Ubiquinol — misleading claims?

Lately, I have been reading a biography of Louis Pasteur (1).  In it, Rene Dubos reports that Pasteur’s passion for science and scientific results often caused Pasteur to be upset with people who responded to his experimental results with speeches and claims (p. 74).  Pasteur wanted every bio-medical claim to be based solely on precise facts, official reports, and evaluations by the most competent experts (p. 72).

More research on ubiquinol!  Please. 
Today, we need fewer marketing claims about the ubiquinol form 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 and more results from solid research studies.  It is the old familiar problem in the pharmaceutical industry: too much money spent on marketing, too little money spent on research.

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
In particular, what we need is randomized, double blind, placebo-controlled studies of the effects of taking 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 in its reduced ubiquinol form.  I can find lots of marketing claims for the reduced form of Q10, and I can see that some absorption studies have been done.  But I cannot find any studies of the efficacy of the ubiquinol form that can begin to compare with the results of the following 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 of ubiquinoneUbiquinone, 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. More supplementation:

• the Q-Symbio study of ubiquinoneUbiquinone, 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. More and 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 Morisco multi-center study of ubiquinoneUbiquinone, 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. More and 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 Swedish study of ubiquinone and selenium for healthy elderly citizens
• the Gulf War Veterans study

Unsubstantiated claims for the ubiquinol form
Recently, I read a blog post extolling the virtues of Q10 supplements in the ubiquinol form.  Two statements in the blog brought me up short.

One was the claim, once again, that the ubiquinol form of Q10 is absorbed better than the ubiquinoneUbiquinone, 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. More form.  The other was the incorrect claim that the ubiquinol form of Q10 is needed for energy synthesis.

Absorption important; effect of Q10 more important
Actually, not all studies show ubiquinol being absorbed better than ubiquinoneUbiquinone, 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. More.  And not all comparisons of absorption are meaningful.  Sending your best ubiquinol product out to compete against poorly absorbed versions of ubiquinoneUbiquinone, 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. More (in dry powder form as opposed to crystal-free lipid-based preparations) does not prove much. Comparing absorption in elderly or unhealthy individuals with absorption in younger or healthy individuals is misleading.

When asked, Dr. William Judy of the SIBR Institute said: There is no scientifically logical reason why the ubiquinol form should be absorbed more easily than ubiquinoneUbiquinone, 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. More form of Q10, … and, … notice, … there is no reason given in the marketing claims for ubiquinol absorption. If anything, the larger ubiquinol molecule could be more difficult to absorb. … There is no reason to think that adding two hydrogen ions to the head of the ubiquinoneUbiquinone, 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. More molecule would make the molecule into a water-soluble molecule, and, … even if it did, molecules with more than 10 carbon atoms in its structure cannot be absorbed as water soluble molecules. … But, never mind, we know that ingested ubiquinol is converted to ubiquinoneUbiquinone, 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. More in the stomach and small intestine prior to absorption.

The further point is that … yes … it is important to know that a particular Q10 supplement is well absorbed … but … the most important thing to know is that the Q10 supplement has had 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 effects compared to placebo.

Show us some beneficial effects
Simply put, documented beneficial effects will always trump documented absorption data. The effects of taking a ubiquinoneUbiquinone, 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. More Q10 supplement are well documented by now:

• Improved symptoms and quality of life
• Improved mortality
• Fewer adverse cardiovascular events
• Fewer hospitalizations

UbiquinoneUbiquinone, 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. More form of Q10 necessary for cellular energy production
Indisputably, it is the ubiquinoneUbiquinone, 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. More Q10 form – the form that the body itself synthesizes — that is necessary for cellular energy production.  The ubiquinol QH2 form is a by-product of the energy production process in the cells. Let me repeat that for emphasis: only the ubiquinoneUbiquinone, 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. More form is synthesized in the body.  The ubiquinol form is not synthesized in the body.  It is formed from the ubiquinoneUbiquinone, 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. More form in redox reactions that take place all over the body.

Dr. William Judy of the SIBR Institute (see photo) has explained the process of energy production in the cells (2).  In the electron transport chainThe electron transport chain is the pathway in the mitochondria in which nutrients are oxidized and converted to generate the energy that used to produce ATP energy. The mitochondria require an optimal supply of Coenzyme Q10 in the form of ubiquinone to generate ATP energy. More in that process, electrons have to be shuttled across the inner membrane of 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.  The form of Q10 that does this shuttling of electrons has to be an electron acceptor. Only the ubiquinoneUbiquinone, 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. More form is an electron acceptor and can do this.

