The Q-Symbio randomized, double-blind, controlled study of the effect of Coenzyme Q10 supplementation on morbidity and mortality in heart failure shows that adjuvant supplementation of heart failure patients with 300 milligrams of Coenzyme Q10 daily reduces the all-cause risk of death by half [Mortensen 2014]. The 300-milligram dosage was administered in 100-milligram increments three times a day, always with meals. Dr. Svend Aage Mortensen, the lead researcher on the Q-Symbio study, recommended that daily administration of Coenzyme Q10 should become a component of the standard treatment of heart failure [Mortensen 2015].
Coenzyme Q10 has become the third most purchased specialty nutritional supplement according to a recent survey. The number of daily users of Coenzyme Q10 in the United States has risen from some 3 million people in the year 2000 to over 16 million people at present [Sinatra 2018].
There are good reasons for this increase, which the American cardiologist Dr. Stephen Sinatra has explained in a recent electronic book published by the WholeFoods Magazine [Sinatra 2018]. I want to summarize Dr. Sinatra’s reasoning for my readers.
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.
Heart disease continues to be the number 1 cause of death in the developed world. Much research has been done on efforts to modify some of the known risk factors for heart disease:
However, modifying these risk factors alone is not always sufficient to prevent heart disease. Hence, the extensive prescription of statin medications in the United States because changing the lipid profiles of potential heart disease patients is do-able and effective.
But the statin medications are not without adverse effects. Even in generally healthy study participants given moderate statin doses, there can be unfavorable statin medication effects on energy and exertional fatigue. Both simvastatin and pravastatin have been seen to contribute to a significant adverse effect of statins on energy and fatigue with exertion [Golomb 2012; Okuyama and Langsjoen 2015].
Coenzyme Q10 as an adjunctive therapy added to conventional medication improves the symptoms and the survival of heart failure patients. It reduces the number and length of hospitalizations of heart failure patients.
We know this from the documented results of randomized, double-blind, placebo-controlled studies [Morisco; Munkholm; Mortensen].
Coenzyme Q10 adjunctive therapy for heart failure
Recently, Dr. William Judy, founder and president of SIBR Research Institute, told me about an interesting outcome of the early Coenzyme Q10 studies with heart failure patients.
Coenzyme Q10 as a nutritional supplement – if properly formulated – gets an A grade for performance. Coenzyme Q10 goes right to the head of the class on our list of daily nutritional supplements, right up there with vitamin D capsules, organic high-selenium yeast tablets, and fish oil capsules (if we don’t eat as much fish as we should).
Properly formulated Coenzyme Q10 supplements
Right. We want to get a supplement made with pharmaceutical-grade Coenzyme Q10 and manufactured under conditions of pharmaceutical control. We want a Coenzyme Q10 supplement that meets the following criteria:
Q. Good morning, Dr. Judy. You have talked with us about the safety of Coenzyme Q10 supplements, and you have told us that the formulation of the supplement is decisive for the absorption of Coenzyme Q10. Shouldn’t we talk today about why we adults need daily Coenzyme Q10 supplements?
A. Yes, indeed. Coenzyme Q10 is very much needed and, at the same time, very little known by most people. Our bodies produce Coenzyme Q10 –called ubiquinone –, and Coenzyme Q10 is found in all of our cells except the red blood cells. That should tell us something.
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.
The biggest difference in elderly (70+) men and women still living at home and still relatively healthy is the extent to which they exercise. Among elderly adults of the same socioeconomic status, nutrition and lifestyle do not vary much. Exercise levels do vary considerably.
With the variations in exercise level come variations in ageing. The question is, what is the role of Coenzyme Q10 status in the elderly and the rate at which they age?
The differences in ageing – manifested in differences in functional capacity, exercise status, and body weight — are connected to Coenzyme Q10 plasma levels and to Coenzyme Q10/cholesterol ratios in plasma.
Coenzyme Q10 supplements are so safe that I have not spent much time writing about their safety. It would not be much of an exaggeration to say that Coenzyme Q10 supplements are as safe as water. In fact, in study after study, there is no difference in side effects between the Coenzyme Q10 active treatment group and the placebo control group.
We need a good Coenzyme Q10 status. There are two primary reasons why Coenzyme Q10 supplementation provides heart health benefits:
- Coenzyme Q10 is essential to the process of cellular energy production.
- Coenzyme Q10 works as an antioxidant to protect the cells against the damage caused by harmful free radicals.
Let’s look at some of the studies.