C O Q10 AND M IGRAINES By Lauren Griffiths

What is CoQ10 and its role in migraines and treatment of migraines Many patients suffering from migraines are found to have deficient levels of CoQ10. CoQ10 is naturally produce and it is in many foods that are consumed daily such as fish, beef, eggs (not in chicken), vegetables, and grains.

T HE E LECTRON TRANSPORT CHAIN -CoQ10 in the green, (UQ) - The enzyme is active in every cell in the body. -Can act as an anti-oxidant that can manage the inflammatory nature of migraine and as a mitochondrial component involved in the electron transport chain and energy production

T HE SAFETY OF C O Q10 John N. Hathcock, Andrew Shao conducted a study to determine the safety of taking CoQ10 as a supplement to treat various mitochondrial disorders. There were no controls over dietary consumption of CoQ10 so it was assumed that normal levels were consumed in addition to supplementary amounts. CoQ10 was found to be safe to consume, in some individuals there were nausea, heartburn, or upset stomach but it was not consistently found at a certain dosage. Ex. The same number of patients with these problems was found at 1200 mg/day as with patients taking 60 mg/day. The number of patients reporting side effects was extremely small and statistically irrelevant.

E ARLY C O Q10 R ESEARCH Rozen TD, Oshinsky ML, Gebeline CA, Bradley KC, Young WB, Shechter AL & Silberstein SD conducted a study with 32 participants on the efficacy of CoQ10 supplementation as a treatment for migraines Patients needed to have a history of at least 1 year of migraines with 2-8 migraines per month. 61.3% of patients had a greater than 50% reduction in number of days with migraine headache, 93.5% of the patients had at least a 25% reduction in number of days with migraine during a 4 month study while taking 150 mg/day of CoQ10 supplements for the last 3 months. Side effects of CoQ10 treatment were minimal, 1% of patients in large studies experience gastrointestinal side-effects.

C O Q10 D EFICIENCY Andrew D. Hershey, MD, PhD; ScottW. Powers, PhD; Anna-Liisa B. et al. conducted a study on coenzyme Q10 as a supplement. CoQ10 plays an essential role in the electron transport chain in the mitochondria and is thought to play a role in migraines, but the link is unknown The patients CoQ10 levels were measured before and after treatment, supplements were taken as treatment 46.3% of patients who took CoQ10 supplements reported 50% reduction in headaches per month About 1/3 of patients had CoQ10 levels below the reference point, or a significant deficiency.

C O Q10 S UPPLEMENTATION IN C HILDREN Shalonda K Slater, Timothy D Nelson, Marielle A Kabbouche et al. conducted a study on the effects of CoQ10 supplementation on children ages 6-17 as a treatment for migraine headaches Started with 120 participants, only 50 participants left by the end of study for various reasons. The study was a randomized, double-blinded, placebo-controlled, crossover study where the patients received either the placebo or the CoQ10 supplement for the first half of the study and then switched treatments for the other half of the study. The study looked at headache frequency per month, average severity, average duration and associated symptoms before and after study

R ESULTS After the crossover, those subjects crossing from placebo to CoQ10 continued to improve, while those subjects crossing from CoQ10 to placebo worsened. Over the time of the study the placebo group and the CoQ10 group both reported reduction in frequency and severity of migraines, but there was little difference between the two groups. Due to the high drop-out rate from this study the results were not statistically relevant. It was also suggested that the dose of CoQ10 was too low to see statistical improvement, but because it was being tested on children they kept the dose low. CoQ10 has been tested on adults with success in much higher doses than 100mg per day.

P.S. Sándor, MD; L. Di Clemente, MD; G. Coppola, MD; U. et al. conducted a study on 42 patients age to determine the effect that CoQ10 had on migraines. Patients were given 100mg of CoQ10 in solution 3 times a day in liquid form. CoQ10 was superior to placebo for attack frequency, headache-days and days-with-nausea in the third treatment month and well tolerated; 50%-responder-rate for attack frequency was 14.4% for placebo and 47.6% for CoQ10.

R EFERENCES Hathcock, John N., Andrew Shao. Risk assessment for coenzyme Q10 (Ubiquinone). Regulatory Toxicology and Pharmacology 45 (2006) 282–288 Hershey AD, Powers SW, Vockell AL, Lecates SL, Ellinor PL, Segers A, et al. Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache 2007; 47: 73–80. P.S. Sándor, MD; L. Di Clemente, MD; G. Coppola, MD; U. Saenger; A. Fumal, MD; D. Magis et al. Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology 2005;64:713–715 Slater SK, Nelson TD, Kabbouche MA, Lecates SL, Horn P, Segers A, Manning P, et al. A randomized, double-blinded, placebo-controlled, crossover, add-on study of CoEnzyme Q10 in the prevention of pediatric and adolescent migraine. Cephalalgia 2011; 31(8) 897–905 Rozen TD, Oshinsky ML, Gebeline CA, Bradley KC, Young WB, Shechter AL & Silberstein SD. Open label trial of coenzyme Q10 as a migraine preventive. Cephalalgia 2002; 22:137–141. London. ISSN