Doctors are people with a scientific slant of mind. They tend to be skeptical. They want proof. And, when it comes to clinical research, they want results from randomized, double-blindA 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. More, placebo-controlled studies with very large sample sizes. Then, if there is a statistically significantThe 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. More result, they want to see the study replicated.
Access to information about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More
So, one big reason that I write articles about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More is that I want heart disease patients (and people wanting to avoid heart disease) to have a chance to inform themselves about the heart health effects of a good Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplement. After all, I am a librarian by training and by trade.
Preparing to talk to the cardiologist about Q10
What do we know by now? That it is a rare doctor (or cardiologist) who likes to talk with a patient who has already consulted Dr. Google, isn’t that right? Clearly, it bothers some doctors that we read about disease conditions and possible remedies on the Web and want to discuss what we have read. And, for doctors, time is money.
Much worse, I should think, are the television commercials paid for by the pharmaceutical companies that try to scare people into asking the doctor for a prescription. But, never mind. I want to talk about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, not about commercials for prescription drugs for depression and erectile function.
Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More relevant for depression and erectile dysfunction?
By the way, doesn’t it seem probable that, for many people, there may be a connection between an energy-deprived heart and feelings of listlessness and depression? Couldn’t it be that there is a connection between an energy-starved heart and the inability to get and maintain an erection?
I am just thinking out loud here. It seems to me that it ought to be possible to raise and discuss issues like this with a doctor with whom you have a good relationship, isn’t that fair?
Asking Dr. Judy for advice about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More
I asked long-time Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More researcher Dr. William Judy: How do we go about talking with the doctor about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More?
Me. … Dr. Judy, what do I want to say to the cardiologist to get the ball rolling?
Dr. Judy. … Well, you could start by asking the doctor if he has seen the Q-Symbio study results in the Journal of the American College of Cardiology in December of 2014. The article by Dr. Svend Aage Mortensen and the other Q-Symbio researchers.
Me. … Okay, good, that is a start. And I can imagine that I need to mention that the article appeared in the JACC specialty journal Heart FailureThe 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... More. What if the doctor hasn’t seen the article?
Dr. Judy. … You could take a copy with you to give to the doctor. Admittedly, some doctors might find that a bit presumptuous of a patient, but you would offer the article to the doctor only after finding out that he has not seen it. You would be saving him time looking for it.
Me. … Okay, right. I can see that. What do I say, then, if he says, well, he doesn’t think that 400-plus patients in a study is not a really big study?
Dr. Judy. … Ah, that is where you say, true, but … as Dr. Mortensen has already pointed out, … 13 out of the 16 previous double-blind placebo-controlled studies of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More adjuvant supplementation showed improvement of clinical parameters or hemodynamic parameters or exercise tolerance.
Plus, remember, there have been three meta-analyses of randomized controlled trialsRandomized 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... More with Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More, all of which showed small but significantThe 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. More improvement in left ventricular ejection fractionEjection 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... More. Improved ejection fraction is directly related to the force of heart muscle contraction and to increased myocardial energy production.
In other words, the people taking Coenzyme Q10 saw their heart function improve; the people taking a placebo did not.
Me. … Right. Good. The numbers are there if you add them up. The Morisco study alone enrolled something like 641 chronic heart failureThe 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... More patients. The KiSel-10 study enrolled 443 elderly people. Both of those studies were randomized controlled studies.
Dr. Judy. … Good. But, don’t get too hung up in the number of clinical trials and participants. You want to say a word or two about why Coenzyme Q10 has a significant effect.
I would say that the big problem causing many cases of worsening heart failureThe 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... More is the problem of energy starvation of the heart muscle. The mitochondriaThe mitochondria are the bean-shaped organelles in the cells. They are the key organelles with responsibility for the production of ATP energy molecules. More in the heart muscle cells simply do not get as much Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More as they need to produce enough ATPATP (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. More. That’s it in a nutshell.
Me. … Got it. And then say something about the fact that Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More is synthesized in the body in the same biological pathway as cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More is?
