Can CoQ10 reverse fatty liver?
Fatty liver disease is a growing health concern affecting millions of people worldwide. Also known as hepatic steatosis, fatty liver occurs when too much fat accumulates in the liver cells. While alcohol abuse is a common cause, nonalcoholic fatty liver disease (NAFLD) from poor diet and lack of exercise now accounts for most cases. Left untreated, fatty liver can progress to more serious liver damage and cirrhosis. Finding ways to reverse fatty liver has become an important goal. Coenzyme Q10 (CoQ10) shows promising potential as a natural treatment. Here is an in-depth look at the research on using CoQ10 to reverse fatty liver disease.
- What Causes Fatty Liver Disease?
- Stages of Fatty Liver Disease
- Signs and Symptoms of Fatty Liver
- Diagnosing Fatty Liver
- Using CoQ10 to Reverse Fatty Liver
- CoQ10 Protects the Liver Against Oxidative Stress
- CoQ10 Reduces Liver Inflammation & Fibrosis
- Clinical Research on CoQ10 and Fatty Liver
- CoQ10 Supplements for Fatty Liver
- Lifestyle Changes Are Also Critical
- Can CoQ10 reverse fatty liver? Conclusion
- Resources used to write this article
What Causes Fatty Liver Disease?
The liver performs over 500 vital functions, including metabolizing fats. Normally, fat makes up about 5-10% of the liver's weight. Fatty liver occurs when fat accounts for more than 5-10% of the liver's total weight. Several factors can cause fat to build up in liver cells:
- Diet high in refined carbs and sugar - Fructose sugar from sodas, candy, baked goods promotes fatty liver. The typical Western diet contains too many refined carbs and sugar that get converted to fat.
- Insulin resistance - This pre-diabetic condition makes it harder for the body to control blood sugar and fat storage. Insulin resistance promotes excess fat accumulation in the liver.
- Obesity - Being overweight or obese increases the risk of fatty liver disease. Body fat, especially around the abdomen, is more likely to accumulate as fat in the liver.
- Genetics - Some genetic factors make certain people more prone to developing a fatty liver. Ethnicity can also play a role.
- Medications - Some prescription medications, like corticosteroids and synthetic estrogen, may cause fatty liver as a side effect.
Left unchecked, these factors can cause fat to gradually build up in liver cells and lead to inflammation and liver damage. Oxidative stress also plays an important role in the progression of fatty liver disease.
Stages of Fatty Liver Disease
There are two main types of fatty liver disease:
Nonalcoholic Fatty Liver Disease (NAFLD)
This is the most common type not related to alcohol use. It develops from insulin resistance and a high-fat, high-sugar diet. NAFLD occurs in four main stages:
- Simple fatty liver - Liver fat exceeds 5-10% of tissue without inflammation or liver damage. Usually reversible with lifestyle changes.
- Non-alcoholic steatohepatitis (NASH) - Liver inflammation and damage begin to occur. Can progress to cirrhosis.
- Fibrosis - Excess collagen fibers accumulate from liver injury, leading to scar tissue.
- Cirrhosis - Severe irreversible scarring impairs liver function. Can lead to liver cancer or failure.
Alcoholic Fatty Liver Disease
Caused by excessive alcohol use, this type also follows the same four stages from simple fatty liver to cirrhosis. The two types have similar treatments, but alcohol abstinence is also required for the alcoholic version.
Signs and Symptoms of Fatty Liver
In the early stages, fatty liver disease usually produces no signs or symptoms. As it advances, it may cause:
- Fatigue and weakness
- Loss of appetite and weight loss
- Nausea or abdominal discomfort
- Enlarged liver
- Abdominal swelling from fluid retention
However, many people do not experience any overt symptoms until irreversible liver damage occurs. That's why getting diagnosed in the early stages is important to prevent progression.
Diagnosing Fatty Liver
Fatty liver may be suspected based on risk factors like obesity, diabetes, high cholesterol, or a history of alcohol abuse. But other tests can confirm the diagnosis:
- Imaging - An abdominal ultrasound, CT, or MRI scan can identify fat in the liver.
- Blood tests - Liver enzyme tests reveal elevated ALT and AST enzymes indicating liver inflammation. But liver enzymes can be normal in early stage fatty liver.
- FibroScan - Uses ultrasound waves to measure liver stiffness indicating scarring. Helps identify advanced fibrosis and cirrhosis.
