects: A Double-Blind Randomized Controlled Study | Journal of Medicinal Food (liebertpub.com)，每天服用200毫克輔酶Q10連續12個星期，有助改善整體膽固醇和「好膽固醇（HDL-C）」的水平，但就未必能有效降低「壞膽固醇（LDL-C）」和甘油三酯（TG）的水平。
輔酶Q10（CoQ10）可以改善血糖控制／糖尿病嗎？
有關輔酶Q10改善血糖控制的數據較為薄弱，從不同研究中我們得出相異的結論。
按照目前資料，服用低劑量（< 200毫克）輔酶Q10可能有助改善空腹血糖值（FBG），但就未能有效改善糖化血色素（HbA1c，代表「長期血糖平均值」）水平7Stojanović M, Radenković M. A meta-analysis of randomized and placebo-controlled clinical trials suggests that coenzyme Q10 at low dose improves glucose and hba1c levels. Nutrition Research [Internet]. 2017;38:1–12. Available from: A meta-analysis of randomized and placebo-controlled clinical trials suggests that coenzyme Q10 at low dose improves glucose and HbA1c levels - ScienceDirect8MORADI MAEDEH, HAGHIGHATDOOST FAHIMEH, FEIZI AWAT, AZADBAKHT LEILA. EFFECT OF COENZYME Q10 SUPPLEMENTATION ON DIABETES BIOMARKERS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED CLINICAL TRIALS. ARCHIVES OF IRANIAN MEDICINE. 2016 [cited 2022May03];19(8):588-596. Available from: SID.ir | Effect Of Coenzyme Q10 Supplementation On Diabetes Biomarkers: A Systematic Review And Meta-Analysis Of Randomized Controlled Clinical Trials9Zhang S-ying, Yang K-lin, Zeng L-ting, Wu X-he, Huang H-yong. Effectiveness of coenzyme Q10 supplementation for type 2 diabetes mellitus: A systematic review and meta-analysis. International Journal of Endocrinology [Internet]. 2018;2018:1–11. Available from: Effectiveness of Coenzyme Q10 Supplementation for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis (hindawi.com)。
有另一項研究則發現，連續12星期每天補充200毫克輔酶Q10，未能明顯改善糖尿病患的各項指標和糖尿病引致的神經病變症狀10Akbari Fakhrabadi M, Zeinali Ghotrom A, Mozaffari-Khosravi H, Hadi Nodoushan H, Nadjarzadeh A. Effect of coenzyme Q10 on oxidative stress, glycemic control and inflammation in diabetic neuropathy: A double blind randomized clinical trial. International Journal for Vitamin and Nutrition Research [Internet]. 2014;84(5-6):252–60. Available from: Effect of Coenzyme Q10 on Oxidative Stress, Glycemic Control and Inflammation in Diabetic Neuropathy: A Double Blind Randomized Clinical Trial | International Journal for Vitamin and Nutrition Research (hogrefe.com)。
輔酶Q10（CoQ10）對心臟病有幫助嗎？
補充輔酶Q10有助改善心臟衰竭病人的射血分數（Ejection Fraction，代表「心臟是否能有效將當中的血液泵出」）11Fotino AD, Thompson-Paul AM, Bazzano LA. Effect of coenzyme Q10 supplementation on heart failure: A meta-analysis. The American Journal of Clinical Nutrition [Internet]. 2012;97(2):268–75. Available from: Effect of coenzyme Q10 supplementation on heart failure: a meta-analysis | The American Journal of Clinical Nutrition | Oxford Academic (oup.com)。
有趣的是，這種改善只出現在「服用不超過100毫克輔酶Q10少於12週」的病人身上。
由於糖尿病人有著較高的心臟病風險，因此也有一些研究嘗試針對糖尿病人，找出補充輔酶Q10是否能降低他們的心臟病風險。
而目前的研究已經發現輔酶Q10有助改善糖尿病人的膽固醇水平（其中一項重要的心臟病風險因素）12Dludla PV, Nyambuya TM, Orlando P, Silvestri S, Mxinwa V, Mokgalaboni K, et al. The impact of coenzyme Q 10 on metabolic and cardiovascular disease profiles in diabetic patients: A systematic review and meta‐analysis of Randomized Controlled Trials. Endocrinology, Diabetes & Metabolism [Internet]. 2020;3(2). Available from: The impact of coenzyme Q10 on metabolic and cardiovascular disease profiles in diabetic patients: A systematic review and meta‐analysis of randomized controlled trials - Dludla - 2020 - Endocrinology, Diabetes & Metabolism - Wiley Online Library，所以每天補充輔酶Q10有助降低糖尿病人的心臟病風險。
