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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Coenzyme Q10 Question & Answer session with Dr. William Judy

Dr. William Judy, Founder and President of the SIBR Research Institute, is one of the leading Coenzyme Q10 experts in the United States and one of the oldest.  His 2007 paper on the absorption and transfer of Coenzyme Q10 is still the seminal paper on the subject.  His research efforts have focused on Coenzyme Q10 and heart failure, cancer, chronic fatigue syndrome, and Prader-Willi syndrome as well as studies of Coenzyme Q10 absorption and bioavailability.

Good morning, Dr. Judy.  Thank you for taking the time to answer some questions about Coenzyme Q10, the substance that your friend and colleague Dr. Karl Folkers liked to call “the essential bio-nutrient.”

Q. Why did Dr. Folkers call Coenzyme Q10 “the essential bio-nutrient,” Dr. Judy?  Let’s start there.

A. Yes, and you know, I think, that Dr. Emile Bliznakov called Coenzyme Q10 the “Miracle Nutrient” and Dr. Peter Mitchell, the Nobel Prize winner, called it the “Wonder Nutrient.”

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Drugs that deplete Coenzyme Q10

Many different prescription drugs, the statin medications prominent among them, inhibit the bio-synthesis and/or absorption of Coenzyme Q10. And Coenzyme Q10 is vital to life.  We must be mindful of the need for a well-formulated Coenzyme Q10 supplement whenever we are taking a Coenzyme Q10 depleting medication.

There are surprisingly many prescription drugs that inhibit the body’s bio-synthesis of Coenzyme Q10 or inhibit the body’s absorption of Coenzyme Q10 from supplements or both.  Of course, there are many drugs that inhibit the uptake of other nutrients as well, but it is difficult to think of any one supplement that is more important to us as we age.

Coenzyme Q10 is “the essential bio-nutrient” (in the words of the chemist Dr. Karl Folkers), and our bodies produce less and less of it as we get older.  It is practically impossible to make up for the decreased bio-synthesis from food alone.  We, all of us, need a well-formulated Coenzyme Q10 supplement.

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Cheap Coenzyme Q10 in some hospital pharmacies?

Some drug wholesalers may be providing Coenzyme Q10 supplements to the hospital pharmacy based on lowest price instead of based on documented absorption and health effects.  In that case, the chronic heart failure patients will not be getting the absorption and health benefits documented in the Q-Symbio trial.

Imagine my surprise, recently, when I heard from a reliable source that some hospital pharmacies are stocking cheap powder-based Coenzyme Q10 products for use with hospitalized heart failure patients.

I was shocked.

The most important thing about the Coenzyme Q10 supplement is its formulation.  Without a good formulation, there will very poor absorption.  Without good absorption, there can be no real benefit to heart failure patients.

Powder-based Coenzyme Q10 supplements are not going to do the job optimally.

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Factors affecting the absorption of Coenzyme Q10

The Andalusian Center for Developmental Biology at the Pablo de Olavide University in Sevilla, Spain,  has become an important center for Coenzyme Q10 research. Shown here:  a picture of the Plaza de España in Sevilla.

The absorption of Coenzyme Q10 is even more complicated than we realized.  Absorption of Coenzyme Q10 from supplements is difficult.  Okay, we know that.  Dr. William Judy, SIBR Research Institute, has explained why that is.  The formulation and composition of the Coenzyme Q10 capsule are the most important factors in the absorption of the Coenzyme Q10 molecules.

Recently, I watched a video of a presentation by Professor Guillermo López Lluch, University of Sevilla, Spain.  Dr. López Lluch was addressing the members of the International Coenzyme Q10 Association at a symposium in Bangkok, Thailand. He enumerated several factors that may affect the absorption of Coenzyme Q10.

