Coenzyme Q10’s therapeutic value

Human bio-synthesis of Coenzyme Q10 peaks in the early 20s and then declines with increasing age. Supplementation is necessary to provide adequate intakes of the substance for energy production and antioxidant defense. Coenzyme Q10 dissolved in vegetable oils and sealed in gelatin capsules has shown impressive health benefits in randomized controlled trials: Q-Symbio study, KiSel-10 study, and Gulf War Veterans study.

Coenzyme Q10 is a marvelously versatile natural substance.  It is essential for cellular energy production, and it is an important lipid-soluble antioxidant.  Its use as a daily supplement in conjunction with conventional medicines can give heart patients valuable health benefits.

In a 2015 review article, Professor Dr. Roland Stocker of the Medical College, University of New South Wales, in Sydney, Australia, and colleagues evaluated the potential therapeutic value of Coenzyme Q10 supplements:

  • for heart failure patients
  • for patients with high blood pressure
  • for ischemic heart disease patients
  • for cardiac surgery patients
  • for patients taking statin medications

We want to look at the evidence presented in this review article [Ayer 2015].

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Coenzyme Q10: ubiquinone or ubiquinol?

Q10 crystals
Formulation of the Coenzyme Q10 supplements is very important. How do we know which producers of Coenzyme Q10 supplements can take the raw material, pictured here, and dissolve it in lipids and seal it in capsules so that it gives good health effects?

Recently, some readers have written in asking what my problem with the ubiquinol version of Coenzyme Q10 supplements is.  Let me try to answer that question.  I don’t think that I have a problem with ubiquinol itself.  I have great respect for ubiquinol’s utility as a lipid-soluble antioxidant.  The problem that I have tried to address on is the misleading nature of the marketing claims and the stretching of scientific facts in many of the marketing claims for the ubiquinol products.

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The antioxidant function of Coenzyme Q10

To live as long in life as we can and stay as young as we can, we need the protection of antioxidants. Coenzyme Q10 is, practically, a human immune system in itself. It quenches harmful free radicals and keeps them from damaging our cells and our DNA.

One theory to explain the process of aging is that there is an accumulation of oxidative damage through the years.  Oxidative damage is the damage to cells and DNA and lipids that occurs as a result of an excess of reactive oxygen species (also called free radicals) beyond the body’s ability to neutralize the harmful free radicals.  The free radical theory of aging presupposes higher free radical production and lower antioxidant protection in older adults.  In accordance with this theory, the use of supplements with antioxidant effects such as Coenzyme Q10, selenium, vitamin C, vitamin E, and various carotenoids and flavonoids is desirable.

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Coenzyme Q10 and older adults and fitness

woman golfing
More physical activity is positively associated with higher plasma levels of Coenzyme Q10 in older adults. CoQ10 is vital for the process of cellular energy production and for antioxidant protection of the cells and plasma lipoproteins.

A 2014 study has shown that greater fitness among older adults is associated with the following health benefits:

  • higher levels of plasma Coenzyme Q10
  • lower levels of lipid peroxidation (degradation of lipids)
  • lower levels of cholesterol

The study participants – 19 men and 24 women – had an average age of 71 years.  The data from the study show that physical activity in the senior years can increase plasma concentrations of Coenzyme Q10 and can reduce the presence in plasma of a well-established bio-marker for oxidative stress [Del Pozo-Cruz 2014].

Coenzyme Q10 and oxidative stress
In the daily course of our using food and oxygen to make energy, we produce dangerous by-products called free radicals.  Exposure to radiation and environmental toxins also produces harmful free radicals in our bodies.

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Dr. Judy explains Coenzyme Q10 and the Q cycle

Woman in front of water
As we get older, we need a good Coenzyme Q10 supplement. Once we pass our 20’s, our bodies produce less and less Coenzyme Q10, and we do not get enough in our diets to make up the difference.

Coenzyme Q10, the essential bio-nutrient, is categorized as a redox molecule.  The Coenzyme Q10 molecules exist in three different forms as they take part in redox reactions in the body.  It is the ability of the Coenzyme Q10 molecules to give up or take on one or two electrons that makes Coenzyme Q10 so valuable both in the process of cellular energy production and in cellular antioxidant activities.

What is a redox reaction?
Redox is short for reduction-oxidation.  Redox reactions are quite common in nature.  Such everyday processes as combustion (burning), corrosion (rusting), photosynthesis (converting sunlight into energy), and respiration (exchanging gases between the blood and the tissue fluids) involve redox reactions.

