Coenzyme Q10, older athletes, and statins

woman-exercising
The more intensely and strenuously we exercise, the more quickly we reach the anaerobic threshold. A 2012 study has shown that 200 milligrams of Coenzyme Q10 daily can significantly delay the time to the anaerobic threshold. The Coenzyme Q10 supplementation was also associated with significant improvement in muscle strength in the study.

Older active adults who are taking a statin medication?  Shouldn’t they go right to the top of the list of people who need a good Coenzyme Q10 supplement?

That is the question that Dr. Richard Deichmann and his colleagues in the Department of Internal Medicine at the Ochsner Clinical School in New Orleans asked themselves. They tested whether daily supplementation with 200 milligrams of Coenzyme Q10 daily for six weeks would improve measures of cellular energy production, muscle function, and well-being in older active adults taking statin medications.

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Coenzyme Q10 and liver cancer

Recovery from surgery
Studies show that supplementation with Coenzyme Q10 during and after surgery can shorten the length of the stay in the hospital following surgery. Coenzyme Q10 supplementation is also associated with increased energy and less muscle pain and weakness following surgery.

Coenzyme Q10 supplementation as a therapeutic option for chronic disease management and for recovery from surgery?  Yes.  I have just seen interesting reports from two Taiwanese research studies of Coenzyme Q10 supplementation of liver cancer patients.

The study participants were patients with hepatocellular carcinomas: patients whose liver cancer had started in the liver, not migrated to the liver from some other site in the body.  Hepatocellular carcinomas are one of the leading causes of cancer death world-wide [Liu 2016].

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Coenzyme Q10 and chronic fatigue syndrome

Tired woman
Patients diagnosed with chronic fatigue syndrome have abnormally low plasma (and muscle tissue) Coenzyme Q10 concentrations. Supplementation with a well-formulated Coenzyme Q10 preparation improves symptoms.

Chronic fatigue syndrome is a complicated illness.  As its name states, it is a chronic condition, and it is characterized by a debilitating fatigue.  The fatigue may be exacerbated by physical or mental exertion.  Strangely enough, the fatigue is not alleviated by rest or relaxation [Mayo Clinic].

The cause of chronic fatigue syndrome is still unknown.  The major symptom, the chronic fatigue, is also seen in such related conditions as myalgic encephalomyelitis (ME) and systemic exertion intolerance disease (SEID) [Mayo Clinic].

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The proper manufacture of Coenzyme Q10 supplements

Nurse picture
Health professionals know that it is the formulation of the Coenzyme Q10 nutritional supplement that is decisive in the absorption and the heart health effects. It is important to choose a daily Coenzyme Q10 supplement that has documented results in randomized controlled trials.

Coenzyme Q10 supplements are clearly one of the products in today’s America that come in many different formulations.  And, with respect to Coenzyme Q10’s absorption and effectiveness, the important difference is the difference in the formulation.  Dr. William Judy, the director of the SIBR Research Institute, has tested Coenzyme Q10 supplements with absorption rates ranging from below 1% to as high as 8% of a 100-milligram capsule.

Coenzyme Q10 absorption necessary for heart health benefits
That is as good as saying that some Coenzyme Q10 supplements give no absorption of consequence at all.  At the other end of the spectrum, we know that some formulations give an absorption that is associated with statistically significant health benefits.  I am referring, of course, to the results that we have seen in these randomized controlled trials:

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Coenzyme Q10 and diabetes: a systematic review

Cyclist
A woman cycles to raise money for a diabetes awareness event. A recent systematic review of the research literature shows that diabetics can safely take Coenzyme Q10 supplements to achieve documented heart health benefits.

A 2016 systematic review and meta-analysis of the evidence from randomized controlled trials has shown that daily supplementation with Coenzyme Q10 slightly but significantly reduced fasting blood sugar levels.  Another good thing: Coenzyme Q10 supplementation did not significantly affect fasting insulin levels or Hb1Ac levels.

In other words, pre-diabetics and diabetics can safely take Coenzyme Q10 supplements to gain these known heart health benefits:

  • Improvement of the ATP energy production in the heart muscle cells [Mortensen]
  • Protection of the heart muscle cells against oxidative damage [Alehagen]
  • Improvement of endothelial function in the heart and blood vessels [Littarru]
  • Reduction of high blood pressure [Rosenfeldt]

Good Coenzyme Q10 news for pre-diabetics and diabetics
Yes, pre-diabetics and diabetics will want to talk with their physicians about the meta-analysis conducted by Dr. Moradi and his colleagues.  Pre-diabetics and diabetics can benefit from taking daily Coenzyme Q10 supplements in the same way that participants receiving the active Coenzyme Q10 treatment in the following studies have benefited as compared to participants in the placebo control groups:

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A review of Coenzyme Q10 research results

Pharmaceutical control
The Coenzyme Q10 supplements with the best documented results in randomized controlled trials have been manufactured under national-level pharmaceutical control.

Recently, I read a published review of the research literature about the nutritional and therapeutic supplement Coenzyme Q10.  It was very interesting to see what the research has revealed and to see what the authors of the review chose to emphasize [Potgieter].