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Coenzyme Q10: head-to-head comparison study of ubiquinone and ubiquinol absorption

What are we looking for in a Coenzyme Q10 nutritional supplement?  We want “full-range documentation” – documentation for good absorption, good response rate, and for health benefits. There is much variation in the formulation and absorption of Coenzyme Q10 supplements. It is best to select one with documented heart health benefits.

What we have been missing until now is a good study comparing the absorption of the more stable ubiquinone Coenzyme Q10 supplements with the absorption of the newer and less stable ubiquinol Coenzyme Q10 supplements head-to-head.  Now, the Coenzyme Q10 researchers at the University of Sevilla in Spain have carried out a direct comparison study in which the same study participants have been tested, with appropriate wash-out periods, on both ubiquinone and ubiquinol supplements.

The result:  One well-formulated ubiquinone Coenzyme Q10 preparation – the same preparation used in the Q-Symbio study, the KiSel-10 study, and the Gulf War Illness study –  has tested out significantly better than the ubiquinol preparation.  This particular ubiquinone Coenzyme Q10 supplement had nearly twice the absorption response as did the ubiquinol supplement in the study.

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Coenzyme Q10 Nutritional Supplements, 1981 to 2016

Gummy bears
Dr. Judy has watched the progression of Coenzyme Q10 supplements from dry powder tablets to dry powder in two-piece hard-gel capsules to dry powder in soybean oil in soft-gel capsules to Coenzyme Q10 dissolved in multiple lipids in soft-gel capsules. Today there are even Coenzyme Q10 gummy bears on the market. But what about the formulation? It is the supplement manufacturer’s formulation of the Coenzyme Q10 raw material that is most important for the absorption and health effects.

In line with other technologies, the production technology for Coenzyme Q10 nutritional supplements has advanced over the years.  For the past 35 years, Dr. William Judy of the SIBR Research Institute has followed the development of the Coenzyme Q10 nutritional supplements produced in the USA and around the world.

Dr. Judy has seen considerable improvement in the formulations of the Coenzyme Q10 nutritional supplements and in their effectiveness as an adjuvant treatment of chronic heart failure and other clinical conditions.  He has seen increasing awareness of the need for Coenzyme Q10 supplements in patients taking statin medications.  He has seen increasing awareness of the health benefits for healthy middle-aged and elderly people.

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Absorption of Coenzyme Q10, part III

Food
As we age beyond our 30s into middle age and old age, our bodies produce less and less Coenzyme Q10, but our need for Coenzyme Q10, especially for good heart health, does not decline. Healthy meals, even meals containing meat and fish, cannot make up the difference. We need a good daily supplement.

In this three-part series of articles, we have been discussing the absorption and bio-availability of the vital bio-nutrient Coenzyme Q10.  As we come into middle age and then into our senior years, we produce less and less Coenzyme Q10 ourselves.  Plus, certain medications — statin medications in particular — inhibit our bodies’ production of Coenzyme Q10 even more.  And, we know that adequate intakes of Coenzyme Q10 are necessary for good heart health and a decent quality of life.

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Absorption of Coenzyme Q10, part II

woman-strength
An adequate supply of Coenzyme Q10 to the heart muscle tissue cells is absolutely essential for good heart health. Coenzyme Q10 is necessary for the production of ATP energy in the cells. An energy starved heart is a failing heart.

Once we have swallowed a Coenzyme Q10 capsule, what happens next? Specifically, what happens as the Coenzyme Q10 flows from the stomach to the blood?  As it turns out, we know a fair amount about the transfer of the Coenzyme Q10.

The basics of Coenzyme Q10 absorption
Dr. William Judy’s study of Coenzyme Q10 absorption in large animals (large dogs that are conscious during the testing) and in humans have resulted in the following understanding:

Coenzyme Q10 is absorbed in the form of ubiquinone
Coenzyme Q10, regardless of whether it is taken in the form of ubiquinone supplements or in the form of ubiquinol supplements, will be absorbed in the small intestine in the form of ubiquinone.

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