Many women wonder about the safety of continuing supplements during pregnancy, particularly those taken for fertility or general health. Coenzyme Q10 (CoQ10) is a naturally occurring compound that supports cellular energy production and acts as an antioxidant. Whilst it's available over the counter and used by some women before conception, the question 'can you take CoQ10 while pregnant?' requires careful consideration. Current NHS and NICE antenatal guidance does not include CoQ10 amongst recommended pregnancy supplements, and safety data specific to pregnancy remains limited. This article examines the evidence, potential risks, and safer alternatives for supporting health during pregnancy.

What Is CoQ10 and Why Do People Take It?

Coenzyme Q10 (CoQ10), also known as ubiquinone, is a naturally occurring compound found in virtually every cell of the human body. It plays a crucial role in the mitochondria—the energy-producing structures within cells—where it helps convert nutrients from food into adenosine triphosphate (ATP), the primary energy currency used by cells. CoQ10 also functions as a potent antioxidant, protecting cells from oxidative damage caused by free radicals.

The body produces CoQ10 naturally, with the highest concentrations found in organs with high energy demands, such as the heart, liver, and kidneys. However, CoQ10 levels naturally decline with age, and certain medical conditions or medications—particularly statins used to lower cholesterol—may reduce endogenous production. This has led to growing interest in CoQ10 supplementation.

People take CoQ10 supplements for various reasons, including:

• Cardiovascular health: Some evidence suggests CoQ10 may support heart function, particularly in individuals with heart failure or those taking statins, though NHS guidance does not routinely recommend CoQ10 for statin-associated muscle symptoms

• Fertility considerations: Some fertility specialists suggest CoQ10 might influence egg quality, though NICE fertility guidelines (CG156) do not include CoQ10 in their recommended treatments

• Energy and fatigue: Many users report taking CoQ10 to combat tiredness, though clinical evidence for this remains limited

• Migraine prevention: NICE Clinical Knowledge Summary on migraine notes some limited evidence for CoQ10 in migraine prophylaxis, though it is not recommended as a first-line treatment

CoQ10 supplements are available over the counter in various formulations, including ubiquinone and ubiquinol (the reduced form). Typical doses in non-pregnant adults range from 100 to 300 mg daily, though higher doses are sometimes used under medical supervision. It's important to note that dosing in pregnancy is not established, and supplementation during pregnancy is not routinely recommended without specialist advice.

Can You Take CoQ10 While Pregnant?

The safety of CoQ10 supplementation during pregnancy has not been definitively established. The NHS and NICE antenatal care guidance (NG201) do not include CoQ10 as part of standard recommended supplements during pregnancy. Unlike folic acid and vitamin D—which have robust evidence supporting their use in pregnancy—CoQ10 lacks the same level of clinical validation for pregnant women.

There is limited high-quality research specifically examining CoQ10 use during human pregnancy. Most available data comes from animal studies or small observational studies in women with specific medical conditions, such as pre-eclampsia or gestational diabetes. While some small randomised trials have investigated CoQ10 in high-risk pregnancies (particularly for pre-eclampsia prevention), the evidence is insufficient to support routine clinical use. For context, NICE guidance (NG133) recommends low-dose aspirin for women at increased risk of pre-eclampsia, not CoQ10.

Current evidence is insufficient to establish safety in pregnancy; therefore, CoQ10 is not recommended for routine use. The developing foetus is particularly vulnerable to external substances, especially during the first trimester when organ formation occurs. Without adequate safety data, healthcare professionals typically adopt a precautionary approach.

Some women may already be taking CoQ10 before conception—often as part of fertility treatment protocols—and wonder whether to continue. In such cases, individualised medical advice is essential. Your GP, midwife, or fertility specialist can weigh the potential benefits against theoretical risks based on your specific circumstances, medical history, and the reason for supplementation. Self-prescribing or continuing supplements without professional guidance is not advisable during pregnancy.

Potential Risks and Safety Concerns During Pregnancy

Whilst no major adverse effects have been conclusively linked to CoQ10 use in pregnancy, several theoretical concerns warrant consideration. The primary issue is the lack of robust safety data from randomised controlled trials in pregnant populations. Ethical constraints make it difficult to conduct such studies, leaving significant knowledge gaps about potential effects on foetal development, pregnancy outcomes, and long-term child health.

Possible concerns include:

• Unknown effects on foetal development: Whether and to what extent CoQ10 crosses the placental barrier is not well documented in humans. Without comprehensive studies, we cannot rule out subtle developmental effects

• Interaction with pregnancy-related changes: Pregnancy involves profound physiological adaptations, including changes in drug metabolism, blood volume, and hormonal balance. How these changes affect CoQ10 absorption, distribution, and activity is not well characterised

• Potential medication interactions: CoQ10 may interact with several medications relevant to pregnancy, including:

• Anticoagulants like warfarin (though warfarin itself is contraindicated in pregnancy)
• Antihypertensives (CoQ10 may have blood pressure-lowering effects)
• Medications affecting blood glucose (theoretical concerns for women with gestational diabetes)

• Potential antiplatelet effects that could theoretically interact with low-dose aspirin used for pre-eclampsia prevention

• Quality and purity concerns: In the UK, most CoQ10 products are classified as food supplements regulated under food law (not licensed medicines). This means they are subject to less rigorous testing than prescription medications, with potential variability in product quality, purity, and actual CoQ10 content

Reported side effects of CoQ10 in non-pregnant adults are generally mild and may include gastrointestinal symptoms (nausea, diarrhoea, stomach upset), headaches, and insomnia when taken late in the day. Whether pregnancy alters the frequency or severity of these effects is unknown.

