encyclopedia

Coenzyme Q-10

Natural Sources:    

Fatty fish (mackerel and sardines); organ meats; soy oil and peanuts.    
 
   
Forms:    

Standardized Coenzyme Q-10 supplements including capsules and tablets.    
     

Therapeutic Uses:    

– Aging Disorders
– Alzheimer's Disease
– Antioxidant
– Atherosclerosis
– Brain Functioning
– Cancer Prevention
– Cancer Treatment
– Cellular Regeneration
– Cirrhosis
– Congestive Heart Failure
– Dental Health
– Energy Boosting
– Fatigue
– Gingivitis
– Gum Health
– Heart Health Maintenance
– High Blood Pressure
– Hypertension
– Immunodeficiency
– Immune System Boosting
– Liver Health Maintenance
– Lou Gehrig's Disease
– Memory Loss
– Mental Functioning
– Obesity
– Periodontal Health
– Vascular Disorders
– Weight Loss     
     
    
Overview:    

Coenzyme Q10 (CoQ-10) is also known as ubiquinone, stemming from the root word ubiquitous that means “found everywhere”, as this coenzyme is found in every cell of the body except mature red blood cells. CoQ-10 is a powerful antioxidant that is naturally produced by the body. Scientists are hailing this coenzyme as being one of the most important antioxidants for postponing aging and preventing or treating heart disease and cancer. CoQ-10 is primarily concentrated in tiny powerhouse organelles within cells called mitochondria, but it is also found in varying amounts in all cell membranes. CoQ-10 is essential for the energy production of cells and is most concentrated in heart and liver cells that contain thousands of mitochondria for energy production. The main function of Coenzyme Q10 in the inner membranes of mitochondria is to act as an important carrier of electrons in the electron-transport chain. A deficiency of Coenzyme Q10 may impair the body's normal ability to convert nutrients into ATP to supply energy to cells, and it may also impede proper muscle function. One study showed that pre-treatment with Coenzyme Q10 minimized myocardial injury caused by heart bypass surgery and improved heart function, compared to patients not pre-treated with Coenzyme Q10. Another study found that 150 mg of Coenzyme Q10 reduced the frequency of angina by up to 46% while improving the capacity for physical activity in those patients. Other clinical trials have shown that Coenzyme Q10 has the ability to reduce elevated blood pressure in hypertensive individuals and inhibits atherosclerosis through dissolving into low-density lipoprotein (LDL) particles and preventing oxidation of cholesterol. CoQ10 supplements have also been shown to make certain cancers disappear, boost the immune system, improve athletic performance, improve fat metabolism and weight loss, reduce fatigue associated with liver cirrhosis, reduce gum inflammation and treat gingivitis.
    
    
Chemistry:    

Coenzyme Q-10 is a quinone derivative similar to vitamin K with a long isoprenoid tail that can insert itself into fatty cell membranes. As a coenzyme it supports the action of enzymes involved in energy production within cells (i.e. it supports the adenosine triphosphate (ATP) cycle). The liver normally synthesizes Coenzyme Q10 and maintains an estimated 500-1500 mg of Coenzyme Q10 in the entire body. However, CoQ-10 levels within the body decline with age and are also diminished by stress, infections and certain cholesterol-lowering drugs. Coenzyme Q10 is particularly abundant in the heart, lungs, liver, kidneys, spleen, pancreas and adrenal glands. Coenzyme Q10 has three major functions within a cell. It serves as a highly mobile carrier of electrons between the flavoproteins and the cytochromes of the electron-transport chain in mitochondria; it neutralizes free radicals generated in the energy-making process; and it helps protect the integrity of mitochondrial membranes. Coenzyme Q10 was first isolated in 1956 by Dr. Federick Crane at the University of Wisconsin as an orange-colored compound from beef heart. Dr Karl Folkers identified the molecular structure of Coenzyme Q10 in 1958 and hypothesized that when Coenzyme Q10 levels dropped below 25% (resulting in a 75% deficiency), death would occur. In 1961, Dr. Peter Mitchell at the University of Edinburgh in Scotland determined how Coenzyme Q10 produces energy at the cellular level. Dr. Karl Folkers at the University of Texas was the first to begin using Coenzyme Q10 to promote a healthy heart and cardiovascular system in 1972. By 1995, over 10 million Japanese people were taking Coenzyme Q10 daily. Sales of CoQ-10 finally began to increase in North America in 1999.    
     
