Coenzyme Q-10 ( ubiquinone )

What Is It?

One of the world's most popular supplements, the chemical coenzyme Q 10 has generated great excitement as a heart disease remedy and a cure for countless other conditions. The body naturally produces this compound, which has been dubbed "Vitamin Q" because of its essential role in keeping all systems running smoothly. In fact, the scientists who identified coenzyme Q 10 in 1957 initially honored its ubiquitous presence--it's found in every human cell and in all living organisms--by naming it "ubiquinone." Small amounts are also present in most foods.

A member of a family of compounds called quinones, coenzyme Q10 (sometimes called Co Q 10 ) works in concert with enzymes (hence the name "coenzyme") that are necessary for chemical reactions throughout the body. It is particularly abundant in high-energy-demanding cells, such as those found in the heart. In addition, coenzyme Q 10 acts as a powerful antioxidant to prevent the cellular damage caused by unstable oxygen molecules called free radicals.

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Health Benefits

Control high blood pressure

Results from a Boise, Idaho, study demonstrate that coenzyme Q10 supplementation reduces isolated systolic hypertension (ISH), the condition in which systolic blood pressure (the top number) is greater than 140 mm Hg (millimeters of mercury), while diastolic blood pressure (the bottom number) remains below 90 mm Hg. This type of high blood pressure is very common in the elderly; in fact, two-thirds of all hypertensive patients over the age of 65 have ISH.

Forty-one men and 35 women, all with systolic blood pressure between 150 and 170 mm Hg and diastolic blood pressure below 90 mm Hg, enrolled in the study. (Nine additional patients with normal blood pressure - average 138/79 - participated as controls.) Each patient was randomly assigned to either the treatment group (60 mg of coenzyme Q 10 with 150 IU of vitamin E twice a day - an amount of vitamin E that has no effect on blood pressure) or to the placebo group (150 IU of vitamin E twice a day). Each treatment lasted for 12 weeks, and each patient's blood pressure was monitored twice weekly.

At the end of the 12-week coenzyme Q 10 treatment, an impressive 55% of the patients were found to be responders. The average reduction in the patients' systolic blood pressure was 25.9 mm Hg, with no detectable change in diastolic blood pressure. As with any study, some of the patients did not have significant drops in their systolic blood pressure.

For the 55% of the ISH patients classified as responders, the potential benefit for improved heart function is promising. For example, a separate study revealed that, in ISH patients over the age of 60, a reduction of systolic blood pressure by 20 mm Hg had obvious health benefits and significantly reduced the incidence of stroke, heart failure, and mortality. This suggests that the responders in the Boise trial, who averaged a decrease of 25.97 mm Hg in systolic blood pressure following coenzyme Q 10 supplementation, are likely to enjoy appreciable improvements in their cardiovascular health.

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Improve Endothelial Function

CoQ10's ability to improve heart health is the property that first attracted scientists and health-conscious adults to this vitally important nutrient. For years, scientists have known that by supporting energy production in the heart tissues, CoQ10 may aid conditions such as congestive heart failure, angina, arrhythmia, mitral valve prolapse, and high blood pressure. Compelling new evidence suggests that CoQ10 may fight an instigating factor in heart disease—the insidious threat known as endothelial dysfunction.

Endothelial dysfunction occurs when the blood vessels are unable to dilate in response to increased demand for blood flow. Endothelial dysfunction plays a central role in the development of cardiovascular disease, America's number-one cause of premature death.

In an exciting study from Germany, researchers found that when men with impaired endothelial function received supplemental CoQ10, they demonstrated improved endothelial function of the brachial artery, which supplies blood to the arms and hands. This important finding suggests that CoQ10 supplementation may help prevent and treat endothelial dysfunction, thus protecting the cardiovascular system against an initiating cause of atherosclerosis.

An extensive eight-year clinical trial found that CoQ10 helped patients with existing cardiovascular disease to improve their condition and decrease their reliance on heart medications. After 18 months of CoQ10 supplementation, an impressive 58% improved their American Heart Association scores by one “class,” or health gradient, while 28% improved by two classes. Most importantly, nearly half of all participants demonstrated a decreased need for medications.

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Complement cholesterol-lowering statin drugs

Coenzyme Q 10 is an essential supplement when using statin drugs such as Lipitor, Pravachol, Lescol, and Zocor. While blocking the liver mechanism that manufactures cholesterol, statins also block the production of coenzyme Q 10. Although the long-term effect of this is unknown, some nutritionally oriented doctors have asked the FDA to attach a warning label to statin prescriptions. In Europe many physicians routinely prescribe coenzyme Q 10 as a supplement for anyone taking a statin drug.

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Peter H. Langsjoen, MD, is the foremost authority on the use of coenzyme Q10 in the treatment of heart disease. His numerous research studies can be found in the world's most prestigious scientific journals.

In 1990, the Proceedings of the National Academy of Science published Dr. Langsjoen's studies on the safety of statin drugs. Dr. Langsjoen explained that the mechanism by which statin drugs lower cholesterol also inhibits the natural biosynthesis of coenzyme Q10 in the liver. Dr. Langsjoen said that he conducted these studies because, “if lovastatin were to reduce levels of coenzyme Q10, this reduction would constitute a new risk of cardiac disease, since it is established that coenzyme Q10 is indispensable for cardiac function.” Dr. Langsjoen then reported that his animal and human studies showed that lovastatin does indeed lower levels of coenzyme Q10. Dr. Langsjoen went on to describe case histories of his lovastatin patients who suffered from progressive cardiac degeneration, but whose heart function improved after oral administration of coenzyme Q10 .

