In the gums and supporting tissues around the teeth, low CoQ10 levels have been linked to worse periodontal inflammation and deeper pocketing, likely because CoQ10 is essential for local mitochondrial energy production and antioxidant defense. Small human studies have found that people with periodontitis often have reduced CoQ10 in gingival tissue or crevicular fluid, and that topical or oral CoQ10 used alongside standard scaling and root planing can modestly improve measures such as bleeding on probing and pocket depth. The practical implication is that maintaining adequate CoQ10 status may help support healthier periodontal tissues and could be a useful adjunctive strategy, particularly in individuals with chronic gum disease or high oxidative stress in the oral cavity. This medication is commonly used for Diabetes.
Prakash S, Sunitha J, Hans M. Role of coenzyme Q(10) as an antioxidant and bioenergizer in periodontal diseases. Indian J Pharmacol. 2010 Dec;42(6):334-7. R. Nakamura, G.P. Littarru, K. Folkers, & E.G. Wilkinson. Study of CoQ10-Enzymes in Gingiva from Patients with Periodontal Disease and Evidence for a Deficiency of Coenzyme Q10*, Proc. Natl. Acad. Sci. U.S.A. 71 (4) 1456-1460. Ali K. Barakat et.al. Clinical Evaluation of Co-enzyme Q10 in Management of Chronic Periodontitis Patients: Mouth Split Study. International Journal of Health Sciences & Research. Vol.9; Issue: 1; January 2019.
Some side effects may be linked to nutrient depletion caused by this medication.
Long term treatment with Biguanides, such as Metformin or Metformin combinations with other drugs, are found in research to reduce vitamin B12 absorption due to it hindering the activity of a calcium-dependent mechanism. Insufficient levels of vitamin B12 can lead to higher circulating homocysteine levels and the elevated risk of neurological problems and cardiovascular diseases.
Biguanide (anti-diabetic) drugs have been found in scientific evidence to decrease serum levels of coenzyme Q10. Type 2 diabetes can increase oxidative stress in the body, weakening its defenses and potentially harming cells. CoQ10, a powerful antioxidant, plays a crucial role in protecting cells from this damage. CoQ10 supplementation may help restore these levels, potentially improving mitochondrial function and protecting the kidneys from damage.
Research has shown that anti-diabetic Biguanide drugs may reduce folic acid absorption. Folic acid is a powerful antioxidant and low levels make the body more susceptible to oxidative stress, which can damage enzymes involved in homocysteine metabolism, and subsequently increase its accumulation. Elevated levels of homocysteine (hyperhomocysteinemia) are a risk factor for various health problems including cardiovascular diseases, neurological problems, osteoporosis, and vision problems.
Biguanides, such as Metformin or Metformin combinations with other drugs, may contribute to reduced levels of thiamine (vitamin B1) in end-stage renal failure patients. Research has found metformin encephalopathy present in patients on hemodialysis for end-stage diabetic renal failure (ESRD). Patients with ESRD should consider having thiamine (vitamin B1) status monitored and supplementing with thiamine when levels are insufficient or deficient.