Coenzyme Q10 is used in the mitochondrial electron
transport system for producing
ATP, and for modulating mitochondrial oxidative stress since mitochondria
are the sites
of greatest oxy-free radicals generation.(1,2) The modulation of
mitochondrial oxidative
stress is recognized as an anti-aging effect.(2)
Coenzyme Q10 is used for enhancing cellular function relating to improved
energy levels
in cardiac performance (particularly for angina, heart failure, congestive
heart failure, and
cardiomyopathy), in immune performance in the immune-compromised older
person and
in those with HIV, and in liver and kidney performance.(1,6,11)
Coenzyme Q10 can be used in any health condition where energy depletion is
considered
to be a causative or symptomatic factor,1 or as a part of a general
antioxidation program.(1,2)
* Please Note: This information is based partly on Traditional Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
Description
Pharmaceutical Commentary
Coenzyme Q10 is best understood as an obligatory player in the mitochondrial electron transport system culminating in the synthesis of ATP. In more recent years it has become clearer that failing mitochondria are linked with pathology, referred to as mitochondrial cytopathy. This is not surprising since life and being healthy are directly related to available ATP. It has been estimated that a 25% tissue depletion of coenzyme Q10 can cause serious metabolic health problems, and a 75% depletion can cause death.(1)
Coenzyme Q10 is also called ubiquinone, because its presence in the body and in nature is ubiquitous. Plant and animal foods regularly supply the body with a daily micro-stream of coenzyme Q10. As well, the body is able to produce coenzyme Q10. Growing older is associated with reduced coenzyme Q10 synthesis, similar to other key biomolecules. Coenzyme Q10 is a potent antioxidant in its own right, and also like vitamin C, it recycles vitamin E.(2) Having optimal levels in the mitochondria can provide an antioxidant effect that preserves mitochondria fatty acid membranes from peroxidation and destruction, prolonging tissue health and life.
Coenzyme Q10 supplementation may be especially necessary in older people, whose nutritional deficiencies and compromised liver function have curtailed coenzyme Q10 production. Of special importance is the way coenzyme Q10 enhances immune system performance, cardio performance, especially with heart failure and congestive heart failure, and liver and kidney performance.
Since the establishment of the statin class of cholesterol lowering medications, concern has been expressed that statins could cause a practical depletion of the isoprenoid intermediates that are required for both cholesterol and coenzyme Q10 synthesis. The most notable adverse effects associated with statin medications relate to the metabolic consequences of reduced isoprenoid units. So while statins favorably modulate cholesterol synthesis by denied isoprenoid synthesis into cholesterol, they may unfavorably modulate coenzyme Q10 synthesis as well. With statin intervention, based on the required dose, drug potency, and the duration of use, the available mevalonate pool can be so reduced over time that obligatory mevalonate isoprenoid intermediates are critically reduced and coenzyme Q10 synthesis is adversely affected.
Some mevalonate shortages have been shown to result in compensatory adjustments that raise the HMG-CoA reductase enzyme level as much as 200-fold.(15) Some clinical trials have demonstrated that statin drugs reduce coenzyme Q10 blood levels over time, some with reductions as great as 50 percent within 30 days can be cited.(16,17) Patients being treated for elevated cholesterol, and particularly older patients, using a statin drug are ironically at risk for developing adverse effects in the cardiovascular system.
This product is designed to assist those who require a large daily dose of coenzyme Q10, especially in addressing cardiovascular health where coenzyme Q10 is depressed by statin medication.
References
1. Bliznakov, Emile G., Hunt, Gerald L., The Miracle Nutrient Coenzyme Q10, Bantam Books, New York, 1989 2. Packer, Lester, Colman, Carol, The Antioxidant Miracle, John Wiley & Sons, New York, 1999 3. Firshein, Richard N., The Nutraceutical Revolution, Riverhead Books, New York, 1998 4. Graedon, Joe, Graedon, Teresa, Deadly Drug Interactions: The People's Pharmacy Guide, St. Martin's Press, New York, 1995 5. Spigset, Olav, Reduced Effect of Warfarin Caused by Ubidecarenone (Letter), Lancet, 344:1372-1373, 1994 6. Jellin, JM, Gregory, P., Batz, F., Hitchens, K., et al, Pharmacists Letter/Prescriber's Letter Natural Medicines Comprehensive Database, 3rd ed., Stockton, CA: Therapeutic Research Faculty, 2000, p 302-303 7. Teo, K.K., et al, "Role of magnesium in reducing mortality in acute myocardial infarction: A review of the evidence", Drugs, 46: 347-359, 1993 8. Turlapaty, P., et al, "Magnesium deficiency produces spasms of coronary arteries: Relationship to etiology of sudden ischemic heart disease", Science, 208: 199-200,1980 9. www.naturaldatabase.com 10. Bargossi, A.M., et al, Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors, Mol Aspects Med, 15(Suppl):187-193 11. Langsjoen, P.H., et al, Pronounced increase of survival of patients with cardiomyopathy when treated with coenzyme Q10 and convential therapy, International Journal of Tissue Reactions, 12 (3):163-168, 1990 12. Langsjoen, P.H., and Langsjoen, A.M., Overview of the use of CoQ10 in cardiovascular disease, BioFactors, 9(2-4):237-284, 1999, 13. Langsjoen, P.H., Langsjoen, A.M., Review of Coenzyme Q10 in cardiovascular disease with emphasis on heart failure and ischemic reperfusion, Asia Pacific Heart Journal, 7(3):160-168, 1998 14. Williams, K.D., et. al., 52-Week oral gavage chronic toxicity study with ubiquinone in rats with a 4-week recovery, Journal of Agriculture Food Chemistry, Sept, 47(9):3756-63, 1999 15. Voet, Donald, Judith G. Voet, and Charlotte W. Pratt, Fundamentals of Biochemistry, John Wiley & Sons Inc, Toronto, 2002, p 603-606 16. Ghirlanda, G., et. al., Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study, Journal of Clinical Pharmacology, 33:226-229, 1993 17. Rundek, T., et. al., Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke, Archives in Neurology, Vol 61, June, 889-892, 2004
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Directions
Use 1 softgel daily or as directed by a physician.
