Clinically studied Lactobacillus reuteri NCIMB 30242 (LRC™) with CoQ10 in delayed-release capsules (DRcaps™).* In addition to gastrointestinal benefits, this combination provides synergistic support for the cardiovascular system, and helps support healthy cholesterol levels within the normal level.* Non-dairy, gluten free, stable at room temperature.
LRC™ is a trademark of UAS Laboratories, LLC and used under license.
DRcaps™ & logo are trademarks of Lonza or its affiliates.
Description
Lactobacillus is a type of bacteria. There are many species of lactobacillus. These are “friendly” bacteria that normally live in our digestive, urinary, and genital systems without causing disease. Lactobacillus is also in some fermented foods like yogurt and in dietary supplements.
Lactobacillus is most commonly taken by mouth to treat and prevent diarrhea, including infectious diarrhea and diarrhea linked with using antibiotics. Some people also take lactobacillus by mouth for general digestion problems, irritable bowel syndrome (IBS), colic in babies, inflammatory bowel disease (IBD), inflammation of the colon, stomach pain, constipation, and many other conditions but there is no good scientific evidence to support many of these uses.
Coronavirus disease 2019 (COVID-19): There is no good evidence to support using lactobacillus for COVID-19. Follow healthy lifestyle choices and proven prevention methods instead.
Effectiveness Header
Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Possibly Effective
- Stomach pain. Taking lactobacillus short-term seems to reduce symptoms in children with stomach pain. Early research also shows that taking lactobacillus and bifidobacterium short-term can improve symptoms in women with stomach pain.
- Hay fever. Taking 2 billion colony-forming units of lactobacillus daily for 5 weeks can improve quality of life by almost 18% in people with grass pollen allergy that doesn’t respond to the anti-allergy drug loratadine. In children with allergies that persist throughout the year, taking 10 billion colony-forming units of lactobacillus for 12 weeks seems to improve itchy eye symptoms. But taking lactobacillus during pregnancy doesn’t seem to prevent the infant from developing allergies.
- Diarrhea in people taking antibiotics (antibiotic-associated diarrhea). Taking probiotics products containing lactobacillus strains helps prevent diarrhea caused by antibiotics in adults and children. The most well-studied strain of lactobacillus seems to reduce the chance of diarrhea by about 60% to 70% when started within 2 days of beginning antibiotic treatment and continued for at least 3 days after finishing the antibiotics.
- Eczema (atopic dermatitis). Most research shows that taking lactobacillus products can reduce eczema symptoms in infants and children. Research also shows that lactobacillus can help PREVENT eczema from developing. When taken by a mother during the last month of pregnancy, lactobacillus probiotics can reduce the chance of the child developing eczema. But not all strains seem to work.
- Prone to allergies and allergic reactions (atopic disease). Research shows that taking certain lactobacillus strains can prevent the development of allergic reactions, such as asthma, runny nose, and eczema, in infants with a family history of this condition. However, not all strains seem to work.
- Overgrowth of bacteria in the vagina. Researchers have found that lactobacillus suppositories and vaginal tablets may be effective in treating this condition. Researchers have also found that eating yogurt or using vaginal capsules containing lactobacillus can help prevent these infections from occurring again. But taking lactobacillus capsules does not seem to prevent bacteria overgrowth in the vagina in pregnant women.
- Diarrhea caused by cancer drug treatment. A chemotherapy drug called 5-fluorouracil can cause severe diarrhea and other gastrointestinal (GI) side effects. There is some evidence that patients with cancer of the colon or rectum have less severe diarrhea, less stomach discomfort, and shorter hospital care when they take lactobacillus.
- Excessive crying in infants (colic). Some research shows that giving lactobacillus to nursing infants reduces daily crying time. Some research suggests that lactobacillus is more effective at reducing crying time than using the drug simethicone. But one large study shows that lactobacillus does not reduce crying. It’s possible that infants in the large study had more severe colic than those in the earlier research.
- Constipation. Taking lactobacillus probiotics for 4-8 weeks can reduce symptoms of constipation including stomach pain and discomfort, bloating, and incomplete bowel movements. It might also increase the number of bowel movements in some people.
- Diabetes. Taking lactobacillus starting at the beginning of the second trimester of pregnancy helps to prevent diabetes during pregnancy, especially in mothers over 35 years of age and mothers that had diabetes during another pregnancy. In women who develop diabetes during pregnancy, taking lactobacillus seems to help control blood sugar. In non-pregnant adults with diabetes, some early research shows that lactobacillus reduces sugar in the blood.
- Diarrhea. Giving lactobacillus to infants and children 1-36 months old when they are admitted to the hospital seems to reduce the risk of developing diarrhea. Also, lactobacillus can reduce the risk of diarrhea from all causes in undernourished children. But most research shows that giving lactobacillus to children who already have diarrhea does not help them to get better faster.
- A digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori). Research shows that taking lactobacillus probiotics along with “triple therapy” that consists of the prescription drugs clarithromycin, amoxicillin, and a proton-pump inhibitor helps treat stomach ulcers caused by H. pylori. About 7-11 patients with H. pylori infections need to be treated with lactobacillus plus “triple therapy” for one additional patient to achieve remission compared to what would be achieved with “triple therapy” alone. But taking lactobacillus probiotics does not help treat the infection when taken alone, with only an antibiotic, with other “triple therapies,” or with “quadruple therapy” that includes bismuth. It is unclear if lactobacillus can reduce triple therapy-related adverse effects.
- High cholesterol. Taking lactobacillus probiotics can lower total cholesterol by about 10 mg/dL and low-density lipoprotein (LDL or “bad”) cholesterol by about 9 mg/dL in people with or without high cholesterol. However, lactobacillus probiotics do not seem to improve high-density lipoprotein (HDL or “good”) cholesterol or fats called triglycerides.
- Swelling (inflammation) and sores inside the mouth (oral mucositis). Research shows that taking lozenges containing lactobacillus from the first day of radiation/chemotherapy treatment until one week after reduces the number of patients who develop severe mouth sores.
