Decoding CoQ10

Learn about the role of this coenzyme and the benefits of taking it as a supplement.

Written By:
Cassandra King
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Coenzyme Q10, or CoQ10, is found in every cell membrane in the human body, and is responsible for providing energy to the cells for maintenance and growth. Additionally, it works as an antioxidant, fighting any damage to cells caused by free radicals. It can be found in its highest concentrations in the organs that need the most energy, such as the heart and liver. Some healthy adults get an adequate amount of the coenzyme naturally through their diets, but other individuals, including adults over 40 years of age, may benefit from a CoQ10 supplement.

The list of benefits of CoQ10 supplements is continually increasing, from blood sugar care to migraine support, but do your shoppers really understand how these supplements work?

The Super Coenzyme
CoQ10 is best known for its benefits toward heart health, which include helping maintain a normal level of LDL cholesterol without over-oxidation, circulatory health, vascular health and proper heart function (1). These effects have much research backing, and some interesting research points to some additional uses (though CoQ10 will not prevent or cure disease).

For instance, CoQ10 was found to help those with heart failure when used in conjunction with medication. A 2013 meta-analysis regarding this use was published in the American Journal of Clinical Nutrition by a group from Tulane University (2). The meta-analysis covered 13 controlled trials involving congestive heart failure patients whose ejection fractions (or the fraction of blood pumped out of the heart every time it contracts) were studied.

The analysis revealed that a combined 365 patients had a net increase of 3.67% in ejection fraction when on a CoQ10 supplement. The dosages ranged from 60–300 milligrams per day for 4–28 weeks. The most significant improvement occurred among patients who had at least a 30% ejection fraction before starting the supplement (2).

Heart transplant patients may also benefit from CoQ10. A double-blind study published by Clinical Cardiology took 32 patients with end-stage heart failure awaiting heart transplants that were either given 60 mg U/d of a CoQ10 supplement or a placebo for three months. The group experienced improvement in a six-minute walk test, the New York Heart Association function scale, nocturia and fatigue. Researchers concluded that giving heart transplant patients CoQ10 leads to better functional status, clinical symptoms and quality of life (3).

Statins Support
A more immediate application of CoQ10 supplementation may be for clientele taking cholesterol-lowering medications called statins. Statins have been shown to lower the levels of CoQ10 in the body, thus causing a host of problems. In a study published in the Clinical Journal of Lipidology, a group of 84 subjects were given 80 mg of atorvastatin, a statin drug, for 16 weeks. Researchers found that CoQ10 levels decreased by 45% in subjects (4).

Common side effects of statin drugs include muscle pain and fatigue. In a study done by the Department of Cardiology at Stony Brook University, published in the American Journal of Cardiology, patients suffering from muscle weakness were randomly treated with either 100 mg of CoQ10 per day or 400 IU of vitamin E for 30 days in a double-blind study. After 30 days, pain severity decreased by 40% and pain interference by 38% in patients who were given CoQ10 (5).

In a separate study published in Biofactors by researchers from the East Texas Medical Center and Trinity Mother Francis Hospital, 50 patients who had been on statins for at least 28 months discontinued statins and began CoQ10 supplements to help reduce statins side effects including shortness of breath, muscle pain and fatigue, peripheral neuropathy and memory loss. Patients took an average 240 mg of CoQ10 per day and followed up after an average of 22 months. Researchers found a decrease in all side effects: Muscle fatigue dropped from 84%to 16%, muscle pain from 64% to 6%, shortness of breath from 58% to 12%, peripheral neuropathy from 10% to 2% and memory loss from 8% from 4% (6). Overall heart function also improved.

Cholesterol Aid
On top of providing support for the side effects of statin drugs, CoQ10 has also been shown in some studies to help maintain healthy LDL cholesterol levels and prevent LDL oxidation. One such study published in UMB Life showed that patients taking CoQ10 supplements had a 6% overall decrease in LDL cholesterol, as well as decreases in LDL subfractions B by 33%, C by 14.62% and E by 16.52%. The study consisted of 53 healthy males spanning ages 21 to 48 who were given 150 mg of CoQ10 or a placebo every day for two weeks (7).

Vascular Health
People with high blood pressure may benefit from a CoQ10 supplement. A research group based in Australia published a meta-analysis in the Journal of Human Hypertension pooling data from a total of 362 patients within 12 clinical trials. The CoQ10 dosages ranged from 34 to 360 milligrams daily for 6–12 weeks. Patients saw a drop in blood pressure by 16.6 mmHg in double-blind controlled trials, and by 13.5 mmHg in open-label, uncontrolled trials (8).

Cancer Support
While CoQ10 cannot cure or prevent cancer in any way, it’s interesting to note some research groups are looking at the link between CoQ10 and cancer support. For instance, a study by the Institute of Basic Medical Sciences, University of Madras, published in Vascular Pharmacology, suggests that breast cancer patients may benefit from CoQ10 supplementation. The study was composed of 84 breast cancer patients who used a combination of supplements (including CoQ10) in addition to the chemotherapy drug tamoxifen. They were given 100 mg of CoQ10, 10 mg of riboflavin and 50 mg of niacin on top of their 10 mg of tamoxifen per day for either 45 days or 90 days. Researchers found that the supplements reduced pro-angiogenic factors and increased anti-angiogenic factors, moreso than using tamoxifen alone (9).

