The administration of supplemental Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More in addition to conventional medical treatment has beneficial effects on traumatic injury patients in the intensive care unit and has no observed adverse effects.
This is the conclusion from a clinical trialClinical trials are research studies in which various treatments, interventions, or tests are investigated for their safety and efficacy when used to detect, prevent, or treat diseases and medical conditions in patients and healthy volunteers. The gold standard for clinical trials are randomized, double-blind, placebo-controlled studies. More that enrolled patients who had been admitted to the intensive care unit [Hasanloei 2021].
The problem: trauma
-Traumatic injury is not uncommon: nearly one-third of the patients admitted to a typical intensive care unit in pre-Covid 19 days were admitted with traumatic injuries of one type or another.
-In many countries, traumatic injury is the third leading cause of death in hospitals.
-Many trauma patients require intubation and mechanical ventilation. Prolonged mechanical ventilation has 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. More adverse effects on the physical health of patients; it can cause severe complications in patients. Consequently, the medical staff are concerned to take eligible patients off the mechanical ventilation as soon as possible.
The hypothesis: Coenzyme Q10 as adjunctive treatment for trauma
-Long-term mechanical ventilation in trauma patients causes increased of oxidative stress, increased endothelial injury, increased mitochondrial dysfunctionMitochondrial dysfunction is the loss of efficiency in the process of ATP energy production. As such, mitochondrial dysfunction is a factor in the ageing process and in virtually all chronic diseases including cancer, cardiovascular diseases, chronic fatigue syndrome and fibromyalgia, diabetes and metabolic syndrome, and neurodegenerative diseases. Coenzyme Q10 is an essential component in the mitochondrial production of ATP energy. More, tissue injury, organ failure, and death.
–Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More as a 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,... More can have beneficial effects in trauma patients on mechanical ventilation: reduction of oxidative stress, reduction of 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... More, reduction of endothelial dysfunctionEndothelial dysfunction may be thought of as the failure of the cells lining the inside of arteries and veins to regulate properly blood vessel relaxation and contraction, blood clotting, immune function, and platelet adhesion. Endothelial dysfunction prevents the blood vessels from dilating sufficiently and can lead to increased risk of atherosclerosis, heart attack, and stroke. Coenzyme Q10 supplementation is associated... More, improved mitochondrial function.
The clinical trial: 400 mg/day Coenzyme Q10 for seven days
-From September 2019 to January 2020, researchers enrolled forty traumatic injury patients with sub-therapeutic plasma CoQ10 levels (below 2.5 mg/L) in a randomized controlled trial.
-The study participants included adult patients (age: 18–65 years) with an expected need of mechanical ventilation for at least 48 hours and an expected stay in the intensive care unit of at least seven days.
-The patients received either 400 mg/day of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More (100 mg administered every six hours by the sublingual route) or matching placebos for seven days.
Assessment of outcomes: Adjunctive CoQ10 treatment for trauma patients
-No patients were lost to follow up in the clinical trialClinical trials are research studies in which various treatments, interventions, or tests are investigated for their safety and efficacy when used to detect, prevent, or treat diseases and medical conditions in patients and healthy volunteers. The gold standard for clinical trials are randomized, double-blind, placebo-controlled studies. More.
-No side effects were reported following administration of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More.
-The active treatment resulted in 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. More increase in plasma total CoQ10 concentration compared to the placebo treatment.
Clinical outcomes: CoQ10 administration to trauma patients
-Seven-day administration of 400 mg/day of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More reduced the plasma interleukin-6 levels significantly compared to placebo administration. IL-6 is a known bio-marker for 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... More.
-Seven-day administration of 400 mg/day of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More reduced the serum values of malondialdehyde significantly compared to the placebo group. Malondialdehyde is a known bio-marker for oxidative stress.
– Seven-day administration of 400 mg/day of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More reduced considerably the length of the trauma patients’ stay in the ICU and in the hospital and significantly reduced the duration of the mechanical ventilation.
CoQ10 adjuvant therapy to shorten the period of mechanical ventilation
-Mechanical ventilation is ordered for critically ill patients in an attempt to save their lives.
-Unfortunately, prolonged mechanical ventilation can damage lung tissue and cause ventilator-induced lung injury. It can also cause reduced diaphragm strength and increased diaphragm dysfunction.
-Consequently, it is important to reduce the amount of time that critically ill patients spend on mechanical ventilation.
-Given the excellent safety profile of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More supplementation [Hidaka 2008], raising CoQ10 plasma concentrations to therapeutic levels (above 2.5 milligrams per liter) has a positive benefit/risk ratio.
Summary: Choosing the right CoQ10 preparation for traumatic injury patients
–Not all CoQ10 supplements are equally well-absorbed, not even if they have been manufactured with the same raw material. The absorption and bio-availability and efficacy of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More depends very much on the composition and formulation of the CoQ10 capsule [Lopez-Lluch 2019].
-The manufacturing process – combining the right carrier oils with the Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More at the right temperatures in the heating and cooling processes – is expensive. It is not likely that a less expensive CoQ10 product will be as effective as a more expensive CoQ10 product. Money spent on a cheap CoQ10 product is likely to be money wasted [Lopez-Lluch 2019].
-There have been many misleading marketing claims for the ubiquinol version of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More: the research shows that it is not necessary to take a ubiquinol supplement to get enough ubiquinol in the blood and lipoproteinsLipoproteins are particles comprised of protein and lipids, with a core of triglycerides and cholesterol esters and an outer layer of phospholipids. Lipoproteins transport lipids through the bloodstream. LDL-lipoproteins carry cholesterol from the liver to the body tissues. HDL- lipoproteins carry cholesterol back to the liver from the body tissues. LDL-lipoproteins also bind and transport Coenzyme Q10 molecules, predominately in... More. A well-formulated 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. More CoQ10 supplement will do the job [Mantle & Dybring 2020].
Sources
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López-Lluch G, Del Pozo-Cruz J, Sánchez-Cuesta A, Cortés-Rodríguez AB, Navas P. Bioavailability of coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More supplements depends on carrier lipids and solubilization. Nutrition. 2019 Jan;57:133-140.
Mantle D, Dybring A. Bioavailability of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized 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... More: An Overview of the Absorption Process and Subsequent Metabolism. Antioxidants (Basel). 2020 May 5;9(5):386.
The information presented in this review article is not intended as medical advice and should not be used as such.
15 October 2021
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