- A complication after surgery for ulcerative colitis (pouchitis). Taking lactobacillus by mouth seems to help treat pouchitis, a complication of surgery for ulcerative colitis. Taking a probiotic containing lactobacillus, bifidobacterium, and streptococcus for one year seems to maintain remission in 85% of people with this condition. Taking a different formulation containing two lactobacillus species and bifidobacterium for 9 months seems to reduce pouchitis severity.
- Infection of the airways. Some research shows that lactobacillus probiotics can help prevent airway infections in infants and children. Giving lactobacillus to infants and children seems to reduce the chance of upper airway infections. Also, children ages 1-6 years who attend daycare centers seem to get fewer and less severe airway infections when given milk containing lactobacillus. However, not all strains seem to work. In adults, drinking fermented milk or taking powder that contains lactobacillus might help prevent airway infections and decrease how long the symptoms last.
- Rheumatoid arthritis (RA). Research shows that taking lactobacillus for 8 weeks reduces tender and swollen joints in women with rheumatoid arthritis.
- Travelers’ diarrhea. Travelers’ diarrhea is caused by bacteria, viruses, or parasites that the traveler has not been exposed to before. Taking lactobacillus seems to help prevent diarrhea in travelers. The effectiveness can vary a lot depending on the travel destination because of differences in bacteria in different locations.
- A type of inflammatory bowel disease (ulcerative colitis). Lactobacillus probiotics seem to increase remission in people with ulcerative colitis. The best evidence of benefit is for a multi-species probiotic containing lactobacillus, bifidobacterium, and streptococcus. Research shows that taking this product can increase remission rates by almost 2-fold when used with standard ulcerative colitis treatment. Taking a single strain of lactobacillus also seems to improve symptoms. But lactobacillus doesn’t seem to prevent ulcerative colitis relapse.
Possibly Ineffective
- Infection of the gastrointestinal tract by a bacteria called Clostridium difficile. People who are treated for Clostridium difficile infections often experience recurrence. Although some conflicting results exist, most research shows that taking lactobacillus does not prevent recurrent episodes of Clostridium difficile diarrhea. Most research also shows that lactobacillus probiotics do not prevent first episodes of Clostridium difficile diarrhea.
- Crohn disease. Taking lactobacillus probiotics does not prevent Crohn disease from becoming active again in people who are in remission or in those who have just had surgery for Crohn disease.
- Tooth plaque. Giving lactobacillus to pregnant women starting 4 weeks before delivery until birth, and then continuing in the infants until 12 months of age, does not seem to reduce tooth plaque in the baby teeth of the child by the age of 9 years.
- Airway infections caused by exercise. Research in trained athletes shows that taking lactobacillus probiotics does not reduce the risk of developing a airway infection. It also does not seem reduce the symptoms of airway infections in athletes.
- Vaginal yeast infections. Taking lactobacillus by mouth or eating yogurt enriched with lactobacillus doesn’t prevent vaginal yeast infections in women that have used antibiotics. However, symptoms seem to improve if vaginal suppositories containing lactobacillus are used along with conventional treatment.
Insufficient Evidence
- Aging skin. Early research shows that taking lactobacillus improves skin moisture and reduces wrinkles.
- Eye strain (asthenopia). Early research shows that taking lactobacillus does not reduce the strain on the eyes caused by monitors and screens. However, in some people who already have a lot of strain on the eyes, taking lactobacillus might help to reduce additional strain and redness.
- Asthma. A small clinical study in children with asthma shows that taking lactobacillus slightly reduces asthma severity and increases asthma control.
- Bipolar disorder. Taking a probiotic containing lactobacillus and bifidobacterium after being discharged from the hospital might reduce the chance that people with bipolar disorder will need to be readmitted due to worsening of symptoms.
- Common cold. Early research shows that taking lactobacillus daily for 12 weeks reduces the risk of common cold by about 12% and reduces the number of days with symptoms from 8.6 to 6.2 in adults. Also, taking lactobacillus plus bifidobacterium for 3 months seems to reduce school absences due to cold symptoms. However, research is inconsistent. Taking some lactobacillus strains does not seem to reduce the risk of catching a cold or the number of cold/flu days.
- Cystic fibrosis. Research suggests that taking lactobacillus daily for 6 months reduces the percentage of cystic fibrosis patients with lung complications from 37% to 3% and the percentage with upper respiratory tract infections from 20% to 3%.
- Cavities. Giving lactobacillus to pregnant women starting 4 weeks before delivery until birth, and then continuing in the infants until 12 months of age, helps to prevent cavities in the child’s baby teeth. But giving lactobacillus to infants does not prevent cavities in teeth.
- Depression. Early research in patients with major depression shows that taking lactobacillus plus bifidobacteria for 8 weeks seems to improve symptoms of depression.
- Inflammation of small pouches on the intestine wall (diverticulitis). Early research in people with this diverticulitis shows that taking lactobacillus along with antibiotics reduces pain and time spent in the hospital.
- Fractures. Early research shows that taking lactobacillus improves hand function and pain after fracture in elderly people.
- Genital herpes. Early research in patients with genital herpes shows that applying lactobacillus in the vagina may reduce symptoms of genital herpes. Higher quality research is needed to confirm these results.
- High levels of fats called triglycerides in the blood (hypertriglyceridemia). Some research in people with this condition shows that taking lactobacillus modestly reduces triglycerides in the blood.
- Flu (influenza). Taking a drink containing one strain of lactobacillus 5 days weekly for 8 weeks reduces the incidence of the flu in schoolchildren during flu season. Taking a different lactobacillus strain daily for 6 weeks does not reduce the number of cold/flu days in otherwise healthy adults.
- A long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS). Many studies have evaluated lactobacillus species for treating IBS. Some strains might reduce IBS symptoms including abdominal pain, bloating, and gas in some people. But other lactobacillus strains don’t seem to work in most people with IBS. Lactobacillus strains also might work better for specific types of IBS.
