CoQ10:
Time to fill 'er up?

CoQ10 is sometimes confused with enzymes but it is not an enzyme but an enzyme cofactor.  As such it is critically necessary for some vital bodily functions to proceed normally.   

The fact is, it just doesn't seem to fit neatly into a specific niche; it could be covered as an antioxidant, a vitamin or an enzyme cofactor.

It is a vitamin-like compound that is made naturally in the body but production typically decreases as we age.  Decreased levels of CoQ10 have been noted in many catastrophic illnesses including heart disease, Parkinson's, some cancers, diabetes, muscular dystrophy and HIV/AIDS.  

Whether the low levels seen with the disease conditions is the cause or effect has not been proven.

In fact, the jury is still out as to whether supplementing with coenzyme Q10 does any good at all relative to the disease in question.  Unfortunately, as with most supplement nutrients, funding to do the clinical testing is very scarce.  

Once again, who wants to lay out millions of dollars proving the efficacy of a nutrient, especially one that is made naturally in the body, if they can't patent it and make millions?

Nomenclature or "What's in a Name?"

Cofactors were covered in the lead-in page for enzymes so all we will say here, by way of review, is that a cofactor is a molecule that helps a biological chemical reaction to proceed. 

Cofactors are non-proteins that are bound to a protein such as an enzyme and can greatly accelerate the reaction.  If the cofactor is loosely bound to its enzyme protein, it is called a coenzyme.   So now we know why CoQ10 is called a coenzyme.

The "Q" refers to quinone which is an organic compound derived from chemicals such as benzene or naphthalene.  For this reason, coenzyme Q10 is sometimes called vitamin Q. 

The "10" refers to the number of carbon/hydrogen subunits, called an isoprene, in the tail of its molecular diagram.  For our purposes, that was totally useless information but someone might have been wondering.


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CoQ10 as an antioxidant

What is interesting to know is that CoQ10 is one of the four natural antioxidants made in our body (endogenous antioxidants).

They are glutathione, superoxide dismutase (SOD), catalase and coenzyme Q10.

Of the four, only SOD and catalase are true enzymes and they
will be discussed in separate pages.

Coenzyme Q10 as an antioxidant goes through some very complex maneuvers and takes on different forms depending on whether it is giving up electrons (oxidizing) or accepting electrons (reducing). 

Rather than go into all the chemical transformations, let's just say that as an antioxidant, CoQ10 protects both lipids and proteins from oxidation. 

Regarding lipids, it is worth mentioning that coenzyme Q10's ability to prevent the oxidation of LDL cholesterol is what makes many researchers think that it has tremendous benefits for cardiovascular health.

CoQ10 and Energy

What we need to know for maintaining our health is that coenzyme Q10 is found in every cell in our body and for that reason it is also called ubiquinone; stems from "ubiquitous" which refers to something that is found everywhere.

Utiquitous seems to be a good word to describe CoQ10 since the cover of the book The Coenzyme Q10 Phenomenon describes it as "The breakthough nutrient that helps combat heart disease, cancer, aging and more".  Sounds like a phenomenon all right; click on the books image to review it or order it. 

Just where it is found in our cells is what makes it a vital cofactor.  Just as our bodies have organs; our cells are populated with little organs as well, called organelles.

CoQ10 is primarily found in the membranes of those organelles with its highest concentrations being seen in the inner membrane of the mitochondria.  For those of us who are biology challenged, the mitochondria are the little organs inside the cell that generate energy and there can hundreds of them in a given cell. 

In the mitochondria, coenzyme Q10 is key to the production of the chemical phosphate compound called ATP or adenosine triphosphate.  It is the source of energy for all activities of the body and specifically the key to contraction of our muscles. 

So as we age, if we are feeling tired, have no energy, our strength is waning, maybe it is due to the production of our coQ10 starting to fall off...but then again, maybe it’s just because we don't get off our butts and exercise enough.

Clinical Studies

There have been numerous randomized, placebo controlled trials done with fairly small groups that have yielded some
very encouraging results. 

The following trials were reported in Ask.com/Alternative Medicine, June 27, 2008 by Cathy Wong.

  • 641 people with congestive heart failure were divided into two groups where one was given a placebo plus standard treatment and the other was given ubiquinone. The CoQ10 group experienced "significant symptom reduction and fewer hospitalizations".
  • 32 patients with end-stage heart failure awaiting a heart transplant were given either 60mg of coenzyme Q10 or a placebo for 3 months. The CoQ10 group experienced "significant improvement in functional status, clinical symptoms and quality of life"; there was "no change in heart ultrasound or objective markers".
  • 28 Parkinson's disease patients were treated with 360mg of CoQ10 or a placebo. After four weeks the coenzyme group showed mild improvements in early Parkinson's symptoms and significantly improved performance in visual function.
  • An 80 patient study on early stage Parkinson's funded by the NIH, using a placebo or ubiquinone showed significant improvement in the coenzyme Q10 group at higher levels of 1200mg/day had "significant reduction in disability" compared to the placebo group.
  • Food Sources

    Food sources for ubiquinone are fish, meat and eggs.  Fish with the highest content are sardines and mackerel but who eats
    sardines or mackerel? 