    
Suggested Amount:    

The recommended daily dose for Coenzyme Q10 is 30 mg; however, no toxic effects have been reported at daily doses as high as 390 mg. Coenzyme Q10 is readily absorbed by the small intestine, and a steady-state concentration can be attained in the body in 5-6 weeks. A clinical trial with significant results for heart patients used a dosage of 120 mg daily for three months and found this level to be very safe with no toxic effects. Strenuous exercise reduces blood levels of Coenzyme Q10, and supplementation with 60 mg/day has been found to improve athletic performance. Many overweight people have low levels of Coenzyme Q10, and supplementation may help them maintain a normal body weight though enhanced metabolism of fat. Coenzyme Q10 is also found concentrated in fatty fish (mackerel and sardines); organ meats; soy oil, peanuts, spinach and broccoli.
 
Note: Individuals over the age of 35 begin to decline in their ability to synthesize Coenzyme Q10 and so supplementation is recommended to slow the aging process. Poor eating habits, stress and infections also increase the body's need for Coenzyme Q10.
    
   
Drug Interactions:    

Certain cholesterol-lowering drugs block the natural synthesis of Coenzyme Q10. (i.e. statin drugs including cholestyramine, colestipol and coenzyme A reductase inhibitors). Therefore, supplementation with 100 mg Coenzyme Q10 a day has been recommended for individuals taking these drugs.    
     
    
Contraindications:    

The safety of Coenzyme Q10 has not been established for pregnant or nursing mothers, so supplements are not recommended in these cases.    
   
     
Side Effects:    

Coenzyme Q10 is deemed one of the safest substances ever tested. It has not produced any toxic side effects when ingested by humans or animals. The only very rare side effect noted from taking oral dosages has been mild transient nausea. It is listed in the 42nd edition of the Physicians Desk Reference as replacement therapy for a nutrient, and no adverse reactions are listed.    
     
    
References:    

Burke BE, Neuenschwander R, Olson RD. 2001. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J 2001 Nov; 94(11): 1112-7.
 
Carper, J. 1995. Stop Aging Now. HarperCollins Publishers, 10 East 53rd Street, New York, New York 10022-5299. Pp. 138-147.
 
Munkholm H, Hansen HH, Rasmussen K. 1999. Coenzyme Q10 treatment in serious heart failure. Biofactors 1999; 9(2-4): 285-9.
 
Singh RB, Wander GS, Rastogi A, Shukla PK, Mittal A, Sharma JP, Mehrotra SK, Kapoor R, Chopra RK. 1998. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther 1998 Sep; 12(4): 347-53.
 
Watson JP, Jones DE, James OF, Cann PA, Bramble MG. 1999. Case report: oral antioxidant therapy for the treatment of primary biliary cirrhosis: a pilot study. J Gastroenterol Hepatol 1999 Oct; 14(10): 1034-40.
    
    
Additional Information:    

Positive Clinical Results for Treating Heart Disease and Improving Survival:
The effects of oral treatment with coenzyme Q10 (120 mg/d) were compared for 28 days in 73 (intervention group A) and 71 (placebo group B) patients with acute myocardial infarction (AMI). After treatment, angina pectoris (9.5 vs. 28.1), total arrhythmias (9.5% vs. 25.3%), and poor left ventricular function (8.2% vs. 22.5%) were significantly (P < 0.05) reduced in the coenzyme Q group than placebo group. Total cardiac events, including cardiac deaths and nonfatal infarction, were also significantly reduced in the coenzyme Q10 group compared with the placebo group (15.0% vs. 30.9%, P < 0.02). The extent of cardiac disease, elevation in cardiac enzymes, and oxidative stress at entry to the study were comparable between the two groups. Lipid peroxides, diene conjugates, and malondialdehyde, which are indicators of oxidative stress, showed a greater reduction in the treatment group than in the placebo group. The antioxidants vitamin A, E, and C and beta-carotene, which were lower initially after AMI, increased more in the coenzyme Q10 group than in the placebo group. These findings suggest that coenzyme Q10 can provide rapid protective effects in patients with AMI if administered within 3 days of the onset of symptoms. More studies in a larger number of patients and long-term follow-up are needed to confirm our results. [Singh RB, Wander GS, Rastogi A, Shukla PK, Mittal A, Sharma JP, Mehrotra SK, Kapoor R, Chopra RK. 1998. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther 1998 Sep; 12(4): 347-53]. Positive Clinical Results for Treating Serious Heart Failure:
Several noninvasive studies have shown the effect on heart failure of treatment with coenzyme Q10. In order to confirm this by invasive methods we studied 22 patients with mean left ventricular (LV) ejection fraction 26%, mean LV internal diameter 71 mm and in NYHA class 2-3. The patients received coenzyme Q10 100 mg twice daily or placebo for 12 weeks in a randomized double-blinded placebo controlled investigation. Before and after the treatment period, a right heart catheterisation was done including a 3 minute exercise test. The stroke index at rest and work improved significantly, the pulmonary artery pressure at rest and work decreased (significantly at rest), and the pulmonary capillary wedge pressure at rest and work decreased (significantly at 1 min work). These results suggest improvement in LV performance. Patients with congestive heart failure may thus benefit from adjunctive treatment with coenzyme Q10. [Munkholm H, Hansen HH, Rasmussen K. 1999. Dept. of Cardiology, Aalborg Hospital, Denmark). Coenzyme Q10 treatment in serious heart failure. Biofactors 1999; 9(2-4): 285-9].
 
