Polly: Coenzyme Q10 is an important nutrient for those with chronic fatigue, fibromyalgia, or dysbiosis. According to Jacob Teitelbaum, MD, without adequate supplies of electron carriers like coenzyme Q10, we have problems producing ATP, the energy molecule. (Iron-sulfur proteins, copper proteins, and riboflavin-based proteins are also electron carriers.)  Coenzyme Q10 is used in the treatment of cancer, mitochondrial disease, and heart disease. However, there is another very important use of coenzyme Q10 that is less well known. In animal models and in a few human examples, pre-treatment or immediate post-treatment with large doses of coenzyme Q10 is extremely important for recovery from stroke. People that are more likely to have a low level of coenzyme Q10 are the elderly, cancer patients, surgical patients, HIV patients, people taking cholesterol blockers, and people with poor nutrient status.
Low levels of coenzyme Q10 can be caused by a poor ability to manufacture it in the body, poor intestinal absorption, and/or higher than normal use (eg lots of exercise). A poor ability to manufacture coenzyme Q10 can be caused by a lack of tyrosine, B6, B2, B3, folic acid, B12, C, pantethenic acid and other nutrients. Yeast interfere with you obtaining coenzyme Q10 from your food. They use it and alter it before you can absorb it. If the upper bowel is colonized by yeast, you can end up with such a low level of coenzyme Q10 that it is life threatening. You may need intravenous feeding of this nutrient. (See these articles on coenzyme Q10 by John Ely. http://faculty.washington.edu/~ely/ Also see this article by Hugh Fudenberg, MD on the “Typical course of an Autistic Patient,” http://www.whale.to/v/fudenburg.html )
How much should one take? I tried only one 50 mg capsule per day and I noticed a difference in energy. It took several months at that dose before I didn’t seem to need it to keep my energy up. I read a suggestion that breast cancer patients should take 300 mg per day of coenzyme Q10. This is similar to the amount taken by many with mitochondrial diseases. The body usually uses about 500 mg per day with a reserve pool of 2 grams.  I’d try close to the 300 mg at first, to shore up your pool of coenzyme Q10. After a while, you might be able to reduce the dose. Many people can use less for maintenance, about 30 mg per day. Also, it is safest to keep coenzyme Q10 in balance with other anti-oxidants.
There are currently two forms of coenzyme Q10 on the market. One is liposoluble (fat-soluble) and is widely available from many different distributors, and the other one is hydrosoluble (water-soluble) and available from Country Life. Both are important for your health. However, I can’t tell you which form would be best for which person. The hydrosoluble coenzyme Q10 might not increase the brain levels of coenzyme Q10 as quickly as the other form. (The blood-brain barrier passes fat-soluble nutrients more easily.) Therefore there should be at least some initial differences in your reaction to these two types of coenzyme Q10, with perhaps the hydrosoluble being gentler. Take the fat-soluble supplement dissolved in oil or eat some fat with it to improve absorption. Thorne Research and Allergy Research/ Nutricology carry a fat-soluble coenzyme Q10 mixed with rice bran oil and vitamin E. DEWS Twenty-first Century Products carries a product called Qzyme that is approximately equivalent to 100 mg of coenzyme Q10 per tablet. (Qzyme supplies the nutrient building blocks necessary for the body to make coenzyme Q10. Qzyme also contains some tyramine.) Any of the above should be a fairly stable preparation (less likely to degrade before you get it), and thus would be a good choice. Here is one place to purchase the hydrosoluble form of coenzyme Q10: Phone (800) 649-4372 and website: http://www.mellenmedical.com/coq10.htm
There is also a relatively new product on the market called idebenone. It is a coenzyme Q-10 derivative with increased blood-brain barrier penetration. Under low oxygen conditions, regular coenzyme Q10 can change from an anti-oxidant to a pro-oxidant. However, idebenone does not have this problem. The Vitamin Research site has a lot of information on idebenone. http://www.vrp.com Phone (800) 877-2447. Here is another good article on idebenone, http://www.smart-drugs.com/ias-idebenone.htm . The product can also be found at Kirkman labs, which carries many of the supplements used in the treatment of autism. http://www.kirkmanlabs.com phone 800-245-8282.
Food will not provide as high a dose of coQ10 as you can get from these supplements, but for general health maintenance, you might try eating very lightly cooked liver. It has a fair amount of coenzyme Q10. However, if you overcook the liver, you will destroy the coenzyme Q10 in it.