Coenzyme Q10 and fatty acids and statin medications

Statin medications, also known as HMG-CoA reductase inhibitors, have a good record at reducing high cholesterol levels. However, statin medications inhibit not only the body’s synthesis of cholesterol but also the body’s synthesis of Coenzyme Q10, which the heart muscle cells need for energy production and antioxidant protection. Statin drugs lower the plasma and tissue levels Coenzyme Q10. We need greater awareness of this relationship between statin drugs and the essential bio-nutrient Coenzyme Q10.

Statin medications?  What are we to think?  Statins undoubtedly lower cholesterol levels and reduce the number of heart attacks.

But statin medications can and do have adverse effects [Okuyama].  One of the undesirable unintended consequences of taking a statin medication is that the patient’s bio-synthesis of Coenzyme Q10 is also inhibited.  The body produces cholesterol and Coenzyme Q10 in the same biological pathway.  Cut off one, and you cut off the other as well.

The heart muscle cells need Coenzyme Q10

Low plasma and tissue concentrations of Coenzyme Q10 are clearly associated with increased risk of heart failure [Folkers].

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Interview with Dr. Judy: the need for Coenzyme Q10

Q.  Good morning, Dr. Judy.  You have talked with us about the safety of Coenzyme Q10 supplements, and you have told us that the formulation of the supplement is decisive for the absorption of Coenzyme Q10.  Shouldn’t we talk today about why we adults need daily Coenzyme Q10 supplements?

Coenzyme Q10 molecules are redox molecules.  Ubiquinone can accept electrons, and ubiquinol can donate electrons.   Oxireductase enzymes catalyze ubiquinone’s accepting electrons.  Free radicals take electrons from ubiquinol and become stable.

A.  Yes, indeed.  Coenzyme Q10 is very much needed and, at the same time, very little known by most people.  Our bodies produce Coenzyme Q10 –called ubiquinone –, and Coenzyme Q10 is found in all of our cells except the red blood cells.  That should tell us something.

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Drugs that deplete Coenzyme Q10

Many different prescription drugs, the statin medications prominent among them, inhibit the bio-synthesis and/or absorption of Coenzyme Q10. And Coenzyme Q10 is vital to life.  We must be mindful of the need for a well-formulated Coenzyme Q10 supplement whenever we are taking a Coenzyme Q10 depleting medication.

There are surprisingly many prescription drugs that inhibit the body’s bio-synthesis of Coenzyme Q10 or inhibit the body’s absorption of Coenzyme Q10 from supplements or both.  Of course, there are many drugs that inhibit the uptake of other nutrients as well, but it is difficult to think of any one supplement that is more important to us as we age.

Coenzyme Q10 is “the essential bio-nutrient” (in the words of the chemist Dr. Karl Folkers), and our bodies produce less and less of it as we get older.  It is practically impossible to make up for the decreased bio-synthesis from food alone.  We, all of us, need a well-formulated Coenzyme Q10 supplement.

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Statin medications and Coenzyme Q10

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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Dr. Judy speaks about Coenzyme Q10

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 prior to heart surgery

Australia map
Coenzyme Q10 Research in a land down under. Teams of Coenzyme Q10 researchers at The Alfred teaching hospital in Victoria, Australia, have shown significant results, results that translate into fewer hospitalizations for the patients and into savings for the national health care system.

Professor Franklin Rosenfeldt, MD and Fellow of the Royal College of Surgeons (Edinburgh), is an adjunct professor and cardiac surgeon in the Department of Surgery, Monash University,  a university based in Melbourne, Australia.  Dr. Rosenfeldt is also the administrative supervisor of The Integrative Cardiac Wellness Program at The Alfred, a tertiary teaching hospital in Prahran, (a suburb of Melbourne), Victoria, Australia.

Q10 research at The Alfred
The Alfred’s services include heart and lung replacement and transplantation as well as many other specialized services.  For 30 years, Dr. Rosenfeldt has been conducting cardiac surgery research at The Alfred.  His special research interest has been the protection of the heart against damage during heart surgery.  In this context, he has done much research on the role of Coenzyme Q10 and fish oil in the management of heart disease.

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