Big new Coenzyme Q10 in heart failure study proposed in the UK

The thickened heart muscle makes it more difficult for the heart to pump out adequate quantities of blood. Source: Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2).

Researchers in the United Kingdom are developed the methodology for a new randomized controlled trial of the efficacy of Coenzyme Q10 adjunctive treatment of heart failure patients.

Two earlier randomized controlled studies have produced results suggesting that daily supplementation with Coenzyme Q10 substantially reduces the morbidity and mortality in patients who are at risk for or have been diagnosed with heart failure.

Q-Symbio Study: Daily supplementation with 300 milligrams of Coenzyme Q10 for two years significantly improved the symptoms, quality of life, and survival of chronic heart failure patients [Mortensen 2014].

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Coenzyme Q10 is a life-long essential supplement

Dr. William V. Judy, founder and president of SIBR Research Institute, has done studies of Coenzyme Q10 supplementation of patients with chronic heart failure and chronic fatigue syndrome. Generally, after 10 -12 weeks of supplementation, the patients’ symptoms and quality of life improve significantly. However, if the supplementation is stopped, the patients suffer a relapse to their previous condition. Coenzyme Q10 supplementation is a life-long adjuvant therapy.

Coenzyme Q10 is a life-time essential supplement for most people as they get on in years.  People who especially need a Coenzyme Q10 supplement – heart failure patients and chronic fatigue syndrome patients, for example – will suffer a relapse if they stop taking their daily CoQ10 supplements.

CoQ10 and the constant need for ATP energy

Dr. William Judy, founder and president of the SIBR Research Institute, tells me that the life-long need for Coenzyme Q10 supplementation is related to the cells’ constant need for ATP energy.

Excesses of ATP energy cannot be stored.  The cells must produce ATP energy when they need the energy.  CoQ10 is a vital co-factor in the production of ATP energy in the cells.

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Coenzyme Q10 supplements: cheaper is not a good investment

In a double-blind, cross-over study, Professor Guillermo Lopez-Lluch and a team of researchers at the Pablo de Olavide University in Sevilla, Spain, have demonstrated that the composition and the formulation of the supplement is very important to the absorption and bio-availability of the Coenzyme Q10.

On this website, we review the results of clinical trials of the effects of oral Coenzyme Q10 supplementation.  We high-light human studies that show the following significant health benefits of taking a well-formulated CoQ10 supplement:

  • Improved symptoms and survival of heart failure patients
  • Reduced risk of death from heart disease and better maintained heart function among senior citizens
  • Improved quality of life for chronic fatigue syndrome patients
  • Faster recovery with fewer complications following heart surgery
  • Lowered systolic and diastolic blood pressure
  • Reduced frequency and intensity of migraine headaches

Why the need for CoQ10 supplementation?

Bio-synthesis of CoQ10 falling with increasing age.

Yes, our bodies do synthesize Coenzyme Q10 in almost all cells; however, the bio-synthesis of Coenzyme Q10 is a complicated multi-step process, and the extent of Coenzyme Q10 bio-synthesis decreases with increasing age once we pass our 20s.

Insufficient uptake of CoQ10 from the diet.

Moreover, it is difficult to get enough Coenzyme Q10 from our food alone to make up the difference in the declining endogenous production of CoQ10.  Remember, too, that it becomes more difficult to extract nutrients from our food as we get older.

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Coenzyme Q10: the European Q-Symbio study analysis

Biochemist Anne-Louise Mortensen shows that serum Coenzyme Q10 levels above 3.0 micrograms per milliliter can be achieved through daily supplementation with 300 milligrams of a patented ubiquinone Coenzyme Q10 supplement. The outcomes of the long-term supplementation of chronic heart failure patients were reduced risk of death from heart disease, reduced risk of death from all causes, reduced incidence of hospitalization, and reduced incidence of other major adverse cardiovascular events.

The Q-Symbio randomized, double-blind, placebo-controlled study of the effect of Coenzyme Q10 adjunctive treatment on the symptoms, adverse cardiovascular events, and survival of chronic heart failure patients is the single best Coenzyme Q10 clinical study that we have.

The Q-Symbio study was a two-year multi-center study enrolling 420 patients with moderate to severe heart failure.  The patients were randomly assigned to an active treatment group receiving 100 milligrams of Coenzyme Q10 three times a day or to a group taking matching placebos three times a day [Mortensen 2014].  The Coenzyme Q10 or placebo treatment was given in addition to the conventional heart failure medication.  The patients were recruited for the study in several European, Asian, and Australian countries.

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Highlights of the 9th International Coenzyme Q10 Association Conference

The 9th Conference of the International Coenzyme Q10 Association was held June 21 – 24 in the Faculty House at Columbia University in New York. Researchers from many different countries and continents attended.

What did the leading Coenzyme Q10 researchers have to say in New York?