Coenzyme Q10 supplements confer the following known health benefits:

  • improve the symptoms and survival of heart failure patients
  • provide antioxidant protection to patients taking statin medications
  • help to lower high blood pressure
  • maintain good heart function in middle-aged and elderly people
  • provide heart health benefits to people with diabetes

Normal unsupplemented levels of plasma Coenzyme Q10
First off, there is wide variation in the plasma Coenzyme Q10 concentrations of individuals who are not taking Coenzyme Q10 supplements.  There are many factors that influence any one individual’s Coenzyme Q10 status:

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Coenzyme Q10 and exercise in younger and older adults

sevilla-cathedral
Sevilla is famous for its cathedral, Santa Maria de la Sede, the largest Gothic cathedral in the world, built during the 15th century. Sevilla is also famous for its university. Within the university, the Developmental Biology Institute has been doing much research into the nutritional and medical importance of Coenzyme Q10.

Spanish researchers at the Pablo de Olavide University in Sevilla hypothesized that the effect of physical activity on plasma Coenzyme Q10 levels and on plasma Coenzyme Q10/cholesterol ratios might vary according to the age of the individuals engaging in the physical activity. Their results show, for the first time, an apparently different effect of exercise on young people and on older people.

  • Lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the young people more so than in older people who were also exercising. That result was surprising.
  • Moreover, lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the younger people more so than with moderate levels of physical activity in younger people. That result was not surprising.
  • What was most surprising was the data that showed that older people who exercised more often and more intensely had higher levels of Coenzyme Q10 in plasma and higher ratios of Coenzyme Q10 to cholesterol in plasma than did older adults who exercised moderately or who were mostly sedentary. In this respect, the effect of exercise on the older people differed from the effect of exercise on the younger participants [Del Pozo-Cruz 2014].

Coenzyme Q10 and physical activity in young people
In the Spanish study, the young participants had an average age of 20 years plus or minus 2 years.  Two possible explanations come to mind for the lower plasma Coenzyme Q10 levels in highly active younger people:

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Statin medications and Coenzyme Q10

Mevalonate_Pathway
In blocking the body’s production of mevalonate, the statin medications inhibit the production of cholesterol. They also inhibit the body’s bio-synthesis of the essential bio-nutrient Coenzyme Q10, and they inhibit the body’s ability to use dietary and supplemental selenium to make the selenocysteine amino acid that is needed to make vital selenoproteins. Drs. Okuyama and Langsjoen have called for a critical re-evaluation of the guidelines for statin medication use.

There are two issues concerning the use of statin medications that relate to Coenzyme Q10.  

The more serious issue is that several animal and human studies have shown that the administration of statin medications leads to a reduction in the plasma and muscle tissue levels of Coenzyme Q10.  There is no doubt that depletion of Coenzyme Q10 is an unintended consequence of taking statin medications.  Some human trials have shown the extent of the reduction to be 40 % or greater.  Furthermore, ageing seems to play a role in the diminution of Coenzyme Q10 levels caused by the administration of statin medications [Deichmann].  Decreased plasma and heart muscle tissue levels of Coenzyme Q10 are associated with the increasing severity of heart failure [Folkers, Mortensen].

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Coenzyme Q10 Nutritional Supplements, 1981 to 2016

Gummy bears
Dr. Judy has watched the progression of Coenzyme Q10 supplements from dry powder tablets to dry powder in two-piece hard-gel capsules to dry powder in soybean oil in soft-gel capsules to Coenzyme Q10 dissolved in multiple lipids in soft-gel capsules. Today there are even Coenzyme Q10 gummy bears on the market. But what about the formulation? It is the supplement manufacturer’s formulation of the Coenzyme Q10 raw material that is most important for the absorption and health effects.

In line with other technologies, the production technology for Coenzyme Q10 nutritional supplements has advanced over the years.  For the past 35 years, Dr. William Judy of the SIBR Research Institute has followed the development of the Coenzyme Q10 nutritional supplements produced in the USA and around the world.

Dr. Judy has seen considerable improvement in the formulations of the Coenzyme Q10 nutritional supplements and in their effectiveness as an adjuvant treatment of chronic heart failure and other clinical conditions.  He has seen increasing awareness of the need for Coenzyme Q10 supplements in patients taking statin medications.  He has seen increasing awareness of the health benefits for healthy middle-aged and elderly people.

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Coenzyme Q10 improves endothelial function

woman-boxer
Good health and good fitness depend on good blood circulation.  Good blood circulation depends on good endothelial function.  Research shows that taking a daily Coenzyme Q10 supplement is associated with improved endothelial function.  Supplementation with a combination of Coenzyme Q10 and high selenium yeast has significantly reduced the risk of dying from heart disease in elderly KiSel-10 study participants.

How does Coenzyme Q10 supplementation keep the heart young and healthy? The primary explanation is that Coenzyme Q10 is absolutely vital to the cellular process of producing energy, and the heart muscle needs energy constantly.  An energy-starved heart is a failing heart.

A second and also important explanation is that oxidative damage causes the heart muscle cells to age and deteriorate. Coenzyme Q10 has antioxidant and anti-inflammatory effects that can help to prevent the development of atherosclerosis.

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