- Inability to properly digest the sugar lactose (lactose intolerance). Some research shows that drinking milk with lactobacillus still causes symptoms, like gas, in people with lactose intolerance. But other research shows that drinking a milk product containing lactobacillus reduces symptoms of lactose intolerance.
- Infants born weighing less than 2500 grams (5 pounds, 8 ounces). Supplementing feed with lactobacillus in very low birth weight infants is not linked to improved movement or mental abilities at two years of age.
- Swelling of breast tissue (mastitis). Early research in pregnant women shows that taking lactobacillus reduces breast tissue swelling involving an infection.
- A grouping of symptoms that increase the risk of diabetes, heart disease, and stroke (metabolic syndrome). Early research shows that taking lactobacillus doesn’t improve weight, blood pressure, blood sugar, or lipid levels in people with this condition.
- A serious intestinal disease in premature infants (necrotizing enterocolitis or NEC). When results from multiple clinical studies are evaluated, giving lactobacillus to preterm infants seems to reduce the risk of severe NEC by 30% to 55%. But when results from individual clinical studies are considered, lactobacillus does not seem to prevent NEC. It’s possible that the individual clinical studies are too small to show benefit. It’s also possible that lactobacillus may be more beneficial when used along with other probiotics than when used as a single probiotic.
- Obesity. Research shows that taking lactobacillus does not reduce fat or weight in most obese adults. But it might reduce body weight in women.
- A serious gum infection (periodontitis). Early research shows that taking a lactobacillus lozenge doesn’t improve gum health in people with this condition.
- Skin rash caused by sun exposure (polymorphous light eruption or PMLE). Early research shows that taking a supplement containing lactobacillus and other ingredients reduces how severe skin reactions are after sun exposure in people with a disorder called polymorphous light eruption.
- Rheumatoid arthritis (RA). Early research in people with moderate-to-severe RA shows that taking lactobacillus plus bifidobacteria does not reduce symptom severity or lessen joint pain.
- Diarrhea caused by rotavirus. Some small studies show that certain lactobacillus strains can help some children with rotaviral diarrhea get over their diarrhea up to 3 days sooner. But other research shows that giving lactobacillus to children with rotaviral diarrhea does not help them to get better faster. More research is needed to understand which strains, if any, can help with this condition. Also, more research is needed to determine if lactobacillus has different effects in children who have been given rotavirus vaccine compared with those who have not.
- Excessive growth of bacteria in the small intestines. Some clinical research has evaluated lactobacillus for treating and preventing the growth of potentially harmful bacteria in the intestines. Some of this research shows slight improvements in symptoms such as stomach pain, bloating, and diarrhea. But other research has found no benefit in people with this condition. Lactobacillus does not seem to be helpful for preventing growth of harmful bacteria in the intestines.
- Stress. Early research shows that taking lactobacillus reduces stress and sleep problems in students preparing for exams.
- Infections of the kidney, bladder, or urethra (urinary tract infections or UTIs). There is some early evidence that taking lactobacillus by mouth or putting it on the vagina might be helpful for preventing UTIs. However, not all strains seem to work, and not all studies agree.
- Pneumonia in people on breathing machines in the hospital. Early research shows that taking lactobacillus might reduce the incidence of pneumonia in people in the intensive care unit.
- Acne.
- Boosting the immune system.
- Cancer.
- Canker sores.
- Child development.
- Fever blisters.
- Hives.
- Lyme disease.
- Diarrhea caused by radiation therapy.
- Other conditions.
More evidence is needed to rate lactobacillus for these uses.
Action
Many bacteria and other organisms live in our bodies normally. “Friendly” bacteria such as Lactobacillus can help us break down food, absorb nutrients, and fight off “unfriendly” organisms that might cause diseases such as diarrhea.
Safety
When taken by mouth Lactobacillus is LIKELY SAFE when taken by mouth appropriately. Side effects are usually mild and most often include intestinal gas or bloating.
When applied to the vagina Lactobacillus is LIKELY SAFE for women to use inside the vagina.
Special Precautions & Warnings:
Children: Lactobacillus is LIKELY SAFE when taken by mouth appropriately in children.
Pregnancy and breast-feeding: Lactobacillus is POSSIBLY SAFE when taken by mouth appropriately while pregnant and breastfeeding.
Weakened immune system: There is some concern that lactobacillus from supplements that contain live bacteria might grow too well in people whose immune systems are weakened. This includes people with HIV/AIDS or people who have taken medicines to prevent rejection of a transplanted organ. Lactobacillus has caused disease (rarely) in people with weakened immune systems. To be on the safe side, if you have a weakened immune system, talk with your healthcare provider before taking lactobacillus.
Short bowel syndrome: People with short bowel syndrome might be more likely than other people to develop lactobacillus infections. If you have this condition, talk with your healthcare provider before taking lactobacillus.
Ulcerative colitis: People with ulcerative colitis that is severe enough to require hospitalization might be more likely than other people to develop lactobacillus infections. If you have this condition, talk with your healthcare provider before taking lactobacillus.
Damaged heart valves: Lactobacillus can cause an infection in the inner lining of the heart chambers and heart valve, but this is extremely rare. However, people with damaged heart valves might be more likely than other people to develop this type of infection, especially if they take lactobacillus before dental or invasive stomach and intestinal procedures. People with damaged heart valves should stop taking probiotics before dental procedures or invasive stomach and intestinal procedures such as an endoscopy.
Drug Interactions
Antibiotic drugs
Interaction Rating=Moderate Be cautious with this combination.
Antibiotics are used to reduce harmful bacteria in the body. Antibiotics can also reduce friendly bacteria in the body. Lactobacillus is a type of friendly bacteria. Taking antibiotics along with lactobacillus can reduce the effectiveness of lactobacillus. To avoid this interaction take lactobacillus products at least 2 hours before or after antibiotics.
Medications that decrease the immune system (Immunosuppressants)
Interaction Rating=Moderate Be cautious with this combination.