  • Coenzyme Q10 has three primary fields of activity in the body: as a co-factor in the energy production process in the cells, as a fat-soluble antioxidant protecting cells against oxidative damage, and as a regulator of endothelial function.  In addition, Coenzyme Q10 has anti-inflammatory properties and plays a role in proper cell signaling activity.
  • The most recently published data from the KiSel-10 study done in Sweden shows that the beneficial heart health effects of supplementation of elderly live-at-home individuals with a combination of Coenzyme Q10 and high-selenium yeast have persisted through year 12.
  • A bio-availability study done at a university in Spain shows that the formulation of the Coenzyme Q10 supplement is even more important than the form of the supplement.  The absorption of a well-formulated ubiquinone Coenzyme Q10 supplement is better than the absorption of a ubiquinol supplement.
  • A sub-group analysis of the data from the Q-Symbio study of the effect of adjunctive Coenzyme Q10 treatment on European chronic heart failure patients shows even better results for Europeans than for all patients in the multi-center study.
  • Studies show that there may be interactions between Coenzyme Q10 and other nutritional supplements, meaning that we should be careful not to take these supplements at the same time we take our Coenzyme Q10.
  • The consensus at the conference was that the therapeutic level of Coenzyme Q10 in the plasma or serum is somewhere between 2.5 and 3.5 micrograms per milliliter.  Above 4.0 micrograms per milliliter, the beneficial effect of Coenzyme Q10 supplementation is thought to flatten out.
  • Statin medications only deprive the body of Coenzyme Q10 by inhibiting the bio-synthesis of Coenzyme Q10 just as they inhibit the bio-synthesis of cholesterol.  Now there is evidence that long-term use of statins has undesirable effects on cognitive function and on memory in particular.  The statins easily cross the blood-brain barrier and adversely affect the protective myelin sheaths in which cholesterol is a key component.

More about these topics below.

The 9th conference of the International Coenzyme Q10 Conference at Columbia University in New York

Every three years, the International Coenzyme Q10 Association (ICQA) holds a conference at which researchers from around the world present their research findings related to Coenzyme Q10.  This year, the conference was held at Columbia University in New York the 21st-24th of June. Many of the presentations and papers concerned the biochemistry of Coenzyme Q10’s effects.

In this article, I want to focus in on the presentations of results from human clinical studies.  In the clinical area, the emphasis was demonstrating the importance of Coenzyme Q10 supplementation to heart health, healthy ageing, and better quality of life.

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Coenzyme Q10 and statin medications

A set of pharmacological mechanisms suggests that the use of statin medications may be stimulating the development of atherosclerosis and chronic heart failure.  Japanese and American researchers have documented the mechanisms by which statin medications may be causing coronary artery calcification.  They propose that the guidelines regulating the use of statin medications be critically re-evaluated [Okuyama 2015].

Statin medications reduce total and bad cholesterol levels but may not reduce the extent of atherosclerosis or the risk of chronic heart failure.                         Attribution: By BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons.
If the researchers are correct, then, yes, statin medications do reduce total cholesterol and bad cholesterol levels.  However, statin medications may not reduce the incidence of coronary heart disease.  Furthermore, statin medications may be at least partially responsible for the increased incidence of chronic heart failure that has been observed in the period since statin medications were introduced in 1987.

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Coenzyme Q10 as heart failure medicine

Chronic heart failure is characterized by an energy starved heart.  The Q-Symbio study’s lead researcher, Dr. Svend Aage Mortensen, treated chronic heart failure patients with 300 milligrams of Coenzyme Q10 daily as an adjunctive treatment to the conventional heart failure medications. His thinking was that the conventional treatments block rather enhance cellular processes and do not address the heart muscle cells’ need for the cofactor Coenzyme Q10 in the ATP energy production process. He used Coenzyme Q10 supplements to address the dysfunction of cellular bio-energetics that is associated with heart failure.

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].

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Coenzyme Q10 and heart health

Coenzyme Q10, also known as ubiquinone, is a fat-soluble substance that is similar to a vitamin but is synthesized in our bodies. In adulthood, the body’s synthesis of Coenzyme Q10 declines with increasing age.  Furthermore, statin medications inhibit the body’s production of Coenzyme Q10. Supplementation is nearly always necessary; it is not possible to make up deficits of Coenzyme Q10 by careful eating. Optimal concentrations of Coenzyme Q10 in the blood and in the heart muscle tissues is especially important for good heart health.

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.

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Coenzyme Q10 therapeutic applications

Evidence from randomized controlled trials like the Q-Symbio study show the efficacy of Coenzyme Q10 adjuvant treatment in improving the symptoms and survival of chronic heart failure patients. Illustration courtesy of Dr. William Judy, SIBR Research Institute.

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.

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Coenzyme Q10 and Red Yeast Rice against Heart Disease

Illustration showing how statin medications block the bio-synthesis of Coenzyme Q10 just as statin medications block the body’s synthesis of cholesterol.  Blocking the bio-synthesis of Coenzyme Q10 ultimately deprives the heart muscle cells of ATP energy and of antioxidant protection.  Illustration courtesy of Dr. William Judy, SIBR Research Institute.

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:

  • Diet
  • Exercise
  • Lifestyle

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].

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