Coenzyme Q10 for diabetes patients

diabetes-picture
Some 21 million Americans have diabetes. Diabetes increases the inflammation that is associated with hardening of the arteries (called atherosclerosis). Atherosclerosis increases the risk of heart attack or stroke and the risk of chronic heart failure. Prolonged supplementation with Coenzyme Q10 may have beneficial health effects for diabetes patients.

Twelve weeks of supplementation with Coenzyme Q10 can significantly reduce the levels of oxidative stress associated with diabetes.

Recently, Swedish researchers reported the results of a study of the effects of daily Coenzyme Q10 supplementation on type-1 and type-2 diabetes patients.  Twice a day for a period of 12 weeks, the 22 diabetes patients in the study received 100 milligrams of oral Coenzyme Q10 in the form of ubiquinone.

The patients averaged 57 years of age (type-1 diabetes patients) and 63 years of age (type-2 diabetes patients). They were predominantly male patients [Montano].

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Coenzyme Q10 and chronic low-grade inflammation

Researcher
Long-term adjunctive treatment of chronic heart failure patients with Coenzyme Q10 supplements is safe and has improved the patients’ symptoms and has reduced the patients’ risk of major adverse cardiovascular events.  Now, researchers have begun to investigate whether adjunctive treatment with Coenzyme Q10 reduces chronic low-grade inflammation.

Chronic, low-grade, systemic inflammation is common in many diseases: cardiovascular disease, metabolic syndrome, non-alcoholic fatty liver disease, obesity, type-2 diabetes [Zhai 2017].  Anti-inflammatory drugs give modest improvement at best and are associated with long-term adverse effects [Esser 2015].  Some researchers have begun to investigate whether Coenzyme Q10 as an adjunctive treatment has anti-inflammatory health benefits.

The results of the KiSel-10 study have shown that daily supplementation with 200 milligrams of Coenzyme Q10 and 200 micrograms of SelenoPrecise® selenium significantly reduced the levels of sP-selectin and hs-CRP, both markers for inflammation, as compared to placebo supplementation.

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Coenzyme Q10 and fibromyalgia

Fibromyalgia woman
Fibromyalgia patients have low Coenzyme Q10 levels and low serotonin levels.  Studies done in the Faculty of Medicine at the University of Sevilla, Spain, show that Coenzyme Q10 supplements can restore both Coenzyme Q10 and serotonin levels and can improve the symptoms of depression. Other studies show that Coenzyme Q10 supplementation can inhibit the inflammatory process and reduce oxidative stress damage.

Can we make a convincing argument for fibromyalgia patients to take a daily Coenzyme Q10 nutritional supplement?  If so, what is the basis for the argument?

Fibromyalgia is a complex disorder.  It causes pain, joint stiffness, debilitating fatigue, and difficulty thinking and remembering.  Its cause is not known; its treatment is uncertain.  It affects as many as five million Americans above the age of 18 years.  It affects many more women than men.

Coenzyme Q10 status and fibromyalgia
The first thing to know is that fibromyalgia is associated with low plasma Coenzyme Q10 levels [Garrido-Maraver 2014].

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Coenzyme Q10 and healthy ageing

Elderly couple on the beach
Given the importance of Coenzyme Q10 in the process of cellular energy production and in the process of neutralizing harmful free radicals, it is very important to take a daily Coenzyme Q10 supplement as we grow older.

Coenzyme Q10 is an essential bio-nutrient that is made naturally in the human body.  It is a necessary co-factor in the process of cellular energy production.  It also functions as a lipid-soluble antioxidant protecting our cells against oxidative damage (oxidative damage = damage caused by free radicals that harm cell membranes and cell DNA and proteins and fats in the blood).

Unfortunately, as we pass through our 20s and move into our 30s and 40s and head towards senior citizen status, our cells produce less of this essential substance with increasing age [Kalén]. We know this.

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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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