Lactobacillus contains live bacteria and yeast. The immune system usually controls bacteria and yeast in the body to prevent infections. Medications that decrease the immune system can increase your chances of getting sick from bacteria and yeast. Taking lactobacillus along with medications that decrease the immune system might increase the chances of getting sick.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
Herb Interactions
Iron: Some lactobacillus seems to increase the absorption of iron when taken at the same time. It’s possible that taking this lactobacillus species along with iron supplements might cause some people to get too much iron. But this has not been reported in humans.
Food Interactions
Iron-containing foods: Some lactobacillus seems to increase the absorption of iron from food when taken at the same time. It’s possible that taking this lactobacillus along with iron supplements might cause some people to get too much iron. But this has not been reported in humans.
Dosage
The strength of lactobacillus products is usually indicated by the number of living organisms per capsule. Typical doses range from 1 to 10 billion living organisms taken daily in 3-4 divided doses.
The following doses have been studied in scientific research:
ADULTS:
BY MOUTH:
- For hay fever: At least 2 billion colony-forming units of lactobacillus daily for 7 weeks has been used along with 10 mg of loratadine once daily for 5 weeks.
- For preventing diarrhea caused by antibiotics: Many different lactobacillus species have been studied. In most cases, lactobacillus is given in daily doses that provide 10-100 billion colony-forming units daily. Lower doses of 100 million colony-forming units have also been used. Usually treatment is started within 2 days of beginning antibiotic treatment and continued for at least 3 days after antibiotic treatment is complete.
- For eczema (atopic dermatitis): For preventing eczema in children, lactobacillus has been given to pregnant women during the last month of pregnancy. Typically, lactobacillus is given alone or along with other probiotic species in doses of 100 million to 10 billion colony-forming units. Doses vary depending on the lactobacillus strain and if the product is a multi-species probiotic.
- For a condition associated with an increased risk for developing allergic reactions (atopic disease): 10-20 billion colony-forming units of lactobacillus have been used daily for 2-4 weeks before delivery.
- For treating vaginal infections caused by bacteria (bacterial vaginosis): 150 mL of yogurt containing lactobacillus has been used daily for 2 months.
- For preventing diarrhea due to cancer treatment (chemotherapy): 5-10 billion colony-forming units of lactobacillus has been used twice daily during 24 weeks of chemotherapy.
- For constipation: 200-400 million colony-forming units of lactobacillus has been taken daily for 4-8 weeks. Also, a multi-species probiotic product containing 5 billion colony-forming units of lactobacillus and other probiotic species has been used twice daily for 7 days.
- For diabetes: For diabetes during pregnancy, probiotic products containing 2-6 billion colony-forming units of lactobacillus daily have been used for at least 6 weeks. For type 2 diabetes, 100 million colony-forming units of lactobacillus have been used daily for 8 weeks.
- For stomach pain: 20 billion colony-forming units of lactobacillus has been taken daily for 30 days.
- For Helicobacter pylori (H pylori) infection: Probiotic products containing 200 million to 15 billion colony-forming units of lactobacillus daily have been used along with triple therapy. Also, a multi-strain probiotic containing 30 million colony-forming units of lactobacillus and other probiotic species has been used for 2 weeks before until 2 weeks after triple therapy. In all cases, triple therapy consisted of the prescription drugs clarithromycin, amoxicillin, and a proton-pump inhibitor.
- For high cholesterol: Probiotic products containing 39 million to 50 billion colony-forming units of lactobacillus have been used for 6-12 weeks.
- For inflamed mouth sores from cancer treatment (oral mucositis): Lozenges containing 2 billion colony-forming units of lactobacillus have been dissolved in the mouth every 2-3 hours up to 6 times daily during chemotherapy and continuing until one week after.
- For a complication from surgery for ulcerative colitis (pouchitis): A combination probiotic containing 900-1500 billion colony-forming units of lactobacillus, bifidobacterium, and streptococcus has been taken twice daily for up to one year. Another probiotic containing about 10 billion colony-forming units of lactobacillus and bifidobacterium has been taken daily for 9 months.
- For airway infections: Drinking fermented milk containing lactobacillus (LCS, Yakolt) 100 billion colony-forming units daily for 12 weeks. A lactobacillus powder containing 1 billion colony-forming units has been used daily for 12 weeks.
- For rheumatoid arthritis (RA): 100 million colony-forming units of lactobacillus have been used daily for 8 weeks.
- For travelers’ diarrhea: 2 billion colony-forming units of lactobacillus has been used daily, starting 2 days before traveling and continuing until the end of the trip.
- For a type of inflammatory bowel disease (ulcerative colitis): A product containing 25 billion colony-forming units of lactobacillus has been taken twice daily for 8 weeks. Also, a probiotic containing 900-1500 billion colony-forming units of lactobacillus, bifidobacterium, and streptococcus has been taken once or twice daily.
APPLIED INSIDE THE VAGINA:
- For treating vaginal infections caused by bacteria: One to two vaginal tablets containing 10 million colon-forming units of lactobacillus per tablet have been taken daily along with 0.3 mg estriol for 6 days. Intravaginal suppositories containing 100 million to 1 billion colony-forming units of lactobacillus, given twice daily for 6 days, has also been used.
CHILDREN:
BY MOUTH:
- For hay fever: 10 billion colony-forming units of lactobacillus has been taken once daily for 12 weeks along with 5 mg of levocetirizine in children 7-12 years-old.
- For diarrhea in people taking antibiotics (antibiotic-associated diarrhea): 10-20 billion colony-forming units of lactobacillus has been taken once daily; 20 billion colony-forming units twice daily has also been used.
- For eczema (atopic dermatitis): For treating eczema in children, 10-100 billion colony-forming units of lactobacillus has been taken daily for 6-12 weeks. For preventing eczema, 100 million to 6 billion colony-forming units of lactobacillus daily from birth until 1-2 years has been used. Also, a probiotic containing 10 billion colony-forming units of lactobacillus and Bifidobacterium has been used daily from birth until 6 months.
