Insufficient Evidence for the Claims for Ubiquinol Supplements

Dr. Karl Folkers
Dr. Karl Folkers was a biochemist who was instrumental in isolating vitamin B12 and in determining the structure of Coenzyme Q10. He was an important force behind the early clinical research into the effect of Coenzyme Q10 supplementation on heart failure 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.

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Dr. Judy: What Does the Evidence Show About Ubiquinone vs Ubiquinol?

Dr Judy's book
Dr. William V. Judy, president of SIBR Research and author of Coenzyme Q10: An Insider’s Guide, addresses the question of whether to buy a ubiquinone 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 ATP 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 antioxidant. 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-energetics.

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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Coenzyme Q10: Misleading claims for ubiquinol products

Dr. William V. Judy (Ph.D. in physiology and bio-physics) founded the SIBR Research Institute to do absorption and bio-availability studies of Coenzyme Q10 and other natural products. Dr. Judy’s clinical research studies have focused on the effects of Coenzyme Q10 supplementation on Prader-Willi syndrome, congestive heart failure, chronic fatigue syndrome, diabetes, and certain cancers.Dr. Judy wants to see scientific documentation for claims of better absorption. There is so much variation in CoQ10 products that consumers must be cautious.

Marketers continue to make many unsubstantiated and misleading claims for the ubiquinol version of Coenzyme Q10 supplements.  As long ago as 2007, Dr. William Judy, the founder and president of the SIBR Research Institute, wrote a seminal article revealing the facts and fabrications that existed in marketing texts for ubiquinol products.  So far, no one has refuted the points that Dr. Judy made [Judy 2007].

CoQ10 formulation more important than CoQ10 form

Now, in 2018, we have the results of the double-blind, cross-over study done in Sevilla, Spain.  That study showed that a well-formulated ubiquinone Coenzyme Q10 supplement gave a significantly better bio-availability than did a well-formulated ubiquinol supplement.  That the ubiquinol supplement itself was well formulated is evidenced by the fact that the ubiquinol product out-performed other less well formulated ubiquinone products [Lopez-Lluch 2018].

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Concerns about claims for ubiquinol products

Woman at computer
People deciding on a nutritional supplement need more than undocumented marketing claims. They need evidence from randomized controlled studies. They need evidence that shows whether the difference in the outcome, e.g. heart function, between the active Coenzyme Q10 treatment study group and the placebo treatment study group is statistically significant.

Sometimes we see people and companies making incorrect and misleading claims without proper documentation to support their claims.  In the years since its introduction in 2007, there have been some questionable claims for the ubiquinol version of Coenzyme Q10 supplements.  The ubiquinol version is not nearly as well tested and documented as the traditional ubiquinone Coenzyme Q10 version is.

In the articles on this web-site, we prefer to report the positive results from randomized controlled trials involving the use of Coenzyme Q10 supplements.  But, occasionally, we must react negatively to the misleading claims that we see in some of the advertisements for some of the Coenzyme Q10 products available for purchase in the US.

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Coenzyme Q10: head-to-head comparison study of ubiquinone and ubiquinol absorption

What are we looking for in a Coenzyme Q10 nutritional supplement?  We want “full-range documentation” – documentation for good absorption, good response rate, and for health benefits. There is much variation in the formulation and absorption of Coenzyme Q10 supplements. It is best to select one with documented heart health benefits.

What we have been missing until now is a good study comparing the absorption of the more stable ubiquinone Coenzyme Q10 supplements with the absorption of the newer and less stable ubiquinol Coenzyme Q10 supplements head-to-head.  Now, the Coenzyme Q10 researchers at the University of Sevilla in Spain have carried out a direct comparison study in which the same study participants have been tested, with appropriate wash-out periods, on both ubiquinone and ubiquinol supplements.

The result:  One well-formulated ubiquinone Coenzyme Q10 preparation – the same preparation used in the Q-Symbio study, the KiSel-10 study, and the Gulf War Illness study –  has tested out significantly better than the ubiquinol preparation.  This particular ubiquinone Coenzyme Q10 supplement had nearly twice the absorption response as did the ubiquinol supplement in the study.

