Heart disease continues to be the number 1 cause of death in the developed world. Much research has been done on efforts to modify some of the known risk factors for heart disease:
- Diet
- Exercise
- Lifestyle
However, modifying these risk factors alone is not always sufficient to prevent heart disease. Hence, the extensive prescription of statin medications in the United States because changing the lipid profiles of potential heart disease patients is do-able and effective.
But the statin medications are not without adverse effects. Even in generally healthy study participants given moderate statin doses, there can be unfavorable statin medication effects on energy and exertional fatigue. Both simvastatin and pravastatin have been seen to contribute to 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 adverse effect of statins on energy and fatigue with exertion [Golomb 2012; Okuyama and Langsjoen 2015].
Nutraceuticals containing Coenzyme Q10 against heart disease
One possible counter-proposal to the use of statin medication — or one possible measure to reduce the dosage of the statin medication– is the use of a carefully formulated nutritional supplement.
Nutritional supplements are sometimes called nutraceuticals because they are medical devices that fit somewhere between pure nutrients (food) and medications (pharmaceutical drugs).
Nutraceuticals that change the blood’s lipid profile most likely need to include a well-formulated Coenzyme Q10 supplement.
Synergy of Coenzyme Q10 and red yeast rice combinations
Red yeast rice is produced during the fermenting of white rice together with a specific yeast species Monascus purpureus. Taken as a nutritional supplement, red yeast rice acts in much the same way as the more widely used statin medications: it inhibits the activity of the HMG-Coenzyme A reductase enzymes. It inhibits the activity that is necessary for the bio-synthesis of cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More [Cicero].
Because the inhibition of the activity of the HMG-Coenzyme A reductase enzymes – whether by statin medications or red yeast rice – also stifles the bio-synthesis of the essential substance 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, it is necessary to add a pharmaceutical-grade Coenzyme Q10 supplement as an adjuvant treatment [Cicero].
Red yeast rice and 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 go together like bacon and eggs. Dr. Arrigo Cicero and his colleagues at the University of Bologna in Italy found that the synergy between red yeast rice and Coenzyme Q10 yields positive outcomes with regard to the following heart disease risk factors:
- 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 reduction of total cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More
- 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 reduction of LDL-cholesterol
- 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 reduction of non-HDL-cholesterol
- 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 reduction of hs-CRP (a 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)
- 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 reduction of GOT and GPT liver enzymes (bio-markers for liver function)
There was also a trend toward improvement of fasting glucose and insulin levels associated with the active nutraceutical treatment, but the improvement did not reach the level of statistical significance.
How Dr. Cicero and his colleagues did the study is interesting.
Study design to test red yeast rice and Coenzyme Q10
The researchers set up a randomized, double-blindA double-blind study is a study in which neither the investigators nor the study participants know which participants are receiving the active treatment and which participants are receiving the control treatment until the study has been completed and the seal on the code has been broken. More, cross-over study to test the effectiveness of the nutritional supplements in reducing heart disease risk factors in patients diagnosed with moderately high cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More levels (LDL-cholesterol levels between 130 and 190 milligrams per deciliter).
- 4-week period of diet and exercise stabilization
- 6-week period of treatment with the nutritional supplement or with placebo
- 2-week washout period
- 6-week period of treatment with the alternative to the treatment in the first 6-week period
The researchers collected clinical and laboratory data at baseline, after the first 6-week treatment period, after the washout period, and after the second 6-week treatment period [Cicero].
Dosages used in the red yeast rice and Coenzyme Q10 study
For the active treatment, the researchers administered a combination of the following nutritional supplements:
- 200 milligrams of red yeast rice (equivalent to 10 milligrams of the active ingredient monacolin K) = for its cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More lowering properties
- 50 milligrams 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 = for its cellular 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. More and 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 properties
- 500 milligrams of artichoke extract = for its liver-protective and bile enhancing properties
- 75 milligrams of banaba extract = for its blood glucose lowering properties
- 9 milligrams of vitamin B3
- 1.4 milligrams of vitamin B6
- 0.83 micrograms of vitamin B12
- 110 micrograms of folic acid
Note: The banaba plant is a tropical plant found in the Philippines and much of Southeast Asia. Its dried and shredded leaves seem to have protective effects against diabetes and kidney disease.
