Absorption of Coenzyme Q10, part II

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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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Coenzyme Q10 in muscle tissue cells

Bill Judy Picture
How much of the concentration of Coenzyme Q10 in muscle tissue is endogenous Coenzyme Q10 produced in the muscle tissue cells themselves, and how much is exogenous Coenzyme Q10 entering the tissue from the blood? Dr. Judy remembers that Japanese researchers were the first to determine these cellular levels in muscle tissue. They tagged the plasma Coenzyme Q10 – the Coenzyme Q10 from supplements –with an isotope. Then, afterwards, they measured the Coenzyme Q10 in muscle tissue cells. In their measurements, the tagged exogenous Coenzyme Q10 was about 48% of the total, and the endogenous Coenzyme Q10 was about 52%. Of course, in the case of older people and in cases of cellular Coenzyme Q10 deficiencies (heart failure and chronic fatigue, for example), the levels of exogenous CoQ10 can be expected to exceed the levels of endogenous Coenzyme Q10.

Okay, from solid research results, we know several things about the essential bio-nutrient Coenzyme Q10.

  • our bodies produce Coenzyme Q10, which is an essential substance for our cells’ energy production and for the antioxidant protection of our cells
  • once we reach our 20’s, our body’s own production of Coenzyme Q10 decreases with increasing age
  • statin medications inhibit our bodies’ production of Coenzyme Q10
  • we are very unlikely to get all the Coenzyme Q10 that we need from our food
  • the risk of heart disease and other diseases increases with the lesser availability of Coenzyme Q10
  • we need a daily Coenzyme Q10 supplement.

Coenzyme Q10 levels in tissue cell and in plasma
Basic fact: Plasma Coenzyme Q10 levels will always exceed tissue cell Coenzyme Q10 levels except, possibly, in some very well-conditioned athletes, e.g. soccer players and cross-country skiers and cyclists. In some superior athletes, the tissue cell Coenzyme Q10 levels and the plasma Coenzyme Q10 levels may come close to being equal.

How does Coenzyme Q10 get from the blood to the cells?
Coenzyme Q10 molecules move from the blood into the tissue cells by the process of diffusion.  If plasma Coenzyme Q10 concentrations were lower than the tissue cell Coenzyme Q10 concentrations, then the diffusion of Coenzyme Q10 from the blood into the tissue cells could not take place.  There would need to be some sort of active transport of Coenzyme Q10 into the tissue cells, and we know of no active transport of Coenzyme Q10 into the tissue cells [Judy 2016].

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Dr. Judy speaks about Coenzyme Q10

dr-judy-in-bologna-2015
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 and immune system activity

innate-immunity
The protective antioxidant function of Coenzyme Q10 in neutralizing harmful free radicals is well known. How Coenzyme Q10 modulates the immune system is less well researched. The Brauner study suggests that Coenzyme Q10 supplementation improves natural killer cell activity and reduces the extent of inflammatory processes.

What is the effect of Coenzyme Q10 supplementation on the functioning of the immune system?  We know that randomized controlled trials of Coenzyme Q10 supplementation have shown the beneficial role of Coenzyme Q10 in the prevention and adjuvant treatment of chronic heart failure and ischemic heart disease.  We know that Coenzyme Q10 supplementation has been shown to be especially important for patients on statin medications and for middle-aged and elderly healthy individuals whose bodies no longer produce as much Coenzyme Q10 as in earlier years.  What about Coenzyme Q10 supplements for patients whose immune system is weak?

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Ageing and plasma Coenzyme Q10 status

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Dr. Judy analyzed the data from 5000 healthy adult volunteers. The data showed that, through the course of their lives, approximately 13% (green) of the volunteers had low plasma Coenzyme Q10 status, nearly 75% (blue) had medium plasma Coenzyme Q10 status, and only 12% (red) had high Coenzyme Q10 status. Conclusion: fully 88% of healthy adults, starting in their 30s and 40s, could benefit from a daily Coenzyme Q10 supplement.

As with so many other things in life, “normal” as in normal Coenzyme Q10 status is a topic about which reasonable people can reasonably disagree.  The range for normal Coenzyme Q10 status, measured in plasma or in serum, is relatively wide and can vary according to a number of factors: age, diet, fitness level, gender, heredity, and nature of work activity.

Plasma Coenzyme Q10 normally distributed
As far as we know, the distribution of human Coenzyme Q10 status in plasma and serum resembles more or less a normal bell-shaped curve with 50 percent of adults having below average Coenzyme Q10 status and approximately 16 percent of adults having very low Coenzyme Q10 status.  Only about 16 percent of adults at the top end of the curve can be said to have unusually high Coenzyme Q10 status.

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Coenzyme Q10 and energy for the immune system

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The immune system protects us against bacterial and viral infections. Coenzyme Q10 is an important bio-nutrient for the optimal functioning of the immune system. It helps to provide energy for the bio-synthesis of immune system cells and energy for the activities of immune system cells.

Energy starvation in the immune system?  Immune system cells starved for energy?  There is a very plausible theory that chronic heart failure is a disease caused by the energy starvation of the heart muscle cells.  Lacking adequate Coenzyme Q10 – an indispensable component of the human cell respiration and oxidative phosphorylation process – the heart muscle cells produce less ATP than is needed to supply the cells with energy. (A concomitant theory holds that Coenzyme Q10, in its reduced form, also protects the heart muscle cells against oxidative damage.)

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Coenzyme Q10 and exercise: what do we know?

exercise-and-coq10
Coenzyme Q10 supplementation performs many roles in the body that benefit athletes and people who exercise. It is an essential co-factor in cellular energy production, it is the most important fat-soluble antioxidant preventing oxidative damage and muscle damage,, and it improves endothelial function.

Does Coenzyme Q10 supplementation improve exercise capacity?  Do we know?  In 2016, Professor Julio J. Ochoa and his colleagues at the University of Granada in Spain conducted an exhaustive review of the published literature about the Coenzyme Q10 supplementation and exercise.  The researchers did database searches and found 372 journal articles about Coenzyme Q10 and exercise.  An amazing number.

Variation in the Coenzyme Q10 and exercise studies
Of course, the results of the studies reported in the 372 journal articles varied quite a bit for a variety of reasons:

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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.

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