    Not to worry, cod, salmon, tuna and rainbow trout also have decent amounts.  With beef, the liver and heart have the highest content but who eats organ meats anymore? 

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    Eating organ meats from factory farmed animals is really rolling the dice.  However, just about any cuts of red meat and fresh cuts of lamb and pork also contain respectable amounts of CoQ10. 

    With any cut of red meat, grass-fed beef is the only way to go and grass-fed means for the animals whole life; not finishing off in a feed lot with grain.  Grass fed beef is shown to be considerably higher in nutrients than grain fed and that includes Coenzyme Q10.

    With vegetable sources, fresh and raw is the way to go.  A vegetarian coenzyme Q10 meal would be something like a salad of uncooked fresh spinach, raw fresh broccoli, sprinkled with wheat germ with a few chopped nuts mixed in.

    Nuts are a great source and the best include peanuts, walnuts, hazelnuts and pistachios.  Sesame seeds also contain good amounts of the nutrient.

    Supplementation

    There are several reasons why we might need to add a CoQ10 supplement to our daily diet however the case for doing so is a bit inconclusive. 

    We make it in our bodies in a multistep process that depends on the presence of many other substances.  Thus one reason we might need to supplement is simply that our body no longer makes the needed amount of coenzyme Q10. 

    Biosynthesis is the name given to the transformation of molecules into a more complex compound through a series of enzyme catalyzed steps.  If a required nutrient or compound is missing or deficient in one of the steps then the output of coenzyme Q10 would suffer. 

    It would difficult to pinpoint exactly what substance is retarding the production chain so a direct supplementation could be the solution.

    Since lower levels of CoQ10 have been observed in many disease conditions, a higher utilization of it in response to disease would represent another reason for supplementation. 

    Whether the lower levels are cause or effect doesn't really matter, just take capsule with a meal and be done with it.

    One more reason we may need to supplement coenzyme Q10 is because we have an absorption problem.  So one might reason that if we have a problem absorbing the cofactor what good would supplementation do?  It probably wouldn't get absorbed either.  

    The solution is to find out why the coenzyme Q10 isn't getting absorbed from food.   One answer might be that we are on a no-fat or very low-fat diet; bad idea any time.  For good absorption, CoQ10 needs lipids (dietary fat in this case). 

    The presence of lipids in food stimulates the excretion of bile acids (biliary action) from the liver and greatly improves the absorption of coenzyme Q10 in the small intestine.  

    That is the reason CoQ10 supplement containers will always say to take it with a meal, but be sure there is a little fat in the meal.  CoQ10 is not soluble in water, it is a fat-soluble substance.

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    Dosage

    If we decide to supplement, how much is enough?  Typical coenzyme Q10 content in supplements ranges from 30mg to 120mg with some as high as 200mg. 

    Unless there is some therapeutic reason for taking more, a daily supplemental dose shouldn't exceed 200mg/day. 

    Some the therapeutic reasons could be related to those diseases and clinical trials mentioned above.  In these cases, a doctor must be involved and know what is being consumed. 

    Actually it's a good idea for our doctor to be aware of any and all supplements we are taking in that there are some side effects and interactions to be aware of.

    Side effects and Interactions

    There aren't many side effects or interactions from CoQ10, certainly not when compared to a prescription drug.  Ever listened to those drug commercials on TV and paid close attention to the side effects?  Scary!

    The two main concerns are that some research indicates that coenzyme Q10 could lower the effectiveness of blood thinners such as Coumadin (warfarin) and decrease insulin requirements in diabetics. 

    The flip side is that medications such as statins that lower blood cholesterol or lower blood sugar can cause a decrease in coenzyme Q10 levels in the body and decrease the effectiveness of supplements. 

    The message is that diabetics and cardiovascular patients should only supplement under a doctor’s supervision.

    Lesser minor side effects could include mild insomnia, rashes, headache, heartburn, fatigue or dizziness.  All of these are fairly rare but may occur with dosages in the higher ranges; 200mg and over.

    While most of the discussion has been focused on the heart, the book shown above is a more scientific oriented look at how how Coenzyme Q10 is being used to help with neurological disorders.  As always ubiquinol is not approved by the FDA as a drug and thus should not be presented as a cure or treatment for any disease condition.

    Lastly the University of Maryland Medical Center has a very comprehensive presentation of Coenzyme Q10 which includes numerous possilbe health benefits, side effects, possilbe interactions and, most important, a long list of supporting research.
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