Safety of the red yeast rice-Coenzyme Q10-banaba plant extract nutraceutical combination
Dr. Cicero and his colleagues report that the nutraceutical supplement was well tolerated by the patients diagnosed with moderately high cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More levels.
Conclusion: red yeast rice and Coenzyme Q10 combination safe and effective
Of course, we would like to see more randomized controlled studies of this combination, and we would like to see a study with a larger sample size.
But, the results are very encouraging. Dr. Cicero’s study suggests that red yeast rice and 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 combination may be a viable alternative to statin medications for patients who have difficulty with cumulative high statin dosages.
In a related study, Dr. Giuseppe Marazzi and his colleagues in Rome, Italy, have shown that low-dose statin therapy together with an adjuvant nutraceutical combination containing both red yeast rice and Coenzyme Q10 is well tolerated and effective in patients with coronary artery disease and high-dose statin intolerance.
The researchers in Rome concluded that a combination of low-dose statin therapy and adjuvant red yeast rice and Coenzyme Q10 treatment represents a valuable therapeutic option to high-dose statin therapy.
Sources
Cicero, A. G., Colletti, A., Fogacci, F., Bove, M., Rosticci, M., & Borghi, C. (2017). Effects of a Combined Nutraceutical on Lipid Pattern, Glucose MetabolismThe glucose metabolism is the process by which the body processes and uses sugars in the diet to produce energy. In patients with diabetes, the body’s tolerance and processing of sugars is impaired or damaged. Clinical studies have shown that the use of Coenzyme Q10 supplements does not impair the body’s glucose metabolism. More and Inflammatory Parameters in Moderately Hypercholesterolemic Subjects: A Double-blindA double-blind study is a study in which neither the investigators nor the study participants know which participants are receiving the active treatment and which participants are receiving the control treatment until the study has been completed and the seal on the code has been broken. More, Cross-over, Randomized 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. High Blood Pressure & Cardiovascular Prevention, 24(1), 13-18. doi:10.1007/s40292-016-0163-2
Golomb, B. A., Evans, M. A., Dimsdale, J. E., & White, H. L. (2012). Effects of statinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More on energy and fatigue with exertion: results from a randomized controlled trial. Archives Of Internal Medicine, 172(15), 1180-1182. doi:10.1001/archinternmed.2012.2171
Marazzi, G., Campolongo, G., Pelliccia, F., Quattrino, S., Vitale, C., Cacciotti, L., & … Rosano, G. (2017). Comparison of Low-Dose Statin Versus Low-Dose Statin + Armolipid Plus in High-Intensity Statin-Intolerant Patients with a Previous Coronary Event and Percutaneous Coronary Intervention (ADHERENCE Trial). The American Journal of Cardiology, 120(6), 893-897. doi:10.1016/j.amjcard.2017.06.015
Okuyama, H., Langsjoen, P. H., Hamazaki, T., Ogushi, Y., Hama, R., Kobayashi, T., & Uchino, H. (2015). StatinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More stimulate atherosclerosisAtherosclerosis is the thickening of the artery walls brought about by the build-up of plaque (plaque is made up of cholesterol and other fatty substances and waste products and calcium and fibrin) and the subsequent slowing of the flow of blood through the clogged arteries. More research is needed into the role of Coenzyme Q10 in the prevention and adjunct... More and 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... More: pharmacological mechanisms. Expert Review of Clinical Pharmacology, 8(2), 189-199.
The information presented in this review article is not intended as medical advice and should not be construed as such.
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