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May 28, 2011 | Supplement Articles
Coenzyme Q10 is a substance that acts very much like a vitamin in the body.
Coenzyme Q10 is a substance that acts very much like a vitamin in the body. It is a member of the ubiquinone family, which are characterized by solubility in fat, hydrophobicity, and which are involved in electron transport and energy production. Coenzymes are non-proteinaceous substances that combine in the body with apoenzymes, which are proteinaceous, to form active enzyme systems. These enzyme systems are in turn involved in the breakdown of proteins (often into their component amino acids, which feed, fuel, repair, and maintain the health of the body). Since vitamins are essential precursors to enzyme systems (“essential” means that they must be consumed and are physiologically necessary), and coenzyme Q10 is needed by the body, it is often considered a vitamin, however it is not truly “essential” – your body can produce Coenzyme Q10. If our bodies were unable to produce Coenzyme Q10, it likely would have been called “vitamin Q”.
Coenzyme Q10 can supply or remove oxygen from biologically active molecules. Every cell in your body contains intercellular components (organelles) called mitochondria, which produce 95% of the total energy of the body. Coenzyme Q10 is an integral part of the membranes of the mitochondria where it is involved in the production of ATP (adenosine triphosphate), the basic energy molecules of the cell. It is important to understand that ATP, produced by your mitochondria IS energy in potentia; that is, when you breath, sit, stand, run, exercise, walk, digest, laugh, whistle or mow the lawn, even think – everything that takes energy, which is everything you do – comes at the cost of your ATP stores. Supplementing coenzyme Q10 aids in the body’s cellular respiration and energy production; it’s that fundamental and it is fundamentally that important. Our bodies could not survive without coenzyme Q10, as it is necessary in the synthesis of ATP (Pizzorno 1999). If body levels start dropping, so does our general health; scientists have estimated that once body levels of coenzyme Q10 drop below the 25% deficiency levels, many health problems begin to flourish, including cardiovascular problems, immune system depression, periodontal problems, lack of energy, and weight gain, and it may be a contributing factor to the aging process (Pizzorno 1999).
Coenzyme Q10 is a nutrient necessary to the functioning of every cell in our bodies, and now you know why. The greater the oxidative stress on a given organ tissue, the greater the need for Coenzyme Q10, which may explain its usefulness in heart conditions (Pizzorno 1999).
Interestingly, our bodies’ production of Coenzyme Q10 begin to decline around age 30 and steadily decreases with age, making supplementation increasingly important. Since Coenzyme Q10 production occurs in the same metabolic pathway as does cholesterol, it is suspected that the increased cholesterol synthesis that occurs as we age may be responsible for the drop off in Coenzyme Q10 levels (Hendler 2001). It may be that as our cholesterol synthesis increases, the body’s capacity to produce Coenzyme Q10 necessarily decreases (since both share the same metabolic pathway – specifically, Coenzyme Q10 production diverts some farnesyl diphosphate away from squalene production which, in turn, is used to make cholesterol) (Pizzorno 1999). It is also suspected that increasing Coenzyme Q10 in the body can help decrease lipid peroxidation (Aejmelaeus 1997).
In general, Coenzyme Q10 benefits as an adjuvant therapy in cases where disease etiology is affected by oxidative stress and/or mitochondrial dysfunction, which include Parkinson’s Disease, congestive heart failure, hypertension, migraine, macular degeneration, asthenozoospermia (infertility due to poor sperm motility), and Friedrich’s ataxia (an inherited nerve-degenerative disease) (Littaru 2005). It is also quite helpful in cases of periodontal disease (Pizzorno 1999). It is very important to understand, however, that in most cases Coenzyme Q10 is beneficial when used as an adjuvant therapy (not a primary therapy except where indicated), and nothing on this page is meant to be construed as a recommendation, diagnosis, or an endorsement of Coenzyme Q10 as a primary medicinal treatment or cure of any disease.
Coenzyme Q10 made headlines a few years ago when a study funded by the National Institute of Neurological Disorders and Stroke, conducted at the University of California at San Diego, was published in the journal, “Archives of Neurology”. In that study, Coenzyme Q10 was demonstrated to slow the progress of early-stage Parkinson’s disease.