Positive Clinical Results for Treating Hypertension:
BACKGROUND: Increasing numbers of the adult population are using alternative or complementary health resources in the treatment of chronic medical conditions. Systemic hypertension affects more than 50 million adults and is one of the most common risk factors for cardiovascular morbidity and mortality. This study evaluates the antihypertensive effectiveness of oral coenzyme Q10 (CoQ), an over-the-counter nutritional supplement, in a cohort of 46 men and 37 women with isolated systolic hypertension.
METHODS: We conducted a 12-week randomized, double-blind, placebo-controlled trial with twice daily administration of 60 mg of oral CoQ and determination of plasma CoQ levels before and after the 12 weeks of treatment.
RESULTS: The mean reduction in systolic blood pressure of the CoQ-treated group was 17.8 +/- 7.3 mm Hg (mean +/- SEM). None of the patients exhibited orthostatic blood pressure changes.
CONCLUSIONS: Our results suggest CoQ may be safely offered to hypertensive patients as an alternative treatment option. [Burke BE, Neuenschwander R, Olson RD. 2001. (Research Service, Department of Veterans Affairs Medical Center, Boise, Idaho 83702, USA). Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J 2001 Nov; 94(11): 1112-7].
 
Positive Clinical Results for Treating Liver Cirrhosis:
BACKGROUND: The symptoms of the chronic cholestatic liver disease primary biliary cirrhosis (PBC), in particular fatigue and chronic pruritus, adversely affect quality of life and respond only poorly to treatment. Recent studies have suggested that oxidative stress may play a role in tissue damage in cholestatic liver disease and may contribute to symptoms, such as fatigue. We have, therefore, examined, in an open-label pilot study, the therapeutic effects of antioxidant medication on the biochemistry and symptomatology of PBC.
METHODS: Patients were randomized to 3 months treatment with a compound antioxidant vitamin preparation (Bio-Antox), four tablets daily (n = 11, group 1), or the combination of Bio-Quinone Q10 (100 mg) with Bio-Antox (n = 13, group 2). Biochemical and symptomatic responses were assessed at 3 months.
RESULTS: Significant improvement in both pruritus and fatigue was seen in the patients in group 2. Mean itch visual analogue score improved from 2.4 +/- 3.0 to 0.4 +/- 0.7 post therapy (P < 0.05) while mean night itch severity score improved from 2.6 +/- 1.9 to 1.3 +/- 0.7 (P < 0.05). Nine of 13 of these patients reported less fatigue, while 10/13 showed an improvement in at least one domain of their Fisk Fatigue Severity Score. No significant improvement in itch and only limited improvement in fatigue were seen in the patients in group 1. No change in biochemical parameters was seen in either group.
CONCLUSIONS: Antioxidant therapy, as a combination of Bio-Antox and Bio-Quinone Q10, may improve the pruritus and fatigue of PBC. This combination of therapy should be investigated further in a double-blind, placebo-controlled trial. [Watson JP, Jones DE, James OF, Cann PA, Bramble MG. 1999. (Centre for Liver Research, University of Newcastle, UK). Case report: oral antioxidant therapy for the treatment of primary biliary cirrhosis: a pilot study. J Gastroenterol Hepatol 1999 Oct; 14(10): 1034-40].

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