Coenzyme Q10: the best of q10facts.com — part II

emergency-room
Daily supplementation with 200 milligrams of Coenzyme Q10 has been shown to reduce the number of hospitalizations and re-hospitalizations of chronic heart failure patients. The use of Coenzyme Q10 as an adjuvant treatment improves the quality of life for patients and reduces the expenses of health care systems.

Last month, I wrote brief summaries of some of the best articles that have been published on this website.  This month, I want to present summaries of several more good q10facts.com articles about the health benefits of Coenzyme Q10 supplementation.  The information in all of these articles is based on clinical study results published in peer-reviewed bio-medical journals.  In each summary, there is a link to the original article.

Fewer hospitalizations with Coenzyme Q10
In the Q-Symbio study, 420 chronic heart failure patients on conventional heart failure medications were randomly assigned to an adjuvant Coenzyme Q10 treatment group (n=202) or to a placebo control group (n=218).  In the study, Dr. Svend Aage Mortensen and his fellow researchers wanted to test the hypothesis that the condition of the energy-starved heart could be improved by the use of Coenzyme Q10 supplementation.

The results of the study, published in the Journal of the American College of Cardiology’s specialty journal Heart Failure, show that supplementation with 300 milligrams of Coenzyme daily significantly improved the symptoms and survival of the chronic heart failure patients.  In the active treatment group, the Coenzyme Q10 group, there were lower rates in the following indices:

  • Re-hospitalizations
  • Major cardiovascular events
  • Cardiovascular-related deaths — a 43% reduction in heart-related deaths
  • All-cause-related deaths — a 42% reduction in deaths from all causes

Similarly, in the Morisco study, which enrolled 641 congestive heart failure patients, the number of hospitalizations in the Coenzyme Q10 active treatment group was significantly lower than the number of hospitalizations in the placebo control group.

The reduction in the number of hospitalizations with Coenzyme Q10 supplementation means better quality of life for the patients and less expense for the health care system.

Coenzyme Q10 and energy and fitness
Coenzyme Q10 supplementation has not yet been shown, definitively, to improve performance or recovery time, but it has been shown to protect against inflammation and oxidative stress in athletes.  It is certainly a necessary supplement for patients taking statins medications, the more so if they exercise regularly.  Coenzyme Q10 supplements are safe, they are affordable, and they contribute both to ATP energy production and to antioxidant protection against harmful free radicals that are created as by-products when the body burns oxygen.  In the context of energy and fitness, there is also evidence that Coenzyme Q10 supplementation benefits patients with low energy syndrome. (More about that topic at a later date)

Coenzyme Q10 for diabetics
Patients with diabetes are known to be at increased risk of heart disease.  Patients taking statin medications are at increased risk of developing type-2 diabetes.  Studies show that Coenzyme Q10 supplements do not disturb the glycemic control of type-1 and type-2 diabetes patients.  Patients with diabetes should, of course, check first with their physicians, but they can safely take Coenzyme Q10 supplements and can get the heart health benefits of the supplementation.

Coenzyme Q10 by the numbers
In this article, we present some of the important facts about Coenzyme Q10 supplements:

  • 2 – 3 hours after ingestion: Q10 peaks in the abdominal lymph
  • 6 – 8 hours after ingestion: Q10 peaks in the venous blood
  • 24 hours after ingestion: a second smaller Q10 peak appears in the blood circulation
  • 33 hours after ingestion: elimination half-life of Q10
  • 7 – 10 days after ingestion: 90% steady-state Q10 concentration is reached
  • 0.6 – 1.5 micrograms per milliliter: the normal unsupplemented CoQ10 level in plasma
  • 2.5 micrograms per milliliter: the expected CoQ10 concentration in plasma following supplementation
  • 100-300 milligrams per day: the typical supplementation dosage(Divided dosages, twice or three times daily, with meals, are more effective than single daily doses)
  • 1200 mg per day: the observed safe upper limit for daily Q10 intakes
  • 43% decrease in cardiovascular death in the CoQ10 group compared to the placebo group in the Q-Symbio study of adjunctive treatment of chronic heart failure patients with 300 mg daily of a ubiquinone Q10 supplement
  • 54% reduction in cardiovascular-related deaths in the CoQ10/selenium group in the KiSel-10 study of supplementation of healthy elderly people still able to live at home

Coenzyme Q10 and warfarin
Coenzyme Q10 is one of the safest supplements available.  Even in dosages four times the daily dosage used in the Q-Symbio study, it is not toxic.  If you are taking an anti-coagulant medication like Coumadin (warfarin) or Plavix or lots of aspirin but still want the heart health benefits of a Coenzyme Q10 supplement, you should ask your physician first just to keep him or her in the picture.  Some of the anti-coagulants (warfarin, for example) are notoriously difficult to work with.  Fortunately, there are now published studies in the medical journal literature that indicate that supplement with Coenzyme Q10 does not affect the action of the anti-coagulant medication.  Patients taking an anti-coagulant medication do not necessarily need to miss out on the beneficial effects of Coenzyme Q10 supplementation.  In the Q-Symbio study, 74 of the 202 chronic heart failure patients treated daily with 300 milligrams of Coenzyme Q10 for two years were patients who were taking an anti-coagulant medication.

