Coenzyme Q10 and diabetes: a systematic review

Cyclist
A woman cycles to raise money for a diabetes awareness event. A recent systematic review of the research literature shows that diabetics can safely take Coenzyme Q10 supplements to achieve documented heart health benefits.

A 2016 systematic review and meta-analysis of the evidence from randomized controlled trials has shown that daily supplementation with Coenzyme Q10 slightly but significantly reduced fasting blood sugar levels.  Another good thing: Coenzyme Q10 supplementation did not significantly affect fasting insulin levels or Hb1Ac levels.

In other words, pre-diabetics and diabetics can safely take Coenzyme Q10 supplements to gain these known heart health benefits:

  • Improvement of the ATP energy production in the heart muscle cells [Mortensen]
  • Protection of the heart muscle cells against oxidative damage [Alehagen]
  • Improvement of endothelial function in the heart and blood vessels [Littarru]
  • Reduction of high blood pressure [Rosenfeldt]

Good Coenzyme Q10 news for pre-diabetics and diabetics
Yes, pre-diabetics and diabetics will want to talk with their physicians about the meta-analysis conducted by Dr. Moradi and his colleagues.  Pre-diabetics and diabetics can benefit from taking daily Coenzyme Q10 supplements in the same way that participants receiving the active Coenzyme Q10 treatment in the following studies have benefited as compared to participants in the placebo control groups:

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A review of Coenzyme Q10 research results

Pharmaceutical control
The Coenzyme Q10 supplements with the best documented results in randomized controlled trials have been manufactured under national-level pharmaceutical control.

Recently, I read a published review of the research literature about the nutritional and therapeutic supplement Coenzyme Q10.  It was very interesting to see what the research has revealed and to see what the authors of the review chose to emphasize [Potgieter].

Coenzyme Q10 supplements confer the following known health benefits:

  • improve the symptoms and survival of heart failure patients
  • provide antioxidant protection to patients taking statin medications
  • help to lower high blood pressure
  • maintain good heart function in middle-aged and elderly people
  • provide heart health benefits to people with diabetes

Normal unsupplemented levels of plasma Coenzyme Q10
First off, there is wide variation in the plasma Coenzyme Q10 concentrations of individuals who are not taking Coenzyme Q10 supplements.  There are many factors that influence any one individual’s Coenzyme Q10 status:

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Coenzyme Q10 and exercise in younger and older adults

sevilla-cathedral
Sevilla is famous for its cathedral, Santa Maria de la Sede, the largest Gothic cathedral in the world, built during the 15th century. Sevilla is also famous for its university. Within the university, the Developmental Biology Institute has been doing much research into the nutritional and medical importance of Coenzyme Q10.

Spanish researchers at the Pablo de Olavide University in Sevilla hypothesized that the effect of physical activity on plasma Coenzyme Q10 levels and on plasma Coenzyme Q10/cholesterol ratios might vary according to the age of the individuals engaging in the physical activity. Their results show, for the first time, an apparently different effect of exercise on young people and on older people.

  • Lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the young people more so than in older people who were also exercising. That result was surprising.
  • Moreover, lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the younger people more so than with moderate levels of physical activity in younger people. That result was not surprising.
  • What was most surprising was the data that showed that older people who exercised more often and more intensely had higher levels of Coenzyme Q10 in plasma and higher ratios of Coenzyme Q10 to cholesterol in plasma than did older adults who exercised moderately or who were mostly sedentary. In this respect, the effect of exercise on the older people differed from the effect of exercise on the younger participants [Del Pozo-Cruz 2014].

Coenzyme Q10 and physical activity in young people
In the Spanish study, the young participants had an average age of 20 years plus or minus 2 years.  Two possible explanations come to mind for the lower plasma Coenzyme Q10 levels in highly active younger people:

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Statin medications and Coenzyme Q10

Mevalonate_Pathway
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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Coenzyme Q10 Nutritional Supplements, 1981 to 2016

Gummy bears
Dr. Judy has watched the progression of Coenzyme Q10 supplements from dry powder tablets to dry powder in two-piece hard-gel capsules to dry powder in soybean oil in soft-gel capsules to Coenzyme Q10 dissolved in multiple lipids in soft-gel capsules. Today there are even Coenzyme Q10 gummy bears on the market. But what about the formulation? It is the supplement manufacturer’s formulation of the Coenzyme Q10 raw material that is most important for the absorption and health effects.

In line with other technologies, the production technology for Coenzyme Q10 nutritional supplements has advanced over the years.  For the past 35 years, Dr. William Judy of the SIBR Research Institute has followed the development of the Coenzyme Q10 nutritional supplements produced in the USA and around the world.

Dr. Judy has seen considerable improvement in the formulations of the Coenzyme Q10 nutritional supplements and in their effectiveness as an adjuvant treatment of chronic heart failure and other clinical conditions.  He has seen increasing awareness of the need for Coenzyme Q10 supplements in patients taking statin medications.  He has seen increasing awareness of the health benefits for healthy middle-aged and elderly people.