- For a condition associated with being prone to allergies and allergic reactions (atopic disease): 10-20 billion colony-forming units of lactobacillus have been used daily for the first 3-6 months of life.
- For constipation: 100 million colony-forming units of lactobacillus have been used daily for 8 weeks.
- For diarrhea: Six billion colony-forming units of lactobacillus has been used twice daily in infants while hospitalized. Also, 37 billion colony-forming units of lactobacillus has been used daily, 6 days weekly, for 15 months in children 6-24 months-old.
- For stomach pain: One hundred million colony-forming units of lactobacillus have been used twice daily for 4 weeks in children aged 6-16 years.
- For a digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori): A probiotic containing about 100 billion colony-forming units of lactobacillus and bifidobacterium has been used for 2 weeks along with triple therapy and for 4 weeks after triple therapy was complete. Triple therapy consisted of the prescription drugs clarithromycin, amoxicillin, and a proton-pump inhibitor.
- For colic in babies: 100 million colony-forming units of lactobacillus have been used daily for up to 90 days in breast-fed and formula-fed infants. Also, a specific multi-ingredient product containing 65 mg of lemon balm, 9 mg of German chamomile, and 1 billion colony-forming units of lactobacillus (ColiMil Plus by Milte Italia SPA ) has been used twice daily for 4 weeks.
- For infection of the airways: Milk products containing 130 million to 10 billion colony-forming units of lactobacillus have been used daily.
- For travelers’ diarrhea: 2 billion colony-forming units of lactobacillus has been used daily, starting 2 days before traveling and continuing until the end of the trip.
- For a type of inflammatory bowel disease (ulcerative colitis): A combination probiotic containing 450-1800 billion colony-forming units of lactobacillus, bifidobacterium, and streptococcus has been used daily in children with moderate-to-severe ulcerative colitis.
Other Names
Acidophilus, Acidophilus Bifidus, Acidophilus Lactobacillus, L. Acidophilus, L. Amylovorus, L. Brevis, L. Bulgaricus, L. Casei, L. Casei Immunitas, L. Crispatus, L. Delbrueckii, L. Fermentum, L. Gallinarum, L. Helveticus, L. Johnsonii, L. Johnsonii LC-1, L. Lactis, L. Plantarum, L. Reuteri, L. Rhamnosus, L. Salivarius, Lacto Bacillus, Lactobacille, Lactobacilli, Lactobacilli Acidophilus, Lactobacilli Bulgaricus, Lactobacilli Plantarum, Lactobacilli Rhamnosus, Lactobacilli Salivarium, Lactobacillus acidophilus, Lactobacillus amylovorus, Lactobacillus brevis, Lactobacillus bulgaricus, Lactobacillus casei, Lactobacillus casei sp. rhamnosus, Lactobacillus crispatus, Lactobacillus delbrueckii, Lactobacillus delbrueckii ssp. bulgaricus, Lactobacillus fermentum, Lactobacillus gallinarum, Lactobacillus Gasseri, Lactobacillus GG, Lactobacillus Helveticus, Lactobacillus johnsonii, Lactobacillus Lactis, Lactobacillus Paracasei, Lactobacillus plantarum, Lactobacillus reuteri, Lactobacillus Rhamnosus GG, Lactobacillus rhamnosus, Lactobacillus sakei, Lactobacillus Salivarium, Lactobacillus salivarius, Lactobacilo, Lactospores, LC-1, Probiotic.
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Description
Coenzyme Q10 is a vitamin-like substance found throughout the body, but especially in the heart, liver, kidney, and pancreas. It is eaten in small amounts in meats and seafood. Coenzyme Q10 can also be made in a laboratory.
Coenzyme Q10 is most commonly used for conditions that affect the heart such as heart failure and fluid build up in the body (congestive heart failure or CHF), chest pain (angina), and high blood pressure. It is also used for preventing migraine headache, Parkinson disease, and many other conditions.
Coenzyme Q10 was first identified in 1957. The “Q10” refers to the chemical make-up of the substance.
Effectiveness Header
Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Likely Effective
- Coenzyme Q10 deficiency. Taking coenzyme Q10 by mouth seems to improve symptoms of coenzyme Q10 deficiency. This is a very rare condition. The symptoms include weakness, fatigue, and seizures.
- A group of disorders that most often cause muscle weakness (mitochondrial myopathies). Taking coenzyme Q10 by mouth seems to reduce symptoms of mitochondrial myopathies. However, improvement in symptoms is slow. Some people have to take coenzyme Q10 for 6 months to get the most benefit.
Possibly Effective
- Heart failure and fluid build up in the body (congestive heart failure or CHF). Early research found that heart failure might be linked with low coenzyme Q10 levels. Some research shows that taking coenzyme Q10 might help reduce some symptoms of heart failure. Coenzyme Q10 might also reduce the chances of death or hospitalization related to heart failure.
- Nerve pain in people with diabetes (diabetic neuropathy). Research shows that taking coenzyme Q10 improves nerve damage and nerve pain in people with nerve damage caused by diabetes.
- Fibromyalgia. Some research shows that taking coenzyme Q10 by mouth reduces pain, tenderness, fatigue, and sleep issues in people with fibromyalgia.
- HIV/AIDS. Taking coenzyme Q10 by mouth seems to improve immune function in people with HIV/AIDS.
- Tissue damage caused when there is limited blood flow and then blood flow is restored (ischemia-reperfusion injury). Reduced blood supply during heart or blood vessel surgery can deprive tissue of oxygen. When blood supply returns to this tissue, the tissue can become damaged. There is some evidence that taking coenzyme Q10 by mouth for at least one week before heart bypass surgery or blood vessel surgery might help to reduce tissue damage. However, not all research agrees with this finding.
- Migraine. Taking coenzyme Q10 by mouth seems to help prevent migraine. Research shows it can decrease the frequency of these headaches by about 30% and the number of days with headache-related nausea by about 45% in adults. More than half of patients taking coenzyme Q10 experience a 50% decrease in the number of headache days per month. Taking coenzyme Q10 also appears to reduce migraine frequency in children who have low levels of coenzyme Q10. It can take up to 3 months to see any benefit.
- Multiple sclerosis (MS). Taking coenzyme Q10 by mouth seems to reduce tiredness and low mood in people with MS.
- A group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy). Taking coenzyme Q10 by mouth seems to improve physical performance in some people with muscular dystrophy.
- Heart attack. When started within 72 hours of a heart attack and taken for one year, coenzyme Q10 appears to lower the risk of heart-related events, including another heart attack.
- A disease that causes curved, painful erections (Peyronie disease). Research shows that taking coenzyme Q10 improves erectile function in men with painful erections.
Possibly Ineffective
- Alzheimer disease. Taking coenzyme Q10 does not seem to improve mental function in people with Alzheimer disease.
- Lou Gehrig’s disease (amyotrophic lateral sclerosis or ALS). Research shows that taking coenzyme Q10 does not slow the progression of ALS.
- Tiredness in people treated with cancer drugs. Taking coenzyme Q10 does not seem to reduce fatigue in people being treated for breast cancer.
- Cocaine use disorder. Taking a combination of coenzyme Q10 and L-carnitine does not reduce cocaine use.
- Diabetes. Research has found that taking coenzyme Q10 does not lower blood sugar levels in people with type 1 or type 2 diabetes.
- Symptoms such as muscle weakness and fatigue that affect polio survivors. Research shows that taking coenzyme Q10 does not improve muscle strength, muscle function, or fatigue in polio survivors.
Likely Ineffective
- Athletic performance. Taking coenzyme Q10 by mouth, alone or with other ingredients, doesn’t improve athletic performance in athletes or non-athletes.
- An inherited brain disorder that affects movements, emotions, and thinking (Huntington disease). One large research study shows that taking coenzyme Q10 in large doses (2.4 grams daily) for up to 5 years does not stop Huntington disease symptoms from getting worse.
Insufficient Evidence
- Chest pain (angina). Some early research shows that taking coenzyme Q10 by mouth might reduce chest pain and improve exercise ability in people with chest pain.
- Heart damage caused by certain cancer drugs (anthracycline cardiotoxicity). Early research shows that taking coenzyme Q10 by mouth might protect the heart in children aged 3-12 years who are being treated with a class of drugs called anthracyclines. But results from larger studies are inconsistent.
- Autism. Early research shows that taking a specific form of coenzyme Q10 called ubiquinol improves autism symptoms in autism patients aged 3-6 years according to parent assessment. Higher quality studies are needed to confirm these results.
- Bipolar disorder. Early research shows that taking coenzyme Q10 improve symptoms of depression in people over 55 years of age with bipolar disorder.
- Breast cancer. Some research in Chinese women suggests that having low blood levels of coenzyme Q10 is linked to an increased risk of breast cancer. Also, early research shows that taking coenzyme Q10 by mouth might be helpful in advanced breast cancer when used along with surgery and conventional treatment plus other antioxidants and omega-3 and omega-6 fatty acids. Higher quality studies are needed to confirm these results.
- Cancer. Low coenzyme Q10 levels seem to be linked with an increased risk of skin cancer. Early research suggests that taking coenzyme Q10 along with other antioxidants increases survival time by 40% in patients with terminal cancer. Higher quality studies are needed to confirm these results.
- Brain damage that affects muscle movement (cerebellar ataxia). Early research suggests that taking coenzyme Q10 by mouth can improve posture and muscle function in people with cerebellar ataxia and low coenzyme Q10 levels. However, it doesn’t seem to benefit people with normal coenzyme Q10 levels.
- A lung disease that makes it harder to breathe (chronic obstructive pulmonary disease or COPD). Early research suggests that taking coenzyme Q10 does not improve lung function or exercise performance in people with COPD.
- An open sore (ulcer) on the cornea of the eye. Early research suggests that using coenzyme Q10 eye drops might make ulcers on the cornea heal faster.
- A disorder that causes repeated episodes of nausea and vomiting (cyclic vomiting syndrome or CVS). Early research suggests that taking coenzyme Q10 might work as well as prescription medications used to treat CVS.
- Weakened and enlarged heart (dilated cardiomyopathy). Early research suggests that taking coenzyme Q10 improves heart function in children and adolescents with dilated cardiomyopathy.
- Dry mouth. Early research suggests that taking an altered form of coenzyme Q10 called ubiquinol improves dry mouth.
- An inherited disease of the nerves and muscles (Friedreich ataxia). Some early research shows that taking coenzyme Q10 plus vitamin E improves heart function but not posture or manner of walking in some people with Friedreich ataxia. However, other early research suggests that taking vitamin E together with coenzyme Q10 helps prevent decline in coordination, posture, and movement in people with Friedreich ataxia compared to no treatment. Coenzyme Q10 seems to work best in people with low coenzyme Q10 levels.
- Hearing loss. Some research suggests that taking a specific coenzyme Q10 product (Q-TER) by mouth improves hearing in people with age-related hearing loss. However, combining coenzyme Q10 with conventional steroid treatments does not improve hearing more than steroid treatment alone in people with sudden deafness. Also, it doesn’t appear to improve hearing in people with noise-induced hearing loss.
- Swelling (inflammation) of the liver caused by the hepatitis C virus (hepatitis C). Research shows that taking coenzyme Q10 does not improve liver function in people with hepatitis C who are not responding to conventional treatment.
- High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). It’s unclear if coenzyme Q10 reduces cholesterol levels. One study shows it might lower triglycerides and LDL (or “bad” cholesterol) by a small amount. Other studies show no benefit of taking coenzyme Q10 for lowering total cholesterol or LDL or increasing HDL (or “good” cholesterol) levels. It may take at least 3 months to see any benefit.
