Coenzyme Q10 is an essential bio-nutrient that has vitamin-like properties.
- It is a vital co-factor in 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 generation.
- It is an important lipid-soluble Antioxidants 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,... Read more about this term. It has anti-inflammatory effects.
- Substantial reduction of bio-markers for oxidative stress and 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 has been seen in several Randomized controlled trials are studies in which patients or healthy volunteers are assigned at random (purely by chance) to receive one or more clinical interventions. One or more of the interventions is the active treatment being tested. Another of the interventions is the control against which the active treatment is being tested. The control is, typically, the standard practice or... Read more about this term [Martelli 2020].
Coenzyme Q10 is a Redox is the abbreviated term for reduction-oxidation. Coenzyme Q10 molecules are redox molecules. Redox refers to the oxidation state of the molecule. Oxidized Coenzyme Q10 molecules, called ubiquinone (CoQ10), are Coenzyme Q10 molecules that can accept (take on) two electrons and thus become reduced Coenzyme Q10 molecules called ubiquinol. Reduced Coenzyme Q10 molecules, called ubiquinol (CoQH2), are Coenzyme Q10 molecules... Read more about this term, having both an oxidized 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) and a reduced form (ubiquinol).
- Several enzyme systems facilitate the conversion of the ubiquinone form of Coenzyme Q10 to the ubiquinol form. It is not necessary to take a ubiquinol supplement to get enough ubiquinol in the plasma and 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 [Mohr 1992].
- Absorption of Coenzyme Q10 from commercially available supplements varies widely. Marketing claims for a superior absorption of ubiquinol supplements seem to be misleading.
- A 2019 double-blind crossover study has shown that a well-formulated ubiquinone supplement – with the correct carrier oils, the correct heating and cooling process, the correct excipients – gave significantly better bioavailability than did a ubiquinol supplement. The ubiquinol supplement used in the study did, however, outperform a ubiquinone supplement that did not have the proper formulation and processing [Lopez-Lluch 2019].
CoQ10 Supplementation and Heart Disease Risk Factors
Coenzyme Q10 and Heart Failure
In 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, researchers gave 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 300 mg/day (3 x 100 mg in divided dosages) or matching placebos for two years.
- The CoQ10 adjuvant treatment significantly improved the symptoms, quality of life, and survival of the 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].
- A sub-analysis of the European segment of the international multi-center Q-Symbio Study showed that the CoQ10 intervention also significantly improved the patients’ Ejection fraction, sometimes called left ventricular ejection fraction, measures the percentage of blood that the heart pumps out of the left ventricle with each heart contraction. According to the Mayo Clinic guidelines, an ejection fraction above 55% is regarded as normal. An ejection fraction under 50% is regarded as reduced. An ejection fraction below 40% is indicative of heart failure... Read more about this term [Mortensen 2019].
Coenzyme Q10 and High Blood Pressure
Older meta-analyses of the effect of Coenzyme Q10 on Hypertension is abnormally high blood pressure, usually defined as adult systolic blood pressure above 140 mm Hg or adult diastolic blood pressure above 90 mm Hg. Systolic blood pressure is blood pressure measured during the contracting (pumping) of the left ventricle of the heart. Diastolic blood pressure is blood pressure measured during the relaxation of the left ventricle. A meta-analysis... Read more about this term showed 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 both systolic and diastolic blood pressure [Rosenfeldt 2007; Ho 2009]. A more recent meta-analysis has shown that CoQ10 supplementation is associated with a significant reduction in systolic blood pressure but not in diastolic blood pressure in patients with Metabolic syndrome is the medical term for a cluster of conditions such as excess body fat around the waist, high blood sugar, high blood pressure, high cholesterol or triglyceride levels. Metabolic syndrome is associated with increased risk of diabetes, heart disease, and stroke. Individuals with metabolic syndrome are at higher risk of heart disease, diabetes, and stroke and have, therefore,... Read more about this term [Tabrizi 2018].
