Coenzyme Q10: Good news for dialysis patients

Did you know? Kidney disease kills more Americans every year than either breast cancer or prostate cancer. High blood pressure and diabetes are the main causes of chronic kidney disease. Some 468,000 Americans depend on dialysis. Coenzyme Q10 supplements can reduce the risk of oxidative damage to the cells and can reduce the risk of damage to the heart muscle for dialysis patients.

Supplementation of patients undergoing maintenance dialysis with 1200 milligrams of Coenzyme Q10 for four months has been shown to be safe and effective at reducing a bio-marker of oxidative stress [Rivara].

Super, I thought, when I read this report, which appeared in the medical journal The American Journal of Kidney Diseases.  The journal is the official journal of the National Kidney Foundation.

1200 milligrams a day.  That is four times the daily dosage used in Dr. Mortensen’s Q-Symbio study of chronic heart failure patients.  Six times the daily dosage used in Dr. Alehagen’s KiSel-10 study of elderly Swedish citizens.  And 1200 milligrams per day were safe and well tolerated.  Good news.  Not surprising news but good to see confirmed.

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Interview with Dr. Judy: the need for Coenzyme Q10

Q.  Good morning, Dr. Judy.  You have talked with us about the safety of Coenzyme Q10 supplements, and you have told us that the formulation of the supplement is decisive for the absorption of Coenzyme Q10.  Shouldn’t we talk today about why we adults need daily Coenzyme Q10 supplements?

Coenzyme Q10 molecules are redox molecules.  Ubiquinone can accept electrons, and ubiquinol can donate electrons.   Oxireductase enzymes catalyze ubiquinone’s accepting electrons.  Free radicals take electrons from ubiquinol and become stable.

A.  Yes, indeed.  Coenzyme Q10 is very much needed and, at the same time, very little known by most people.  Our bodies produce Coenzyme Q10 –called ubiquinone –, and Coenzyme Q10 is found in all of our cells except the red blood cells.  That should tell us something.

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Coenzyme Q10 and metabolic syndrome

Recent scientific studies show that daily Coenzyme Q10 supplements confer beneficial health outcomes in patients diagnosed with metabolic syndrome. Among the improvements associated with the Coenzyme Q10 supplementation are improved serum insulin levels, glucose homeostasis levels, and plasma total antioxidant capacity concentrations.

Until recently, we have not seen much research done concerning the effects of Coenzyme Q10 supplementation on metabolic syndrome.  Now, a start has been made.  The preliminary results show that Coenzyme Q10 supplementation has beneficial effects on serum insulin concentrations, glucose homeostasis parameters, and bio-markers of oxidative stress in patients diagnosed with metabolic syndrome [Raygan].

Dr. Raygan and colleagues have reported in the European Journal of Nutrition that daily supplementation with 100 milligrams of Coenzyme Q10 for eight weeks resulted in the following significantly improved health outcomes for overweight or obese patients aged 45-80 years who had been diagnosed with diabetes and coronary heart disease:

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Dr. Judy’s Coenzyme Q10 research history

When the ubiquinol supplement enters the stomach and when the capsule opens, the ubiquinol begins to oxidize. In the small intestine, the ubiquinol is converted to almost all ubiquinone. In the absorption cells and in the abdominal lymph ducts, the Coenzyme Q10 is initially almost all in the ubiquinone form. The Coenzyme Q10 enters the blood from the lymph. Thus, it appears that ubiquinol is absorbed as ubiquinone and not as ubiquinol. It is then converted back to ubiquinol before entering the blood. From: Dr. Judy’s presentation at the International Coenzyme Q10 Association symposium in Bologna, Italy, October, 2015.

Q. Good morning, Dr. Judy.  Let’s talk about the Coenzyme Q10 research you have done in your career.  But, first, do you remember when you first met Dr. Karl Folkers, the grand old man of Coenzyme Q10 research?

A. Good morning.  Yes, I met Dr. Folkers in 1968.  He had just started the Institute for Bio-Medical Research at UT in Austin.  He came to talk to Dr. Les Geddes and Dr. Lee Baker in the Physiology and Biophysics Department at Baylor University Medical School in Houston, Texas.  He talked to them about the bio-electrical impedance method for non-invasively measuring cardiac function in heart failure patients.

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Coenzyme Q10 Absorption Q & A with Dr. Judy

Long-time Coenzyme Q10 researchers and colleagues of Dr. Judy: Dr. Karl Folkers (left) and Dr. Svend Aage Mortensen, the lead researcher on the Q-Symbio study.

Q.  Good morning, Dr. Judy.  Thank you for taking some time for q10facts.com.  Last time we talked about the safety of Coenzyme Q10.  What about the absorption and bioavailability of Coenzyme Q10?  That has been a special area of research for you at the SIBR Research Institute, I think.

A.  Good morning.  Yes, you are correct.  I have been involved in several clinical studies of the efficacy of Coenzyme Q10 supplementation, but my big interest for the past 20 years has been in testing the absorption and bioavailability of the various Coenzyme Q10 supplements.  Maybe I should start by distinguishing between absorption studies and bioavailability studies.