- High blood pressure. Some research shows that taking coenzyme Q10 by itself or along with other medications for treating high blood pressure helps lowers blood pressure in people with high blood pressure. However, not all research has shown benefit. Coenzyme Q10 might only benefit people with high blood pressure who also have diabetes or low blood levels of coenzyme Q10 before treatment. Taking coenzyme Q10 by mouth daily appears to lower systolic blood pressure (the top number) in some people with high systolic blood pressure but normal diastolic blood pressure (the bottom number).
- Weakened and thickened heart (hypertrophic cardiomyopathy). Taking coenzyme Q10 by mouth seems to decrease the thickness of the heart wall and decrease symptoms of shortness of breath and fatigue in people with hypertrophic cardiomyopathy.
- Inability to become pregnant within a year of trying to conceive (infertility). Although coenzyme Q10 might increase the chance of getting pregnant, it might not reduce miscarriage or increase successful pregnancies in women with this condition.
- Conditions in a man that prevent him from getting a woman pregnant within a year of trying to conceive (male infertility). There is some early evidence that taking coenzyme Q10 or an altered form of coenzyme Q10 called ubiquinol by mouth for 3-6 months can improve the movement and density of sperm in men with certain types of infertility. It’s unclear if these improvements increase pregnancy rate.
- An inherited form of diabetes that is linked with deafness. Early research suggests that taking coenzyme Q10 by mouth might prevent the progression of a rare form of diabetes that is inherited from the mother.
- Build up of fat in the liver in people who drink little or no alcohol (nonalcoholic fatty liver disease or NAFLD). Early research shows that taking coenzyme Q10 can improve markers of liver injury and disease severity in people with NAFLD.
- Parkinson disease. Some research shows that taking coenzyme Q10 by itself or along with other supplements might slow mental decline in people with early-stage Parkinson disease. At least 16 months of treatment and doses above 600 mg daily appear to be needed to achieve these benefits. However, not all data has been positive. Some research shows that coenzyme Q10 does not benefit people with early or mid-stage Parkinson disease.
- A serious gum infection (periodontitis). Applying coenzyme Q10 to the gums is not effective for treating gum disease. However, there is some early evidence that taking coenzyme Q10 by mouth might be helpful.
- A hormonal disorder that causes enlarged ovaries with cysts (polycystic ovary syndrome or PCOS). Early research shows that taking coenzyme Q10 can reduce hair loss and acne in women with PCOS. It might also reduce blood sugar levels and cholesterol levels.
- A rare inherited disorder that causes obesity, short stature, and learning disability (Prader-Willi syndrome or PWS). Early research suggests that taking coenzyme Q10 improves mental and physical development in children with PWS. But it is not clear if these improvements are due to the coenzyme Q10 or an age-related phenomenon.
- A pregnancy complication marked by high blood pressure and protein in the urine (pre-eclampsia). Pre-eclampsia is a condition that some women develop during pregnancy. Some research shows that women who are at risk have a lower chance of developing the condition if they take coenzyme Q10 from week 20 of pregnancy until the baby is delivered.
- Kidney failure. Some early research suggests that taking coenzyme Q10 improves kidney function in people with end-stage kidney disease. However, other research shows that taking coenzyme Q10 does not improve kidney function.
- Blood infection (sepsis). Some early research shows that taking coenzyme Q10 might prevent death in people with blood infections. But other research shows that taking a form of coenzyme Q10 called ubiquinol doesn’t prevent death. Coenzyme Q10 doesn’t seem to reduce time in the hospital due to a blood infection.
- Muscle pain caused by statin drugs (statin-induced myalgia). Statins, a class of drugs used to lower cholesterol, can sometimes cause muscle pain. There is some evidence that taking coenzyme Q10 might reduce this pain. But not all research agrees.
- Muscle weakness caused by statin drugs (statin-induced myopathy). Statins, a class of drugs used to lower cholesterol, can sometimes cause muscle weakness. There is some evidence that taking coenzyme Q10 might improve this weakness. But not all research agrees.
- Hair loss caused by the drug warfarin. There is some early evidence that taking coenzyme Q10 might be helpful for preventing hair loss caused by the blood-thinning drug, warfarin.
- Skin wrinkles from sun damage. Early evidence suggests that applying a coenzyme Q10 cream to the skin improves wrinkled skin.
- An eye disease that leads to vision loss in older adults (age-related macular degeneration or AMD).
- Asthma.
- Cataracts.
- Chronic fatigue syndrome (CFS).
- Dry eye.
- Heart disease.
- Kidney damage in people with diabetes (diabetic nephropathy).
- Life extension.
- Lyme disease.
- Prostate cancer.
- Swelling (inflammation) of the heart (myocarditis).
- Other conditions.
More evidence is needed to rate coenzyme Q10 for these uses.
Action
Coenzyme Q10 is an important vitamin-like substance required for the proper function of many organs and chemical reactions in the body. It helps provide energy to cells. Coenzyme Q10 also seems to have antioxidant activity. People with certain diseases, such as heart failure, high blood pressure, gum disease, Parkinson’s disease, blood infections, certain diseases of the muscles, and HIV infection, might have lower levels of coenzyme Q10.
Safety
When taken by mouth: Coenzyme Q10 is LIKELY SAFE for most adults. While most people tolerate coenzyme Q10 well, it can cause some mild side effects including stomach upset, loss of appetite, nausea, vomiting, and diarrhea. It can cause allergic skin rashes in some people. It also might lower blood pressure, so check your blood pressure carefully if you have very low blood pressure. Dividing the total daily dose by taking smaller amounts two or three times daily instead of a large amount all at once can help reduce side effects.
When applied to the skin: Coenzyme Q10 is LIKELY SAFE for most adults when applied directly to the gums.
Special Precautions & Warnings:
Pregnancy and breast-feeding: Coenzyme Q10 is POSSIBLY SAFE when taken by mouth appropriately during pregnancy. Coenzyme Q10 has been used safely when taken twice daily starting at 20 weeks until delivery. Not enough is known about the use of coenzyme Q10 during breast-feeding. Stay on the safe side and avoid use.
