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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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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