輔酶Q10具有抗氧化功能，因此也能提升血液中一些抗氧化酵素水平，達到保護心血管的效果13Jorat MV, Tabrizi R, Kolahdooz F, Akbari M, Salami M, Heydari ST, et al. The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: A systematic review and meta-analysis of randomized controlled trials. Inflammopharmacology [Internet]. 2019;27(2):233–48. Available from: The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: a systematic review and meta-analysis of randomized controlled trials | SpringerLink。
輔酶Q10（CoQ10）可以改善肌肉痛症嗎？
其中一類最常用的膽固醇藥物就是「他汀類（Statins）」，包括：Simvastatin（舒降之 Zocor）、Atorvastatin（膽固清 Lipitor）和Rosuvastatin（冠脂妥® Crestor）。
他汀類藥物有機會造成一種罕見但嚴重的副作用，名為「橫紋肌溶解症（Rhabdomyolysis）」，患者會感到肌肉異常疼痛、無力、全身疲倦，另外肌肉纖維溶解會令尿液會變為深色，而這些溶解了的肌肉纖維會損害腎臟，造成腎衰竭，所以一旦出現以上症狀，就要馬上求醫。
根據一篇發表於2018年的文獻回顧，服用輔酶Q10有助改善由他汀類藥物引起的肌肉病變症狀，包括：肌肉疼痛、虛弱和抽筋等情況，但就未能明顯降低血液中與肌肉細胞損壞相關的酵素水平（意味著補充輔酶Q10可以改善肌肉痛等症狀，但未必能減少肌肉溶解的程度）14Qu H, Guo M, Chai H, Wang W, Gao Z, Shi D. Effects of coenzyme Q10 on statin‐Induced Myopathy: An updated meta‐analysis of Randomized Controlled Trials. Journal of the American Heart Association [Internet]. 2018;7(19). Available from: Effects of Coenzyme Q10 on Statin‐Induced Myopathy: An Updated Meta‐Analysis of Randomized Controlled Trials | Journal of the American Heart Association (ahajournals.org)。
輔酶Q10（CoQ10）可以預防偏頭痛嗎？
雖然服用輔酶Q10未能改善偏頭痛發作時的嚴重程度和發作日數，但在整合了4項臨床研究的數據後發現，每日服用輔酶Q10有助減少偏頭痛的發作頻率15Parohan M, Sarraf P, Javanbakht MH, Ranji-Burachaloo S, Djalali M. Effect of coenzyme Q10 supplementation on clinical features of Migraine: A systematic review and dose–response meta-analysis of randomized controlled trials. Nutritional Neuroscience [Internet]. 2019;23(11):868–75. Available from: Effect of coenzyme Q10 supplementation on clinical features of migraine: a systematic review and dose–response meta-analysis of randomized controlled trials: Nutritional Neuroscience: Vol 23, No 11 (tandfonline.com)。
要預防偏頭痛，你可以每天三次，每次補充100毫克輔酶Q1016Sandor PS, Di Clemente L, Coppola G, Saenger U, Fumal A, Magis D, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology [Internet]. 2005;64(4):713–5. Available from: Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial | Neurology。
輔酶Q10（CoQ10）可以改善神經病變／神經痺痛嗎？
每天補充輔酶Q10未能有效改善由糖尿病導致的神經病變症狀17Akbari Fakhrabadi M, Zeinali Ghotrom A, Mozaffari-Khosravi H, Hadi Nodoushan H, Nadjarzadeh A. Effect of coenzyme Q10 on oxidative stress, glycemic control and inflammation in diabetic neuropathy: A double blind randomized clinical trial. International Journal for Vitamin and Nutrition Research [Internet]. 2014;84(5-6):252–60. Available from: Effect of Coenzyme Q10 on Oxidative Stress, Glycemic Control and Inflammation in Diabetic Neuropathy: A Double Blind Randomized Clinical Trial | International Journal for Vitamin and Nutrition Research (hogrefe.com)。
輔酶Q10（CoQ10）可以改善生育能力／增加懷孕成功率嗎？