Children: Coenzyme Q10 is POSSIBLY SAFE for children when taken by mouth. However, coenzyme Q10 should not be used in children without medical supervision.
Chemotherapy: People undergoing chemotherapy with a class of drugs called alkylating agents should use coenzyme Q10 with caution. There is some concern that coenzyme Q10 might lower the effectiveness of these drugs. Some alkylating agents include busulfan, carboplatin, cisplatin, cyclophosphamide (Cytoxan), dacarbazine, thiotepa, and many others.
High blood pressure or low blood pressure: Coenzyme Q10 might lower blood pressure. It can increase the effects of medications used to lower blood pressure. Discuss your use of coenzyme Q10 with your healthcare provider if you have blood pressure problems.
Smoking: Cigarette smoking depletes the amount of coenzyme Q10 stored by the body.
Surgery: Coenzyme Q10 might interfere with blood pressure control during and after surgery. Stop using coenzyme Q10 at least two weeks before a scheduled surgery.
Drug Interactions
Medications for cancer (Chemotherapy)
Interaction Rating=Moderate Be cautious with this combination.
Coenzyme Q-10 is an antioxidant. There is some concern that antioxidants might decrease the effectiveness of some medications used for cancers. But it is too soon to know if the interaction occurs.
Medications for high blood pressure (Antihypertensive drugs)
Interaction Rating=Moderate Be cautious with this combination.
Coenzyme Q-10 seems to decrease blood pressure. Taking coenzyme Q-10 along with medications for high blood pressure might cause your blood pressure to go too low.
Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
Warfarin (Coumadin)
Interaction Rating=Moderate Be cautious with this combination.
Warfarin (Coumadin) is used to slow blood clotting. Coenzyme Q-10 might help the blood clot. By helping the blood clot, coenzyme Q-10 might decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
Herb Interactions
Acacia: Taking coenzyme Q10 with acacia gum seems to increase the body’s absorption of coenzyme Q-10. In theory, this might increase the effects and side effects of coenzyme Q10.
Beta-carotene: Coenzyme Q10 can increase blood levels of beta-carotene. In theory, this might increase the effects and side effects of beta-carotene.
Herbs and supplements that might lower blood pressure: Coenzyme Q10 might decrease blood pressure. Combining coenzyme Q10 with other herbs and supplements with that lower blood pressure might make blood pressure go too low. Some of these herbs and supplements include andrographis, casein peptides, cat’s claw, fish oil, L-arginine, lycium, stinging nettle, theanine, and others.
Omega-3 fatty acids: Combining coenzyme Q10 with omega-3 fatty acids can reduce blood levels of coenzyme Q10. In theory, this might reduce the effects of coenzyme Q10.
Red yeast rice: Red yeast rice might reduce coenzyme Q10 levels. In theory, this might reduce the effects of coenzyme Q10.
Vitamin A: Coenzyme Q10 can increase blood levels of vitamin A. In theory, this might increase the effects and side effects of vitamin A.
Vitamin C: Coenzyme Q10 can increase blood levels of vitamin C. In theory, this might increase the effects and side effects of vitamin C.
Vitamin E: Coenzyme Q10 can increase blood levels of vitamin E. In theory, this might increase the effects and side effects of vitamin E.
Vitamin K: Coenzyme Q10 can have effects in the body that are similar to vitamin K, including inhibiting the effects of blood thinning drugs such as warfarin. Taking coenzyme Q10 with vitamin K might increase the risk of blood clotting in people taking blood thinning drugs.
Food Interactions
There are no known interactions with foods.
Dosage
The following doses have been studied in scientific research:
ADULTS
BY MOUTH:
- For coenzyme Q10 deficiency: 150-2400 mg per day.
- For a group of disorders that most often cause muscle weakness (mitochondrial myopathies): 150-160 mg per day, or 2 mg/kg per day. In some cases, doses may be gradually increased to 3000 mg per day.
- For heart failure and fluid build up in the body (congestive heart failure or CHF): 30 mg once daily, or up to 300 mg per day divided into two or three doses for up to 2 years. Also, 2 mg/kg daily for up to one year has been used.
- For nerve pain in people with diabetes (diabetic neuropathy): 400 mg per day for 12 weeks.
- For fibromyalgia: 300 mg daily for about 6 weeks or 200 mg twice daily for 3 months has been used. A combination of 200 mg of coenzyme Q10 (Bio-Quinon Q10, Pharma Nord) plus 200 mg of ginkgo (Bio-Biloba, Pharma Nord) per day for 12 weeks.
- For HIV/AIDS: 100-200 mg per day for over 4 years.
- For tissue damage caused when there is limited blood flow and then blood flow is restored (ischemia-reperfusion injury): 150-300 mg per day in up to three divided doses for 1-2 weeks before surgery.
- For preventing migraine: 100 mg three times per day, 150 mg once per day, or 100mg once per day for 3 months. A dose of 1-3 mg/kg per day for 3 months has also been used.
- For multiple sclerosis (MS): 500 mg twice daily for 3 months.
- For a group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy): 100 mg per day for 3 months.
- For heart attack: 120 mg per day in two divided doses for up to one year. A combination of 100 mg of coenzyme Q10 (Bio-Quinon, Pharma Nord) and 100 mcg of selenium (Bio-Selenium, Pharma Nord) per day for up to one year has also been used.
- For Peyronie disease: 300 mg per day for 6 months
CHILDREN
BY MOUTH:
- For coenzyme Q10 deficiency: 60-250 mg per day in up to three divided doses.
- For preventing migraine: 1-3 mg/kg daily for 3 months has been used in patients aged 3-18 years.
- For a group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy): 100 mg daily for 3 months in children aged 8-15 years.
Other Names
Co Q10, Co Q-10, Coenzima Q-10, Co-Enzyme 10, Coenzyme Q 10, Coenzyme Q10, Co-Enzyme Q10, Co-Enzyme Q-10, Co-Q 10, CoQ10, Co-Q10, CoQ-10, Ubidecarenone, Ubidécarénone, Ubiquinone-10.
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