Coenzyme Q10’s Anti-Inflammatory Effects

Professor Urban Alehagen
A well-designed randomized controlled clinical trial, the KiSel-10 study, has shown that a combined daily supplementation of senior citizens with Coenzyme Q10 and high-selenium yeast can reduce cardiovascular mortality by over 50%. Professor Urban Alehagen thinks that a special interrelationship between the two supplements has resulted in less oxidative stress, less low-grade chronic inflammation, and less fibrosis in the senior citizens taking the active treatment as opposed to the placebo treatment.

Two independent meta-analyses of the available research literature have shown that Coenzyme Q10 supplementation is associated with healthy levels of bio-markers for chronic systemic inflammation [Zhai 2017; Fan 2017].

  • Chronic inflammation – a persistent low-grade inflammation – can have deleterious effects throughout the body. Over time, it can result in tissue damage.
  • Chronic inflammation is something different from acute inflammation, which is the immune system’s short-term response to an injury or an infection.
  • Chronic low-grade inflammation has been linked to increased risk of heart disease, stroke, diabetes, and metabolic disorders [Zhai 2017].
  • The extent of chronic low-grade inflammation can be measured by testing for the blood levels of known bio-markers for inflammation [Zhai 2017].

Coenzyme Q10 Effect on Tumor Necrosis Factor-Alpha

Zhai et al analyzed nine randomized controlled trials enrolling 428 study participants.  The results of their analysis showed that CoQ10 supplementation significantly improved the serum concentration of Coenzyme Q10 by 1.17 micrograms per milliliter on average compared to placebo treatment [Zhai].

Note: The cardiologist Dr. Peter H. Langsjoen has stated that it is important to raise plasma/serum CoQ10 levels above 2.5 micrograms per milliliter to have a therapeutic effect on the cardiovascular system [Langsjoen 2014].

In the Zhai meta-analysis, the increased serum CoQ10 concentrations were associated with a significant decrease in the inflammation bio-marker tumor necrosis factor-alpha (TNF-α) by 0.45 picograms per milliliter.

Note: Increased blood concentrations of TNF-a are common in both acute and chronic inflammation.  Reducing TNF-a levels is a potential therapeutic goal for reducing the risk of atherosclerosis and diabetes and metabolic disorders [Zhai 2017].

Coenzyme Q10 and Bio-Markers of Chronic Inflammation

Fan et al examined the data from 17 randomized controlled trials enrolling 811 patients (412 assigned to the CoQ10 treatment group and 399 assigned to the placebo control group).

The researchers found that the CoQ10 supplementation was associated with a significant reduction of the blood levels of C-Reactive Protein (C-RP) and TNF-a compared to the placebo treatment. They were able to show that the reduction in C-RP levels was independent of the baseline CR-P levels, the treatment duration, the treatment dosage, and patient characteristics [Fan 2017]. 

The CoQ10 treatment also had a significant lowering effect on blood levels of the inflammation bio-marker IL-6 [Fan 2017].

Note: C-Reactive Protein is a protein produced in the liver.  During times of elevated inflammation in the body, the concentrations of C-RP increase in the blood, making it a good bio-marker for detecting chronic inflammation.

Note: The immune system produces interleukin 6 (IL-6) at the site of the inflammation. At healthy levels, IL-6 acts as a defense mechanism; however, at elevated levels, it can have a pro-inflammatory effect [Gabay 2006].

Dr. William V. Judy portret
Dr. William V. Judy, long-time Coenzyme Q10 researcher and president of SIBR Research, has written about the Q-Symbio Study and the KiSel-10 Study in his book, The Insider’s Guide to Coenzyme Q10, now available on amazon.com.

Decrease in Inflammatory Bio-Markers with Selenium and Coenzyme Q10 Combination

Neither the Zhai study nor the Fan study included data from the KiSel-10 study conducted by Professor Urban Alehagen and a team of university researchers.  Zhai and Fan concentrated on studies using a single supplement: Coenzyme Q10.

The four-year KiSel-10 study was a study of the effect of combined daily supplementation (200 milligrams of Coenzyme Q10 and 200 micrograms of high-selenium yeast) on senior citizens.  The KiSel-10 study results showed the following statistically significant outcomes:

In follow-up analyses, Professor Alehagen and his team confirmed that the combined supplementation regimen was significantly associated with reductions in the levels of a number of inflammatory bio-marker concentrations [Alehagen 2015; Alehagen 2019].

Summing up: CoQ10 Supplementation and Chronic Inflammation

  • Our bodies produce less and less Coenzyme Q10 as we get older [Kalen 1989].
  • Coenzyme Q10 has a number of clinically important functions in the body [Littarru 2010].
    • essential to the cellular generation of ATP energy
    • important as a fat-soluble antioxidant
    • necessary for good endothelial function
    • associated with reductions in bio-markers of chronic inflammation
  • Coenzyme Q10 is safe, well-tolerated, effective, and affordable.

Important to Keep in Mind When Buying a Coenzyme Q10 Supplement

  • Not all CoQ10 supplements are absorbed equally well.  To get the anti-inflammatory effect and the beneficial heart health effects, it is important to buy a CoQ10 supplement that is well-documented.
  • The formulation of the CoQ10 supplement is more important than the form of the CoQ10 supplement [Lopez-Lluch 2019].  The ubiquinone form of Coenzyme Q10 is the more stable, better documented (in terms of absorption and health effects), and more affordable CoQ10 supplement.
  • Adequate intakes of Coenzyme Q10 are important for energy, for immune defense, and healthy ageing.

Sources

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.

Alehagen, U., Lindahl, T. L., Aaseth, J., Svensson, E., & Johansson, P. (2015). Levels of sP-selectin and hs-CRP Decrease with Dietary Intervention with Selenium and Coenzyme Q10 Combined: A Secondary Analysis of a Randomized Clinical Trial. Plos One, 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, 16,5,1-9.

Fan, L., Feng, Y., Chen, G.-C., Qin, L.-Q., Fu, C.-L., & Chen, L.-H. (2017). Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Pharmacological Research, 119, 128–136.

Gabay, C. (2006). Interleukin-6 and chronic inflammation. Arthritis Res Ther; 8(Suppl 2): S3.

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.

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.

Littarru, G-P & Tiano, L. (2010). Clinical aspects of Coenzyme Q10: an update. Nutrition, 26(3):250-4.

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.

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.

Zhai, J., Bo, Y., Lu, Y., Liu, C., & Zhang, L. (2017). Effects of Coenzyme Q10 on Markers of Inflammation: A Systematic Review and Meta-Analysis. Plos One, 12(1), e0170172.

The information contained in this review article in not intended as medical advice and should not be used as such.

21 December 2019

Please click here for more information about the heart health effects of Coenzyme Q10 supplementation.

 

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