本身精子質素稍遜的男士可以透過補充輔酶Q10，改善精子的濃度和質素18Lafuente R, González-Comadrán M, Solà I, López G, Brassesco M, Carreras R, et al. Coenzyme Q10 and male infertility: A meta-analysis. Journal of Assisted Reproduction and Genetics [Internet]. 2013;30(9):1147–56. Available from: Coenzyme Q10 and male infertility: a meta-analysis | SpringerLink。多數男士生育相關的研究劑量為每天200-400毫克19Salvio G, Cutini M, Ciarloni A, Giovannini L, Perrone M, Balercia G. Coenzyme Q10 and male infertility: A systematic review. Antioxidants [Internet]. 2021;10(6):874. Available from: Antioxidants | Free Full-Text | Coenzyme Q10 and Male Infertility: A Systematic Review | HTML (mdpi.com)。
較難成孕的女性服用輔酶Q10，同樣有助改善卵子質素和數量。
研究人員為一些準備懷孕的女士補充輔酶Q10，發現能增加人工授孕過程中成功採集到的卵子質素和數量，以及臨床懷孕率20Florou P, Anagnostis P, Theocharis P, Chourdakis M, Goulis DG. Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. Journal of Assisted Reproduction and Genetics [Internet]. 2020;37(10):2377–87. Available from: Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials | SpringerLink21Xu Y, Nisenblat V, Lu C, Li R, Qiao J, Zhen X, et al. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: A randomized controlled trial. Reproductive Biology and Endocrinology [Internet]. 2018;16(1). Available from: Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial | Reproductive Biology and Endocrinology | Full Text (biomedcentral.com)。但要留意，對於本身生育能力正常的女性，便沒有充足的數據證實輔酶Q10能進一步增加懷孕機率。
輔酶Q10（CoQ10）可以預防妊娠毒血症嗎？
高風險患有妊娠毒血症的孕婦（包括：上一胎懷孕時曾患有妊娠毒血症、患有妊娠高血壓、妊娠糖尿病或自身免疫力疾病、肥胖、35歲或以上懷孕等）由懷孕第20週開始，每天補充200毫克輔酶Q10直至分娩，能有效預防患上妊娠毒血症22Teran E, Hernandez I, Nieto B, Tavara R, Ocampo JE, Calle A. Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia. International Journal of Gynecology & Obstetrics [Internet]. 2009;105(1):43–5. Available from: Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia - ScienceDirect。
輔酶Q10（CoQ10）可以抗衰老嗎？
隨著年齡增長，身體製造輔酶Q10的速度就會有所下降。
有少量研究指出補充輔酶Q10有助激活腺粒體生成的機制和延緩衰老，但目前並不足以支持「額外補充輔酶Q10有助抗衰老」的結論23Hernández-Camacho JD, Bernier M, López-Lluch G, Navas P. Coenzyme Q10 supplementation in aging and disease. Frontiers in Physiology [Internet]. 2018;9. Available from: Frontiers | Coenzyme Q10 Supplementation in Aging and Disease | Physiology (frontiersin.org)。
輔酶Q10（CoQ10）可以改善腦退化症／改善記性嗎？
輔酶Q10並未能有效改善記性或腦退化症的情況24Galasko DR, Peskind E, Clark CM, Quinn JF, Ringman JM, Jicha GA, et al. Antioxidants for alzheimer disease. Archives of Neurology [Internet]. 2012;69(7). Available from: Antioxidants for Alzheimer disease: a randomized clinical trial with cerebrospinal fluid biomarker measures - PubMed (nih.gov)。
輔酶Q10（CoQ10）可以改善柏金遜症嗎？
研究發現，每天服用300-1200毫克輔酶Q10，並未能有效改善柏金遜症的症狀25Beal MF, Oakes D, Shoulson I, Henchcliffe C, Galpern WR, Haas R, et al. A randomized clinical trial of high-dosage coenzyme Q10 in early parkinson disease. JAMA Neurology [Internet]. 2014;71(5):543. Available from: A Randomized Clinical Trial of High-Dosage Coenzyme Q10 in Early Parkinson Disease: No Evidence of Benefit | Complementary and Alternative Medicine | JAMA Neurology | JAMA Network26Zhu Z-G, Sun M-X, Zhang W-L, Wang W-W, Jin Y-M, Xie C-L. The efficacy and safety of coenzyme Q10 in parkinson’s disease: A meta-analysis of randomized controlled trials. Neurological Sciences [Internet]. 