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Coenzyme Q10 on prescription?

Mother and daughter
We know that the body’s production of Coenzyme Q10 begins to decrease with age once we reach our 20’s, and we know that Coenzyme Q10 plays an important role in both cellular bio-energetics and antioxidant protection. It just makes sense to supplement our diets with Coenzyme Q10 in an attempt to avoid heart failure later on in life.

For as long as I have been writing this blog, I have been wondering why cardiologists are not prescribing Coenzyme Q10 for certain classes of heart disease patients.  Two classes of patients come to mind immediately: chronic heart failure patients and patients taking statin medications.  Let’s look at the evidence for heart failure patients. (We can talk about patients on statin medications next week.)

Coenzyme Q10 and chronic heart failure
Chronic heart failure.  Heart failure.  It sounds scary.  It is scary.  The words “heart failure” do not mean that the heart has stopped working.  What heart failure means is some combination of the following conditions:

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Dr. Judy explains Coenzyme Q10 absorption

Bill Judy Picture
Dr. William Judy, founder and director of the SIBR Institute, is arguably the world’s leading expert on Coenzyme Q10 absorption. He has led numerous lab studies and animal studies and clinical trials on the absorption and effects of Coenzyme Q10 preparations.

We know that Coenzyme Q10 is an essential co-factor in at least three important processes in the body: cellular energy production, cellular and lipid antioxidant defense, and regulation of endothelial cell function. We know that our adult bodies produce less Coenzyme Q10 with increasing age, and we know that most of us cannot make up the difference through the food that we eat [6]. From the age of 40 on, we need a good Coenzyme Q10 supplement daily.  I asked Dr. William Judy what is involved in getting a good Coenzyme Q10 supplement.

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Coenzyme Q10 and people taking statin medications

Yes, cholesterol lowering statin medications have proven to be effective at lowering cholesterol. Yes, statin medications are generally well-tolerated. But … statin medications inhibit the body’s synthesis of Coenzyme Q10. Anyone taking a statin medication needs to be taking a supplement to restore the depleted Coenzyme Q10.

Last week, we looked at the question of Coenzyme Q10 supplementation for chronic heart failure patients.  We know that chronic heart failure patients have abnormally reduced levels of Coenzyme Q10 in both their blood and their heart muscle tissue [Folkers 1985, Kitamura 1984].  We know that supplementation with Coenzyme Q10 can increase blood Coenzyme Q10 levels and can improve outcomes in the treatment of chronic heart failure and in coronary artery bypass surgery [Morisco 1993, Mortensen 2014, Rosenfeldt 2002].

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Coenzyme Q10 and inflammation

Beautiful woman
Being healthy and in good physical condition means having low levels of inflammation in our bodies. A simple blood test of the levels of C-reactive protein in our blood shows the level of inflammation. The CRP levels predict the risk of heart disease and stroke. Daily supplementation with Coenzyme Q10 and the trace element selenium has been shown to reduce CRP and inflammation levels.

Data from gold standard studies – randomized, double-blind, placebo-controlled studies – indicate that daily supplementation with Coenzyme Q10 significantly reduces the levels of C-reactive protein (CRP) in the body.  Our bodies produce CRP as a by-product of the inflammation process.  Consequently, increased levels of CRP in the blood indicate increased levels of inflammation.

Inflammation and increased risk of heart disease
Inflammation of our arteries is positively associated with an increased risk of heart disease and heart attack and stroke. Moreover, increased inflammation can be an indicator of other conditions such as infections and arthritis.

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Coenzyme Q10 and biological markers for heart failure

Beautiful girl
Good health depends upon the optimal functioning of the cells. Optimal functioning of the cells depends upon the availability of Coenzyme Q10 for energy production and for antioxidant protection. There is, moreover, a vital interrelationship between Coenzyme Q10 and selenium that promotes the optimal functioning of the cells.

People who have heart failure – people whose heart is no longer able to provide an adequate flow of blood to the rest of the body – produce two proteins that can be measured in the blood.  These proteins can be used as biological markers for the existence of heart failure and for the worsening of heart failure. The two proteins go by the names B-type natriuretic peptide (BNP) and N-terminal-pro-BNP (NT-pro-BNP). The levels of these proteins in plasma or serum tell the cardiologist whether your symptoms are caused by heart failure, and they tell the cardiologist whether your heart failure condition is worsening. The BNP blood test is the test that tells the cardiologist whether the patient’s fatigue and shortness of breath and limited physical exertion are caused by heart failure rather than by some other condition [3].

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