My name is Ross Pelton, and I “brand” myself as The Natural Pharmacist. I am deeply interested in and passionate about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term, which is a critically important biochemical compound and a critically important nutritional supplement.
Because I am a natural pharmacist and nutritionist, I recognize that most people in their middle and senior years are going to need a daily Coenzyme Q10 supplement. The simple fact is that from our 20s on, most of us synthesize less and less Coenzyme Q10 as we get older. The absorption rate of many CoQ10 products is very low. The situation is further complicated by many misleading marketing claims for some of the CoQ10 supplements.
The internet has rapidly become a vast source of information – and misinformation.
Unfortunately, misinformation and untruths about Coenzyme Q10 makes selecting a quality CoQ10 nutritional supplement a difficult and confusing problem for the general public.
In the KiSel-10 project, our research group has reported that daily supplementation of elderly community living Swedish citizens with a combination of 200 micrograms of organic seleniumSelenium (symbol Se, atomic number 34) is a trace element that is an essential nutrient and an essential component of some of the most important antioxidants in the body, in particular the selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Selenium is involved in the optimal functioning of the immune system. Professor Alehagen has pointed out that there exists a... Read more about this term and 200 milligrams of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term for four years is associated with the following statistically significantThe outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant.... Read more about this term heart health outcomes [Alehagen 2013: Johansson 2015]:
reduced blood levels of a protein bio-marker for heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term
Low intakes of selenium are associated with the increased risk of death from heart disease. Supplementation with selenium and Coenzyme Q10 reduce the risk by reducing oxidative stress, systemic inflammation, fibrosis, and endothelial dysfunction [Alehagen 2018].
Possible Mechanisms for the Positive Clinical Outcomes
Thus far, our research group has published sub-analyses from the KiSel-10 StudyThe KiSel-10 study was a four-year randomized, double-blind, placebo-controlled study of 443 Swedish citizens aged 70 to 88 who received either a combined daily supplementation of high-selenium yeast and Coenzyme Q10 or matching placebos. The elderly Swedish citizens who received the active treatment of selenium and Coenzyme Q10 had significantly reduced risk of death from heart disease, significantly better heart... Read more about this term that illuminate possible mechanisms to explain the positive clinical effects of the combined supplementation:
Over the years, many physicians have worked with SIBR Research by entering their patients into clinical trials conducted by SIBR Research. Many of these physicians, after seeing the benefits that Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term gave to their patients, requested Coenzyme Q10 for their families or for themselves. In this article, I will relate some of their successes and failures.
I have had two pacemakers over a 20-year interval. My mother has had four pacemakers in 40 years. We have taken CoQ10 for 30 and 49 years respectively. At SIBR Research, we have seen no problems in pacemaker patients taking CoQ10. In fact, CoQ10 seems to stabilize the heart cell membranesThe cell membranes, sometimes called plasma membranes, are the physical barrier that protects the contents of the cells from everything that is outside the cells. The cell membranes also regulate what can move in and out of the cells. Coenzyme Q10 is present in all cell membranes in the body except in the red blood cells. It helps to prevent... Read more about this term and to prevent cells other than the A-V and V pacemaker nodes from initiating ventricular systoles.
A physician requested CoQ10 for his mother
In 2002, a heart surgeon called our office and asked about our experiences in supplementing heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term patients with Coenzyme Q10. I had previously met this physician in 1966 when he was a surgical fellow at Methodist Hospital in Houston, and I was a fellow in the department of Physiology at Baylor School of Medicine. We met at a lecture given by Dr. Karl Folkers on the biochemistry of CoQ10 in heart failure.
In 2013, Professor Urban Alehagen and a team of researchers reported on the beneficial effects of daily supplementation of elderly Swedish citizens with a combination of 200 mg of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term and 200 mcg of seleniumSelenium (symbol Se, atomic number 34) is a trace element that is an essential nutrient and an essential component of some of the most important antioxidants in the body, in particular the selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Selenium is involved in the optimal functioning of the immune system. Professor Alehagen has pointed out that there exists a... Read more about this term, in divided doses with meals, over a four-year period.
I am Jan Aaseth, a Norwegian medical doctor and university professor and researcher. In my career, I have specialized in medical biochemistry and in internal and occupational medicine. Much of my research focuses on the importance of micronutrient status throughout all stages of life. In recent years, I have investigated the role of selenium and coenzyme Q10 deficiency in the development of cardiovascular disease, with particular emphasis on oxidative stress and low-grade systemic inflammationInflammation is an immune system response to an injury to cells or tissues. It is the body’s attempt to defend against invaders such as bacteria andviruses and to mend the damage done by invaders. Typically, inflammation manifests itself in the form of fever and swelling, in the swarming of white blood cells and the release of cytokines to fight against... Read more about this term.