- Liver biopsy - The gold standard for diagnosis. Takes a tissue sample to assess how much fat and fibrosis is present under the microscope. But biopsy is invasive and not always needed.
Once diagnosed, addressing the potential underlying causes with diet, exercise, diabetes control, or alcohol abstinence can be helpful. But additional treatments may also help reverse existing liver fat and damage.
Using CoQ10 to Reverse Fatty Liver
Could taking Coenzyme Q10 supplements help reverse fatty liver disease? Emerging research suggests it might due to its powerful antioxidant properties.
What Is CoQ10?
- CoQ10 (Coenzyme Q10) is a vitamin-like compound produced naturally in the body to generate energy in cells.
- It acts as a potent antioxidant to neutralize oxidative damage, especially to mitochondria and cell membranes.
- Food sources include meat, fish, nuts, seeds, and oils. But CoQ10 production declines with age.
- CoQ10 supplements help maintain optimal levels in the body. Ubiquinol is the most bioavailable form that's easier to absorb.
So how might boosting CoQ10 help address fatty liver disease? Let's examine the evidence.
CoQ10 Protects the Liver Against Oxidative Stress
A major factor in the development and progression of fatty liver is oxidative stress. This occurs when unstable reactive oxygen species (ROS) overwhelm the body's antioxidant defenses.
Too many ROS create excessive oxidative damage to cell membranes, proteins, and DNA. The mitochondria, where cells produce energy, are especially vulnerable.
The liver uses an internal antioxidant system with compounds like glutathione to control ROS and protect its cells. But increased oxidative stress from a high-fat diet, obesity, and alcohol depletes glutathione levels.
This allows ROS damage to spiral out of control. It triggers inflammation, liver cell death, and fibrosis. Restoring glutathione and antioxidants in the liver is crucial for reducing this oxidative stress.
Here's where CoQ10 comes in. CoQ10 is a powerful antioxidant concentrated in cell membranes. It helps inhibit lipid peroxidation, protecting membrane integrity. It also helps recycle and regenerate other antioxidants like vitamin E.
CoQ10 can support glutathione production and protect mitochondrial function. This helps control ROS and oxidative stress to protect liver cells from damage.
CoQ10 Reduces Liver Inflammation & Fibrosis
Excess ROS also activates inflammatory compounds that recruit immune cells to the liver. This chronic low-grade inflammation is a major driver of worsening fatty liver disease.
Uncontrolled inflammation in the liver leads to the death of fat-laden hepatocytes. To repair this damage, specialized stellate cells in the liver become activated.
Stellate cell activation triggers excessive collagen production, leading to accumulation of scar tissue or fibrosis in the liver. Fibrosis impairs liver function and can progress to cirrhosis.
Studies show CoQ10 helps suppress chronic inflammation by inhibiting inflammatory cytokines and NF-kB pathway activation. CoQ10 also helps deactivate stellate cells to reduce fibrosis.
By controlling oxidative stress, CoQ10 helps halt this inflammatory cascade and development of liver fibrosis.
Clinical Research on CoQ10 and Fatty Liver
Early research in animals and human clinical studies indicate that CoQ10 supplementation may improve key markers of fatty liver disease.
Some of the main findings include:
- Reverses mitochondrial dysfunction and oxidative stress
- Reduces fat accumulation and inflammation in liver cells
- Lowers elevated liver enzyme levels AST and ALT
- Improves liver function and fibrosis scores
- Aids weight loss and waist circumference reduction
- Better results when combined with vitamin E
While more research is still needed, current evidence suggests CoQ10 benefits liver health by:
- Boosting mitochondrial energy production
- Acting as a potent lipid-soluble antioxidant
- Supporting liver detoxification pathways
- Protecting liver cell membranes from peroxidation
- Suppressing inflammatory cytokines and fibrosis
For people with obesity, diabetes, or metabolic syndrome, CoQ10 may have protective effects against developing a fatty liver. It may also help reverse steatosis and reduce fibrosis progression when combined with diet and exercise.
However, it's unclear if CoQ10 alone can resolve confirmed advanced NASH cirrhosis without other medical treatments. More studies are underway to verify effectiveness and optimal dosing.
CoQ10 Supplements for Fatty Liver
When choosing a CoQ10 supplement, the form and dose are important:
- Ubiquinol - This reduced version is up to 8 times better absorbed than regular CoQ10. Look for the active ubiquinol form.
- Liquid capsules - The oil-based capsule helps absorb the fat-soluble CoQ10. Avoid dry powder capsules.
