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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Drugs that deplete Coenzyme Q10

Many different prescription drugs, the statin medications prominent among them, inhibit the bio-synthesis and/or absorption of Coenzyme Q10. And Coenzyme Q10 is vital to life.  We must be mindful of the need for a well-formulated Coenzyme Q10 supplement whenever we are taking a Coenzyme Q10 depleting medication.

There are surprisingly many prescription drugs that inhibit the body’s bio-synthesis of Coenzyme Q10 or inhibit the body’s absorption of Coenzyme Q10 from supplements or both.  Of course, there are many drugs that inhibit the uptake of other nutrients as well, but it is difficult to think of any one supplement that is more important to us as we age.

Coenzyme Q10 is “the essential bio-nutrient” (in the words of the chemist Dr. Karl Folkers), and our bodies produce less and less of it as we get older.  It is practically impossible to make up for the decreased bio-synthesis from food alone.  We, all of us, need a well-formulated Coenzyme Q10 supplement.

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Coenzyme Q10 and end-stage cancer

Actually, the best cocktail to reach for may be an antioxidant cocktail made with Coenzyme Q10, selenium, antioxidant vitamins, and omega-3 fatty acids.  Clinical studies have shown an anti-cancer effect associated with such a daily adjuvant treatment.

Coenzyme Q10 in combination with selenium and other antioxidant supplements can help to prevent cancer or slow the progression of cancer.  There are several plausible mechanisms that could explain an anti-cancer effect of supplementation with Coenzyme Q10, selenium, and other antioxidants:

  • beneficial effect on cell signaling molecules (cytokines) that are important in immune system response
  • anti-inflammation effect
  • modulating effects on the expression of the tumor suppressor gene p53
  • inhibiting effect on gene mutation
  • inhibiting effect on tumor angiogenesis (angiogenesis = the development of new blood vessels that would feed tumor cells and help them spread)
  • inhibiting effect on oxidative stress [Hertz & Lister]

The results of the ANICA study – the Adjuvant Nutritional Intervention in Cancer study – showed that adjuvant treatment of high-risk breast cancer patients with a cocktail of nutritional supplements including Coenzyme Q10 and selenium can slow the development of the cancer and permit the patients to live longer with the cancer under control [Lockwood].

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Coenzyme Q10 and selenium and breast cancer

Sven Moesgaard, Pharma Nord technical director (left), introduced Dr. Knud Lockwood (right) to Dr. Karl Folkers (center). Dr. Folkers had evidence of low Coenzyme Q10 status in cancer patients. Dr. Lockwood was treating breast cancer patients. The meeting led to the start of the ANICA breast cancer study.

The ANICA study – the Adjuvant Nutritional Intervention in Cancer study – was an open clinical study conducted in Denmark in the 1990s.  It was an interesting study with thought-provoking results.  Its design reflected outside-the-box thinking.

The ANICA study enrolled 32 typical breast cancer patients who were classified high risk because their tumors had spread to the lymph nodes.  The 32 women received the standard breast cancer treatment at the time.  In addition, they were treated with an adjuvant therapy in the form of a combination of various micronutrients.

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