Male Fertility
One interesting new focus among CoQ10 researchers is for male fertility support. A recent study in Andrologia suggests that infertile men with idiopathic oligoasthenoteratozoospermia, or OAT, may find benefits in taking a CoQ10 supplement. Researchers studied 60 infertile men in a randomized controlled study, giving them either a placebo or 200 mg of CoQ10 over a three-month period. The group taking CoQ10 showed “a significant positive correlation between CoQ10 concentration and normal sperm morphology”(10).

In a separate study of 212 infertile men, taking 300 mg of CoQ10 (Kaneka Q10, from Kaneka North America) for six months increased the conception rate by 34% in males who were previously considered infertile (11).

Brain Health
Other exciting research is focusing on the benefits of CoQ10 for brain health. In lab and small-animal studies, the supplement was said to revise amyloid beta-peptides in brain cells, a marker of Alzheimer’s disease (12). It also showed promise in animal studies for reducing neuron damage in areas of the brain affected by Parkinson’s disease (12).

Meanwhile, CoQ10 may help those with migraines, and is actually listed among the 11 most effective “drugs” for preventing migraines by the Canadian Headache Society (12). And, those with depression may also benefit from this supplement (12).

CoQ10 Forms
There are many CoQ10 supplements in today’s market, including both ubiquinol and ubiquinone forms. Ubiquinone, when used by the body, becomes a reduced form called ubiquinol. However, when the reduced CoQ10 ubiquinol carries out its function in the body, it becomes ubiquinone again. Essentially, the coenzyme switches back and forth between the two forms as it needs to provide both cellular energy and antioxidant protection (13).

Some would argue that the reduced ubiquinol is superior to ubiquinone because it is easier for the body, particularly in those over 40, to metabolize (14). Both forms will yield positive results in the body and are key for optimal health. WF

References
1. “CoQ10,” www.drweil.com/drw/u/ART03367/Coenzyme-Q10-CoQ10.html, accessed May 21, 2013.
2. A.D. Fontino, A.M. Thompson-Paul and L.A. Bazzano, “Effect of Coenzyme Q10 Supplementation on Heart Failure: A Meta-Analysis,” Am. J. Clin. Nutr. 97 (2), 268–275 (2013).
3. M. Berman, et al., “Coenzyme Q10 in Patients With End-Stage Heart Failure Awaiting Cardiac Transplantation: A Randomized, Placebo-Controlled Study,” Clin. Cardiol. 27, 295–299 (2004).
4. M.A. Pacanowski, et al., “Plasma Coenzyme Q10 Predicts Lipid-Lowering Response to High-Dose Atorvastatin,” J. Clin. Lipidol. 2 (4), 289–297 (2008).
5. G. Caso, et al., “Effect of Coenzyme Q10 on Myopathic Symptoms in Patients Treated with Statins,” Am. J. Cardiol. 99 (10), 1409–1412 (2007).
6. P.H. Langsjoen, “Treatment of Statin Adverse Effects with Supplemental Coenzyme Q10 and Statin Drug Discontinuation,” Biofactors 25(1-4), 147–52 (2005).
7. G. Arnold, “CoQ10 Helps Maintain Healthy LDL Cholesterol Levels,” Mar. 10, 2011, www.now-university.com/BasicArticles/082200, accessed May 21, 2013.
8. F.L. Rosenfeldt et al., “Coenzyme Q10 in the Treatment Of Hypertension: A Meta-Analysis Of The Clinical Trials," J. Hum. Hypertens. 21(4), 297–306 (2007).
9. V.G. Premkumar, et al., “Anti-Angiogenic Potential of Coenzymeq10, Riboflavin and Niacin in Breast Cancer Patients Undergoing Tamoxifen Therapy,” Vascul. Pharmacol. 48 (4–6), 191–201 (2008).
10. A. Nadjarzadeh, et al.,  “Effect of Coenzyme Q10 Supplementation on Antioxidant Enzymes Activity and Oxidative Stress Of Seminal Plasma: A Double-Blind Randomised Clinical Trial,” Andrologia, Jan 7, 2013, [Epub ahead of print].
11. “CoQ10 May Help Infertile Men,” WholeFoods Mag. 35 (8), 59 2012.
12. L. Buchanan, “CoQ10: The Longevity Factor,” Life Ext. Mag, Jan. 2013.
13. M. Lyons, “Understanding CoQ10: Ubiquinone vs. Ubiquinol,” www.naturemade.com/’resource-center/articles-and-videos/heart-health/understanding-coq10-ubiquinone-vs-ubiquinol, accessed May 21, 2013.
14. Kaneka, “What is Ubiquinol?: Ubiquinone vs. Ubiquinol,” www.kanekaqh.com/ubiquinone-vs-ubiquinol.html, accessed May 21, 2013.

Published in WholeFoods Magazine, July 2013