A well-formulated ubiquinone Coenzyme Q10 supplement was absorbed significantly better than a well-formulated ubiquinol supplement. This is one of the take-home messages from a recent carefully designed Spanish university study [Lopez-Lluch 2018].
Remember: Ubiquinol supplements are notoriously difficult to work with. As an antioxidant posed to give up its two extra electrons, ubiquinol is by its very nature unstable. Often, the ubiquinol is oxidized (gives up its electrons) while still in the soft-gel capsule.
On this website, we review the results of clinical trials of the effects of oral Coenzyme Q10 supplementation. We high-light human studies that show the following significant health benefits of taking a well-formulated CoQ10 supplement:
Improved symptoms and survival of heart failure patients
Reduced risk of death from heart disease and better maintained heart function among senior citizens
Improved quality of life for chronic fatigue syndrome patients
Faster recovery with fewer complications following heart surgery
Lowered systolic and diastolic blood pressure
Reduced frequency and intensity of migraine headaches
Why the need for CoQ10 supplementation?
Bio-synthesis of CoQ10 falling with increasing age.
Yes, our bodies do synthesize Coenzyme Q10 in almost all cells; however, the bio-synthesis of Coenzyme Q10 is a complicated multi-step process, and the extent of Coenzyme Q10 bio-synthesis decreases with increasing age once we pass our 20s.
Insufficient uptake of CoQ10 from the diet.
Moreover, it is difficult to get enough Coenzyme Q10 from our food alone to make up the difference in the declining endogenous production of CoQ10. Remember, too, that it becomes more difficult to extract nutrients from our food as we get older.
Marketers continue to make many unsubstantiated and misleading claims for the ubiquinol version of Coenzyme Q10 supplements. As long ago as 2007, Dr. William Judy, the founder and president of the SIBR Research Institute, wrote a seminal article revealing the facts and fabrications that existed in marketing texts for ubiquinol products. So far, no one has refuted the points that Dr. Judy made [Judy 2007].
CoQ10 formulation more important than CoQ10 form
Now, in 2018, we have the results of the double-blind, cross-over study done in Sevilla, Spain. That study showed that a well-formulated ubiquinone Coenzyme Q10 supplement gave a significantly better bio-availability than did a well-formulated ubiquinol supplement. That the ubiquinol supplement itself was well formulated is evidenced by the fact that the ubiquinol product out-performed other less well formulated ubiquinone products [Lopez-Lluch 2018].
The Q-Symbio randomized, double-blind, placebo-controlled study of the effect of Coenzyme Q10 adjunctive treatment on the symptoms, adverse cardiovascular events, and survival of chronic heart failure patients is the single best Coenzyme Q10 clinical study that we have.
The Q-Symbio study was a two-year multi-center study enrolling 420 patients with moderate to severe heart failure. The patients were randomly assigned to an active treatment group receiving 100 milligrams of Coenzyme Q10 three times a day or to a group taking matching placebos three times a day [Mortensen 2014]. The Coenzyme Q10 or placebo treatment was given in addition to the conventional heart failure medication. The patients were recruited for the study in several European, Asian, and Australian countries.
Arguably, the most exciting Coenzyme Q10 research results of 2018 are the results of a comparative bio-availability study done at the Pablo de Olavide University in Sevilla, Spain. The researchers’ carefully designed study demonstrates that the uptake of Coenzyme Q10 from oral supplements depends primarily on two factors [López-Lluch 2018]:
***The composition and formulation of the supplement, especially the types of substances used to dissolve the Coenzyme Q10 raw material in the supplement capsules
What did the leading Coenzyme Q10 researchers have to say in New York?
Coenzyme Q10 has three primary fields of activity in the body: as a co-factor in the energy production process in the cells, as a fat-soluble antioxidant protecting cells against oxidative damage, and as a regulator of endothelial function. In addition, Coenzyme Q10 has anti-inflammatory properties and plays a role in proper cell signaling activity.
The most recently published data from the KiSel-10 study done in Sweden shows that the beneficial heart health effects of supplementation of elderly live-at-home individuals with a combination of Coenzyme Q10 and high-selenium yeast have persisted through year 12.