2016;38(2):215–24. Available from: The efficacy and safety of coenzyme Q10 in Parkinson’s disease: a meta-analysis of randomized controlled trials | SpringerLink27Storch A. Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q10 in parkinson disease. Archives of Neurology [Internet]. 2007;64(7):938. Available from: Randomized, Double-blind, Placebo-Controlled Trial on Symptomatic Effects of Coenzyme Q10 in Parkinson Disease | Movement Disorders | JAMA Neurology | JAMA Network28Negida A, Menshawy A, El Ashal G, Elfouly Y, Hani Y, Hegazy Y, et al. Coenzyme Q10 for patients with parkinson';s disease: A systematic review and meta-analysis. CNS & Neurological Disorders - Drug Targets [Internet]. 2016;15(1):45–53. Available from: Coenzyme Q10 for Patients with Parkinson's Disease: A Systematic ...: Ingenta Connect。
輔酶Q10（CoQ10）可以改善疲倦問題嗎？
額外補充輔酶Q10有助改善由他汀類藥物和纖維肌痛症引起的疲倦疲勞，但輔酶Q10對於舒緩由其他原因引起的疲倦效果則尚需要更多研究才能證實29Mehrabani S, Askari G, Miraghajani M, Tavakoly R, Arab A. Effect of coenzyme Q10 supplementation on fatigue: A systematic review of Interventional Studies. Complementary Therapies in Medicine [Internet]. 2019;43:181–7. Available from: Effect of coenzyme Q10 supplementation on fatigue: A systematic review of interventional studies - ScienceDirect。
輔酶Q10（CoQ10）的保健劑量和上限
在參考各類文獻後，我們發現輔酶Q10最常用的劑量是每天200-400毫克。
在某些特定情況下（例如：偏頭痛），我們使用的劑量會有所不同，詳情可以參考上文。
由於輔酶Q10基本上不會產生毒性或副作用，目前建議的劑量上限為每日1200毫克30Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K. Safety assessment of coenzyme Q10(coq10). BioFactors [Internet]. 2008;32(1-4):199–208. Available from: Safety assessment of coenzyme Q10 (CoQ10) - PubMed (nih.gov)（部分研究使用的劑量甚至可達每日3000毫克）。
輔酶Q10（CoQ10）的服用方法和注意事項
由於輔酶Q10屬於油溶性成分，跟隨油脂量高的食物一同進食可以增加其吸收31OCHIAI A, ITAGAKI S, KUROKAWA T, KOBAYASHI M, HIRANO T, ISEKI K. Improvement in intestinal coenzyme Q10 absorption by food intake. YAKUGAKU ZASSHI [Internet]. 2007;127(8):1251–4. Available from: Improvement in Intestinal Coenzyme Q10 Absorption by Food Intake (jst.go.jp)，所以我們可以將輔酶Q10隨午餐或晚餐（通常較早餐豐富）服用。
補充輔酶Q10（CoQ10）的副作用
輔酶Q10屬於較溫和的保健成分，如果每次服用的份量不超過100毫克（如，每日三次，每次100毫克），甚少會產生副作用。
最有可能出現的副作用包括（但出現機率也低於1%）：
- 腸胃不適
- 食慾不振
- 噁心／嘔吐
- 火燒心
其他可能會出現的副作用包括：
- 疲倦
- 頭痛
- 腹瀉
- 紅疹
如何（從不同牌子）挑選合適的輔酶Q10（CoQ10）補充劑？
傳統型態（Ubiquinone）vs 還原型態（Ubiquinol）
市面上大家見到的CoQ10產品多為Ubiquinone傳統型態。
相比起Ubiquinone，有研究指Ubiquinol的吸收率更佳，然而這些研究只收集了十多位參與者的樣本，認受性相對較低32Zhang Y, Liu J, Chen X-qiang, Oliver Chen C-Y. Ubiquinol is superior to ubiquinone to enhance coenzyme Q10 status in older men. Food & Function [Internet]. 2018;9(11):5653–9. Available from: Ubiquinol is superior to ubiquinone to enhance Coenzyme Q10 status in older men - Food & Function (RSC Publishing)33Langsjoen PH, Langsjoen AM. Comparison study of plasma coenzyme Q10levels in healthy subjects supplemented with Ubiquinol Versus Ubiquinone. Clinical Pharmacology in Drug Development [Internet]. 2013;3(1):13–7. Available from: Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone - Langsjoen - 2014 - Clinical Pharmacology in Drug Development - Wiley Online Library。
雖然還原型態的抗氧化功能理論上較佳，但實際上Ubiquinone和Ubiquinol在我們體內會互相轉化，因此服用後的效果也相似，目前並未有稍具規模的臨床研究證實Ubiquinol的效果明顯優於Ubiquinone。
總括而言，暫時未有足夠證據能證明兩種型態在效果或吸收率上有明顯分別，因此選擇品牌時應優先考慮劑量和性價比，而非型態間的分別。