Patients diagnosed with Parkinson’s disease for 5 years were divided into four groups and given varying amounts of CoEnzyme Q10 and Vitamin E. The four groups were as follows:
· 300mg of Coenzyme Q10;
· 600mg of Coenzyme Q10;
· 1200mg of Coenzyme Q10; or
· a placebo.
All groups received Vitamin E.
The patients’ improvement in mental function, motor ability and activities of daily living were dose dependent; those receiving 1200 mg of Coenzyme Q10 each day showed the greatest improvement (44% less decline in the above function categories as compared to the placebo group). Patients receiving the smaller amounts of Coenzyme Q10 did not fare as well as those in the 1200 mg group, but did better than those not receiving any Coenzyme Q10 (Shults 2002).
Since then, much research into Coenzyme Q10 and Parkinsin’s disease has been initiated but has mostly not been completed. However, a recent meta-analysis of Coenzyme Q10/Parkinson’s disease studies has indicated that Coenzyme Q10 is indeed of some benefit to sufferers of Parkinson’s disease (Weber 2006), but left conclusive value as to its benefit in question for further research.
NOTE regarding statins and PD: though statins reduce the levels of Coenzyme Q10 in the body, and Coenzyme Q10 is known to benefit in PD, it has not been shown that statins worsen the severity of PD (Lieberman 2005). (More under “Statins”, below.)
Perhaps the best researched aspect of Coenzyme Q10 is it’s use as an adjuvant therapy in cases of heart disease, both in preventative and palliative scenarios. The reason why Coenzyme Q10 is so beneficial to the heart is because Coenzyme q10 possesses the ability to protect the heart during periods of aschemia, or oxygen deprivation. When the mitochondria are performing optimally, cellular respiration is at its best, too, and this is quite beneficial to your heart. Additionally, researchers believe that Coenzyme q10 prevents the oxidation of low-density lipoproteins (LDL; i.e., the “bad” cholesterol), making it an important supplement for anyone with high cholesterol (more on this topic under “Statins”, below).
Numerous studies have shown that pre-treatment with Coenzyme Q10 helps heart patients come through various open heart surgeries in better health, and with shorter recovery times, than those who have not been so treated (Judy 1993, Rosenfeldt 1999, 2005).
In a study performed in 1998, Coenzyme q10 was shown to halve the total number of subsequent cardiovascular incidents in patients who had suffered myocardial infarctions (heart attack), as long as the Coenzyme q10 was begun within three days of the infarction (Singh 1998). That’s a really big deal as anyone who has had, or knows someone who has had, a heart attack can attest. Maybe most exciting are the studies that show that Coenzyme Q10 has helped patients with severe cardiomyopathy to live well beyond their usual life expectancies1, and has helped those with congestive heart failure (Sinatra 1997), as well as those awaiting heart transplant, enjoy an improved quality of life (Berman 2004).
Also of interest, and a topic that is currently undergoing more rigorous study, is the use of Coenzyme Q10 in reducing liver and cardio-toxicity due to cancer chemotherapy (Roffe 2004). (Interesting side note: one study we found indicated that baseline Coenzyme Q10 levels were strongly predictive of melanoma metastasis (Rusciani 2006).)
But you certainly do not have to be in such dire health circumstances to benefit from Coenzyme Q10. Overall, it has been shown to improve ejection fraction and end diastolic volume of the heart (Weant 2005), and it can be used as part of a lifestyle method of reducing hypertension (Wilburn 2004).
High cholesterol is very common health concern in America today; odds are almost certain that you or someone you know has been instructed by their physician to reduce their cholesterol level. Statin drugs, also known as HMG-CoA Reductase Inhibitors, are extremely popular prescriptions for the reduction of cholesterol (accounting for many of the top sellers for the pharmaceutical companies). But, as discussed above, cholesterol and Coenzyme Q10 are produced through the same metabolic pathway and when you block the pathway to effect a reduction in cholesterol, you also effect a reduction in endogenous Coenzyme Q10 production. This, as the reader may suspect, is not good.
Another problem that occurs with prolonged use of statin drugs is a condition known as rhabdomyolysis. Rhabdomyolysis is why statin users must have their liver enzymes checked periodically. It is a nasty condition whereby skeletal muscle tissue is destroyed and its contents (many things, but of most concern is potassium) dumped into the blood stream, taxing the liver and causing, in the worst case scenario, acute renal failure if left untreated.