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Coenzyme Q10 Question & Answer session with Dr. William Judy

Dr. William Judy, Founder and President of the SIBR Research Institute, is one of the leading Coenzyme Q10 experts in the United States and one of the oldest.  His 2007 paper on the absorption and transfer of Coenzyme Q10 is still the seminal paper on the subject.  His research efforts have focused on Coenzyme Q10 and heart failure, cancer, chronic fatigue syndrome, and Prader-Willi syndrome as well as studies of Coenzyme Q10 absorption and bioavailability.

Good morning, Dr. Judy.  Thank you for taking the time to answer some questions about Coenzyme Q10, the substance that your friend and colleague Dr. Karl Folkers liked to call “the essential bio-nutrient.”

Q. Why did Dr. Folkers call Coenzyme Q10 “the essential bio-nutrient,” Dr. Judy?  Let’s start there.

A. Yes, and you know, I think, that Dr. Emile Bliznakov called Coenzyme Q10 the “Miracle Nutrient” and Dr. Peter Mitchell, the Nobel Prize winner, called it the “Wonder Nutrient.”

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Coenzyme Q10 and exercise and ageing

Coenzyme Q10 supplementation and exercise confer significant heart health benefits and anti-ageing benefits.  The exercise can be aerobic exercise or strength training or both.  The Coenzyme Q10 supplement you choose should be a supplement with well-documented absorption and efficacy.

The biggest difference in elderly (70+) men and women still living at home and still relatively healthy is the extent to which they exercise.  Among elderly adults of the same socioeconomic status, nutrition and lifestyle do not vary much.  Exercise levels do vary considerably.

With the variations in exercise level come variations in ageing.  The question is, what is the role of Coenzyme Q10 status in the elderly and the rate at which they age?

The differences in ageing – manifested in differences in functional capacity, exercise status, and body weight — are connected to Coenzyme Q10 plasma levels and to Coenzyme Q10/cholesterol ratios in plasma.

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Coenzyme Q10 and MS (multiple sclerosis)

What do we know about MS?  It is a disabling disease of the brain and spinal cord.  It is two to three times more common in women than in men. Depending on the nerve damage, people with MS may lose the ability to walk independently.  There is no cure. Fatigue and depression are common symptoms. Now, a study shows that large daily doses of Coenzyme Q10 can reduce the extent of depression and fatigue in MS patients.

Pilot study news:  A new study shows that Coenzyme Q10 supplementation reduces depression and fatigue in multiple sclerosis patients.  This is good news indeed.  Moreover, these are research results that make sense.

We know that Coenzyme Q10 supplementation improves the symptoms of both chronic fatigue syndrome patients [Castro-Marrero 2016] and fibromyalgia patients [Cordero 2013].  At least one study has shown that Coenzyme Q10 supplementation improves the symptoms of depression [Forester 2012].

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More about Coenzyme Q10 and breast cancer

Pink awareness. Very important. Awareness of the risk of breast cancer. We want to be aware, also, of the need for daily Coenzyme Q10 supplementation. Our bodies produce less Coenzyme Q10 as we get older. Breast cancer patients need Coenzyme Q10’s energy producing function and its antioxidant role.

Breast cancer is doubly frightening.  First, there is the fear that the tumor will metastasize, leading to more deadly cancers.  Secondly, there is the dread of the chemotherapy and its adverse effects: the hair loss, the sores in the mouth, the nausea and vomiting, the diarrhea.  But Coenzyme Q10 supplements may help.

How can Coenzyme Q10 help in the fight against breast cancer?  There is research evidence for beneficial effects of Coenzyme Q10 supplements:

  • delay the progression of the tumor [Folkers; Lockwood, Hertz & Lister]
  • reduce levels of oxidative stress and inflammation [Premkumar 2007]
  • reduce the levels of biological markers for breast cancer tumors [Premkumar 2007]
  • increase the number of DNA repair enzymes {Premkumar 2008]

Coenzyme Q10 delays the growth of breast cancer tumors
The Danish ANICA study and the Danish End-Stage Cancer study have shown that daily supplementation with Coenzyme Q10 in combination with other antioxidant nutritional supplements is associated with significant health benefits [Lockwood; Hertz & Lister]:

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Coenzyme Q10 for brain and muscle tissue

Supplementation with Coenzyme Q10 can increase brain mitochondrial concentrations and increase neuro-protective effects.   In addition to providing antioxidant defense against free radical damage, Coenzyme Q10 is essential for the process of cellular energy production.

So, it seems clear that Coenzyme Q10 supplementation is not needed when we are young and healthy, in our teenage years and in our early 20’s.  But … definitely … from our 20s onward, and increasingly as we get older, we need a well-formulated daily Coenzyme Q10 (preferably taken twice daily with meals) … or we need to take nutritional supplements that will enhance our bodies’ bio-synthesis of Coenzyme Q10.  Or both.

Because there is no doubt that we need to maintain functional levels of Coenzyme Q10 in the cell membranes and in the mitochondria, particularly in the brain and muscle tissue.  Coenzyme Q10 is essential in the process of cellular ATP energy production, and Coenzyme Q10 is the most important fat-soluble antioxidant protector of the cells [Littarru].

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