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Absorption of Coenzyme Q10, part I

steak
Once we pass the age of 20, our bodies begin to produce less Coenzyme Q10 with increasing age. Various medications, including statin medications, interfere with our production of Coenzyme Q10. Most of us cannot hope to make up the difference in our meals. For good heart health, we need a daily Coenzyme Q10 supplement. The ubiquinone form of supplement is the most stable form and the most carefully researched form.

Coenzyme Q10 is a vitamin-like substance that is an essential bio-nutrient.  It is vital for the cellular process of ATP energy production. It is an important antioxidant protecting the cells against harmful free radicals. It is thought to improve epithelial cell function in the blood vessels and to protect against the development of atherosclerosis and high blood pressure. In this essay, we review some of  the basic facts of Coenzyme Q10 absorption and bio-availability.

Importance of Coenzyme Q10 absorption
Coenzyme Q10 bio-synthesis declines with age
Our bodies produce Coenzyme Q10 in much the same way that they produce cholesterol.  However, once we reach our 20’s, our bio-synthesis of Coenzyme Q10 begins to decline with increasing age [Kalén].  One estimate is that the plasma Coenzyme Q10 concentration of an average 65-year-old will be only about half the plasma concentration of an average 25-year-old: approximately 0.65 micrograms per milliliter versus 1.35 micrograms per milliliter.

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Coenzyme Q10: the best of q10facts.com — part II

emergency-room
Daily supplementation with 200 milligrams of Coenzyme Q10 has been shown to reduce the number of hospitalizations and re-hospitalizations of chronic heart failure patients. The use of Coenzyme Q10 as an adjuvant treatment improves the quality of life for patients and reduces the expenses of health care systems.

Last month, I wrote brief summaries of some of the best articles that have been published on this website.  This month, I want to present summaries of several more good q10facts.com articles about the health benefits of Coenzyme Q10 supplementation.  The information in all of these articles is based on clinical study results published in peer-reviewed bio-medical journals.  In each summary, there is a link to the original article.

Fewer hospitalizations with Coenzyme Q10
In the Q-Symbio study, 420 chronic heart failure patients on conventional heart failure medications were randomly assigned to an adjuvant Coenzyme Q10 treatment group (n=202) or to a placebo control group (n=218).  In the study, Dr. Svend Aage Mortensen and his fellow researchers wanted to test the hypothesis that the condition of the energy-starved heart could be improved by the use of Coenzyme Q10 supplementation.

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Coenzyme Q10 and selenium: partners against heart disease

Surgeons and hospitalized patient
Swedish seniors, both men and women, who took Q10 and selenium supplements for a 4-year period spent 13% fewer days in the hospital and had significantly better quality of life than did Swedish seniors who took placebos.

There is a tantalizingly interesting relationship between the essential bio-nutrient Coenzyme Q10 and the trace element selenium and heart disease.  One of the first clinical researchers to tease out the effects of supplementation with Q10 and selenium in heart attack patients was Dr. Bodo Kuklinski.  

Coenzyme Q10 and selenium for heart attack patients
Dr. Kuklinski tested 61 patients who had been admitted to the hospital in Rostock, Germany, with an acute myocardial infarction and with symptoms of less than six hours’ duration.  He assigned 32 of the patients to the adjuvant treatment group and 29 of the patients to the control group.

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Strange TV ad for Q10 Ubiquinol product

Pro football picture
TV commercials reach many people. It is just not possible to do justice to the ubiquinone-ubiquinol Q10 controversy in a 30-second TV commercial. The topic is a bit more complicated than that.

Commercial spots on prime time television must be expensive, right?  Can we agree that the information in television commercials should be accurate?  Is the Federal Communications Commission doing what it should be doing to protect consumers against misleading television commercials?  Sometimes, it seems that consumers are being misled by the advertising of Q10 products.

Dr. William Judy, long-time Coenzyme Q10 researcher and Chairman and founder of SIBR Research, told me that, one evening recently, his wife called to him while he was watching an Indianapolis Colts game in his home office.  Mrs. Judy wanted him to come see a commercial running during the showing of a film on television.

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