Move forward to July 8, 2002, and we find that Dr. Langsjoen has become a vocal critic of statin drugs and has published a new paper titled “Statin-Induced Cardiomyopathy.” In an excerpt from this paper, Dr. Langsjoen describes his 17-year experience with statin drugs as follows:

“I have seen a frightening increase in heart failure secondary to statin usage, ‘statin cardiomyopathy.' Over the past five years, statins have become more potent, are being prescribed in higher doses, and are being used with reckless abandon in the elderly and in patients with ‘normal' cholesterol levels.”

Dr. Langsjoen attributes these heart failure cases as being caused by “statin-induced coenzyme Q10 depletion” that is preventable if statin drug users supplemented with coenzyme Q10 .

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Treat heart disease, especially congestive heart failure

Heart disease sufferers tend to be relatively deficient in coenzyme Q 10. When levels are boosted by supplements, heart function appears to be enhanced. In addition, the compound's antioxidant properties may inhibit artery-clogging plaque buildup and potentially fatal blood clots.

People with congestive heart failure, in which a weakened heart pumps inefficiently, may stand to benefit the most from coenzyme Q 10 supplements. In a 12-month placebo-controlled trial of more than 2,500 people suffering from this disease, 80% experienced an improvement in symptoms--less ankle swelling and shortness of breath, and better color and sleep habits--when they supplemented their standard medications with a daily 100 mg dose of coenzyme Q 10. They were also far less likely than placebo-takers to require hospitalization for their condition. Rates of death from the disease did not change, however. Recent research suggests that it may even be a useful adjunctive therapy for those awaiting heart transplant surgery. Study participants showed a decrease in the 6-min walk test and a decrease in dyspnea, New York Heart Association (NYHA) classification, nocturia, and fatigue.

Most importantly, it appears to support the heart muscle's strenuous efforts to beat 100,000 times a day. Without adequate levels of this enzyme, the heart muscle can become weaker and less efficient at pumping blood through the body. Coenzyme Q 10's popularity as a heart supplement is very well established in countries such as Sweden , Italy , and Canada. In Japan , up to 10% of adults take coenzyme Q 10 regularly.

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In particular, a study of heart attack patients showed that compared to placebo, supplementation with 120 mg a day of coenzyme Q10 reduced secondary cardiac events by 45% and significantly reduced the number of cardiac deaths. Many of these heart-attack patients were prescribed a “statin” drug to lower cholesterol levels. The major adverse effect of statin treatment was fatigue that occurred in 40.8% of the placebo group, whereas only 6.8% of the patients supplemented with coenzyme Q10 experienced fatigue.

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Treat Angina and arrhythmias.

The intense chest pain known as angina may occur less frequently under the influence of coenzyme Q 10's heart-enhancing actions. In lightening the heart's workload and steadying heart rhythm, coenzyme Q 10 may be particularly useful for people who suffer from irregular heart beats (arrhythmias) following a heart attack. Scientists have found that people suffering from coronary artery disease have very low levels of coenzyme Q 10. More research is needed to determine whether this relationship is causal, however because of the low risk of side effects supplementation with co Q 10 is widely used by people suffering from this condition.

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Heart Attack

One important study, for example, found that people who received daily CoQ10 supplements within 3 days of a heart attack were significantly less likely to experience subsequent heart attacks and chest pain. In addition, these same patients were less likely to die of heart disease than those who did not receive the supplements.

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Heart Surgery

Research indicates that introducing CoQ10 prior to heart surgery, including bypass surgery and heart transplantation, can reduce damage caused by free radicals, strengthen heart function, and lower the incidence of irregular heart beat (arrhythmias) during the recovery phase

University of Maryland Medical School

Diabetes

An Australian study found that patients with type II diabetes who took 200 mg of CoQ10 a day over 12 weeks showed improved blood sugar control. Supplementation produced, on average, a threefold increase in CoQ10 levels in the trial subjects, while decreasing their blood pressure and hemoglobin A1C, a long-term indicator of blood sugar control. By improving blood pressure and optimizing blood sugar, CoQ10 may help prevent the dangerous metabolic complications of diabetes.
 
In yet another study focused on diabetes, CoQ10 helped patients to optimize their blood sugar levels while guarding against a dangerous condition called diabetic ketoacidosis. In this trial, 39 diabetic patients received 120 mg of a CoQ10 analog for 2-18 weeks. In approximately one third of the patients, blood sugar levels fell dramatically, declining by at least 30%. Additionally, more than half of the patients showed decreased levels of ketone bodies, which are breakdown products of fatty acid metabolism. Excessively high levels of ketone bodies can lead to diabetic ketoacidosis, a condition marked by excessive blood acidity that can result in a loss of consciousness.

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CoQ10 Improves Parkinson's Symptoms and Slows Disease Progression

In a study of Parkinson's disease patients, 360 mg a day of coenzyme Q10 was administered for only 4 weeks and there was a mild symptomatic improvement compared to placebo. More important, an established clinical test to measure Parkinson's symptom function showed significantly better improvement of performance in the coenzyme Q10-supplemented patients compared with the placebo group. This new study helped corroborate a report last year that Parkinson's patients consuming 1200 mg a day of coenzyme Q10 showed a 44% reduction in the decline of motor skills, movement, and mental function compared to the placebo group. Those receiving this high-dose coenzyme Q10 also demonstrated an improved ability to perform daily living tasks. What was remarkable about this 16-month study was that coenzyme Q10 slowed the progression of the disease, something that Parkinson's drugs do not do.

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