Condition
Cardiomyopathy
Cardiomyopathy is a group of heart muscle diseases, including enlarged, thickened, or stiff forms, that make it harder for the heart to pump blood. Coenzyme Q10 and omega-3 fatty acids have the strongest evidence among supplements, yet two small trials of coenzyme Q10 found no clear difference in exercise tolerance. Idebenone eased signs of heart thickening in some people with Friedreich's ataxia, but that evidence is limited and applies to a narrow group.
Sources: PMID 21462215; PMID 20886510
- Supplements studied
- 5
- Graded outcomes
- 4
- Trials
- 4
- People studied
- 251
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Cardiac Function in Friedreich's Ataxia Several clinical trials in Friedreich's ataxia patients showed some improvement in cardiac hypertrophy markers. Two Cochrane systematic reviews (2009, 2012) evaluated antioxidant treatments including idebenone for Friedreich's ataxia, noting partial cardiac benefits but inconsistent neurological outcomes. | Improves (the measure goes up) | Small effect | 6 studies | 200 people | ||
Studies that measured cardiac function in friedreich's ataxia | ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Exercise Tolerance No effect | NoneNo effect | 2 studies | 41 people | |||
| Left Ventricular Ejection Fraction | Improves (the measure goes up) | 1 study | 41 people | |||
Studies that measured left ventricular ejection fraction | ||||||
| Heart Size | Changes; see studies | 41 people | ||||
| Quality of Life | Improves (the measure goes up) | 41 people | ||||
Berberine
- Exercise Tolerance
- Quality of Life: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Exercise Tolerance No effect | NoneNo effect | 1 study | 156 people | |||
Studies that measured exercise tolerance | ||||||
| Quality of Life | Improves (the measure goes up) | 156 people | ||||
Fish Oil
- Blood glucose
- Triglycerides: improves
- High-density lipoprotein (HDL): improves
Terminalia Arjuna
- Left Ventricular Ejection Fraction: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Left Ventricular Ejection Fraction | Improves (the measure goes up) | 1 study | 12 people | |||
Studies that measured left ventricular ejection fraction | ||||||
Key findings
- Cardiac Function in Friedreich's AtaxiaImproves (the measure goes up)
- Exercise Tolerance
- Blood glucose
The Cardiomyopathy Supportive Care protocol
2 primary supplements · 7 supporting supplements
- Coenzyme Q10 (CoQ10)200–400 mg daily in divided doses (ubiquinol form better absorbed)
- Omega-3 Fatty Acids2–4 g EPA+DHA daily
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Cardiomyopathy. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
Fullscript collectionHeart and circulation: evidence-graded picksOpen on Fullscript
The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.
We earn from purchases made in our Fullscript store, and links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Full disclosure
Studies cited
100 studies from PubMed
- Effects of Coenzyme Q10 Supplementation on Depressive Symptoms and Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- Cytoprotective Effect of Idebenone through Modulation of the Intrinsic Mitochondrial Pathway of Apoptosis in Human Retinal Pigment Epithelial Cells Exposed to Oxidative Stress Induced by Hydrogen Peroxide.
- A pilot study of idebenone in the treatment of patients with hereditary myopathies.
- Leber hereditary optic neuropathy: new and emerging therapies.
- Developments in the Treatment of Leber Hereditary Optic Neuropathy.
- Efficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
- Therapeutic Potential and Immunomodulatory Role of Coenzyme Q(10) and Its Analogues in Systemic Autoimmune Diseases.
- Coenzyme Q10 effects in neurological diseases.
- Esculetin and idebenone ameliorate galactose-induced cataract in a rat model.
- Idebenone Has Distinct Effects on Mitochondrial Respiration in Cortical Astrocytes Compared to Cortical Neurons Due to Differential NQO1 Activity.
- Idebenone protects mitochondrial function against amyloid beta toxicity in primary cultured cortical neurons.
