Diomegox+ Tablet (strip of 1x10)

What each ingredient does

Uses

• Oxidative stress in general, as a daily antioxidant and nutritional supplement.
• Male subfertility, with poor sperm count, motility or DNA damage. Campbell-Walsh Urology notes trials where antioxidants (especially vitamin E, zinc and multivitamins) increased live birth rates in subfertile men undergoing assisted reproduction. This was cited from Vandekerckhove et al. (2000). Evidence for CoQ10 in this setting is also discussed there. The evidence is low quality and benefit is not guaranteed. (Campbell Walsh Wein Urology, antioxidant therapy section)
• Correcting a deficiency in the individual micronutrients, such as zinc or selenium. Folic acid and vitamin A are also used this way.
• Fatigue and general wellness, through CoQ10 and omega-3.

Disadvantages and risks

• Large trials of antioxidant vitamins (A, C, E, beta-carotene) have not shown prevention of cardiovascular disease or cancer. Fuster and Hurst's The Heart advises against using vitamins E, C and beta-carotene for primary or secondary prevention of ASCVD (section: Antioxidant Supplements and Folic Acid).
• Tietz Textbook of Laboratory Medicine notes that most studies show no benefit from vitamin C and E supplementation, and possibly harm. One example is increased mortality in critically ill patients with multi-organ failure (section: Measuring Free Radical Activity).
• Sleisenger and Fordtran's also reports inconsistent trial results for antioxidants and gastric cancer risk.
• Too many antioxidants can blunt normal oxidative signalling, so more is not always better.

• CoQ10:
  • Nausea, diarrhoea, insomnia, rash and low blood pressure.
  • It can reduce the effect of warfarin, because it is structurally similar to vitamin K. Katzung advises avoiding this combination or monitoring very carefully (Katzung's Basic and Clinical Pharmacology, 16th Ed., Coenzyme Q10, Drug Interactions).
• Piperine: inhibits CYP3A4 and P-glycoprotein, so it can raise blood levels of other drugs. Examples reported are phenytoin, propranolol, theophylline and carbamazepine. It can also cause stomach irritation and heartburn.
• Zinc: nausea and metallic taste. Long-term high doses cause copper deficiency with anaemia and neutropenia. Acute toxicity occurs with intakes above about 200 mg (Goldman-Cecil Medicine).
• Selenium: excess causes selenosis (garlic breath, hair and nail brittleness and loss, GI upset, neuropathy). The gap between a useful and a toxic dose is small (Lippincott Biochemistry, 8th Ed.).
• Vitamin A: teratogenic at high doses, so it is risky in pregnancy. Chronic excess causes liver toxicity, bone loss and raised intracranial pressure.
• Vitamin E: high doses add to bleeding risk, especially with anticoagulants or antiplatelets.
• Vitamin C: GI upset, and a risk of oxalate kidney stones at high doses. It can worsen iron overload in hemochromatosis.
• Folic acid: can mask vitamin B12 deficiency, so the anaemia improves while neurological damage continues.
• Omega-3: fishy aftertaste, belching and loose stools. High doses increase bleeding tendency and may raise atrial fibrillation risk.
• Astaxanthin: mild stomach upset and reddish stools. It may lower blood pressure and cholesterol, adding to antihypertensives or statins.
• Lycopene: very well tolerated. Very high intake can colour the skin orange (lycopenodermia).

• Pregnant or breastfeeding women, because of vitamin A and the lack of safety data for CoQ10 and astaxanthin.
• People on warfarin, antiplatelets, antihypertensives, antiepileptics, theophylline or chemotherapy.
• People with kidney stones, hemochromatosis, liver or kidney disease, or a bleeding disorder.
• Anyone already taking other multivitamins or zinc or selenium supplements. Doses can stack up.

• Take it after food. CoQ10, vitamins A and E, and omega-3 are fat-soluble and absorb better with a fatty meal.
• It is an add-on to a healthy diet, not a replacement. Lab-confirmed deficiencies or a diagnosed problem, such as semen analysis abnormalities, should guide whether you need it.
• Don't exceed the dose on the label. Check with your doctor or pharmacist before using it long term.