The ubiquinol form is an electron donor — it gives up electrons – which is what permits it to act as an antioxidantAntioxidants 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,... More to neutralize super-oxides and free radicalsFree 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... More.

Both forms of Q10 vital
The ubiquinoneUbiquinone, 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. More form of Q10 is important for the synthesis of energy at the cellular level.  Dr. Judy and Dr. Mortensen – and Dr. Folkers – considered that, at its most basic level, 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 consequence of cellular energy starvation caused by an inadequate supply of ubiquinoneUbiquinone, 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. More Q10.

The ubiquinol form, with electrons to give up, is an antioxidantAntioxidants 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,... More posed to neutralize free radicalsFree 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... More in the cells, which could otherwise start a chain reaction and cause oxidative damage.

Recent changes in the ubiquinol marketing claims
Dr. Judy told me that he has seen many changes, in the years from 2007 to 2015, in the marketing claims for the ubiquinol products.  Here, below, are some of the modifications that the producers and the sellers of ubiquinol have made in their marketing claims.

2007 (unsubstantiated): Ubiquinol is the bio-active form of CoQ10 that the body prefers. UbiquinoneUbiquinone, 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. More has to be converted to ubiquinol in the body to become active.
2015 (modified):  Both ubiquinoneUbiquinone, 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. More and ubiquinol are bio-active in humans, ubiquinoneUbiquinone, 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. More as an energizer and ubiquinol as an antioxidantAntioxidants 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,... More.

2007 (unsubstantiated): The body synthesizes ubiquinol in a multiple series of chemical events.
2015 (modified): Ubiquinol is produced when the head of the ubiquinoneUbiquinone, 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. More molecule accepts two more electrons together with two hydrogen ions.

2007 (unsubstantiated): Commercial ubiquinol is stable and will not convert to the ubiquinoneUbiquinone, 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. More form.
2015 (modified): Ubiquinol is unstable outside the gelatin capsule and will convert to ubiquinoneUbiquinone, 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. More in the stomach or upon exposure to air.

2007 (unsubstantiated): Ubiquinol is an antioxidantAntioxidants 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,... More, and it is also essential for energy synthesis.
2015 (modified): Ubiquinol is a potent antioxidantAntioxidants 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,... More; it is a by-product of the synthesis of energy process involving ubiquinoneUbiquinone, 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. More.

2007 (unsubstantiated): Ubiquinol is 800% more bio-available than ubiquinoneUbiquinone, 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. More. (with no mention that the comparison is with very poorly absorbed dry powder Q10)
2015 (modified): Ubiquinol is 200-800 % more absorbable than ubiquinoneUbiquinone, 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. More.  (Actually, Dr. Judy at SIBR has done studies that show that a crystal free lipid-based ubiquinoneUbiquinone, 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. More product is absorbed better than a leading ubiquinol product.)

2007 (unsubstantiated): Ubiquinol is produced in the outer membrane of 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.
2015 (modified): Ubiquinol is converted from ubiquinoneUbiquinone, 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. More all over the body.

Ethnic variation in the Q10-QH2 conversion
Finally, there is the marketing claim that everyone over the age of 45 should take a Q10 supplement in the form of ubiquinol.  This claim is still being made even though the available evidence shows that only 4-5 percent of the Caucasian and African-American populations and approximately 15 percent of the Mexican-American population may have difficulty converting ubiquinoneUbiquinone, 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. More to ubiquinol after the age of 45 (3).

What it comes down to
We need more well-designed studies accepted and published in peer-reviewed journals.  Unsubstantiated marketing claims for ubiquinol, even those with lists of sources at the bottom of them, must surely be making Louis Pasteur turn over in his grave. The research results for the ubiquinoneUbiquinone, 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. More form are, at this stage of the research and development 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 products, much more impressive that the marketing claims for the ubiquinol form are.

Sources:

Dubos, Rene. (1950). Louis Pasteur: Free Lance of Science.  Boston: Little, Brown.

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

Kelsey K. T., Ross D ., Traver R.D . et al. (1997). Ethnic variation in the prevalence of a common NAD(P)H:quinone oxidoreductase polymorphism and its implications for anticancer chemotherapy.  Br J Cancer 1997;76:852–854.

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