Chronic, low-grade, systemic inflammation is common in many diseases: cardiovascular disease, metabolic syndrome, non-alcoholic fatty liver disease, obesity, type-2 diabetes [Zhai 2017]. Anti-inflammatory drugs give modest improvement at best and are associated with long-term adverse effects [Esser 2015]. Some researchers have begun to investigate whether Coenzyme Q10 as an adjunctive treatment has anti-inflammatory health benefits.
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.
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:
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:
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:
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].
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.
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].
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:
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: