Coenzyme Q10 is a naturally occurring vitamin-like bio-nutrient that is essential to the cellular process of ATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production.... Read more about this term energy production. It is especially important for the optimal functioning of tissues with high energy requirements such as heart muscle tissues [Mantle 2015].
Beyond its role in cellular energy production, Coenzyme Q10 has the following important biological functions:
- In its reduced form, Coenzyme Q10 is a lipid soluble antioxidant that protects The cell membranes, sometimes called plasma membranes, are the physical barrier that protects the contents of the cells from everything that is outside the cells. The cell membranes also regulate what can move in and out of the cells. Coenzyme Q10 is present in all cell membranes in the body except in the red blood cells. It helps to prevent... Read more about this term from oxidative damage caused by harmful Free radicals are unstable and highly reactive molecules that are produced in the body during normal oxygen metabolism. Free radicals derived from oxygen are known as reactive oxygen species. Free radicals play both helpful and harmful roles in the body. Free radicals steal electrons from other substances in order to become stable. In so doing, the free radicals oxidize those... Read more about this term [Mantle 2015].
- Coenzyme Q10 improves endothelium-dependent vaso-dilation in patients with diabetes and in patients with coronary artery disease [Tiano 2007].
- In a meta-analysis of 17 RCTs, CoQ10 supplementation significantly reduces the blood levels of known bio-markers for systemic Inflammation 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... Read more about this term: C-RP, IL-6, and TNF-α [Fan 2017].
Bio-Synthesis of Coenzyme Q10 Declines with Age
The human body’s ability to synthesize Coenzyme Q10 peaks at some time in a person’s 20s and gradually declines thereafter [Kalén 1989]. Consequently, supplementation is necessary. It is not possible to make up the age-related loss of Coenzyme Q10 by eating more carefully.
Furthermore, certain drugs — statin medications in particular — are known to inhibit the body’s synthesis of Coenzyme Q10 [Okuyama 2015].
Absorption and Bio-Availability of the CoQ10 Supplement
There is considerable variability in the absorption and bio-availability of CoQ10 supplements. The CoQ10 raw material is a dry crystalline powder. The human digestive system cannot absorb CoQ10 crystals. To make absorption possible, the Coq10 supplement manufacturer must use a process that dissociates the CoQ10 crystals into single CoQ10 molecules.
- The formulation of the CoQ10 supplement – the composition of the oil matrix and the heating/cooling process – is much more important than the form – Ubiquinone, 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.... Read more about this term vs ubiquinol – is [Lopez-Lluch 2019].
- In a 2019 double-blind crossover study with four-week washout periods, researchers showed that a ubiquinone (oxidized CoQ10) preparation with a patented soybean oil composition and a specific heating and cooling process gave significantly better absorption than a ubiquinol (reduced CoQ10) preparation composed of medium-chain triglycerides and vitamin C [Lopez-Lluch 2019].
Heart Health Benefits of CoQ10 Supplements
In randomized controlled studies enrolling 400+ study participants, researchers reported The 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. ... Read more about this term reductions in death from heart disease associated with the CoQ10 treatment of The 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... Read more about this term patients [Mortensen 2014] and senior citizens [Alehagen 2013].
- The Q-Symbio is the abbreviated name for the two-year multi-center, randomized, double-blind, placebo-controlled study of Coenzyme Q10 supplements as an adjunct treatment of chronic heart failure patients. The name reflects the focus of the study on the SYMptoms, BIomarker status (BNP), and long-term Outcomes (hospitalizations and mortality) of the supplementation. The data from the Q-Symbio study show that long-term supplementation with... Read more about this term showed significant improvement of symptoms and survival in chronic heart failure patients given 3 times 100 milligrams of Coenzyme Q10 daily for two years. The patients in the CoQ10 adjunctive treatment group has a 43% lesser risk of death from heart disease than the patients in the placebo group did [Mortensen 2014].