Coenzyme Q10 and Type 2 Diabetes and Insulin Resistance
In patients with metabolic syndrome, supplementation with 100 mg/day of Coenzyme Q10 for eight weeks significantly improved serum insulin levels, HOMA-IR insulin resistance, HOMA-β beta cell function, and total antioxidant capacity compared to placebo [Raygan 2016].
In a meta-analysis of 14 clinical trials enrolling 693 overweight/obese diabetic subjects, intervention with Coenzyme Q10 significantly reduced fasting blood glucose, hemoglobin A1c levels, and triglyceride levels.
- Subgroup analysis of the data showed that low-dose consumption of CoQ10 (<200 mg/day) effectively reduced fasting blood glucose levels, HbA1c levels, fasting blood insulin levels, homeostatic model, and assessment of insulin resistance levels.
- The CoQ10 treatment was well tolerated by the patients with metabolic syndrome.
- The researchers concluded that daily CoQ10 supplementation has beneficial effects on glucose control and lipid management in overweight and obese patients with type 2 diabetes [Huang 2018].
Coenzyme Q10 and Systemic Inflammation
A 2019 meta-analysis of nine randomized controlled trials enrolling 509 patients showed that daily supplementation with Coenzyme Q10 significantly reduced the blood levels of bio-markers for systemic inflammation: tumor necrosis factor-alpha and interleukin-6 [Farsi 2019].
A 2017 meta-analysis showed a significant association between CoQ10 supplementation and reductions of the same bio-markers for inflammation mentioned above as well as significant reductions in the C-reactive protein levels [Fan 2017].
In a four-year study of the supplementation of senior citizens with 200 mg/day of Coenzyme Q10 and 200 mcg/day of Selenium (symbol Se, atomic number 34) is a trace element that is an essential nutrient and an essential component of some of the most important antioxidants in the body, in particular the selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Selenium is involved in the optimal functioning of the immune system. Professor Alehagen has pointed out that there exists a... Read more about this term, researchers documented significant reductions in various bio-markers for systemic inflammation [Alehagen 2015, Alehagen 2019].
Coenzyme Q10 and Statin Medications
In 2015, Okuyama et al published an article explaining the pharmacological mechanisms by which statin medications may actually stimulate the development of Atherosclerosis 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... Read more about this term and heart failure.
- The researchers posited that Statins 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.... Read more about this term may cause coronary artery calcification and may function as mitochondrial toxins that impair muscle function in the heart and blood vessels.
- Statins inhibit the bio-synthesis of Coenzyme Q10 and heme A, both necessary for the generation of ATP energy.
- Furthermore, statins inhibit the body’s synthesis of vitamin K 2 and inhibits the body’s synthesis of selenium containing proteins, including the antioxidative glutathione peroxidase enzymes [Okuyama 2015].
In a 2018 meta-analysis, researchers analyzed the data from 12 randomized controlled trials with a total of 575 patients enrolled: 294 patients in the CoQ10 supplementation group and 281 in the placebo group. Compared with placebo, the CoQ10 supplementation ameliorated statin-associated muscle symptoms, such as muscle, muscle weakness, muscle cramp, and muscle tiredness. The researchers concluded that CoQ10 supplementation may be a useful complementary therapy for the management of statin-induced myopathy [Qu 2018].
Key Points: CoQ10 and Clinical Applications
- Our bodies’ bio-synthesis of Coenzyme Q10 declines with increasing age as we pass from our 20s into maturity [Kalen 1989].
- Disease conditions and the use of statin medications are associated with reduced CoQ10 status.
- The bioavailability of commercially available CoQ10 supplements varies considerably. It is important to buy a well-documented CoQ10 product.
- It is not necessary to take a ubiquinol supplement to get significant increases in ubiquinol levels in plasma and lipoproteins.
- It is important to take the CoQ10 supplement with meals containing some fat. Divided doses will give better absorption than one large daily dosage.
- Coenzyme Q10 adjuvant treatment of chronic heart failure patients, hypertension patients, and type 2 diabetes patients has documented beneficial effects.