Dr. Judy. … Exactly. And that gives you a chance to mention, first of all, that we synthesize less Coenzyme Q10 as we get older, and, secondly, that taking statin medications inhibits not only the body’s production of cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More but also the body’s production of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More.
Me. … Well, for me, it is a no-brainer that people taking a statin medication need to take a Coenzyme Q10 supplement.
Dr. Judy. … I agree. Absolutely.
Me. … Now I am going to say something controversial, I think. Those chronic heart failureThe 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... More patients and those patients taking statin medications, I think that they should read the relevant articles (Editor: please see my list of sources below; all of the articles are available through PubMed) and then decide if they need to take a Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplement even if their doctor is hesitant to recommend it.
Dr. Judy. … Well, think about it. The studies do show statistically significant improvement with Coenzyme Q10 supplementation.
Me. … Right. And time is running out for some of us. If older people and heart disease patients want a better quality of life, well, Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More has been shown to be safe, affordable, and effective.
Me. … Thank you, Dr. Judy. The time to think seriously about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More is now.
Sources:
Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined seleniumSelenium (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... More and coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplementation: a 5-year prospective randomized double-blindA 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. More placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.
Folkers, K., Vadhanavikit, S., Mortensen, S. A. (1985). Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More. Proc Natl Acad Sci U S A.; 82(3):901-4.
Folkers K, Langsjoen P, Willis R, Richardson P, Xia LJ, Ye CQ, et al. (1990). Lovastatin decreases coenzyme Q levels in humans. Proc Natl Acad Sci USA;87:8931-4.
Fotino, A. D., Thompson-Paul, A. M., & Bazzano, L. A. (2013). Effect of coenzyme Q₁₀ supplementation on heart failureThe 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... More: a meta-analysis. The American Journal of Clinical Nutrition, 97(2), 268-275.
Golomb, B. A., Allison, M., Koperski, S., Koslik, H. J., Devaraj, S., & Ritchie, J. B. (2014). Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More benefits symptoms in Gulf War veterans: results of a randomized double-blindA 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. More study. Neural Computation, 26(11), 2594-2651.
Judy, W.V., Stogsdill, W.W., Judy, D.S., & Judy, J.S. (2007). Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More: Facts or Fabrications? Natural Products Insider. Retrieved from http://www.zmc-usa.com/docs/CoQ10_Facts_or_Fabrications.pdf.
Kalen A, Appelkvist EL, Dallner G. Age-related changes in the lipid compositions of rat and human tissues. Lipids. 1989;24(7):579–584.
Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & … Littarru, G. P. (2014). The effect of coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More on morbidity and mortality in chronic heart failureThe 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... More: results from Q-SYMBIO: a randomized double-blindA 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. More trial. JACC. Heart FailureThe 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... More, 2(6), 641-649.
Mortensen, S. A. (2015). Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More: Will This Natural Substance Become a Guideline-Directed Adjunctive Therapy in Heart FailureThe 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... More? JACC. Heart FailureThe 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... More, 3(3), 270-271. doi:10.1016/j.jchf.2014.12.006
Mortensen, S. A. (2003). Overview on coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More as adjunctive therapy in chronic heart failureThe 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... More. Rationale, design and end-points of “Q-Symbio”–a multinational trial. Biofactors (Oxford, England), 18(1-4), 79-89.
Singh, R. B., Niaz, M. A., Kumar, A., Sindberg, C. D., Moesgaard, S., & Littarru, G. P. (2005). Effect on absorption and oxidative stress of different oral Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More dosages and intake strategy in healthy men. Biofactors (Oxford, England), 25(1-4), 219-224.
Sander, S., Coleman, C. I., Patel, A. A, Kluger, J., White, C. M. (2006). The impact of coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More on systolic function in patients with chronic heart failureThe 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... More. Journal of Cardiac Failure. 12:464–472.
Soja, A.M. and Mortensen, S.A. (1997) Treatment of congestive heart failureThe 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... More with coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More illuminated by meta-analyses of clinical trials. Molecular Aspects of Medicine. 18(suppl):159–168.
Weber C, Bysted A, Hølmer G. The Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More content of the average Danish diet. Int J Vitam Nutr Res 1997;67:123-9.
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