Some good news is on the horizon: Coenzyme Q10 has been shown to be of promise in combination with statin drugs (Chapidze 2005), AND it may be able to help reverse rhabdomyolysis (Farswan 2005). As is nearly always the case, it looks good, but more study is needed.
There is good preliminary evidence that Coenzyme Q10 is a safe, natural, and highly effective way to reduce the occurrence of migraine headache (Bianchi 2004, Modi 2006, Sandor 2005). While general consensus must remain guarded, there is one stand-out study that is worth mentioning because it is of the double-blind, randomized, placebo-controlled variety. This study showed that 100mg, 3x/day reduced the 50%-responder-rate of migraine attack by 47.6% as compared to 14.4% for placebo (Sandor 2005).
We didn’t expect to find this when we were updating our research on Coenzyme Q10, but a new avenue of research into this versatile substance has to do with male fertility. The studies we found were universally promising. In men with infertility or low fertility with a diagnosis of idiopathic asthenozoospermia (low sperm motility), Coenzyme Q10 has been shown to improve sperm fertilization rates, sperm count, and sperm motility (Alleva 1997, Ballercia 2004, Lewin 1997, Mancini). The reason for this is theorized to be that the Coenzyme Q10 concentration in the sperm is directly responsible for reactive oxygen species (ROS) quenching. As we age, we are exposed to environmental toxins which accumulate in the body; without proper anti-oxidant defenses (e.g. endogenous Coenzyme Q10) these toxins take their toll on the body’s tissues and cells. Sperm cells are also susceptible to such attacks, so increasing Coenzyme Q10 and other anti-oxidants in the diet can help to reverse male infertility, when it is due to these oxidative stresses (Sheweita 2005, Sinclair 2000).
For men diagnosed with varicocele, the benefits of Coenzyme Q10 are less clear as there seems to be some as yet unarticulated molecular pathology at work in these patients (Balercia 2002, Mancini).
Usage should be adjusted according to the issue it is being taken to address, but is typically effective in the range of 100-300 mg/day. As coenzyme Q10 is lypophilic it should always be taken with food as this will increase its absorption rate.
There are no contraindications for Coenzyme Q10; it is exceedingly safe. According to the PDR for Nutritional Supplements, precautions include only Warfarin users. Coenzyme Q10 may decrease the effectiveness of Warfarin, though this warning is based on only one report. The PDR also indicates that it may reduce the need for certain type II diabetes medicines, so the type II diabetic user should be aware of this. Adverse reactions include mild gastrointestinal symptoms in some persons (Hendler 2001), though we have received no reports of this.
Footnotes
1. Langsjoen PH, Langsjoen PH, Folkers K (1985). “Long-term efficacy and safety of coenzyme Q10 for idiopathic dilated cardiomyopathy.” Am J Cardiol 65: 521-523, qtd. in Pizzorno: 666-667.
Works Cited
Aejmelaeus, R., T. Metsa-Ketela, et al. (1997).
Alleva, R., A. Scararmucci, et al. (1997).
Balercia, G., G. Arnaldi, et al. (2002).
Balercia, G., F. Mosca, et al. (2004).
Berman, M., A. Erman, et al. (2004).
Bhagavan, H. N. and R. K. Chopra (2005).
Bhagavan, H. N. and R. K. Chopra (2006).
Bianchi, A., S. Salomone, et al. (2004).
Bonakdar, R. A. and E. Guarneri (2005).
Chapidze, G., S. Kapanadze, et al. (2005).
Farswan, M., S. P. Rathod, et al. (2005).
Hendler, Sheldon Saul and Rorvik, David, Eds. 2001.
Judy, W. V., W. W. Stogsdill, et al. (1993).
Levy, H. B. and H. K. Kohlhaas (2006).
Lewin, A. and H. Lavon (1997).
Lieberman, A., K. Lyons, et al. (2005).
Littarru, G. P. and L. Tiano (2005).
Mancini, A., B. Conte, et al. (1994).
Mancini, A., G. Conte, et al. (1998).
Mancini, A., L. De Marinis, et al. (1994).
Mancini, A., D. Milardi, et al. (2003).
Mancini, A., D. Milardi, et al. (2005).
