Coenzyme Q10 and the energy starved heart

The number of bean-shaped mitochondria in our cells varies according to the energy needs of the various organs. The cells in organs with high energy needs, e.g. the heart, the liver, the skeletal muscle, will have greater numbers of mitochondria than will the cells of less active organs, e.g. the skin.  Adequate supply of Coenzyme Q10 is necessary to keep the mitochondria actively producing ATP molecules.

Cellular respiration is the name for the process by which the ATP molecules are produced inside the mitochondria in our cells.  Coenzyme Q10 in its oxidized form is an essential component in this process of energy production.

Fewer Coenzyme Q10 molecules in the mitochondria inevitably mean less ATP energy production.  Fewer ATP molecules mean less energy for our cells. 

Heart muscle cells with low Coenzyme Q10 concentrations and with fewer ATP molecules produced make for an energy starved heart.

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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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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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Coenzyme Q10 and exercise in younger and older adults

sevilla-cathedral
Sevilla is famous for its cathedral, Santa Maria de la Sede, the largest Gothic cathedral in the world, built during the 15th century. Sevilla is also famous for its university. Within the university, the Developmental Biology Institute has been doing much research into the nutritional and medical importance of Coenzyme Q10.

Spanish researchers at the Pablo de Olavide University in Sevilla hypothesized that the effect of physical activity on plasma Coenzyme Q10 levels and on plasma Coenzyme Q10/cholesterol ratios might vary according to the age of the individuals engaging in the physical activity. Their results show, for the first time, an apparently different effect of exercise on young people and on older people.

  • Lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the young people more so than in older people who were also exercising. That result was surprising.
  • Moreover, lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the younger people more so than with moderate levels of physical activity in younger people. That result was not surprising.
  • What was most surprising was the data that showed that older people who exercised more often and more intensely had higher levels of Coenzyme Q10 in plasma and higher ratios of Coenzyme Q10 to cholesterol in plasma than did older adults who exercised moderately or who were mostly sedentary. In this respect, the effect of exercise on the older people differed from the effect of exercise on the younger participants [Del Pozo-Cruz 2014].

Coenzyme Q10 and physical activity in young people
In the Spanish study, the young participants had an average age of 20 years plus or minus 2 years.  Two possible explanations come to mind for the lower plasma Coenzyme Q10 levels in highly active younger people:

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Statin medications and Coenzyme Q10

Mevalonate_Pathway
In blocking the body’s production of mevalonate, the statin medications inhibit the production of cholesterol. They also inhibit the body’s bio-synthesis of the essential bio-nutrient Coenzyme Q10, and they inhibit the body’s ability to use dietary and supplemental selenium to make the selenocysteine amino acid that is needed to make vital selenoproteins. Drs. Okuyama and Langsjoen have called for a critical re-evaluation of the guidelines for statin medication use.

There are two issues concerning the use of statin medications that relate to Coenzyme Q10.  

The more serious issue is that several animal and human studies have shown that the administration of statin medications leads to a reduction in the plasma and muscle tissue levels of Coenzyme Q10.  There is no doubt that depletion of Coenzyme Q10 is an unintended consequence of taking statin medications.  Some human trials have shown the extent of the reduction to be 40 % or greater.  Furthermore, ageing seems to play a role in the diminution of Coenzyme Q10 levels caused by the administration of statin medications [Deichmann].  Decreased plasma and heart muscle tissue levels of Coenzyme Q10 are associated with the increasing severity of heart failure [Folkers, Mortensen].

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Coenzyme Q10 and immune system activity

innate-immunity
The protective antioxidant function of Coenzyme Q10 in neutralizing harmful free radicals is well known. How Coenzyme Q10 modulates the immune system is less well researched. The Brauner study suggests that Coenzyme Q10 supplementation improves natural killer cell activity and reduces the extent of inflammatory processes.

What is the effect of Coenzyme Q10 supplementation on the functioning of the immune system?  We know that randomized controlled trials of Coenzyme Q10 supplementation have shown the beneficial role of Coenzyme Q10 in the prevention and adjuvant treatment of chronic heart failure and ischemic heart disease.  We know that Coenzyme Q10 supplementation has been shown to be especially important for patients on statin medications and for middle-aged and elderly healthy individuals whose bodies no longer produce as much Coenzyme Q10 as in earlier years.  What about Coenzyme Q10 supplements for patients whose immune system is weak?

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Coenzyme Q10 and energy for the immune system

woman-sneezing
The immune system protects us against bacterial and viral infections. Coenzyme Q10 is an important bio-nutrient for the optimal functioning of the immune system. It helps to provide energy for the bio-synthesis of immune system cells and energy for the activities of immune system cells.

Energy starvation in the immune system?  Immune system cells starved for energy?  There is a very plausible theory that chronic heart failure is a disease caused by the energy starvation of the heart muscle cells.  Lacking adequate Coenzyme Q10 – an indispensable component of the human cell respiration and oxidative phosphorylation process – the heart muscle cells produce less ATP than is needed to supply the cells with energy. (A concomitant theory holds that Coenzyme Q10, in its reduced form, also protects the heart muscle cells against oxidative damage.)

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The antioxidant function of Coenzyme Q10

woman-leaning-against-the-tree
To live as long in life as we can and stay as young as we can, we need the protection of antioxidants. Coenzyme Q10 is, practically, a human immune system in itself. It quenches harmful free radicals and keeps them from damaging our cells and our DNA.

One theory to explain the process of aging is that there is an accumulation of oxidative damage through the years.  Oxidative damage is the damage to cells and DNA and lipids that occurs as a result of an excess of reactive oxygen species (also called free radicals) beyond the body’s ability to neutralize the harmful free radicals.  The free radical theory of aging presupposes higher free radical production and lower antioxidant protection in older adults.  In accordance with this theory, the use of supplements with antioxidant effects such as Coenzyme Q10, selenium, vitamin C, vitamin E, and various carotenoids and flavonoids is desirable.

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Dr. Judy explains Coenzyme Q10 and the Q cycle

Woman in front of water
As we get older, we need a good Coenzyme Q10 supplement. Once we pass our 20’s, our bodies produce less and less Coenzyme Q10, and we do not get enough in our diets to make up the difference.

Coenzyme Q10, the essential bio-nutrient, is categorized as a redox molecule.  The Coenzyme Q10 molecules exist in three different forms as they take part in redox reactions in the body.  It is the ability of the Coenzyme Q10 molecules to give up or take on one or two electrons that makes Coenzyme Q10 so valuable both in the process of cellular energy production and in cellular antioxidant activities.

What is a redox reaction?
Redox is short for reduction-oxidation.  Redox reactions are quite common in nature.  Such everyday processes as combustion (burning), corrosion (rusting), photosynthesis (converting sunlight into energy), and respiration (exchanging gases between the blood and the tissue fluids) involve redox reactions.

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