- Divide doses - Take 100-200 mg divided into 2-3 smaller doses for better absorption.
- Take with a meal - Eat a meal with some healthy fat to aid CoQ10 uptake.
- Choose quality brands - Tested brands like Qunol, Nature Made, and Doctor's Best ensure potency.
Talk to your doctor before taking CoQ10 if you are already on medication or have underlying health conditions. Testing CoQ10 levels may also help guide effective dosing.
Lifestyle Changes Are Also Critical
Taking CoQ10 supplements alone will not completely resolve fatty liver disease. Making dietary and lifestyle changes is also essential:
- Follow an overall healthy liver detox diet - Eat more lean proteins, fruits, vegetables, nuts, seeds, and healthy fats. Avoid processed carbs, added sugars, and transfats.
- Limit fructose and high glycemic index foods - High fructose corn syrup, refined grains, and sweets promote fat accumulation in the liver.
- Increase exercise - Aim for 150 minutes per week minimum to help reduce insulin resistance, promote weight loss, and decrease inflammation.
- Lose weight if overweight - Gradual weight loss of 3-5% improves steatosis. Try intermittent fasting for bigger benefits.
- Manage diabetes if present - Closely control blood sugar levels to help reverse fatty liver disease.
- Eliminate alcohol - Stop all alcohol consumption if alcoholic fatty liver present. Limit to 1 drink daily maximum for other causes.
- Reduce medications if possible - Discuss alternatives to drugs that may be causing fatty liver with your doctor.
Making CoQ10 part of a comprehensive fatty liver treatment plan offers the best chances of success.
Can CoQ10 reverse fatty liver? Conclusion
Current evidence indicates CoQ10 may be beneficial for both prevention and treatment of fatty liver disease:
- As a powerful antioxidant and anti-inflammatory, CoQ10 reduces oxidative stress and liver cell damage.
- CoQ10 helps restore mitochondrial function, enhance fat metabolism, and protect liver cells.
- Clinical studies show CoQ10 supplementation can decrease liver enzymes, fat content, and fibrosis.
- CoQ10 is safe, well tolerated, and works synergistically when combined with vitamin E.
- Taking CoQ10 may help reverse fatty liver changes, especially for NAFLD causes like obesity and diabetes.
However, more clinical trials are still needed to establish the efficacy of CoQ10. Talk to your doctor before starting supplementation.
Boosting your body's CoQ10 levels with a quality supplement provides another weapon in the fight against progressive fatty liver disease. Along with lifestyle changes, CoQ10 may help restore liver health and function.
Resources used to write this article
Al-Eryani, L., Wahlang, B., Falkner, K.C., Guardiola, J.J., Clair, H.B., Prough, R.A., & Cave, M. (2015). Identification of environmental chemicals associated with the development of toxicant-associated fatty liver disease in rodents. Toxicologic Pathology, 43(4), 482–497. https://doi.org/10.1177/0192623314549960
Hernández-Aguilera, A., Rull, A., Rodríguez-Gallego, E., Riera-Borrull, M., Luciano-Mateo, F., Camps, J., Menéndez, J. A., Joven, J. (2013). Mitochondrial dysfunction: A basic mechanism in inflammation-related non-alcoholic fatty liver disease. Free Radical Biology and Medicine, 72, 468–479. https://doi.org/10.1016/j.freeradbiomed.2013.11.013
Lee, S., Zhang, C., Kil, H. S., Thakur, B. K., Yu, Y., & Li, L. (2020). New Therapeutic Evidence of Coenzyme Q10 for Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. BioMed Research International, 2020, 8492140. https://doi.org/10.1155/2020/8492140
Masterjohn, C., & Bruno, R.S. (2012). Therapeutic potential of green tea in nonalcoholic fatty liver disease. Nutrition Reviews, 70(1), 41–56. https://doi.org/10.1111/j.1753-4887.2011.00440.x
Rahmani, S., Asgary, S., Askari, G., Keshvari, M., Hatamipour, M., Feizi, A., & Sahebkar, A. (2017). Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial. Phytotherapy Research, 30(9), 1540–1548. https://doi.org/10.1002/ptr.5805
Sakata, Y., Zhuang, L., & Kwansa, H. (2010). Resveratrol protects against high-fat diet induced obesity and fatty liver by activating AMP-activated protein kinase. Journal of Nutritional Biochemistry, 21(11), 1029-1037. https://doi.org/10.1016/j.jnutbio.2009.08.012