Compared to the study participants in the placebo group, the KiSel-10 studyThe KiSel-10 study was a four-year randomized, double-blind, placebo-controlled study of 443 Swedish citizens aged 70 to 88 who received either a combined daily supplementation of high-selenium yeast and Coenzyme Q10 or matching placebos. The elderly Swedish citizens who received the active treatment of selenium and Coenzyme Q10 had significantly reduced risk of death from heart disease, significantly better heart... Read more about this term participants who received the active treatment had significantThe outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant. ... Read more about this term heart health benefits [Alehagen 2013]:
reduced risk of death from heart disease
better heart function as shown on echocardiograms
lower blood levels of the NT-proBNP protein, a bio-marker for the risk of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term
In 2015, Professor Alehagen and I analyzed what we knew, as clinicians, about selenium and Coenzyme Q10 and heart disease [Alehagen & Aaseth 2015]. We asked ourselves why that combination had protected against heart disease in elderly people.
As a pharmacist and a clinical nutritionist, I can see the possibilities of food and dietary supplements as a form of medicine. For example, I am very interested in the health benefits of probiotics. I am intrigued by the manufacturing process that produces probiotic supplements that mimic the activity of our gastrointestinal tract processing food. By that, I mean our GI tract’s use of bacteria to ferment fibers in foods to produce post-biotic metabolites.
As a “natural pharmacist,” I am a passionate advocate of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term supplementation. I suspect that many people get little or no benefit from the daily CoQ10 supplement they take because the absorption rates of many of the commercial products are very low, often only 1-2% of a 100-mg tablet or capsule. It is important to choose a CoQ10 supplement with good documentation of absorption and bio-availability.
In 1993, I wanted to see what protection Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term supplementation could give the heart muscle during and after heart surgery. I discussed the idea with Dr. Karl Folkers and Dr. Willis Stogsdill.
Dr. Willis Stogsdill, “Woody” to his friends and colleagues, was a co-author on my 2007 article “Coenzyme Q10 Facts or Fabrications.” He was a heart surgery anesthesiologist and chairman of the Department of Anesthesia at St. Vincent Hospital in Indianapolis for 25 years. He was instrumental in establishing the St. Vincent open heart surgery program. He was my highly esteemed colleague as well as my father-in-law. He passed away, aged 95, on November 12, 2019. He is missed.
We agreed that the idea had merit. Coenzyme Q10 is a natural and essential cofactor in heart muscle cells. It has bio-energetic, antioxidantAntioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... Read more about this term, and anti-inflammatory effects. Typically, patients with heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term have reduced blood and heart muscle tissue concentrations of Coenzyme Q10.
Heart surgery study in Indianapolis
We conducted a study with 10 high-risk heart surgery patients in a CoQ10 supplementation group and 10 high-risk heart surgery patients in a placebo group. The two groups were similar characteristics before the study began:
Dr. Karl Folkers was a biochemist who was instrumental in isolating vitamin B12 and in determining the structure of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term. He was an important force behind the early clinical research into the effect of Coenzyme Q10 supplementation on heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term patients. We collaborated on several clinical trials.
Looking back over my career, I can see that I have stood on the shoulders of giants. Here is a quick salute to the mentors who sparked my interest in the cardiovascular system, in biophysics and bio-engineering, in the electrical impedance technology, and in Coenzyme Q10 clinical research.
Dr. Loren D. Carlson, University of Kentucky, Lexington Medical School.
Dr. George Armstrong, NASA.
Dr. Lee Baker, Baylor University Medical School.
Dr. Michael Wilson, University of West Virginia Medical School.
Dr. Ishio Ninomiya, West Virginia Medical Center.
Dr. Karl A. Folkers, University of Texas Institute for Biomedical Research. Dr. Folkers was very instrumental in my getting started in clinical research on Coenzyme Q10 as an adjuvant therapy for heart failure. Dr. Folkers was also the person who encouraged me to establish the SIBR Research Institute.
Dr. Ishio Ninomiya on Doing Good Science
Dr. Ishio Ninomiya is the mentor who taught me to be skeptical about what I heard, read, and accepted. He insisted that I trust only the science that I could reproduce myself or that I could find being reproduced in the literature several times.