A bio-availability study done at a university in Spain shows that the formulation of the Coenzyme Q10 supplement is even more important than the form of the supplement. The absorption of a well-formulated ubiquinone Coenzyme Q10 supplement is better than the absorption of a ubiquinol supplement.
A sub-group analysis of the data from the Q-Symbio study of the effect of adjunctive Coenzyme Q10 treatment on European chronic heart failure patients shows even better results for Europeans than for all patients in the multi-center study.
Studies show that there may be interactions between Coenzyme Q10 and other nutritional supplements, meaning that we should be careful not to take these supplements at the same time we take our Coenzyme Q10.
The consensus at the conference was that the therapeutic level of Coenzyme Q10 in the plasma or serum is somewhere between 2.5 and 3.5 micrograms per milliliter. Above 4.0 micrograms per milliliter, the beneficial effect of Coenzyme Q10 supplementation is thought to flatten out.
Statin medications only deprive the body of Coenzyme Q10 by inhibiting the bio-synthesis of Coenzyme Q10 just as they inhibit the bio-synthesis of cholesterol. Now there is evidence that long-term use of statins has undesirable effects on cognitive function and on memory in particular. The statins easily cross the blood-brain barrier and adversely affect the protective myelin sheaths in which cholesterol is a key component.
More about these topics below.
The 9th conference of the International Coenzyme Q10 Conference at Columbia University in New York
Every three years, the International Coenzyme Q10 Association (ICQA) holds a conference at which researchers from around the world present their research findings related to Coenzyme Q10. This year, the conference was held at Columbia University in New York the 21st-24th of June. Many of the presentations and papers concerned the biochemistry of Coenzyme Q10’s effects.
In this article, I want to focus in on the presentations of results from human clinical studies. In the clinical area, the emphasis was demonstrating the importance of Coenzyme Q10 supplementation to heart health, healthy ageing, and better quality of life.
There is a significant reduction in the rate of Coenzyme Q10 bio-synthesis during the ageing process and in ageing-related diseases. Mice studies have given us reason to believe that there is a direct relationship between a longer and healthier life and Coenzyme Q10 function in the mitochondria of the cells [Hernandez-Camacho 2018].
Human studies of Coenzyme Q10 status and healthy ageing
Coenzyme Q10 adjunctive treatment of chronic heart failure patients significantly improves their symptoms and survival [Mortensen 2014]. A recent survey of the scientific literature shows that Coenzyme Q10 supplementation is safe, well-tolerated, and effective as an adjunctive treatment in various disease conditions that involve high cellular and tissue demands for energy and in diseases involving oxidative stress and inflammation [Garrido-Maraver 2014].
Coenzyme Q10 is a naturally occurring essential nutrient. In human cells, it is a vital co-factor in the process of ATP energy generation and one of the most important lipid antioxidants. In this article, I summarize briefly the results of some of the recent scientific research using Coenzyme Q10 as an active treatment compared to a placebo treatment.
NQO1 is the abbreviated form of the name for both the NAD(P)H dehydrogenase (quinone 1) gene and the NAD(P)H:quinone acceptor oxidoreductase enzymes that the gene codes for. The NQO1 enzymes are of interest to us because they are responsible for the reduction of the ubiquinone form of Coenzyme Q10 to the ubiquinol form [Siegel 2017]. That conversion takes the Coenzyme Q10 molecules from their bio-energetics form to their antioxidant form.
NQO1 and the conversion of ubiquinone to ubiquinol
The ubiquinone form of Coenzyme Q10 is the essential form needed for the cellular process of ATP energy production. The ubiquinol form of Coenzyme Q10 is the fat-soluble antioxidant form that provides protection against oxidative damage.
The formulation of the Coenzyme Q10 supplement is of utmost importance. Formulation affects absorption. Absorption affects efficacy. Not all Coenzyme Q10 supplements give the same level of absorption.
Coenzyme Q10 molecules are fairly large, fat-soluble molecules. Coenzyme Q10 has a six-carbon benzoquinone ring as its head and a ten-unit isoprenoid tail that is strongly hydrophobic. For best absorption, Coenzyme Q10 needs to be ingested together with a meal containing some fat. Despite some claims to the contrary, it is not possible to re-make Coenzyme Q10 into a water-soluble substance. Such a product no longer has the properties of Coenzyme Q10 [Judy 2018].