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Coenzyme Q10 improves endothelial function

woman-boxer
Good health and good fitness depend on good blood circulation.  Good blood circulation depends on good endothelial function.  Research shows that taking a daily Coenzyme Q10 supplement is associated with improved endothelial function.  Supplementation with a combination of Coenzyme Q10 and high selenium yeast has significantly reduced the risk of dying from heart disease in elderly KiSel-10 study participants.

How does Coenzyme Q10 supplementation keep the heart young and healthy? The primary explanation is that Coenzyme Q10 is absolutely vital to the cellular process of producing energy, and the heart muscle needs energy constantly.  An energy-starved heart is a failing heart.

A second and also important explanation is that oxidative damage causes the heart muscle cells to age and deteriorate. Coenzyme Q10 has antioxidant and anti-inflammatory effects that can help to prevent the development of atherosclerosis.

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Absorption of Coenzyme Q10, part III

Food
As we age beyond our 30s into middle age and old age, our bodies produce less and less Coenzyme Q10, but our need for Coenzyme Q10, especially for good heart health, does not decline. Healthy meals, even meals containing meat and fish, cannot make up the difference. We need a good daily supplement.

In this three-part series of articles, we have been discussing the absorption and bio-availability of the vital bio-nutrient Coenzyme Q10.  As we come into middle age and then into our senior years, we produce less and less Coenzyme Q10 ourselves.  Plus, certain medications — statin medications in particular — inhibit our bodies’ production of Coenzyme Q10 even more.  And, we know that adequate intakes of Coenzyme Q10 are necessary for good heart health and a decent quality of life.

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Absorption of Coenzyme Q10, part II

woman-strength
An adequate supply of Coenzyme Q10 to the heart muscle tissue cells is absolutely essential for good heart health. Coenzyme Q10 is necessary for the production of ATP energy in the cells. An energy starved heart is a failing heart.

Once we have swallowed a Coenzyme Q10 capsule, what happens next? Specifically, what happens as the Coenzyme Q10 flows from the stomach to the blood?  As it turns out, we know a fair amount about the transfer of the Coenzyme Q10.

The basics of Coenzyme Q10 absorption
Dr. William Judy’s study of Coenzyme Q10 absorption in large animals (large dogs that are conscious during the testing) and in humans have resulted in the following understanding:

Coenzyme Q10 is absorbed in the form of ubiquinone
Coenzyme Q10, regardless of whether it is taken in the form of ubiquinone supplements or in the form of ubiquinol supplements, will be absorbed in the small intestine in the form of ubiquinone.

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Absorption of Coenzyme Q10, part I

steak
Once we pass the age of 20, our bodies begin to produce less Coenzyme Q10 with increasing age. Various medications, including statin medications, interfere with our production of Coenzyme Q10. Most of us cannot hope to make up the difference in our meals. For good heart health, we need a daily Coenzyme Q10 supplement. The ubiquinone form of supplement is the most stable form and the most carefully researched form.

Coenzyme Q10 is a vitamin-like substance that is an essential bio-nutrient.  It is vital for the cellular process of ATP energy production. It is an important antioxidant protecting the cells against harmful free radicals. It is thought to improve epithelial cell function in the blood vessels and to protect against the development of atherosclerosis and high blood pressure. In this essay, we review some of  the basic facts of Coenzyme Q10 absorption and bio-availability.

Importance of Coenzyme Q10 absorption
Coenzyme Q10 bio-synthesis declines with age
Our bodies produce Coenzyme Q10 in much the same way that they produce cholesterol.  However, once we reach our 20’s, our bio-synthesis of Coenzyme Q10 begins to decline with increasing age [Kalén].  One estimate is that the plasma Coenzyme Q10 concentration of an average 65-year-old will be only about half the plasma concentration of an average 25-year-old: approximately 0.65 micrograms per milliliter versus 1.35 micrograms per milliliter.

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Coenzyme Q10 and pregnancy

male-infertility-picture
Pregnancy depends upon the sperm’s reaching the egg. Daily supplementation with Coenzyme Q10 capsules is associated with significantly improved sperm density, sperm movement, and normal sperm shape as well as with improved pregnancy rates.

What about infertility problems and Coenzyme Q10, I was asked the other day. Mightn’t the improvement of cellular energy production and the protection against oxidative stress that Coenzyme Q10 supplements give, mightn’t they also help sperm quality and sperm motility? What about Coenzyme Q10 help for the quality of female egg cells?

Coenzyme Q10 and male infertility
Nature Reviews: Urology
In 2011, Dr. Annette Fenner, chief editor at Nature Reviews: Urology, published a note to the effect that supplementation with Coenzyme Q10 improves semen quality parameters and that the improvement in the sperm has been seen to be associated with improved pregnancy rates and live birth rates [Fenner].

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