- The The KiSel-10 study was a four-year randomized, double-blind, placebo-controlled study of 443 Swedish citizens aged 70 to 88 who received either a combined daily supplementation of high-selenium yeast and Coenzyme Q10 or matching placebos. The elderly Swedish citizens who received the active treatment of selenium and Coenzyme Q10 had significantly reduced risk of death from heart disease, significantly better heart... Read more about this term showed improved heart function on echocardiograms and a 53% lesser risk of death from heart disease among senior citizens in the active treatment group compared to the placebo group. The study participants in the active treatment group took 2 times 100 milligrams of Coenzyme Q10 and 200 micrograms of a selenium-enriched yeast preparation daily for four years [Alehagen 2013].
- In both studies, the CoQ10 preparation used was the ubiquinone CoQ10 preparation that tested best in the 2019 bio-availability comparison study [Lopez-Lluch].
Safety of Coenzyme Q10 Supplements
The safety of CoQ10 supplementation has been verified in some 200 clinical studies. Coenzyme Q10 is well-tolerated, it has no toxic or geno-toxic effects, and it cannot be over-dosed. Very rarely, an individual taking CoQ10 supplements may experience mild gastrointestinal discomfort [Mantle 2015].
CoQ10 Supplementation for Prevention and Treatment of Heart Disease
- The formulation of the CoQ10 supplement is decisive for its absorption, its bio-availability, and its efficacy.
- Less expensive and undocumented CoQ10 supplements are likely to have a significantly lower absorption and bio-availability and thus negligible heart health effects.
- Contrary to misleading marketing claims, it is not necessary to take a ubiquinol supplement to get significant increases of ubiquinol in the blood and in the circulating Lipoproteins 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... Read more about this term. A good ubiquinone CoQ10 supplement will do the job [Mohr 1992].
- CoQ10 supplementation is affordable, effective, and safe. However, consumers should request documentation, in peer-reviewed journals, of the absorption and the efficacy of the CoQ10 supplement.
Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and Coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866. [PubMed]
Alehagen, U., Aaseth, J., Alexander, J., & Johansson, P. (2018). Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly. Plos One, 13(4), e0193120. [PubMed]
Fan L, Feng Y, Chen GC, & Qin LQ. (2017). Effects of Coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res; 119: 128-136. [PubMed]
Kalén, A., Appelkvist E.L., Dallner G. (1989). Age-related changes in the lipid compositions of rat and human tissues. Lipids, 24(7):579–584. [PubMed]
Langsjoen PH & Langsjoen AM. (2014). Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clin Pharmacol Drug Dev; 3(1):13-7. [PubMed]
López-Lluch, G., Del Pozo-Cruz, J., Sánchez-Cuesta, A., Cortés-Rodríguez, A. B., & Navas, P. (2019). Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition, 57, 133–140. [PubMed]
Mantle D. (2015). Coenzyme Q10 to treat and prevent heart disease. British Journal of Cardiac Nursing; 10: 382-7. [PubMed]
Mohr, D., Bowry, V. W., & Stocker, R. (1992). Dietary supplementation with Coenzyme Q10 results in increased levels of ubiquinol-10 within circulating lipoproteins and increased resistance of human low-density lipoprotein to the initiation of lipid peroxidation. Biochimica et Biophysica Acta, 1126(3), 247-254. [PubMed]
Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & Littarru, G. P. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC. Heart Failure, 2(6), 641-649. [PubMed]
Mortensen, A. L., Rosenfeldt, F., & Filipiak, K. J. (2019). Effect of Coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-Symbio randomized double-blind study. Cardiology Journal, 26(2): 147-156. [PubMed]
Tiano L, Belardinelli R, Carnevali P, Principi F & Littarru GP. (2007). Effect of Coenzyme Q10 administration on endothelial function and extracellular superoxide dismutase in patients with ischaemic heart disease. Eur Heart J; 28(18): 2249-55. [PubMed]
N.B. The information presented in this review article is not intended as medical advice and should not be construed as such.
31 March 2020