Does Coenzyme Q10 actually make a difference, or is it overhyped?

Meta-analyses spanning from 1997 through a 2014 Cochrane review find CoQ10 supplementation can modestly improve symptoms and some outcomes in heart failure, though a 2022 health-technology assessment concluded the evidence is not yet strong enough to firmly establish cost-effective clinical benefit for reduced-ejection-fraction heart failure specifically. Weighing the data: Coenzyme Q10 looks an early-stage, lower-priority area for now — the evidence is only moderate (58/100), and its estimated impact (30/100) is on the lower end too.