- Berberine Ameliorates Metabolic Dysfunction in Obesity: A Review
- Berberine for NAFLD: A Systematic Review and Meta-Analysis
- Idebenone has preventative and therapeutic effects on pulmonary fibrosis via preferential suppression of fibroblast activity.
- Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Health
- Berberine: A Plant-Derived Alkaloid with Therapeutic Applications
- Berberine and Gut Microbiota: Clinical Evidence and Mechanisms
- Berberine Improves Glucogenesis and Lipid Metabolism in Diabetes: A Systematic Review
- Safety and Tolerability of Berberine: A Systematic Review of Clinical Studies
- Effects of Berberine on Insulin Resistance: A Comprehensive Review
- Mitochondrial biogenesis and neural differentiation of human iPSC is modulated by idebenone in a developmental stage-dependent manner.
- The Role of Berberine in the Control of Metabolism: A Review
- Molecular Targets of Berberine and Its Derivatives: Focus on Cardiovascular Protection
- Both idebenone and idebenol are localized near the lipid-water interface of the membrane and increase its fluidity.
- Pharmacological effect of a new idebenone formulation in a model of carrageenan-induced inflammatory pain.
- Coenzyme Q10 as a therapy for mitochondrial disease.
- Effects of berberine on lipid profile in subjects with low cardiovascular risk
- Review of clinical trials for mitochondrial disorders: 1997-2012.
- Antioxidants and other pharmacological treatments for Friedreich ataxia.
- Nanostructured lipid carriers improve skin permeation and chemical stability of idebenone.
- Idebenone-loaded solid lipid nanoparticles for drug delivery to the skin: in vitro evaluation.
- Idebenone and resveratrol extend lifespan and improve motor function of HtrA2 knockout mice.
- Pharmacokinetic evaluation of idebenone.
- Pharmacokinetics and metabolism of idebenone in healthy male subjects.
- Low-dose idebenone treatment in Friedreich's ataxia with and without cardiac hypertrophy.
- Antioxidants and other pharmacological treatments for Friedreich ataxia.
- Antioxidant protection against acoustic trauma by coadministration of idebenone and vitamin E.
- Idebenone in Friedreich's ataxia.
- Determination of the antioxidative capacity of an antioxidant complex and idebenone: an in vitro rapid and sensitive method.
- Protective properties of idebenone in noise-induced hearing loss in the guinea pig.
- Dramatic improvement in mitochondrial cardiomyopathy following treatment with idebenone.
- Antioxidant properties of 2,3-dimethoxy-5-methyl-6-(10-hydroxydecyl)-1,4-benzoquinone (idebenone).
- A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults.
- The effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis.
- The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis
- Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine
- Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis.
- Effects of administering berberine alone or in combination on type 2 diabetes mellitus: a systematic review and meta-analysis.
- Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.
- Efficacy of Berberine in Patients with Non-Alcoholic Fatty Liver Disease
- Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion
- Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy
- Effects of berberine gelatin on recurrent aphthous stomatitis: a randomized, placebo-controlled, double-blind trial in a Chinese cohort
- Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials.
- Efficacy and safety of berberine in preventing recurrence of colorectal adenomas: A systematic review and meta-analysis.
- Effects of berberine and barberry on anthropometric measures: A systematic review and meta-analysis of randomized controlled trials
- The Effect of Berberine on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Control Trials.
- Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers
- Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial
- Effectiveness of coenzyme Q10 in prophylactic treatment of migraine headache: an open-label, add-on, controlled trial
- A randomized, double-blinded, placebo-controlled, crossover, add-on study of CoEnzyme Q10 in the prevention of pediatric and adolescent migraine
- The synergistic effects of nano-curcumin and coenzyme Q10 supplementation in migraine prophylaxis: a randomized, placebo-controlled, double-blind trial
- Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement
- Coenzyme Q10 supplementation alleviates pain in pregabalin-treated fibromyalgia patients via reducing brain activity and mitochondrial dysfunction
- Increased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation
- Coenzyme q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients: results of a small clinical trial
- Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia?
