History and Initial Applications:
In 1957, Professor Frederick Crane and colleagues discovered CoQ10 from beef heart mitochondria at the University of Wisconsin-Madison Enzyme Institute.15 R.A. Morton, from the United Kingdom, isolated the compound in rat liver just after Dr. Crane’s discovery. It was Morton who named the compound ubiquinone, meaning ubiquitous quinone or one that “exists everywhere.” 3,6 Scientists at Merck synthesized CoQ10 in 1958. In 1962, Peter D. Mitchell, PhD from University of Edinburgh determined how CoQ10 produces energy at the cellular level and in 1978 he was awarded the Nobel Prize for chemistry based on his discovery.6
Are there established safe intake levels?
The safety of escalated doses of CoQ10 has been evaluated in a randomized, placebo-controlled trials in patients with early Parkinson’s disease.9 A total of 80 patients received doses of 300 mg to 1200 mg per day of CoQ10 for up to 16 months, and there was no difference in the incidence of drug-related toxicities between the placebo and treatment arms.19 The observed safe level (OSL) is intake up to 1,200 mg/day. However, the usual dose is 100-200 mg/day in deficiency states and other disease states.13 The Institute of Medicine at the National Academy of Sciences has not established a Dietary Reference Intake, or DRI, nor Tolerable Upper Intake Level (UL) for CoQ10.2
Food sources:
- Fish
- Calf’s Liver (and other organ meats)
- Germ portion of whole grains
**Research is not currently available to classify food sources of coenzyme Q according to the Quality Rating System used for other nutrients 2
Functions:
A diet high in coenzyme Q10 intake levels can help in the prevention of cardiovascular diseases (arrhythmia, angina, heart attack, mitral valve prolapse, high blood pressure, coronary artery disease, atherosclerosis and congestive heart failure). CoQ10 helps to restore the power of Vitamin E, improve overall cellular energy levels and helps to provide assistance with blood sugar stability.2 CoQ10 regulates glucose levels throughout a lessening of oxidative stress.10 CoQ10 levels decrease with age and may be low in people with cancer, diabetes, various heart conditions, HIV/AIDS, muscular dystrophies, Parkinson’s disease and certain other genetic disorders. Some prescription drugs may also lower CoQ10 levels.1
Clinical Applications and Uses:
- Hypertension – The effectiveness of CoQ10 is perhaps most poignantly illustrated in research studies regarding its usefulness in effectively lowering both systolic and diastolic blood pressures. This can and does occur when CoQ10 is used in conjunction with antihypertensive pharmaceutical interventions or when used singularly. Combining CoQ10 with other antihypertensive agents may permit decrease of antihypertensive dose as it can enhance the effects of antihypertensive medications.16 A recent meta-analysis from 2007, concluded that CoQ10 in hypertensive patients can lower systolic blood pressure by up to 17 mm Hg and diastolic blood pressure by up to 10 mm of Hg without significant side effects.16 Dose of CoQ10 used in these studies ranges from 120-200 mg given twice daily.13 In cases of isolated systolic hypertension, taking CoQ10 orally may lower systolic blood pressure by about 26% after 12 weeks of therapy in some people. Dose used was 60 mg, twice daily.13
- Migraine prevention – Oral CoQ10 helps in preventing migraine headache (prophylaxis). 17 It can decrease the frequency of headaches by about 30%. However, CoQ10 does not seem to be effective in treating migraine once is has developed. Dose is 100 mg given three times daily. It has been used effectively in prophylaxis of migraine (300 mg/day) in combination with magnesium citrate 500 mg/day and riboflavin 400 mg/day.18
- Parkinson’s Disease – It has been suggested that CoQ10 might protect brain cells from damage by free radicals.13 The results of a 16-month trial suggested that CoQ10, especially at 1,200 mg/day dose, had a significant reduction in disability compared to those who took place. A randomized, double blind, placebo controlled multicenter study of 80 patients observed that 1,200 mg/day of Coenzyme Q10 was associated with up to 44% less functional decline in patients with Parkinson’s disease, including activities of daily living.19 Oral CoQ10 may slow the decline in people with early Parkinson’s disease, but not in people with mid-stage Parkinson’s disease. 19,20
- Coronary Artery Disease – In an intervention study conducted on 43 subjects, who were all identified by cardiac catheterization as having at least 50% stenosis of one major coronary artery; a placebo group was formed, a group given 60 mg/d and another group given 150 mg/d of Q10 supplementation for 12 weeks.24 Results show that the plasma CoQ10 levels significantly increased in the 150 mg/d group; more so than in the other two groups (placebo and 60 mg/d). Subjects in the CoQ10-150 group also had a significant correlation with lower levels of low-density lipoprotein levels.24 The authors of the study concluded that CoQ10 supplementation at a dose of 150 mg/day can decrease oxidative stress and increase antioxidant enzyme activity in patients with CAD and they hypothesize that a higher dose of coenzyme Q10 supplements ( > 150 mg/day) might promote rapid and sustainable anti-oxidation in patients with coronary artery disease.24
Conclusion:
Since the discovery of the chemical structure in 1957 there have been nearly 5,000 research studies on coenzyme Q10.2 While considerable research efforts have been put forth in the examination of this molecule, if we are going to change the landscape in acceptable use for CoQ10, more large, double-blind, placebo controlled research studies will certainly need to be conducted. This will be the only way to put CoQ10 on the map with current pharmaceutical options for treatment of conditions like hypercholesterolemia, hypertension, Parkinson’s disease, migraines, periodontitis and many others. Researchers are working hard to uncover the scientific data to support proper dosages for each of the conditions studied. The pairing up of CoQ10 with other beneficial and synergistic nutrients could be another key to unlocking its full potential in standard nutritional medicine.
