Creatine and CoQ10

Creatine and CoQ10 have additive effects in the R6/2 mice

Dr. M. Flint Beal and colleagues have found that creatine and CoQ10 each exert neuroprotective effects in a mouse model of HD and that neuroprotection increases when both are administered.

Both supplements boost energy metabolism which is known to be impaired in HD patients. In addition, both are antioxidants and oxidative damage is known to be a problem in HD. Creatine and CoQ10 are each in Phase III (final) clinical trials conducted by the Huntington Study Group as a result of promising results in mouse models and Phase I and II trials. 
Should both be found effective, doctors and patients will need to know whether they should be taken in combination or whether there is no additional benefit to taking more than one of the supplements.
Creatine and CoQ10 affect cellular energy through different mechanisms.   Creatine plays a key role in energy buffering between the mitochondria and the cytosol of the cell which is especially important in cells with a high demand for energy.  CoQ10 is a cofactor in the electron transport chain which is part of the process by which energy is produced in the mitochondria. CoQ10  accepts electrons from Complex I and II and transfers them to Complex III. 
Dr. Beal and colleagues provided the R6/2 mice with a diet which included two percent creatine or one percent CoQ10 or both and compared the results for the three groups with R6/2 mice which were fed a regular diet. The CoQ10 group did better on the rotorod test of motor performance and survived longer than the control group. The creatine group did better than the CoQ10 group while the group which received both did best of all.
The results suggest that research into whether HD patients would benefit from taking both is worth pursuing. ”If both CoQ10 and creatine show efficacy in … HD trials, then future studies of the two compounds in combination may be warranted. A combination of the two compounds would also be a promising approach for treating pre-symptomatic individuals, since both compounds are natural products and are well-tolerated with few side effects,” the authors conclude.
Dr. M. Flint Beal
Dr. M. Flint Beal

Dr. M. Flint Beal

“Combination therapy with coenzyme Q10 and creatine produces additive neuroprotective effects in models of Parkinson's and Huntington's diseases.”

Lichuan Yang, Noel Y. Calingasan, Elizabeth J. Wille, Kerry Cormier, Karen Smith, Robert J. Ferrante, and M. Flint Beal

Coenzyme Q(10) (CoQ(10)) and creatine are promising agents for neuroprotection in neurodegenerative diseases via their effects on improving mitochondrial function and cellular bioenergetics and their properties as antioxidants. We examined whether a combination of CoQ(10) with creatine can exert additive neuroprotective effects in a MPTP mouse model of Parkinson's disease, a 3-NP rat model of Huntington's disease (HD) and the R6/2 transgenic mouse model of HD. The combination of the two agents produced additive neuroprotective effects against dopamine depletion in the striatum and loss of tyrosine hydroxylase neurons in the substantia nigra pars compacta (SNpc) following chronic subcutaneous administration of MPTP. The combination treatment resulted in significant reduction in lipid peroxidation and pathologic alpha-synuclein accumulation in the SNpc neurons of the MPTP-treated mice. We also observed additive neuroprotective effects in reducing striatal lesion volumes produced by chronic subcutaneous administration of 3-NP to rats. The combination treatment showed significant effects on blocking 3-NP-induced impairment of glutathione homeostasis and reducing lipid peroxidation and DNA oxidative damage in the striatum. Lastly, the combination of CoQ(10) and creatine produced additive neuroprotective effects on improving motor performance and extending survival in the transgenic R6/2 HD mice. These findings suggest that combination therapy using CoQ(10) and creatine may be useful in the treatment of neurodegenerative diseases such as Parkinson's disease and HD.