If you experience any suspected adverse effects from supplements, report them to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme (yellowcard.mhra.gov.uk or via the Yellow Card app).

The precautionary principle—avoiding unnecessary exposures during pregnancy when safety is uncertain—remains the cornerstone of antenatal care in the UK.

Alternative Ways to Support Energy and Health in Pregnancy

Rather than relying on supplements with uncertain safety profiles, pregnant women can support their energy levels and overall health through evidence-based approaches recommended by NICE and the NHS. These strategies address common pregnancy-related fatigue and nutritional needs without the theoretical risks associated with unproven supplements.

Recommended supplements during pregnancy include:

• Folic acid (400 micrograms daily): Essential from before conception through the first 12 weeks to reduce neural tube defect risk. Women at higher risk (previous neural tube defect pregnancy, taking anti-epileptic medicines, diabetes, BMI ≥30, or malabsorption conditions) require 5 mg daily, which is prescription-only

• Vitamin D (10 micrograms daily): Supports bone health for both mother and baby, particularly important given limited sun exposure in the UK

• Iron (if deficient): Anaemia is common in pregnancy and a major cause of fatigue. Your midwife will check iron levels through routine blood tests and prescribe supplementation if needed. In the UK, anaemia in pregnancy is defined as haemoglobin <110 g/L in the first trimester or <105 g/L in the second and third trimesters

These are the only supplements routinely recommended for all pregnant women in the UK. Avoid multivitamins containing vitamin A (retinol), as high doses can harm the developing baby.

Dietary approaches to support energy include:

• Eating regular, balanced meals with complex carbohydrates, lean proteins, and healthy fats

• Staying well hydrated—dehydration exacerbates fatigue

• Including iron-rich foods (lean red meat, beans, fortified cereals) alongside vitamin C sources to enhance absorption

• Consuming foods naturally containing CoQ10, such as oily fish (limit to 2 portions weekly as per NHS advice), whole grains, and nuts

• Limiting caffeine to 200mg per day (about 2 cups of instant coffee)

Lifestyle measures are equally important:

• Prioritising rest and sleep, including daytime naps if needed

• Gentle, regular exercise as recommended by your midwife—walking, pregnancy yoga, or swimming can boost energy

• Managing stress through relaxation techniques or antenatal classes

If fatigue is severe or persistent, it may indicate an underlying condition such as anaemia, thyroid dysfunction, or gestational diabetes, all of which require medical assessment and specific treatment.

When to Speak to Your GP or Midwife About Supplements

You should always consult your GP or midwife before starting, stopping, or continuing any supplement during pregnancy, including CoQ10. This is particularly important if you were taking CoQ10 before conception and are unsure whether to continue. Your healthcare team can provide personalised advice based on your individual circumstances, medical history, and the specific reasons you're considering supplementation.

Specific situations requiring professional discussion include:

• Pre-existing medical conditions: If you have heart disease, diabetes, mitochondrial disorders, or other chronic conditions for which CoQ10 might have been recommended, your doctor needs to reassess the risk-benefit balance during pregnancy

• Fertility treatment: Women who started CoQ10 as part of assisted conception protocols should discuss continuation with their fertility specialist and maternity team

• Medication use: If you're taking any prescribed medications, potential interactions need to be evaluated

• Unusual fatigue or symptoms: Severe tiredness, breathlessness, palpitations, or other concerning symptoms warrant medical assessment rather than self-treatment with supplements

Seek urgent medical advice (contact maternity triage or NHS 111) if you experience:

• Severe headache or visual disturbances

• Right upper abdominal pain

• Sudden swelling of the face, hands or feet

• Severe breathlessness or chest pain

• Heavy bleeding or fainting

These could indicate serious pregnancy complications requiring immediate assessment.

Your midwife or GP should be contacted if:

• You're already taking CoQ10 and have just discovered you're pregnant

• You're experiencing side effects from any supplement

• You're considering supplements beyond the standard folic acid and vitamin D recommendations

• You have questions about nutrition, energy levels, or pregnancy wellness

A pharmacist can also provide advice about over-the-counter supplements during pregnancy.

Regarding breastfeeding: The safety of CoQ10 during breastfeeding is also uncertain. Discuss with your GP, midwife or health visitor before using CoQ10 while breastfeeding.

Remember that your antenatal care team is there to support you throughout pregnancy. They can access the most current evidence, consider your complete medical picture, and help you make informed decisions. The NHS provides comprehensive antenatal care, including nutritional advice, and your midwife is an excellent first point of contact for questions about supplements and general pregnancy health.

In summary, due to insufficient human pregnancy safety data, CoQ10 is not recommended for routine use during pregnancy. Evidence-based alternatives, including recommended supplements and lifestyle measures, provide safer ways to support maternal and foetal health throughout pregnancy.

Frequently Asked Questions