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]:
    • reduced systemic inflammation
    • improved endothelial dysfunction
    • 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].
    • Marketing claims of x times better bioavailability can be very misleading for consumers [I. Pravst].
    • Accordingly, consumers of CoQ10 supplements should be on the alert and should expect documentation of the absorption and bioavailability of the product they choose.
    Franklin Rosenfeldt
    Over the years, the cardiologist Franklin Rosenfeldt has conducted research centered on Coenzyme Q10’s effect on heart function and heart surgery. Pictured here at the 2022 Hamburg conference.

    Coenzyme Q10 and Cognitive Function

    • CoQ10 supplementation may have a positive effect on cognitive function. An Australian clinical study is testing this hypothesis [C. Stough]. The question in the CoQ10 field is: how does exogenous Coenzyme Q10 affect the brain if it does not cross the blood-brain barrier? [F. Rosenfeldt].
    Possible answers from CoQ10 researchers in the audience:
    1. by reducing number of inflammatory proteins crossing into the brain?
    2. by improving the quantity and quality of the mitochondria in the blood crossing into the brain?
    3. by improving endothelial function and thus improving blood pressure and blood fluidity?
    4. by hdl-cholesterol’s transporting Coenzyme Q10 across the blood-brain barrier?
    • An in-vitro study done in London shows the transport of Coenzyme Q10 through the blood-brain barrier, in both directions, from the blood side to the brain side of the barrier and from the brain side to the blood side. In cases of normal CoQ10 levels, there is no net transfer of Coenzyme Q10 from the blood to the brain. In cases of Coenzyme Q10 deficiency, there is net CoQ10 transfer into the brain [I. Hargreaves].

    Coenzyme Q10 and Statin Medications

    • The discontinuation of statin medications and the use of CoQ10 supplementation for heart failure patients has not had any adverse effects and has been helpful, based on the results of a study published in 2019 [P. Langsjoen].
    • Statin-associated cardiomyopathy exists as a common but unrecognized clinical condition. It can present as diastolic heart failure (HFpEF). Discontinuing statin treatment and initiating CoQ10 treatment can improve symptoms and heart function [P. Langsjoen, J. Langsjoen].
    • With the discontinuation of statin medications, daily dosages of 200 mg of Coenzyme Q10 twice daily, together with meals containing some fat, and, in difficult cases, up to 300 mg three times daily have been tested. Better absorption of the Coenzyme Q10 is achieved by having the patients chew the soft-gel capsules rather than swallow them [P. Langsjoen].
    • In stopping the patients’ statin treatment, cardiologists will need to monitor the use of anti-hypertensives, diuretics, and beta-blockers; they should expect changes over the course of months [P. Langsjoen].

    Note: A review of the major trials of the effect of cholesterol lowering in heart failure patients shows no benefit [H. Kloer]:

    • GISSI-HF n=4631 (2008): no benefit
    • CORONA n=5011 (2007): no benefit
    • ODYSSEY OUTCOMES HF n=2815 HF vs 16109 controls (2022): no benefit
    Placido Navas
    Prof. Placido Navas, Pablo de Olavide University, Sevilla, Spain, has presided over three successful ICQA conferences: Bologna 2015, New York 2018, and Hamburg 2022.

    Conclusion: CoQ10 research follows rigorous standards

    Prof. Navas, in his remarks at the conclusion of the conference, was especially proud of three accomplishments:

    • Improved selection of conference presenters from all the applicants
    • More participation by younger researchers
    • More female researchers

    Sources

    Kloer HU, Belardinelli R, Ruchong O, Rosenfeldt F. Combining Ubiquinol With a Statin May Benefit Hypercholesterolaemic Patients With Chronic Heart Failure. Heart Lung Circ. 2020 Feb;29(2):188-195.

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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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Combined Coenzyme Q10 and Selenium Supplementation

There is a special biological interrelationship between Coenzyme Q10 and selenium. From a cardiologist’s perspective, there is a theoretical advantage in using both substances to prevent heart disease if the patients’ intakes are sub-optimal [Alehagen & Aaseth 2015a].

