Coenzyme Q10: Six treatment options

Karl Folkers and Svend Aage Mortensen
Dr. Svend Aage Mortensen (right), pictured here with Dr. Karl Folkers. Dr. Folkers determined the chemical structure of the Coenzyme Q10 molecule. He and Dr. Mortensen did the research establishing the link between low blood and biopsy tissue CoQ10 concentrations and the severity of heart disease.

Dr. Svend Aage Mortensen (1942 – 2015), M.D., DMSc. was associate professor and chief physician (cardiology) at The Heart Centre, Rigshospitalet, Copenhagen, Denmark.  He was the lead researcher on the Q-Symbio study of the beneficial effects of Coenzyme Q10 on morbidity and mortality in chronic heart failure.

Multiple treatment options with Coenzyme Q10
Dr. Mortensen saw six possible treatment options with Coenzyme Q10 in the prevention and treatment of cardiovascular disease.

  • Preventative treatment in statin therapy
  • Adjunctive treatment of ischemic heart disease and angina pectoris
  • Pretreatment for coronary artery bypass surgery or valve surgery
  • Adjunctive treatment in arterial hypertension
  • Preventative treatment in anthracycline therapy
  • Adjunctive treatment in chronic heart failure

What did Dr. Mortensen know about Coenzyme Q10?
In developing a biochemical rationale for the above uses of Coenzyme Q10 in cardiovascular disease, Dr. Mortensen built on documented facts. He knew that Coenzyme Q10 plays an important role in the following biological actions:

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Q10: Known quality versus unknown quality?

Best quality picture
Which Q10 product on the American market is the best buy? You don’t know. But you can see which Q10 products have been tested for effect in gold standard studies.

My friends and colleagues ask me sometimes: is the Coq10 product that was used in the Q-Symbio study the best Coenzyme Q10 product?  And they are surprised when I don’t say, immediately, yes, yes, of course.  I am cautious.  I don’t want to claim to know something that I cannot know with certainty.  Could there be a better Q10 product on the market?  Possibly.  I don’t know for sure.    It’s best never to say never, right? But …

Q10 produced according to medicine standards
What I have found out is that the profile of the Q-Symbio Study CoQ10 treatment is unique.  The Danish producer, Pharma Nord, seems to be one of the few food supplement suppliers in the US that is producing a Q10 product according to medicine standards rather than food supplement standards.

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Talking to the cardiologist about taking Coenzyme Q10

hospital hallway
Two big randomized controlled trials (Morisco 1993 and Mortensen 2014) have shown significantly fewer hospital visits for heart failure patients with Coenzyme Q10 supplementation as compared to placebo supplementation. In addition, a big randomized controlled trial (Alehagen 2013) enrolling healthy elderly people showed significantly fewer admissions to hospital in the Coenzyme Q10 and selenium group.

Doctors are people with a scientific slant of mind.  They tend to be skeptical.  They want proof.  And, when it comes to clinical research, they want results from randomized, double-blind, placebo-controlled studies with very large sample sizes.  Then, if there is a statistically significant result, they want to see the study replicated.

Access to information about Coenzyme Q10
So, one big reason that I write articles about Coenzyme Q10 is that I want heart disease patients (and people wanting to avoid heart disease) to have a chance to inform themselves about the heart health effects of a good Coenzyme Q10 supplement.  After all, I am a librarian by training and by trade.

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Coenzyme Q10 and energy and fitness

swimmers triathlon
Competing in a triathlon or in long distance races requires lots of energy over extended periods. Coenzyme Q10 is instrumental in the body’s production of ATP, the body’s basic unit for the storage of energy in its chemical form.

What about Coenzyme Q10 and energy and physical fitness, I have been wondering.  I know that Coenzyme Q10 in its ubiquinone form plays a vital role in the production of adenosine triphosphate (ATP) molecules in the mitochondria in the cells.

The ATP molecules are the basic units of energy in the body.  The ATP molecules are what provide the energy for the contraction and extension of muscles.

Q10 and ATP and muscle aches and fatigue
Even when we are rested up, we do not have enough ATP molecules to allow us to exert ourselves intensely for more than a few minutes.  When we exercise very intensively (run sprints, for example) or exercise strenuously for longer periods, our muscle tissues are forced to go from aerobic energy production, i.e. from burning oxygen, to the anaerobic (non-oxygen-burning fermentation) mode of energy production.

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Why I am taking ubiquinone Q10 capsules

Q10 molecule
Coenzyme Q10, known as ubiquinone in its oxidized form and as ubiquinol in its reduced form, is a large fat-soluble essential bio-nutrient. The ubiquinone form is a vital component of the energy production process in the cells, and the ubiquinol form provides antioxidant protection throughout the body.

I am a long-time taker of ubiquinone Q10 supplements. 100 mg a day. I take the same ubiquinone Q10 capsules that were used in the Q-SYMBIO and KiSel-10 studies. As a consequence, I think, I have no problems with heart disease, diabetes, and hypertension. May it continue so.

Happy with my ubiquinone Q10 capsules
When, in 2007 – 2008, ubiquinol QH2 products became available commercially for the first time, I didn’t pay any attention, really. My supplement pattern – Q10, selenium, zinc, B-vitamins, vitamin C, fish oil – was not broken. Why fix it?

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Coenzyme Q10 and energy synthesis and Prader-Willi children

kids playing
Energy in the form of ATP molecules is synthesized in the mitochondria in the cells. With insufficient availability of Coenzyme Q10, we get low energy synthesis. With low energy, we exercise less. With too little Coenzyme Q10 and less exercise, the mitochondria — the organelles that synthesize ATP — tend to atrophy and eventually cease to function properly.

Coenzyme Q10 has important functions in the body: energy synthesis, antioxidant activity, and stabilization of cell membranes.  Energy synthesis takes place in the mitochondria of the cells.  This is important to know.  Energy synthesis takes place in the mitochondria of the cells.  Every cell contains some very small oblong bean-shaped organelles called mitochondria.  The mitochondria have both an inner and an outer membrane.

The mitochondria in the cells and Q10
These mitochondria vary considerably in their size and in their numbers in the individual cells.  Typically, mitochondria are 60 – 75 angstroms thick.  That is, they are 60 – 75 ten-billionths of a meter thick.  The length of the mitochondrion is approximately 1 to 10 micrometers, much too small to see.  By comparison, an average strand of human hair is 60 – 80 micrometers in diameter (= 600,000 – 800,000 angstroms).

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Coenzyme Q10 and New Year’s resolutions

2016 is the time to make taking a Coenzyme Q10 supplement one of your New Year’s resolutions. If you are already taking a Coenzyme Q10 supplement, then 2016 may be the time to check to see if you are getting a supplement with well-documented heart health effects.

Every January 1st, we get to start over.  Whatever the mistakes are that we made in 2015, we do not have to repeat them in 2016.  We ask ourselves, what can we do better in the New Year?

Typical New Year’s resolutions
Many people will be starting 2016 with a list of resolutions that look something like this:

  • Exercise more
  • Eat healthier
  • Lose weight
  • Get blood pressure under control

Q10 can help with the resolutions
Those are do-able New Year’s resolutions.  They are resolutions that most of us can keep.  I would add one more resolution to the list:

Q10 and exercise
Coenzyme Q10 in its ubiquinone form is an essential bio-nutrient that plays a vital role in the production of energy in the cells.  As we get older, we feel a decline in the amount of energy that we have.  That decline in energy could well be related to the lesser availability of Coenzyme Q10 in our cells and tissues.

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Coenzyme Q10 and selenium: partners against heart disease

Surgeons and hospitalized patient
Swedish seniors, both men and women, who took Q10 and selenium supplements for a 4-year period spent 13% fewer days in the hospital and had significantly better quality of life than did Swedish seniors who took placebos.

There is a tantalizingly interesting relationship between the essential bio-nutrient Coenzyme Q10 and the trace element selenium and heart disease.  One of the first clinical researchers to tease out the effects of supplementation with Q10 and selenium in heart attack patients was Dr. Bodo Kuklinski.  

Coenzyme Q10 and selenium for heart attack patients
Dr. Kuklinski tested 61 patients who had been admitted to the hospital in Rostock, Germany, with an acute myocardial infarction and with symptoms of less than six hours’ duration.  He assigned 32 of the patients to the adjuvant treatment group and 29 of the patients to the control group.

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Our daily Coenzyme Q10

Healthy food
I am not going to say that supplements are a substitute for a healthy and varied diet. They are not. But, in the case of Coenzyme Q10 intakes, the best imaginable diet needs to be supplemented once we reach our 40’s and beyond.

Coenzyme Q10 supplements are important for the heart health benefits that they confer.  No doubt about it.  We have documented evidence from gold standard clinical trials comparing the outcomes in a ubiquinone Q10 treatment group with the outcomes in a placebo group.

What do we know about Coenzyme Q10?

  • We know that Coenzyme Q10 is a redox molecule that is a vital co-factor in the process of cellular energy production and is a powerful antioxidant.
  • We know that once we get past our mid-20s, our bodies synthesize less and less Coenzyme Q10 with increasing age. (3)
  • We know that the body’s synthesis of Coenzyme Q10 is a complicated 17-step process that can easily go wrong and malfunction.  To be successful, the bio-synthesis of Coenzyme Q10 requires the availability of a large number of vitamins, amino acids, and trace elements.
  • We know that some medications, statin medications in particular, inhibit the bio-synthesis of Coenzyme Q10 (2).
  • We know that Coenzyme Q10 is relatively scarce in foodstuffs (4).  For vegetarians and vegans, whose diet does not include animal proteins, the content of Q10 in their diets is even less.

What don’t we know about Coenzyme Q10?
The thing is this: we do not know that an individual can get enough Coenzyme Q10 from his or her normal diet to meet his or her daily Q10 requirements.

Bill Judy Picture
For Dr. Judy, it is a matter of simple arithmetic. We produce less Q10 as we age, and we do not get enough Q10 in our food to make up the difference. We need a Coenzyme Q10 supplement. Every day. Some of us will need a Q10 supplement twice a day.

What is the typical daily requirement for Coenzyme Q10?
According to Dr. William Judy of the SIBR Research Institute, an adult person requires approximately 3.5 mg of Coenzyme Q10 daily to maintain normal healthy body function.  Is it possible to get 3.5 mg of Coenzyme Q10 from our food every day?

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Coenzyme Q10 by the numbers

Woman on the beach
As we get older, we no longer run as fast or jump as high. Millions of us have chronic heart failure and feel tired and out of breath. Millions more take statin medication. Even more millions have high blood pressure. A well-documented ubiquinone Q10 supplement can help to restore the energy production process in the heart muscle cells.

Coenzyme Q10 is an important substance that, if taken in the form of a well-absorbed lipid-based crystal-free ubiquinone Q10 supplement, has documented health benefits.  Coenzyme Q10 is an essential bio-nutrient.  Coenzyme Q10 in its ubiquinone form plays an essential role in mitochondrial energy production; in its ubiquinol form, it acts as an important antioxidant, quenching harmful free radicals.

Coenzyme Q10 supplementation in the ubiquinone form has been shown to improve chronic heart failure symptoms and survival significantly.  Ubiquinone Q10 has been shown to reduce significantly the number of heart disease deaths in elderly people living at home.  Ubiquinone Q10 has also been shown to provide improvement in a range of symptoms affecting veterans suffering from Gulf War Illness.

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