This product is predissolved in rice oil to facilitate absorption. Coenzyme Q10 is poorly oil soluble and completely water insoluble, making mealtime fat an unreliable way to absorb 150 mg at one time.
The amount of coenzyme Q10 used in clinical settings can range from 100 to 300+ mgs. Clinical use has included treatment for congestive heart failure and prophylactic use against Adriamycin cardiotoxicity where it has demonstrated an ability to prevent Adriamycin free radical damage to the myocardium.(1,3,6)
Cautions
Adverse Side Effects
Coenzyme Q10 has been well tolerated in clinical studies and there is no particular history of adverse side effects with long-term use.(6) It can cause gastritis, loss of appetite, nausea, and diarrhea.(6)
Higher clinical doses in excess of 300 mg per day can elevate serum aminotransferase levels.(6) In clinical trials encompassing 2152 patients, Coenzyme Q10 has been completely safe, and without any reports of toxicity or drug interactions.(12,13) Animal studies have found complete safety and no reports of toxicity, even with doses as high as 1200 mg per kg of body weight over 52 weeks.(14)
Interactions
Magnesium is required for ATP production and may also be an important supplemental cofactor in those using coenzyme Q10 for general energy enhancement. Magnesium depletion is known to be an important risk factor for impaired cardiac function.(7,8)
Precaution / Cautions
HMG CoA reductive inhibitors (Statin drugs) can reduce serum levels of endogenously produced coenzyme Q10.(6) The clinical significance is not clear since muscle levels do not seem to be affected.(9) However, other tissue levels may not avoid depletion as well as muscles.
Supplementation with coenzyme Q10 can normalize plasma levels.(10) Because statin drugs have a reputation for hepatic toxicity, it may be very important to use coenzyme Q10 with statin medication to lower the risk of oxidative stress in the liver.
Contraindications
Concurrent use of coenzyme Q10 with warfarin (Coumadin®) should be provisionally contraindicated.
In a letter to the Lancet published in 1994, it was reported that researchers in Sweden had observed that when patients on a stable regimen of warfarin started using coenzyme Q10, they experienced a greater propensity for blood clotting.(4,5) This interaction has not been widely reported, but concurrent use of coenzyme Q10 with warfarin probably should be considered contraindicated, unless prescribed by a physician.
The Natural Medicines Comprehensive Database states that there is preliminary clinical research that suggests coenzyme Q10 might not significantly decrease the effects of warfarin in patients that have a stable INR.(6)
Patients who are discovered to be using both of these substances concurrently, should not stop coenzyme Q10 suddenly if their warfarin dosage was determined while they were using coenzyme Q10. Such patients can be titrated off coenzyme Q10 according to their physician's judgment. Coenzyme Q10 may be therapeutically important to the best management of the patient.
Coenzyme Q10 is commonly chosen for its ability to increase energy levels and could have particular importance in heart patients who are also on anticoagulation medication. Coenzyme Q10 is becoming better known in general and has a growing reputation among physicians and lay people as a treatment for congestive heart failure. It is possible for people who have had a heart attack and are also on warfarin, to self-select coenzyme Q10.
Label Information
Hermetic seal under cap for safety and freshness. Contains no artificial preservatives, color, dairy, sweeteners, starch, wheat or yeast.
These statements have not been evaluated by the Food and Drug Administration (FDA). Products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor. The essence of the current American rule on Traditional Uses is, as stated by FTC, "Claims based on historical or traditional use should be substantiated by confirming scientific evidence, or should be presented in such a way that consumers understand that the sole basis for the claim is a history of use of the product for a particular purpose."