Heart chambers
Four years of daily supplementation of senior citizens with a combination of Coenzyme Q10 and selenium resulted in reduced risk of death from heart disease and in improved heart function.

This advantage has been demonstrated in the outcomes of the KiSel-10 Study, a randomized controlled trial that enrolled elderly community dwelling Swedish citizens, average age 78 years, with known low serum selenium status (mean: 67.1 mcg/L) [Alehagen 2013; Alehagen 2016a; Alehagen 2016b].

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The Instability of Ubiquinol – Misleading Marketing Claims?

On the Web, I see many incorrect and undocumented marketing claims for ubiquinol supplements. As a long-time Coenzyme Q10 researcher, I worry that consumers will be persuaded by these misleading marketing claims. In this article, I want to give some background information about how the Coenzyme Q10 in supplements is absorbed and transferred in the body.

Choice of Two Different Forms of Coenzyme Q10 in Supplements

Dr. William Judy in the lab
In 2021, I have published the results of the SIBR Research lab studies and large dog studies of the instability of the ubiquinol supplement. The studies show that the ubiquinol in supplements will be converted to ubiquinone in the small intestines prior to absorption, will then be absorbed in the ubiquinone form, and will be converted back to ubiquinol in the lymph.

Let me start by saying that CoQ10 molecules are redox molecules that have an oxidized form called ubiquinone and a reduced form called ubiquinol. Regardless of whether the supplement manufacturer chooses to work with ubiquinone or ubiquinol, he or she must deal with the following problems [Judy 2018]:

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Coenzyme Q10 and the Elderly

As we get older, staying active and maintaining our physical capacity is important if we are to avoid becoming frail and vulnerable to falls.

Elderly couple
In this article, we present information about the relationship of plasma Coenzyme Q10 status to the physical capacity and the frailty of elderly individuals.

Combining daily Coenzyme Q10 supplementation with daily physical activity is good therapy for avoiding sarcopenia, which is the clinical name for the loss of muscle mass caused by ageing.

Professor Guillermo Lopez-Lluch and his colleagues in Sevilla, Spain, have reported the following results from a cross-sectional study of 64 volunteers, 47 women and 17 men. Thirty-two of the volunteers in the study were between 65 and 75 years old, and 32 volunteers were 76 years or older [de la Bella-Garzón 2022].

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Coenzyme Q10 for Longevity

Interesting statistics regarding life expectancy and longevity in the United States:

  • Individuals with no chronic conditions by age 67 years can expect to live another 22.6 years on average.
  • Individuals aged 67 years with 5 chronic conditions can expect to live 7.7 fewer additional years, on average.
  • Individuals aged 67 years with 10 or more chronic conditions can expect to live 17.6 fewer additional years, on average.
Human cells
Our cells’ production of Coenzyme Q10 declines as we get older and older. We need adequate Coenzyme Q10 in our cells to produce ATP energy, to protect against harmful free radicals, and to modulate inflammation.

These are some of the outcomes of a retrospective cohort study done by researchers at the Johns Hopkins University Bloomberg School of Public Health using the data from 1,372,272 Medicare fee-for-service beneficiaries who were 67 and older [DuGoff 2014].

When the researchers talk about chronic conditions (also called co-morbidities), they are referring to such conditions as cancer, cardiovascular disease, diabetes, hypertension, kidney disease, liver disease, and neurodegenerative diseases, among others.

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Coenzyme Q10 Supplementation Increases ATP Levels

Fact: Adequate Coenzyme Q10 is essential for our cells’ generation of ATP energy.

Roger Federer
For cells and tissues with high energy needs, tissues such as heart muscle tissue and skeletal muscle tissue, there is a constant demand for CoQ10 molecules.

Adenosine triphosphate (ATP) molecules have been called the energy currency of the cells. ATP molecules have to be produced and stored for later use, similar to storing money in a bank. All of our cells contain ATP, and the ATP provides the energy for almost all cellular processes. ATP is, so to speak, what drives the cellular machinery.

CoQ10 molecules are vitamin-like substances that are an essential component of the oxidative phosphorylation process in the cells’ mitochondria; they are essential to the process that converts the energy from ingested carbohydrates and fatty acids into ATP [Schniertshauer 2016].

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