- Reversal of mitochondrial dysfunction by coenzyme Q10 supplement improves endothelial function in patients with ischaemic left ventricular systolic dysfunction: a randomized controlled trial
- Dose-Response Effect of Coenzyme Q10 Supplementation on Blood Pressure among Patients with Cardiometabolic Disorders: A Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- Electrocardiographic and hemodynamic effects of coenzyme Q10 in healthy individuals: a double-blind, randomized controlled trial
- Effects of coenzyme Q10 on vascular endothelial function in humans: A meta-analysis of randomized controlled trials
- Coenzyme Q10 and exercise training in chronic heart failure
- Effects of Coenzyme Q10 Supplementation on Lipid Profiles in Adults: A Meta-analysis of Randomized Controlled Trials.
- Mediterranean Diet Supplemented With Coenzyme Q10 Modifies the Expression of Proinflammatory and Endoplasmic Reticulum Stress-Related Genes in Elderly Men and Women
- Efficacy of coenzyme Q10 on semen parameters, sperm function and reproductive hormones in infertile men
- Coenzyme Q(10) supplementation in infertile men with idiopathic asthenozoospermia: an open, uncontrolled pilot study
- Effect of Coenzyme Q10 supplementation on antioxidant enzymes activity and oxidative stress of seminal plasma: a double-blind randomised clinical trial
- Coenzyme Q10 improves seminal oxidative defense but does not affect on semen parameters in idiopathic oligoasthenoteratozoospermia: a randomized double-blind, placebo controlled trial
- Coenzyme Q10 administration has no effect on sICAM-1 and metabolic parameters of pediatrics with type 1 diabetes mellitus
- Clinical trial of the effects of coenzyme Q10 supplementation on glycemic control and markers of lipid profiles in diabetic hemodialysis patients
- Effects of coenzyme Q10 supplementation on serum values of adiponectin, leptin, 8-isoprostane and malondialdehyde in women with type 2 diabetes
- Effects of Coenzyme Q10 Supplementation on Metabolic Indicators in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.
- Effectiveness of Coenzyme Q10 Supplementation for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
- Coenzyme Q(10) improves endothelial dysfunction of the brachial artery in Type II diabetes mellitus
- Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes
- Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients
- The effects of coenzyme Q10 supplementation on cardiometabolic markers in overweight type 2 diabetic patients with stable myocardial infarction: A randomized, double-blind, placebo-controlled trial
- Influence of adjuvant Coenzyme Q10 on inflammatory and oxidative stress biomarkers in patients with bipolar disorders during the depressive episode
- Evaluating the Effect of Coenzyme Q10 Augmentation on Treatment of Bipolar Depression: A Double-Blind Controlled Clinical Trial
- Coenzyme Q10 (CoQ10) in isolated diastolic heart failure in hypertrophic cardiomyopathy (HCM)
- Coenzyme Q10 terclatrate and creatine in chronic heart failure: a randomized, placebo-controlled, double-blind study
- Effects of coenzyme Q10 on arterial stiffness, metabolic parameters, and fatigue in obese subjects: a double-blind randomized controlled study
- Coenzyme Q10 supplementation and exercise-induced oxidative stress in humans
- Effects of Coenzyme Q10 Supplementation on Biomarkers of Oxidative Stress in Adults: A GRADE-Assessed Systematic Review and Updated Meta-Analysis of Randomized Controlled Trials.
- Postprandial antioxidant effect of the Mediterranean diet supplemented with coenzyme Q10 in elderly men and women
- Effects of coenzyme Q10 supplementation on liver mitochondrial function and aerobic capacity in adolescent athletes
- Effects of coenzyme Q10 supplementation on plasma adiponectin, interleukin-6, and tumor necrosis factor-alpha levels in men
- Efficacy and Optimal Dose of Coenzyme Q10 Supplementation on Inflammation-Related Biomarkers: A GRADE-Assessed Systematic Review and Updated Meta-Analysis of Randomized Controlled Trials.
- Effects of coenzyme Q10 supplementation on glycemic control: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.