Coenzyme Q10 and exercise: what do we know?

exercise-and-coq10
Coenzyme Q10 supplementation performs many roles in the body that benefit athletes and people who exercise. It is an essential co-factor in cellular energy production, it is the most important fat-soluble antioxidant preventing oxidative damage and muscle damage,, and it improves endothelial function.

Does Coenzyme Q10 supplementation improve exercise capacity?  Do we know?  In 2016, Professor Julio J. Ochoa and his colleagues at the University of Granada in Spain conducted an exhaustive review of the published literature about the Coenzyme Q10 supplementation and exercise.  The researchers did database searches and found 372 journal articles about Coenzyme Q10 and exercise.  An amazing number.

Variation in the Coenzyme Q10 and exercise studies
Of course, the results of the studies reported in the 372 journal articles varied quite a bit for a variety of reasons:

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Coenzyme Q10: the best of q10facts.com — part II

emergency-room
Daily supplementation with 200 milligrams of Coenzyme Q10 has been shown to reduce the number of hospitalizations and re-hospitalizations of chronic heart failure patients. The use of Coenzyme Q10 as an adjuvant treatment improves the quality of life for patients and reduces the expenses of health care systems.

Last month, I wrote brief summaries of some of the best articles that have been published on this website.  This month, I want to present summaries of several more good q10facts.com articles about the health benefits of Coenzyme Q10 supplementation.  The information in all of these articles is based on clinical study results published in peer-reviewed bio-medical journals.  In each summary, there is a link to the original article.

Fewer hospitalizations with Coenzyme Q10
In the Q-Symbio study, 420 chronic heart failure patients on conventional heart failure medications were randomly assigned to an adjuvant Coenzyme Q10 treatment group (n=202) or to a placebo control group (n=218).  In the study, Dr. Svend Aage Mortensen and his fellow researchers wanted to test the hypothesis that the condition of the energy-starved heart could be improved by the use of Coenzyme Q10 supplementation.

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Coenzyme Q10: The best of q10facts.com

Karl Folkers
Dr. Karl Folkers, the researcher who established the chemical structure of the Coenzyme Q10 molecule and who developed the biochemical rationale for the use of Coenzyme Q10 as an adjuvant treatment of chronic heart disease, called Coenzyme Q10 the “essential bio-nutrient.”

In this article, I look back over the past 80 q10facts.com articles and pick out my favorites.  Together, these articles give a good picture of what I have tried to present on this website: documented results from scientific studies of the absorption, safety, and efficacy of Coenzyme Q10 supplements in the form of ubiquinone.  At the present time, there simply is not the same quality or quantity of research results related to the use of Coenzyme Q10 supplements in the ubiquinol form.

Coenzyme Q10’s therapeutic value
This article summarized the clinical research evidence for the use of Coenzyme Q10 as an adjunctive therapy for the following patients:

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Coenzyme Q10’s therapeutic value

blister-pack
Human bio-synthesis of Coenzyme Q10 peaks in the early 20s and then declines with increasing age. Supplementation is necessary to provide adequate intakes of the substance for energy production and antioxidant defense. Coenzyme Q10 dissolved in vegetable oils and sealed in gelatin capsules has shown impressive health benefits in randomized controlled trials: Q-Symbio study, KiSel-10 study, and Gulf War Veterans study.

Coenzyme Q10 is a marvelously versatile natural substance.  It is essential for cellular energy production, and it is an important lipid-soluble antioxidant.  Its use as a daily supplement in conjunction with conventional medicines can give heart patients valuable health benefits.

In a 2015 review article, Professor Dr. Roland Stocker of the Medical College, University of New South Wales, in Sydney, Australia, and colleagues evaluated the potential therapeutic value of Coenzyme Q10 supplements:

  • for heart failure patients
  • for patients with high blood pressure
  • for ischemic heart disease patients
  • for cardiac surgery patients
  • for patients taking statin medications

We want to look at the evidence presented in this review article [Ayer 2015].

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Coenzyme Q10: ubiquinone or ubiquinol?

Q10 crystals
Formulation of the Coenzyme Q10 supplements is very important. How do we know which producers of Coenzyme Q10 supplements can take the raw material, pictured here, and dissolve it in lipids and seal it in capsules so that it gives good health effects?