Bill Judy Picture
Dr. William Judy: Coenzyme Q10 researcher and director of the SIBR Research Institute. Dr. Judy says: No matter whether the capsule contains Coenzyme Q10 in the form of ubiquinone or in the form of ubiquinol, the Coenzyme Q10 will be absorbed in the small intestine in the ubiquinone form. Once the Coenzyme Q10 enters the abdominal lymph, the absorbed ubiquinone will be converted to the ubiquinol form and will pass through the lymph and into the blood predominantly in the ubiquinol form.

Making a good Coenzyme Q10 supplement
Let’s be clear about this.  Absorption of Coenzyme Q10 does not happen easily.  The raw material comes to the producer of the Coenzyme Q10 supplement in the form of crystals.  The body cannot absorb these crystals.  The CoQ10 crystals must be dissociated into single CoQ10 molecules for the body to be able to absorb at least a portion of the contents of a CoQ10 supplement capsule.  Consequently, the formulation of the Coenzyme Q10 supplement is the single most important factor in the absorption of the substance.  And, without absorption, there can be no health benefits.

Coenzyme Q10 is a redox molecule and exists in three forms: ubiquinone (oxidized form), ubiquinol (reduced form), and semi-ubiquinone (an intermediate semi-reduced form).  The ubiquinone form of Coenzyme Q10 is the best form for a supplement.  Ubiquinone is a much more stable form than ubiquinol, and it is a much more researched form than ubiquinol.

In making a good Coenzyme Q10 supplement, the producer must dissolve the raw material CoQ10 crystal powders in a lipid, usually one or more vegetable oils.  Some oils work better than others.  The important thing is that the Coenzyme Q10 molecules inside the capsules should not re-crystallize.  Body temperature in the stomach and the small intestine is not high enough to dissociate Coenzyme Q10 crystals into molecules for absorption.

The ubiquinone Coenzyme Q10 molecules are fat-soluble and large molecules.  To get from the inside of the small intestine to the absorption cells, the Coenzyme Q10 molecules require some sort of lipid carrier, typically monoglycerides.  Accordingly, it is best to take a Coenzyme Q10 capsule together with a meal that contains some fat.

Coenzyme Q10 benefits Gulf War veterans

Thousands and tens of thousands of veterans of the First Gulf War suffer from a number of symptoms that are related to their service in the desert war. The problems – breathing problems, cognitive disorders, digestive problems, fatigue and sleep disturbances, mood disturbances, muscle dysfunction and pain, skin irritations — of these veterans have not gotten better with the passage of time.

Dr. Beatrice Golomb hypothesized that supplementation with Coenzyme Q10, an important fat-soluble antioxidant and an important co-factor in the process of cellular energy production, might have a beneficial effect on Gulf War veterans affected by oxidative stress and mitochondrial dysfunction.  She set up a randomized controlled trial to test the effect of Coenzyme Q10 on the Gulf War veterans.

The result published in the journal Neural Computation: Supplementation with Coenzyme Q10 was positively associated with statistically significant improvement on the General Self-Rated Health scale.  Supplementation with Coenzyme Q10 was positively associated with statistically significant improvement in physical function, as assessed by Summary Performance Scores. In addition, there was positive change in 19 of the 20 Gulf War Illness symptoms that the researchers tested.

Sources:

Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.

Alehagen, U., & Aaseth, J. (2015). Selenium and coenzyme Q10 interrelationship in cardiovascular diseases–A clinician’s point of view. Journal of Trace Elements in Medicine And Biology, 31157-162.

Golomb, B.  (2014).  Coenzyme Q10 and gulf war illness.  Neural Computation, 26(11), 2594-651.

Judy, W. V., Stogsdill, W. W., & Folkers, K. (1993). Myocardial preservation by therapy with coenzyme Q10 during heart surgery. The Clinical Investigator, 71(8 Suppl), S155-S161.

Morisco, C., Trimarco, B., & Condorelli, M. (1993). Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. The Clinical Investigator, 71(8 Suppl), S134-S136.

Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & … Littarru, G. P. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC. Heart Failure, 2(6), 641-649.

Mortensen, S. A. (2015). Coenzyme Q10: will this natural substance become a guideline-directed adjunctive therapy in heart failure? Journal of The American College of Cardiology. Heart Failure, 3(3), 270-271.

 

Please click here for more information about the health benefits of Coenzyme Q10 supplements.

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