Coenzyme Q10 and NADH and Chronic Fatigue Syndrome

DNA strand
Basically, our efforts to avoid or delay the onset of the various pathologies associated with increasing age involve managing the effects of cellular bio-energetic disturbances, oxidative stress, and mitochondrial dysfunction. Combined supplementation with Coenzyme Q10 and NADH may be a beneficial anti-ageing treatment.

Most recently, nicotinamide adenine dinucleotide (NAD+ in its oxidized form and NADH in its reduced form) has been getting much attention as a possible anti-ageing substance.

  • Like Coenzyme Q10, NAD+/NADH is a coenzyme that is present in nearly all human cells.
  • Like Coenzyme Q10, NAD+/NADH exists in both an oxidized form and a reduced form.
  • Like Coenzyme Q10, NAD+/NADH is needed for the cellular process of producing ATP energy from the food that we eat.
  • Like Coenzyme Q10, NAD+/NADH has an antioxidant function in the cells protecting against the damage caused by oxidative stress.
  • Like Coenzyme Q10, NAD+/NADH is essential for life.  Without NAD+/NADH, the cells will not produce energy and will die.
  • Like Coenzyme Q10, NAD+/NADH levels decrease as we get older.

Coenzyme Q10 and NAD+/NADH and Chronic Fatigue Syndrome

The results of a 2015 Spanish study indicate that Coenzyme Q10 and NADH supplementation could be a beneficial treatment of chronic fatigue syndrome and other chronic fatiguing illnesses for three reasons [Castro-Marrero]:

  • Coenzyme Q10 and NADH are essential co-factors in the process of cellular bio-energetics; they can boost mitochondrial function.
  • Coenzyme Q10 and NADH are powerful free radical scavengers that mitigate lipid peroxidation and DNA damage caused by oxidative stress.
  • Coenzyme Q10 and NADH supplementation can reduce the extent of oxidative damage and mitochondrial dysfunction associated with chronic fatigue syndrome.

In sum, oral CoQ10 plus NADH supplementation seems to be a safe and effective therapy to reduce fatigue, restore mitochondrial function and bio-energetic metabolism, and ameliorate oxidative damage in chronic fatigue syndrome [Castro-Marrero].

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Coenzyme Q10 and healthy ageing

Physical exercise combined with a Mediterranean diet and Coenzyme Q10 supplementation should improve our chances for healthy ageing and for the prevention of chronic oxidative stress leading to neurodegenerative disease and heart disease.

There is a significant reduction in the rate of Coenzyme Q10 bio-synthesis during the ageing process and in ageing-related diseases.  Mice studies have given us reason to believe that there is a direct relationship between a longer and healthier life and Coenzyme Q10 function in the mitochondria of the cells [Hernandez-Camacho 2018].  

Human studies of Coenzyme Q10 status and healthy ageing

Professor Alehagen’s KiSel-10 study:

Four years of daily supplementation with 200 milligrams of Coenzyme Q10 and 200 micrograms of high-selenium yeast resulted in significant health benefits for elderly community-living study participants as compared to placebo supplementation [Johansson 2015]:

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Coenzyme Q10 and exercise and ageing

Coenzyme Q10 supplementation and exercise confer significant heart health benefits and anti-ageing benefits.  The exercise can be aerobic exercise or strength training or both.  The Coenzyme Q10 supplement you choose should be a supplement with well-documented absorption and efficacy.

The biggest difference in elderly (70+) men and women still living at home and still relatively healthy is the extent to which they exercise.  Among elderly adults of the same socioeconomic status, nutrition and lifestyle do not vary much.  Exercise levels do vary considerably.

With the variations in exercise level come variations in ageing.  The question is, what is the role of Coenzyme Q10 status in the elderly and the rate at which they age?

The differences in ageing – manifested in differences in functional capacity, exercise status, and body weight — are connected to Coenzyme Q10 plasma levels and to Coenzyme Q10/cholesterol ratios in plasma.

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Coenzyme Q10 for brain and muscle tissue

Supplementation with Coenzyme Q10 can increase brain mitochondrial concentrations and increase neuro-protective effects.   In addition to providing antioxidant defense against free radical damage, Coenzyme Q10 is essential for the process of cellular energy production.

So, it seems clear that Coenzyme Q10 supplementation is not needed when we are young and healthy, in our teenage years and in our early 20’s.  But … definitely … from our 20s onward, and increasingly as we get older, we need a well-formulated daily Coenzyme Q10 (preferably taken twice daily with meals) … or we need to take nutritional supplements that will enhance our bodies’ bio-synthesis of Coenzyme Q10.  Or both.

Because there is no doubt that we need to maintain functional levels of Coenzyme Q10 in the cell membranes and in the mitochondria, particularly in the brain and muscle tissue.  Coenzyme Q10 is essential in the process of cellular ATP energy production, and Coenzyme Q10 is the most important fat-soluble antioxidant protector of the cells [Littarru].

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Coenzyme Q10 and the energy starved heart

The number of bean-shaped mitochondria in our cells varies according to the energy needs of the various organs. The cells in organs with high energy needs, e.g. the heart, the liver, the skeletal muscle, will have greater numbers of mitochondria than will the cells of less active organs, e.g. the skin.  Adequate supply of Coenzyme Q10 is necessary to keep the mitochondria actively producing ATP molecules.

Cellular respiration is the name for the process by which the ATP molecules are produced inside the mitochondria in our cells.  Coenzyme Q10 in its oxidized form is an essential component in this process of energy production.