Recently, some readers have written in asking what my problem with the ubiquinol version of Coenzyme Q10 supplements is.  Let me try to answer that question.  I don’t think that I have a problem with ubiquinol itself.  I have great respect for ubiquinol’s utility as a lipid-soluble antioxidant.  The problem that I have tried to address on q10facts.com is the misleading nature of the marketing claims and the stretching of scientific facts in many of the marketing claims for the ubiquinol products.

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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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Coenzyme Q10 and older adults and fitness

woman golfing
More physical activity is positively associated with higher plasma levels of Coenzyme Q10 in older adults. CoQ10 is vital for the process of cellular energy production and for antioxidant protection of the cells and plasma lipoproteins.

A 2014 study has shown that greater fitness among older adults is associated with the following health benefits:

  • higher levels of plasma Coenzyme Q10
  • lower levels of lipid peroxidation (degradation of lipids)
  • lower levels of cholesterol

The study participants – 19 men and 24 women – had an average age of 71 years.  The data from the study show that physical activity in the senior years can increase plasma concentrations of Coenzyme Q10 and can reduce the presence in plasma of a well-established bio-marker for oxidative stress [Del Pozo-Cruz 2014].

Coenzyme Q10 and oxidative stress
In the daily course of our using food and oxygen to make energy, we produce dangerous by-products called free radicals.  Exposure to radiation and environmental toxins also produces harmful free radicals in our bodies.

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Coenzyme Q10 and the NQO-1 gene

Cyclist
Coenzyme Q10 is a fat-soluble redox molecule that we produce in nearly all cells in the body. Once we reach our 20’s, our body’s synthesis of Coenzyme Q10 begins to decline with increasing age. But our need for Coenzyme Q10 continues, both in the process of producing ATP energy molecules and in the cells’ defense against harmful free radicals. Consequently, we need a good daily supplement.

NQO1 gene? … NQO-1 enzymes? … I don’t remember reading or hearing about the NQO-1 gene in all of the years that I have been taking Coenzyme Q10 supplements. But, for Dr. William Judy, the NQO-1 gene seems to be one of the three or four Q10 questions that he has been most preoccupied with for several years.

NQO-1 gene important in the biochemistry of Coenzyme Q10
NQO-1 is used as shorthand for both the gene and the oxidoreductase enzymes that the gene codes for.  The NADPH-Quinone Oxidoreductase-1 gene –  to give it its full name –  is the gene that codes in humans for the production of enzymes that reduce quinones to hydroquinones.

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Coenzyme Q10: It’s the formulation that’s important!

Woman making food
To stay as healthy as we can as late in life as possible, we need to eat properly. We also need a daily Coenzyme Q10 nutritional supplement. The Q-Symbio study and the KiSel-10 study have shown the heart health benefits of Coenzyme Q10 supplementation. Those studies show, moreover, that older adults benefit from a Coenzyme supplement based on the ubiquinone form.

What is becoming more and more apparent about the absorption of Coenzyme Q10 nutritional supplements?  I have been putting together the information that I have been reading and hearing.  Here is what seems to be the case:

Raw material Coenzyme Q10: not the big difference maker
The Coenzyme Q10 raw material from the biggest producers of the dry powder crystalline substance seems to be comparable to a high degree. There seems to be equivalency of quality in the Coenzyme Q10 raw material.  What counts is how the maker of Coenzyme Q10 supplements processes that raw material.

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A reader’s comments about Coenzyme Q10

Women at computer
On the Web, there are many poorly documented marketing claims about the absorption of the ubiquinol form of Coenzyme Q10 supplements. A reader has written in to ask about these claims. At this point, there is much more documented evidence for the absorption and the health effects of the more stable ubiquinone form of Coenzyme Q10.

Here, immediately below, is a comment that a reader of the q10facts blog has sent in.  I reproduce the comment here with his permission because it raises interesting questions that deserve to be addressed more fully than in a reply to a comment.  Underneath the reader’s comment, then, I try to pull together my thoughts on the discussion of ubiquinone and ubiquinol supplements.

The reader’s comments
I am a slightly unusual individual because I have some sort of serious metabolic disease (it may be one called MELAS), which results in severely depleted energy in the cells, and the first thing that fails in my case are the nerves causing me to go into a semi-demented confusion, which I have experienced for “months” at a time in recent years (I am 60).

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