Alehagen U, Lindahl TL, Aaseth J, Svensson E, & Johansson P. Levels of sP-selectin and hs-CRP decrease with dietary intervention with selenium and coenzyme Q10 combined: a secondary analysis of a randomized Clinical 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.... Read more about this term. Plos One. 2015; 10(9): e0137680.
Alehagen U, Alexander J, Aaseth J. & Larsson A. (2019). Decrease in inflammatory biomarker concentration by intervention with selenium and Coenzyme Q10: a sub-analysis of osteopontin, osteoprotergerin, TNFr1, TNFr2, and TWEAK. Journal of Inflammation. 2019; 16(5): 1-9.
Fan L, Feng Y, Chen GC, Qin LQ, Fu C, & Chen LH. Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled. Pharmacological Research. 2017. 119: 128–136.
Farsi F, Mohammadshahi M, Alavinejad P & Rezazadeh A. Functions of Coenzyme Q10 supplementation on liver enzymes, markers of systemic inflammation, and adipokines in patients affected by nonalcoholic fatty liver disease. J Am Coll Nutr; 35: 346-53.
Ho MJ, Bellusci A & Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev. 2009; CD007435.
Huang H, Chi H, Liao D & Zou Y. Effects of coenzyme Q10 on cardiovascular and metabolic biomarkers in overweight and obese patients with type 2 Diabetes is a metabolic disease characterized by high blood sugar levels. Diabetes is caused by the body’s failure to produce sufficient insulin (type 1 diabetes) or by the body’s failure to respond to the available insulin (type 2 diabetes). The high blood sugar levels that are characteristic of diabetes are associated with increased risk of heart attack, stroke, and coronary... Read more about this term: a pooled analysis. Diabetes Metab Syndr Obes. 2018; 29(11): 875-886.
Lopez-Lluch G, del Pozo-Cruz J, Sanchez-Cuesta A, Cortes-Rodriguez AB & Navas P.: Bioavailability of Coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrients. 2019; 57: 133-40.
Martelli A, Testai L, Colletti A & Cicero AFG. Coenzyme Q10: Clinical Applications in Cardiovascular Diseases. Antioxidants. 2020; 9: 341.
Mohr D, Bowry VW & Stocker R. Dietary supplementation with coenzyme Q10 results in increased levels of ubiquinol-10 within circulating lipoproteins. Biochim Biophys Acta. 1992; 1126: 247-54.
Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D & Littarru GP. The effect of coenzyme Q10 on morbidity and mortality in chronic heart results from Q-SYMBIO: a randomized A 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.... Read more about this term trial. JACC. Heart Failure. 2014; 2(6): 641-649.
Mortensen AL, Rosenfeldt F. & Filipiak KJ. Effect of Coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-Symbio randomized double-blind study. Cardiology Journal. 2019: 26(2): 147-156.
Qu H, Guo M, Chai H & Wang WT. Effects of Coenzyme Q10 on statin-induced myopathy: an updated meta-analysis of randomized controlled trials. J Am Heart Assoc. 2018; 19: e009835.
Raygan F, Rezavandi Z, Dadkhah Tehrani S, Farrokhian A, & Asemi Z. The effects of coenzyme Q10 administration on glucose homeostasis parameters, lipid profiles, biomarkers of inflammation and oxidative stress in patients with metabolic syndrome. European Journal of Nutrition. 2016; 55(8): 2357–2364.
Rosenfeldt FL, Haas SJ, Krum H & Hadj A. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum Hypertens. 2007; 21: 297-306.
Tabrizi R, Akbari M, Sharifi N & Lankarani KB.: The Effects of Coenzyme Q10 supplementation on blood pressure among patients with metabolic diseases. High Blood Press Cardiovasc Prev. 2018; 25: 41-50.
The information presented in this review article is not intended as medical advice and should not be used as such.
15 June 2020Please click here for more information about the clinical aspects of Coenzyme Q10 supplementation.