Researchers in the United Kingdom are developed the methodology for a new randomized controlled trial of the efficacy of Coenzyme Q10 adjunctive treatment of heart failure patients.
Two earlier randomized controlled studies have produced results suggesting that daily supplementation with Coenzyme Q10 substantially reduces the morbidity and mortality in patients who are at risk for or have been diagnosed with heart failure.
Q-Symbio Study: Daily supplementation with 300 milligrams of Coenzyme Q10 for two years significantly improved the symptoms, quality of life, and survival of chronic heart failure patients [Mortensen 2014].
The nutritional supplement Coenzyme Q10 is non-toxic and without any noteworthy safety concerns [Hathcock; Ikematsu].
Coenzyme Q10 is very well-tolerated, and it does not cause any notable adverse effects at daily dosages as high as 1200 milligrams per day [Hathcock].
Studies of healthy individuals and studies of individuals with kidney impairment and liver impairment have not shown any potential for an adverse effect of CoQ10 supplementation on the kidneys or on the liver [Watson; Mabuchi; Farhangi].
A randomized, double-blind, placebo-controlled study enrolling healthy study participants showed no dose-related changes in hematology, blood biochemistry, and urinalysis [Ikematsu].
Moreover, plasma CoQ10 concentrations after an 8-month period of withdrawal from CoQ10 supplementation were nearly the same as before the supplementation [Ikematsu].
Importance of CoQ10 nutritional supplements
Note: Coenzyme Q10 is arguably the most important nutritional supplement for healthy individuals above the age of 40. Cellular bio-synthesis of CoQ10 begins to slow down once we are past our 20s and lessens then with increasing age [Kalén].
CoQ10 in its oxidized form (ubiquinone form) is an essential co-factor in the process of cellular energy production.
CoQ10 in its reduced form (ubiquinol form) is an important fat-soluble antioxidant, protecting the cells against free radical damage.
CoQ10 is associated with significant improvement in endothelial function [Gao].
Coenzyme Q10 is a necessary supplement for patients taking statin medications as the use of statin medications inhibits the bio-synthesis of CoQ10 [Okuyama].
Daily supplemental dosages of CoQ10
A typical daily nutritional supplement dosage is 100 milligrams per day.
A typical therapeutic dosage for adjuvant treatment of chronic heart failure is 300 milligrams a day, taken as 3 times 100 milligrams with meals [Mortensen].
There are no reports in the bio-medical literature of any potential for an acute intoxicating overdose in humans.
The estimated observed safe level of daily CoQ10 intake for adults is set at 1200 milligrams per day [Hathcock].
The few adverse effects reported in conjunction with Coenzyme Q10 supplementation – primarily nausea and other minor gastrointestinal effects – have been no more common at 1200 milligrams per day than at 60 milligrams per day [Hathcock].
1200 milligrams per day is four times the daily amount of CoQ10 supplementation that resulted in the significantly improved symptoms and survival of chronic heart failure patients [Mortensen] and six times the amount that helped reduce the risk of death from heart disease in healthy senior citizens [Alehagen].
The highest daily dose of CoQ10 that has been investigated is 3600 milligrams per day for 12 weeks [Hyson].
Very low rate of mild adverse effects of CoQ10 supplementation
A 2003 survey of 13 randomized controlled studies of CoQ10 supplementation of heart failure patients as well as of open-label studies in heart failure showed that 200 milligrams of CoQ10 per day for 6–12 months and 100 milligrams per day for up to 6 years resulted in no major side effects. The survey showed a rate of mild adverse effects at less than one-half of one percent [Mortensen].
Congestive heart failure. Chronic heart failure. The inability of the heart to pump adequate blood to the other body organs. In chronic heart failure, the left ventricular ejection fraction – the percentage of blood leaving the heart each time it contracts – is too low.
The medical term heart failure sounds like a death sentence. It does not mean sudden death, but the prognosis is usually not good. Heart failure is a disease that gets progressively worse.
The results of the Q-Symbio study give us good reason to think that CoQ10 adjunctive treatment, i.e. CoQ10 supplementation in addition to conventional medical treatment, can slow down the progression of the disease and improve the symptoms and the survival of heart failure patients [Mortensen].
The mitochondria – those little bean-shaped organelles inside the cells – are the primary source of cellular energy. Coenzyme Q10, both the Coenzyme Q10 the body synthesizes and the Coenzyme Q10 we get in our food and in supplements, is fundamental to the cellular energy production process. That means that Coenzyme Q10 is fundamental to the normal functioning of all tissues that are dependent on energy metabolism. The retina is an example of such tissue.
Why is Coenzyme Q10 important for patients with diabetic retinopathy?
The number of diabetes patients diagnosed with diabetic retinopathy continues to grow.
We need new methods to prevent and treat diabetic retinopathy, which is a complication of diabetes that is caused by oxidative damage to the blood vessels in the retina.
Oxidative stress – the overproduction of harmful free radicals, also known as reactive oxygen species – is perhaps the primary cause of diabetic retinopathy [Calderon 2017].
Coenzyme Q10 supplements at higher than normal doses (400- 500 milligrams per day) can decrease oxidative stress and increase antioxidant enzyme activity in patients [Sanoobar 2013].
Coenzyme Q10 supplements in the form of ubiquinone improve mitochondrial homeostasis and diminish the breakdown of the energy production process [Rodriguez-Carrizalez 2016].
Antioxidant effect of CoQ10 on mitochondrial function in the retina
Researchers at the University of Guadalajara in Mexico investigated the antioxidant effect of adjunctive Coenzyme Q10 treatment on mitochondrial function in blood cells in patients with diabetic retinopathy [Rodriguez-Carrizalez 2016].
Coenzyme Q10 is a life-time essential supplement for most people as they get on in years. People who especially need a Coenzyme Q10 supplement – heart failure patients and chronic fatigue syndrome patients, for example – will suffer a relapse if they stop taking their daily CoQ10 supplements.
CoQ10 and the constant need for ATP energy
Dr. William Judy, founder and president of the SIBR Research Institute, tells me that the life-long need for Coenzyme Q10 supplementation is related to the cells’ constant need for ATP energy.
Excesses of ATP energy cannot be stored. The cells must produce ATP energy when they need the energy. CoQ10 is a vital co-factor in the production of ATP energy in the cells.
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