Why the Ageing Brain May Need More Coenzyme Q10

As we get older, the brain changes physically. It begins to shrink in size after the age of 40 and especially after the age of 70. The prefrontal cortex – associated with cognitive function – is particularly susceptible to shrinkage. The volume of both white and gray matter is reduced in elderly individuals. With increasing age, there are reductions in the levels of the neurotransmitters acetylcholine, dopamine, and serotonin [Mantle 2021].

Coenzyme Q10 has important roles in cellular energy generation and cellular antioxidant protection in the brain. The ageing brain synthesizes less Coenzyme Q10 with the passing of the years. The big question in CoQ10 research is whether Coenzyme Q10 from supplements will cross the blood-brain barrier.

Ageing Brain More Vulnerable to Oxidative Stress

Moreover, increasing age is associated with mitochondrial dysfunction in the brain tissue cells. The mitochondrial dysfunction is characterized by 1) reduced ATP energy production and 2) increased generation of harmful free radicals. The resulting oxidative stress has been associated with normal ageing processes and with the development of neurodegenerative diseases [Mantle 2021].

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Coenzyme Q10 Adjuvant Therapy for Heart Failure

Coenzyme Q10 as an adjuvant therapy to the conventional medication for heart failure patients = an idea whose time has come.

Chambers of the human heart
Patients with the symptoms of heart failure — fatigue, palpitation, shortness of breath, limited physical activity — have lower quality of life and reduced survival. CoQ10 therapy can improve symptoms and survival.

Followers of evidence-based medicine will want to use the ubiquinone form of Coenzyme Q10 in the same dosage and administration (3 times 100 mg daily with meals) as it was used in the Q-Symbio Study of the effect of Coenzyme Q10 on morbidity and mortality in chronic heart failure [Mortensen 2014; Mortensen 2019].

Q-Symbio Study: Coenzyme Q10 and Heart Failure

Adjuvant therapy with Coenzyme Q10 in the ubiquinone form – 300 mg daily for two years – was associated with the following heart health benefits, compared to placebo [Mortensen 2014]:

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Coenzyme Q10 Supplements: What Does Not Work, and Why Not?

Important to know: Not all Coenzyme Q10 supplements are formulated in the same way. Consequently, the absorption and bio-availability of CoQ10 products can differ considerably even if the manufacturers have used the same raw CoQ10 material. In this article, we want to see what does not work well in the formulation of the CoQ10 supplement.

Dr. Judy CoQ10 Insider's Guide
In his book, Dr. William Judy explains the absorption, transfer, and bioavailability of Coenzyme Q10, the conversion of ubiquinone to ubiquinol and vice versa, and the functions of ubiquinone and ubiquinol. The book is available from amazon.com. ISBN: 978-87-7776-186-7.

Basically, it costs money to produce a well-formulated CoQ10 capsule. For us consumers, saving money by buying a cheaper supplement may well mean wasting money and not doing our heart muscle cells any good.

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Coenzyme Q10 and Human Oocyte Quality

Oocytes. The ovaries contain female reproductive cells, which are called oocytes. The non-medical term for the oocyte is “egg.” When oocytes mature, they are capable of being fertilized, which results in a pregnancy. The female egg is also called an ovum (plural ova), comes from the oocyte. Supplementation with Coenzyme Q10 may improve human oocyte quality and female fertility [Rodríguez-Varela & Labarta 2021].

To mature successfully when they are released from the follicles and to transition into a developing embryo, oocytes have certain requirements:

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Potency of Coenzyme Q10 Supplements – Not All Equally Potent

Potency. You want the CoQ10 product you buy to be potent, don’t you? You want what you pay for. Otherwise, what is the point of buying the supplement?

Dr. William Judy
Dr. William Judy, founder and president of SIBR Research, has tested numerous CoQ10 supplements for their crystal dissolution and absorption and bioavailability. He has found considerable variability in the products. In his book, available from amazon.com, he summarizes the results of his studies.

If you think that all of the CoQ10 supplements offered on amazon.com are equally potent, then you could be wasting your money on an inferior CoQ10 product.

In the May 9th Nutraingredients blog, Hank Schultz reports on the results of a study of a few of the CoQ10 products offered on amazon.com. See here for full article.

Questionable Quality Control of Some CoQ10 Products Sold on Amazon.com

Schultz makes the following points in his blog article [Schultz 2022]:

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International CoQ10 Association Conference May 12-15, 2022

CoQ10 research. Every three years, the International Coenzyme Q10 Association (ICQA) holds an international conference. Speakers at the 10th conference of the ICQA held in Hamburg, Germany, May 12-15, 2022, made the following presentations:

Urban Alehagen
Prof. Urban Alehagen lecturing at the Hamburg conference in May 2022. He emphasized the effect of combined CoQ10 and selenium supplementation for elderly individuals with low intakes of both substances.

Coenzyme Q10 and Ageing

  • An ageing-related decrease in growth hormone and insulin-like growth factor 1 result in an increase in sub-clinical inflammation. Coenzyme Q10 levels in organs, except in the liver, decline by approximately 50% in elderly individuals. The decrease in growth hormone and IGF-1 and the decline in Coenzyme Q10 in organs are inter-related [K. Brismar].
  • The biological mechanisms underlying the reduction in cardiovascular mortality and the improvement in heart function seen in senior citizens supplemented with a combination of Coenzyme Q10 and selenium in the KiSel-10 Study include the following [U. Alehagen]:
  1. reduced systemic inflammation
  2. improved endothelial dysfunction
  3. reduced fibrosis
  • Research has confirmed that combined CoQ10 and selenium supplementation is associated with longer telomere length, compared to placebo supplementation [U. Alehagen]. Note: Telomere length is a bio-marker for ageing.