The researcher and cardiologist, Professor Urban Alehagen, asks the question: how much more clinical evidence of the beneficial heart-related health effects of a combo Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term/Selenium supplementation within an elderly Swedish population do we need? He points to the results looking at 18 publications from the set of data based on the randomized controlled trial, the KiSel-10 StudyThe KiSel-10 study was a four-year randomized, double-blind, placebo-controlled study of 443 Swedish citizens aged 70 to 88 who received either a combined daily supplementation of high-selenium yeast and Coenzyme Q10 or matching placebos. The elderly Swedish citizens who received the active treatment of selenium and Coenzyme Q10 had significantly reduced risk of death from heart disease, significantly better heart... Read more about this term.
As a professor and cardiologist at Linköping University and the Linköping University Hospital in Sweden, I was one of the researchers in the multi-center Q-Symbio StudyQ-Symbio is the abbreviated name for the two-year multi-center, randomized, double-blind, placebo-controlled study of Coenzyme Q10 supplements as an adjunct treatment of chronic heart failure patients. The name reflects the focus of the study on the SYMptoms, BIomarker status (BNP), and long-term Outcomes (hospitalizations and mortality) of the supplementation. The data from the Q-Symbio study show that long-term supplementation with... Read more about this term of the effect of Coenzyme Q10 adjuvant therapy on morbidity and mortality in chronic heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term. In that randomized controlled trial, we gave 420 patients 3 x 100 mg of Coenzyme Q10 in divided doses taken with meals or matching placebos daily for two years.
The trial outcomes showed that the CoQ10 treatment added on to the patients’ conventional heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... Read more about this term medication was associated with a significantThe outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant. ... Read more about this term reduction in the symptoms and a significant improvement in the survival of the heart failure patients [Mortensen 2014].
Hello, my name is Ross Pelton. I am a pharmacist, nutritionist, author, and a health educator. My specialty is natural medicine and nutrition. I am also the world’s leading authority on the topic of drug-induced nutrient depletions. My website, bio and blog are available at: https://naturalpharmacist.net/. Here is a link for a FREE copy of my Quick Reference Guide to Drug-Induced Nutrient Depletions: https://naturalpharmacist.net/dind
In April 2020, I published an article in Integrative Medicine: A Clinician’s Journal about the cardiovascular benefits of daily Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term supplement [1]. As most of you know, Coenzyme Q10 is an important antioxidantAntioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... Read more about this term, and it also plays critical roles in the mitochondrial production of energy in the form of ATPATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production.... Read more about this term.
Endogenous production of Coenzyme Q10 peaks at about 20 years of age and then gradually declines throughout our adult years. One estimate is that the heart muscle cells of an 80-year-old will produce about half of the Coenzyme Q10 that the heart muscle cells of a 20-year-old will [2]. It is not practical to think about making up the difference by eating more or better. Consequently, daily CoQ10 supplementation is important [3].
Dr. William V. Judy, president of SIBR Research and author of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both bsynthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... Read more about this term: An Insider’s Guide, addresses the question of whether to buy a ubiquinoneUbiquinone, the oxidized form of Coenzyme Q10, expressed as Q10 or CoQ10, is absolutely essential for the mitochondrial ATP energy production process. Ubiquinone is the form of Coenzyme Q10 that the body synthesizes, and ubiquinone is the form of Coenzyme Q10 that has been extensively tested for safety, absorption, and efficacy in clinical trials.... Read more about this term Coenzyme Q10 supplement or a ubiquinol supplement.
Here Dr. Judy writes about the question of Coenzyme Q10 supplements in the form of ubiquinone vs ubiquinol.
For some time now, I have been thinking about the data comparing the absorption and bioavailability of the two commercially available forms of Coenzyme Q10: ubiquinone and ubiquinol.
Ubiquinone is the oxidized form of Coenzyme Q10, the form that is essential for ATPATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production.... Read more about this term energy production in the cells. It is the most tested form. When it accepts two electrons, it is reduced and becomes ubiquinol.
Ubiquinol is the reduced form of Coenzyme Q10. In its reduced form, Coenzyme Q10 is an important lipid-soluble antioxidantAntioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... Read more about this term. The Coenzyme Q10 in the lymph and blood is predominantly in the ubiquinol form. This makes sense, as there is more need for antioxidant protection in the blood than there is for bio-energeticsBio-energetics is both the process and the study of the flow and transformation of energy in living beings. Coenzyme Q10 has both a bio-energetics function and an antioxidant function in the body.... Read more about this term.
Some of the numbers that have been presented in marketing claims for this newer and less tested form, ubiquinol, have seemed surprisingly high.
Analysis of the Steady-State Bioavailability of Ubiquinone and Ubiquinol
I have done an analysis of the steady-state bioavailability of ubiquinol compared to 1) dry powder ubiquinone, 2) dry-powder-in-oil-base ubiquinone, and 3) crystal-free oil-based ubiquinone formulations. Note that I am not talking about studies of single-dose absorption here.
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