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March 25, 2011

Coenzyme Q 10: Power Plant Protector

Death begins when energy production ends.  Our body’s energy is produced by tiny organelles in the cells known as mitochondria.  Through a series of complex reactions involving the electron transport chain ATP, or adenosine triphosphate is produced, which is the main energy source of the body.   Coenzyme Q 10 (CoQ10) is an essential cofactor in the electron transport chain.  Without adequate levels CoQ10, the mitochondria become inefficient at producing ATP and cells and body cannot function optimally.

In fact, the numbers of mitochondria we have parallel the amount of CoQ10 we have.

Coenzyme Q 10 is a vital and naturally occurring, fat-soluble compound found in the body.  It is important for cellular health and function.  It is also known as ubiquinone which comes from the word “ubiquitous” which means existing or being everywhere.  Coenzyme Q 10 is found in every cell and plays a critical role in the function of mitochondria, the “power producing” organelles of cells.

Coenzyme Q 10 has 3 main benefits; it promotes cellular energy, serves as a potent anti-oxidant, and stabilizes cell and mitochondria membranes. In addition, CoQ10 minimizes shortening of telomeres through its antioxidation properties. See “Telomeres: A Key to Longevity” and “TA-65: Potentially the Best Anti Aging Supplement”.

It exists in high concentrations in the heart, liver, kidneys, pancreas, and brain.  About half the body’s CoQ10 comes from ingestion of dietary fat, and the other is manufactured by the body through a complex series of steps.  Coenzyme Q 10 synthesis and cholesterol synthesis share a common pathway.  Statin drugs which inhibit the production of endogenous cholesterol can also inhibit the production of CoQ10.

Coenzyme Q 10 is the only fat-soluble anti-oxidant synthesized by the body.  Ubiquinol, or the reduced form of ubiquinone inhibits oxidation of LDL cholesterol, or the bad cholesterol.  Oxidation of LDL is a pre-requisite for cholesterol to build-up in the walls of our blood vessels.  Coenzyme Q 10 also limits damage to our cell membranes which results from a process called lipid peroxidation.

Do Coenzyme Q10 Levels Decline as We Age?

As we age our levels of CoQ10 decline.  From age 20 to 80 CoQ10 levels in our hearts are reduced by more than 50%.  In addition, lower levels of CoQ10 have been associated with certain chronic diseases, and lower CoQ10 levels are associated with certain medications.

What Diseases are Associated with Low Coenzyme Q 10 Levels?

High blood pressure, congestive heart failure, and periodontal disease have been associated with lower CoQ10 levels.

Medical Uses of Coenzyme Q 10

Coenzyme Q10 deficiency exists in 39% of people with hypertension (high blood pressure).  Supplementation of CoQ10 in doses of 100 to 200 mg/day for 4 to 12 weeks has been shown to lower blood pressure.   An analysis of 12 clinical trials found that individuals with high blood pressure who were supplemented with CoQ10 had significant reductions in blood pressure with the systolic blood pressure (the upper number) decreasing from 167.7 mmHg to 151.1 mmHg. And, the diastolic pressure (lower number) decreased from 103 mmHg. to 94.8 mmHg. Coenzyme Q10 probably lowers blood pressure because it enhances the utilization of nitric oxide, a potent vasodilator.  Vasodilators relax blood vessels, thereby lowering blood pressure.

Probably most research on CoQ10 has done in the area of its role in congestive heart failure.  It has been known since the late 1960s and early 1970s that patients suffering from congestive heart failure were CoQ10 deficient.  Several studies spanning more than 30 years have found positive findings in the use of CoQ10 supplementation in the treatment of congestive heart failure.  Many of these studies were placebo-controlled randomized clinical trials.  CoQ10 has been an approved drug in Japan for use in congestive heart failure since 1974.  In the United States, CoQ10 is classified as a nutritional supplement.

Coenzyme Q10 supplementation for 7 days prior to cardiac bypass surgery reduced the number of ventricular arrhythmias post-operatively.

Placebo-controlled studies involving in periodontal disease have found that CoQ10 is effective in reducing inflammation of the gingiva.

Coenzyme Q10 supplementations is being studied in the treatment of Parkinson’s Disease and other neurodegengerative disorders such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease), and Huntington’s Disease.  Results from animal studies have been encouraging in the treatment of these neurodegenerative diseases.

Coenzyme Q 10 and Sports Performance

Early evidence suggests that CoQ10 might increase energy and enhance recovery from muscle fatigue related to exercise.  One placebo-controlled study of 17 healthy individuals found that those volunteers receiving CoQ10 (100 mg to 300 mg daily) reported less fatigue and improved physical performance while being subjected to strenuous workloads.  The results were much better in those individuals receiving the 300 mg/day dose.

Statin Drugs and Reduced CoQ10 Levels

Statin drugs prescribed for elevated cholesterol have been show to lower CoQ10 levels by as much as 27% to 54%.  This lowering effect of statins on CoQ10 levels seems to be dose related. One of the more common side effects related to statin drug use is myalgias, or muscular pain. This pain may be related to lower CoQ10 levels in the mitochondria of the muscle cells, but it remains unclear whether supplementing with CoQ10 will prevent myalgias from occurring.  But, given the few side effects associated with CoQ10 supplementation it seems reasonable for individuals suffering from myalgias while taking a statin drug to consider use of CoQ10, if continuing the statin medication if felt necessary.

Medications and CoQ10 Levels and Function

Some antihypertensive medications (high blood pressure medications), especially beta-blockers like propanolol interfere with CoQ10 function. Coenzyme Q10 can improve blood sugar control in some patients with type 2 diabetes.  In these patients, a reduction in their diabetic medication might become necessary.  Warfarin, a blood thinner, has been reported in one study to be less effective in the presence of CoQ10 supplementation.

Absorption of CoQ10 and Dosing

Coenzyme Q10 comes in many forms.  The softgels are claimed to have better absorption rates.  Absorption is better if CoQ10 is taken with food especially with some fat intake.  Doses of 50 mg to 200 mg/day generally is generally adequate to achieve maximal concentrations after 3 weeks of daily use.

The main side effect of CoQ10 is the cost with a month’s supply of 200 mg costing approximately $50 for a high quality CoQ10 supplement.

See related articles.

“Supplements Recommend by Suzanne Somers”

“Resveratrol and Heart Disease”

“Vitamin K: Protect Your Bones and Prevent Cardiovascular Disease”

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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