The proper manufacture of Coenzyme Q10 supplements

Nurse picture
Health professionals know that it is the formulation of the Coenzyme Q10 nutritional supplement that is decisive in the absorption and the heart health effects. It is important to choose a daily Coenzyme Q10 supplement that has documented results in randomized controlled trials.

Coenzyme Q10 supplements are clearly one of the products in today’s America that come in many different formulations.  And, with respect to Coenzyme Q10’s absorption and effectiveness, the important difference is the difference in the formulation.  Dr. William Judy, the director of the SIBR Research Institute, has tested Coenzyme Q10 supplements with absorption rates ranging from below 1% to as high as 8% of a 100-milligram capsule.

Coenzyme Q10 absorption necessary for heart health benefits
That is as good as saying that some Coenzyme Q10 supplements give no absorption of consequence at all.  At the other end of the spectrum, we know that some formulations give an absorption that is associated with statistically significant health benefits.  I am referring, of course, to the results that we have seen in these randomized controlled trials:

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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 improves endothelial function

woman-boxer
Good health and good fitness depend on good blood circulation.  Good blood circulation depends on good endothelial function.  Research shows that taking a daily Coenzyme Q10 supplement is associated with improved endothelial function.  Supplementation with a combination of Coenzyme Q10 and high selenium yeast has significantly reduced the risk of dying from heart disease in elderly KiSel-10 study participants.

How does Coenzyme Q10 supplementation keep the heart young and healthy? The primary explanation is that Coenzyme Q10 is absolutely vital to the cellular process of producing energy, and the heart muscle needs energy constantly.  An energy-starved heart is a failing heart.

A second and also important explanation is that oxidative damage causes the heart muscle cells to age and deteriorate. Coenzyme Q10 has antioxidant and anti-inflammatory effects that can help to prevent the development of atherosclerosis.

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Coenzyme Q10 in muscle tissue cells

Bill Judy Picture
How much of the concentration of Coenzyme Q10 in muscle tissue is endogenous Coenzyme Q10 produced in the muscle tissue cells themselves, and how much is exogenous Coenzyme Q10 entering the tissue from the blood? Dr. Judy remembers that Japanese researchers were the first to determine these cellular levels in muscle tissue. They tagged the plasma Coenzyme Q10 – the Coenzyme Q10 from supplements –with an isotope. Then, afterwards, they measured the Coenzyme Q10 in muscle tissue cells. In their measurements, the tagged exogenous Coenzyme Q10 was about 48% of the total, and the endogenous Coenzyme Q10 was about 52%. Of course, in the case of older people and in cases of cellular Coenzyme Q10 deficiencies (heart failure and chronic fatigue, for example), the levels of exogenous CoQ10 can be expected to exceed the levels of endogenous Coenzyme Q10.

Okay, from solid research results, we know several things about the essential bio-nutrient Coenzyme Q10.

  • our bodies produce Coenzyme Q10, which is an essential substance for our cells’ energy production and for the antioxidant protection of our cells
  • once we reach our 20’s, our body’s own production of Coenzyme Q10 decreases with increasing age
  • statin medications inhibit our bodies’ production of Coenzyme Q10
  • we are very unlikely to get all the Coenzyme Q10 that we need from our food
  • the risk of heart disease and other diseases increases with the lesser availability of Coenzyme Q10
  • we need a daily Coenzyme Q10 supplement.

Coenzyme Q10 levels in tissue cell and in plasma
Basic fact: Plasma Coenzyme Q10 levels will always exceed tissue cell Coenzyme Q10 levels except, possibly, in some very well-conditioned athletes, e.g. soccer players and cross-country skiers and cyclists. In some superior athletes, the tissue cell Coenzyme Q10 levels and the plasma Coenzyme Q10 levels may come close to being equal.

How does Coenzyme Q10 get from the blood to the cells?
Coenzyme Q10 molecules move from the blood into the tissue cells by the process of diffusion.  If plasma Coenzyme Q10 concentrations were lower than the tissue cell Coenzyme Q10 concentrations, then the diffusion of Coenzyme Q10 from the blood into the tissue cells could not take place.  There would need to be some sort of active transport of Coenzyme Q10 into the tissue cells, and we know of no active transport of Coenzyme Q10 into the tissue cells [Judy 2016].

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Dr. Judy speaks about Coenzyme Q10

dr-judy-in-bologna-2015
Dr. William V. Judy delivering remarks about Coenzyme Q10 absorption at the International Coenzyme Q10 Association conference in Bologna, Italy, in October, 2015.

Dr. William V. Judy earned his doctorate degree in physiology and bio-physics in 1971.  He has worked as an aerospace scientist in NASA’s manned spacecraft center and has taught in the Indiana University School of Medicine as a Professor of Physiology.  Dr. Judy has worked in basic and clinical research for 56 years now; the major focus of his research has been on the absorption, efficacy, and safety of Coenzyme Q10.  He was an early colleague of Dr. Karl Folkers, with whom he carried out joint research studies for 21 years.
 
Absorption of Coenzyme Q10 from supplements
Dr. Judy makes the following points about the absorption of Coenzyme Q10:

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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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