Be aware though, some CoQ10 and Ubiquinol (a reduced form of CoQ10) products on the market are much better and effective than others. We can help you with the brands that we have had experience using. Remember though that CoQ10/Ubiquinol doesn’t work by itself. It also needs minerals like magnesium and vitamins like Vitamin E and D and B vitamins. We always recommend getting a thorough evaluation with blood testing to make sure that something important is not being missed. After all, most disease and problems show up in the blood long before you have symptoms. Call our office today for a consultation and testing to make sure you are as healthy as possible and ask us about Ubiquinol and CoQ 10.
References for this newsletter as well as previous newsletters may be found on our website. The information has not been evaluated by the FDA and is not intended to treat, cure, or prevent any disease.
References:
1. http://www.mayoclinic.com/health/coenzyme-q10/NS_patient-coenzymeq10
2. http://www.whfoods.com/genpage.php?tname=nutrient&dbid=118 The World’s Healthiest Foods. The George Mateljan Foundation 2001-2013.
3. Pina LoGiudice ND, LAc and Peter Bongiorno ND, Lac. Ubiquinol: An ally against aging. Inner Source Health. Posted on 1/03/2012
6. http://healthy-aging.advanceweb.com/Patient-Resource-Center/Supplements-and-Nutrition/CoQ10.aspx
9. Lesser et al: A Randomized Double-Blind, Placebo-Controlled Study of Oral Coenzyme Q10 to Relieve Self-Reported Treatment Related Fatigue in Newly Diagnosed Patients with Breast Cancer. J Support Oncol. 2013 March; 11(1): 31-42.
10. Littaru GP, Tiano L: Bioenergetic and antioxidant properties of coenzyme Q10, A review of animal and human publications. Biofactors 2003, 18:101-11.
13. Kapoor, Pragati, and A. K. Kapoor. “Coenzyme Q10–A novel molecule.” J Indian Acad Clin Med 14.1 (2013): 37-45.
15. Crane F, Hatefi Y, Lester R et al. Isolation of a quinone from beef heart mitochondria. Biochimica et Biophysica Act a 1957; 25(1): 220-21.
16. Rosenfeldt FL, Haas SJ, Krum H et al. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Human Hypertension 2007; 21(4): 297-306.
17. Rozen TD, Shinsky ML, Gebeline CA et al. Open label trial of coenzyme Q10 as a migraine preventive. Cephalgia 2002; 22(2): 137-41.
18. Sandor PS, Di Clemente L, Coppola G et al. Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology 2005; 64(4): 713-15.
19. Shults CW, Oakes D, Kieburtz K et al. Effects of Coezyme Q10 in early Parkinson disease: Evidence of slowing of the functional decline. Arch Neurology 2002; 59: 1541-50.
20. Shults CW. Therapeutic role of coenzyme Q10 in Parkinson’s disease. Pharmacological Therapeutics 2005; 107(1): 120-30.
24. Lee B, Huang Y, Chen S, Lin P: Coenzyme Q10 supplementation reduces oxidative stress and increases antioxidant enzyme activity in patient with coronary artery disease. Nutrition March 2012; 28 (3): 250-255.