Absorption and Transport of Coenzyme Q10

Oxidation. We know it from rusting cars and rancid butter. It is the loss of electrons in chemical reactions. The opposite process is called reduction. Reduction is the gain of electrons. Coenzyme Q10 molecules are redox molecules. That means, we can take CoQ10 supplements in their oxidized form, ubiquinone, and be confident that it will be converted to the reduced form, ubiquinol, which is the form that acts as an antioxidant and protects against the oxidation of cells and fats and proteins and DNA.

Coenzyme Q10 supplements are not all the same.  Some give a much better absorption than others. To get real value for the money we spend on CoQ10 supplements, we need to seek out and buy a product with documented good absorption.

A randomized controlled study done in 2018 has shown that a patented ubiquinone Coenzyme Q10 supplement gives significantly better absorption than a patented ubiquinol supplement [Lopez-Lluch 2018].

Dissolving Coenzyme Q10 crystals to single molecules

The Coenzyme Q10 raw material is a crystalline powder.  These crystals cannot diffuse into the intestinal absorption cells.  The crystals will pass right through the intestinal tract and will be eliminated in the feces.

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Choosing a ubiquinone Coenzyme Q10 supplement

Professor Guillermo Lopez-Lluch and a research team tested seven different CoQ10 supplement formulations containing 100 mg of CoQ10 in 14 young, healthy individuals. The researchers measured CoQ10 bio-availability as area under the curve of plasma CoQ10 levels over 48 hours after the ingestion of a single dose. They repeated the measurements in the same group of 14 volunteers in a double-blind crossover design with a minimum of 4-week washout between intakes. The research results showed that there were statistically significant variations in the bio-availability of the CoQ10 formulations. The best absorbed CoQ10 formulation was a formulation containing ubiquinone (oxidized CoQ10) dissolved in a soy oil matrix.

The first-ever head-to-head comparative bio-availability study has shown that a patented ubiquinone Coenzyme Q10 preparation gives a significantly better absorption and bio-availability than a patented ubiquinol product.

That is what happened in the double-blind, cross-over study conducted by researchers at the Pablo de Olavide University in Sevilla, Spain, in 2018 [Lopez-Lluch 2019].  

This is important for several reasons:

Until this study in 2018, there had never been a head-to-head comparison study of the bio-availability of a ubiquinone CoQ10 supplement and a ubiquinol supplement [Judy 2018].

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Not all Coenzyme Q10 supplements are the same

Dr. William V. Judy, founder and president of SIBR Research Institute, has done studies showing that oral ubiquinol is converted to ubiquinone prior to its absorption in the small intestines. In the lymph, it is converted back to the ubiquinol form. It makes sense that the CoQ10 is primarily in the ubiquinol form in the lymph and blood because, there, the need for Coenzyme Q10’s antioxidant properties is greater than the need for the bio-energetics function of the ubiquinone form.

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.

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Coenzyme Q10: a new comparative bio-availability study

Professor Guillermo López-Lluch listens to a comment from professor emeritus Gian Paolo Littarru at the 9th conference of the International Coenzyme Q10 Association in New York, June 24, 2018.

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

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Highlights of the 9th International Coenzyme Q10 Association Conference

The 9th Conference of the International Coenzyme Q10 Association was held June 21 – 24 in the Faculty House at Columbia University in New York. Researchers from many different countries and continents attended.

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.

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Dr. Judy speaks on the formulation of Coenzyme Q10 supplements

Dr. William Judy, founder and president of the SIBR Research Institute, says the manufacturer of a Coenzyme Q10 supplement needs three things in the soft-gel capsule together with the 100 milligrams of dissolved Coenzyme Q10 crystals: A solvent in which the Coenzyme Q10 crystals are dissociated, a stable formulation that will prevent the re-crystallization of the Coenzyme Q10 inside the capsule, and one or more lipids that, ingested together with the Coenzyme Q10, will enhance the absorption of the Coenzyme Q10.

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].

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Coenzyme Q10 therapeutic applications

Evidence from randomized controlled trials like the Q-Symbio study show the efficacy of Coenzyme Q10 adjuvant treatment in improving the symptoms and survival of chronic heart failure patients. Illustration courtesy of Dr. William Judy, SIBR Research Institute.

For 30-plus years now, bio-medical researchers have investigated and documented the functions of Coenzyme Q10 in the human body:

  • An essential role in cellular production of ATP energy [Littarru 2007]
  • An important antioxidant role preventing the oxidation of proteins, lipids, and DNA [Littarru 2007]
  • A role in the enhancement of endothelial function [Littarru 2011]
  • A beneficial role in the expression of genes involved in human cell metabolism, signaling, and transport [Garrido-Maraver]

Moreover, the scientific documentation shows that Coenzyme Q10 supplements are safe, are well-tolerated, and are effective as adjunctive treatments in diseases involving high cellular and tissue demands for energy and in diseases involving oxidative stress and oxidative damage [Garrido-Maraver].

Absorption and Bio-Availability of Coenzyme Q10

As we get older, our bodies produce less Coenzyme Q10 [Kalén].  It is not realistic to make up the difference in the diet [Judy].  Supplementation is necessary.

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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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