Coenzyme Q10 and Bioavailability

The comparison of the results from different CoQ10 absorption and bioavailability studies is ill-advised because the results are based on different study protocols, different study groups, different formulations and different dosages of Coenzyme Q10, different modes of administration (fasting/non-fasting), different blood sampling techniques, and different observation times [I. Pravst].

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Heart Failure and Coenzyme Q10 as Adjuvant Therapy

Heart failure – it sounds scary. It is scary, but the medical term heart failure does not mean that your heart stops beating. No, instead, it means that your heart can’t pump enough blood and oxygen to your body.

Dr. William Judy
In the 30-year study of the management of congestive heart failure patients, Dr. Judy found that CoQ10 therapy in addition to conventional medication is more effective than conventional medication alone; however, the patients’ response to the CoQ10 adjunctive treatment is fairly slow, with peak improvements coming within 8 – 12 months. The conventional medication plus CoQ10 therapy is safe; it improves long-term survival compared to conventional medication alone.

Heart failure may develop because the heart muscle has weakened or has become thicker and stiffer. Your heart muscle can compensate for a period, but, eventually, you will need treatment.

The thing to remember is that the heart tissue is muscle tissue. As such, it needs a constant supply of ATP energy, and Coenzyme Q10 is essential to the process of ATP energy generation [Crane 2001]. Furthermore, the heart muscle tissue needs protection against the oxidative damage caused by harmful free radicals, and Coenzyme Q10 in its reduced form is an important antioxidant [Crane 2001].

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Coenzyme Q10 and Eye Disorders

Coenzyme Q10 is a essential component in the cellular process of energy production, and Coenzyme Q10 plays an important role in the antioxidant protection of the cells [Crane 2001].

Eye glasses
Compared to placebo, a combination of Coenzyme Q10, L-carnitine, and omega-3 fatty acids improved the visual acuity of patients with early age-related macular degeneration [Feher 2005].
With increasing age, our cells decline with respect to energy production and with respect to the threat from increased generation of harmful free radical species [Hargreaves, Heaton, & Mantle 2020].

Most of the Coenzyme Q10 available to the cells comes from endogenous bio-synthesis. Optimal CoQ10 bio-synthesis occurs in our 20’s and then follows a decline with increasing age that varies in different tissues and organs [Kalén 1989]. In heart tissue cells, the bio-synthesis of Coenzyme Q10 at age 80 may be approximately half of what it was at age 25 years.

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Coenzyme Q10 to Alleviate Fatigue

Fatigue. In many disorders, patients experience fatigue, even extreme fatigue, e.g., heart failure patients, chronic fatigue syndrome and fibromyalgia patients, multiple sclerosis patients, post-treatment Lyme disease syndrome patients, etc.

Dr. William V Judy
Today’s author is Dr. William Judy, founder and president of the SIBR Research Institute, where he has conducted studies of the effect of CoQ10 supplementation on fatigue in chronic heart failure and chronic fatigue syndrome patients.

The chronic fatigue may well be associated with cellular energy depletion and impaired mitochondrial function [Mantle 2022].

  • Research studies have implicated mitochondrial dysfunction in the development of chronic fatigue syndrome and fibromyalgia and in the resulting fatigue [Mantle 2022].
  • The outcomes of randomized controlled clinical trials have shown that CoQ10 supplementation significantly improves symptoms in chronic fatigue syndrome and fibromyalgia patients [Mantle 2022].
  • A 2019 systematic review of CoQ10 supplementation studies has shown significant benefits of CoQ10 supplementation on fatigue following exercise, statin intake, the development of multiple sclerosis, and the development of end-stage heart failure [Mehrabani 2019].
  • Supplemental CoQ10 has been shown to significantly improve plasma and skeletal muscle CoQ10 levels, exercise tolerance, and exercise recovery time in chronic fatigue patients. The response is not rapid. It takes months of supplementation to allow mitochondria regeneration and the improvement in exercise tolerance. If the supplementation of CoQ10 is stopped, then the chronic fatigue will slowly return [Judy 2018a, 2018b].

Coenzyme Q10, Inflammation, and Fatigue

Mantle et al [2022] make the point that that inflammation, which involves the release of pro-inflammatory cytokines, is not a wholly negative process in the body. Inflammation is the body’s normal response to infection or injury; it is essential for tissue healing.

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Coenzyme Q10 for People Over 65 Years of Age

Sufficient intakes of Coenzyme Q10 are increasingly important as we age. Our bodies synthesize less and less Coenzyme Q10 as we progress from middle age to our senior years. One estimate is that the CoQ10 status of an 80-year-old man’s heart muscle cells will be about half of what is normal in a 20-year-old man [Alehagen 2015].

Guillermo Lopez-Lluch
Prof. Guillermo Lopez-Lluch says that older people who have more symptoms of fragility also have lower concentrations of Coenzyme Q10 their blood plasma. The study data show that this relationship is more common in women than in men.

Sub-optimal levels of Coenzyme Q10 are associated with ageing, energy insufficiency, cardiovascular disease, stroke, and neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease [Why Humans 2022].

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