Fewer Coenzyme Q10 molecules in the mitochondria inevitably mean less ATP energy production.  Fewer ATP molecules mean less energy for our cells. 

Heart muscle cells with low Coenzyme Q10 concentrations and with fewer ATP molecules produced make for an energy starved heart.

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Coenzyme Q10 and healthy ageing

Elderly couple on the beach
Given the importance of Coenzyme Q10 in the process of cellular energy production and in the process of neutralizing harmful free radicals, it is very important to take a daily Coenzyme Q10 supplement as we grow older.

Coenzyme Q10 is an essential bio-nutrient that is made naturally in the human body.  It is a necessary co-factor in the process of cellular energy production.  It also functions as a lipid-soluble antioxidant protecting our cells against oxidative damage (oxidative damage = damage caused by free radicals that harm cell membranes and cell DNA and proteins and fats in the blood).

Unfortunately, as we pass through our 20s and move into our 30s and 40s and head towards senior citizen status, our cells produce less of this essential substance with increasing age [Kalén]. We know this.

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Coenzyme Q10, older athletes, and statins

woman-exercising
The more intensely and strenuously we exercise, the more quickly we reach the anaerobic threshold. A 2012 study has shown that 200 milligrams of Coenzyme Q10 daily can significantly delay the time to the anaerobic threshold. The Coenzyme Q10 supplementation was also associated with significant improvement in muscle strength in the study.

Older active adults who are taking a statin medication?  Shouldn’t they go right to the top of the list of people who need a good Coenzyme Q10 supplement?

That is the question that Dr. Richard Deichmann and his colleagues in the Department of Internal Medicine at the Ochsner Clinical School in New Orleans asked themselves. They tested whether daily supplementation with 200 milligrams of Coenzyme Q10 daily for six weeks would improve measures of cellular energy production, muscle function, and well-being in older active adults taking statin medications.

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A review of Coenzyme Q10 research results

Pharmaceutical control
The Coenzyme Q10 supplements with the best documented results in randomized controlled trials have been manufactured under national-level pharmaceutical control.

Recently, I read a published review of the research literature about the nutritional and therapeutic supplement Coenzyme Q10.  It was very interesting to see what the research has revealed and to see what the authors of the review chose to emphasize [Potgieter].

Coenzyme Q10 supplements confer the following known health benefits:

  • improve the symptoms and survival of heart failure patients
  • provide antioxidant protection to patients taking statin medications
  • help to lower high blood pressure
  • maintain good heart function in middle-aged and elderly people
  • provide heart health benefits to people with diabetes

Normal unsupplemented levels of plasma Coenzyme Q10
First off, there is wide variation in the plasma Coenzyme Q10 concentrations of individuals who are not taking Coenzyme Q10 supplements.  There are many factors that influence any one individual’s Coenzyme Q10 status:

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Coenzyme Q10 and exercise in younger and older adults

sevilla-cathedral
Sevilla is famous for its cathedral, Santa Maria de la Sede, the largest Gothic cathedral in the world, built during the 15th century. Sevilla is also famous for its university. Within the university, the Developmental Biology Institute has been doing much research into the nutritional and medical importance of Coenzyme Q10.

Spanish researchers at the Pablo de Olavide University in Sevilla hypothesized that the effect of physical activity on plasma Coenzyme Q10 levels and on plasma Coenzyme Q10/cholesterol ratios might vary according to the age of the individuals engaging in the physical activity. Their results show, for the first time, an apparently different effect of exercise on young people and on older people.

  • Lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the young people more so than in older people who were also exercising. That result was surprising.
  • Moreover, lower levels of plasma Coenzyme Q10 and lower Coenzyme Q10/cholesterol ratios were associated with high levels of physical activity in the younger people more so than with moderate levels of physical activity in younger people. That result was not surprising.
  • What was most surprising was the data that showed that older people who exercised more often and more intensely had higher levels of Coenzyme Q10 in plasma and higher ratios of Coenzyme Q10 to cholesterol in plasma than did older adults who exercised moderately or who were mostly sedentary. In this respect, the effect of exercise on the older people differed from the effect of exercise on the younger participants [Del Pozo-Cruz 2014].

Coenzyme Q10 and physical activity in young people
In the Spanish study, the young participants had an average age of 20 years plus or minus 2 years.  Two possible explanations come to mind for the lower plasma Coenzyme Q10 levels in highly active younger people:

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Statin medications and Coenzyme Q10

Mevalonate_Pathway
In blocking the body’s production of mevalonate, the statin medications inhibit the production of cholesterol. They also inhibit the body’s bio-synthesis of the essential bio-nutrient Coenzyme Q10, and they inhibit the body’s ability to use dietary and supplemental selenium to make the selenocysteine amino acid that is needed to make vital selenoproteins. Drs. Okuyama and Langsjoen have called for a critical re-evaluation of the guidelines for statin medication use.

There are two issues concerning the use of statin medications that relate to Coenzyme Q10.  

The more serious issue is that several animal and human studies have shown that the administration of statin medications leads to a reduction in the plasma and muscle tissue levels of Coenzyme Q10.  There is no doubt that depletion of Coenzyme Q10 is an unintended consequence of taking statin medications.  Some human trials have shown the extent of the reduction to be 40 % or greater.  Furthermore, ageing seems to play a role in the diminution of Coenzyme Q10 levels caused by the administration of statin medications [Deichmann].  Decreased plasma and heart muscle tissue levels of Coenzyme Q10 are associated with the increasing severity of heart failure [Folkers, Mortensen].

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