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CoEnzyme Q10 | | |
Coenzyme Q10 is a valuable nutrient that every cell in your body must have
in order to produce energy. It occurs naturally in the body but levels may
decline with age. Food sources include fish, lamb, spinach, and broccoli.
Studies have demonstrated that coenzyme Q10 is effective in the treatment
of congestive heart failure and myocardial infarction. Human trials
related to other serious health concerns like cancer and AIDS are
controversial and inconclusive, so any health benefits in these areas are
scientifically unsubstantiated.
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| Common Name | | | CoEnzyme Q10
| | | Other Names | | | Co-Enzyme Q-10, CoQ10, Q10, Vitamin Q10, Ubiquinone, Ubidecarenone.
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| | | Description | | | Coenzyme Q10 (also known as CoQ10, Q10, vitamin Q10, ubiquinone, or
ubidecarenone) is a compound that is made naturally in the body. It is
sometimes referred to as `ubiquinone' because it is
"ubiquitously" found in whole natural foods. It is a natural
vitamin-like compound that is indispensable to the process of energy
production at the cellular level. A coenzyme is a substance needed for the
proper functioning of an enzyme, a protein that speeds up the rate at
which chemical reactions take place in the body. The Q and the 10 in
coenzyme Q10 refer to parts of the compound's chemical
structure.
Coenzyme Q10 is used by cells to produce energy needed
for cell growth and maintenance. Coenzyme Q10 is required for production
of adenosine triphosphate (ATP), the chemical which transfers energy
within the cells. It is also used by the body as an antioxidant. An
antioxidant is a substance that protects cells from chemicals called free
radicals. Free radicals are highly reactive chemicals that can damage
important parts of cells, including deoxyribonucleic acid (DNA). (DNA is a
molecule inside cells that carries genetic information and passes it from
one generation to the next.) This damage may play a role in the
development of cancer.
Coenzyme Q10 is found in most body tissues.
The highest amounts are found in the heart, liver, kidneys, and pancreas.
The lowest amounts are found in the lungs. Tissue levels of coenzyme Q10
decrease as people get older.
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| | | Daily Requirements | | | Coenzyme Q10 supplements are typically recommended at a minimum daily
dosage of 60 mg (30 mg - 90 mg). Depending on any existing health
conditions as well as dietary considerations, your health care
practitioner may decide to adjust the levels accordingly.
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| | | Traditional Internal Uses | | | Coenzyme Q10 has been investigated for possible effects in cardiovascular
disease, cancer, exercise performance, periodontal disease, acquired
immunodeficiency syndrome (AIDS) and Parkinson's disease.
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| | | Indications | | | Infertility
Primary Indications: Cardiovascular Disorders, Congestive Heart Failure, Acute Myocardial Infarction (Heart Attack)
Secondary Indications: Angina Pectoris (Chest Pain), Hypotension (Low Blood Pressure)
Other Indications: Cancer / Cancer Prevention, HIV / AIDS Support, Immunity / Immune Disorders, Menopause, Parkinson's Disease, Periodontal / Gum Disease, Stamina / Exercise
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| | | Actions | | | Anti-Inflammatory, Antioxidant, Cardioprotective, Cyto-Protective, Hypotensive (Anti-Hypertensive), Neuroprotective
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| | | Pharmacological Summary | | | Laboratory studies of coenzyme Q10 have focused on describing its chemical
structure and how it works in the body. Animal studies have found that
coenzyme Q10 stimulated the immune system and increased resistance to
disease. Coenzyme Q10 helped to protect the hearts of animals given the
anti-cancer drug Doxorubicin, which can cause damage to the heart
muscle.
Results from preliminary studies with coenzyme Q10 suggest
that it may help to improve symptoms of congestive heart failure, and may
also help to protect against myocardial infarction. Studies in angina and
hypertension are inconclusive. It is likely that coenzyme Q10 is
beneficial mainly in people who are deficient. Studies conducted so far do
not justify the use of coenzyme Q10 in cancer, athletes and sports people
and AIDS. However, some of the preliminary research justifies more
rigorous trials to investigate potential benefits. At present, there is
insufficient evidence to make definite recommendations for coenzyme Q10 as
a dietary supplement.
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| | | Dietary Sources | | | The coenzyme Q10 content of different types of food has been evaluated.(1)
Coenzyme Q10 is primarily found in fish and meat. Our bodies are able to
produce some of the coenzyme Q10 that we need. The rest is synthesized
from the foods we eat. The highest dietary sources of coenzyme Q10 come
from - in descending order according to content - fresh sardines and
mackerel, the heart, liver and meat of beef, lamb and pork along with
eggs. There are plenty of vegetable sources of coenzyme Q10, the richest
being spinach, broccoli, peanuts, wheat germ and whole grains - in that
order, although the amount is significantly smaller than that found in
meats. Also, it is important to note that these foods must be raw, fresh
and unprocessed - no milling, canning, preserving, freezing, etc., plus
grown/produced in an unpolluted environment to be considered viable
sources.
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| | | Metabolism | | | Coenzyme Q10 is synthesised endogenously using tyrosine, methionine and
acetyl co-enzyme A as starting materials. The acetyl co-enzyme A pathway
proceeds to both cholesterol and coenzyme Q10 synthesis, so coenzyme Q10
and cholesterol share, to some extent, the same biosynthetic pathway. The
ability to synthesise coenzyme Q10 may decrease with age. Evidence for a
reduction in co-enzyme Q10 concentrations with age in various human
tissues has been demonstrated.(2,3)
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| | | Scientific Research and Pharmacologicial Actions | | | Cardiovascular Disease
Coenzyme Q10 has been suggested to
have a role in the management of cardiovascular disease.
Several
small studies have suggested that coenzyme Q10 has the ability to protect
the ischaemic myocardium in patients with stable angina.(4-6) With doses
of 150-600 mg daily, coenzyme Q10, in comparison with placebo,
significantly prolonged exercise duration, but at least in one study,
angina symptoms and nitrate use were not reduced.(6)
In another
study, in patients with acute myocardial infarction given coenzyme Q10
there was no prolongation of the QT interval, while 40% of the patients on
placebo had a prolonged QT interval. After one year, six patients in the
placebo group died of re-infarction, while there was one non-cardiac death
in the coenzyme Q10 group.(7) Therapy with coenzyme Q10 (60 mg daily) has
also been shown effective in treating ventricular
arrhythmias.(5)
Several studies have reported clinical benefits of
therapy with coenzyme Q10 (50-100 mg daily) in congestive heart failure
when added to conventional therapy, including digoxin, diuretics and
angiotensin-converting enzyme inhibitors.(4,5,8-13) However, one study
failed to show improvement of ventricular function with co-enzyme
Q10.(14)
A meta-analysis of eight clinical trials concluded that
addition of coenzyme Q10 to standard therapy for congestive heart failure
was associated with significant improvements in ejection fraction, stroke
volume and cardiac output.(15) Two case reports suggest that in
non-responders to coenzyme Q10, increasing the dose to 300 mg daily may
result in improved left ventricular function and improved quality of
life.(16)
Coenzyme Q10 therapy (30-90 mg daily) has been reported
to reduce both systolic and diastolic blood pressure in uncontrolled
studies involving small numbers of patients.(5,17,18) A large multicentre
trial is needed to further assess the efficacy of co-enzyme Q10 in
hypertension.
Cancer
Coenzyme Q10 is claimed to have
a protective effect against cancer, but data are limited. Folkers et
al.(19) reported that coenzyme Q10 has shown macrophage-potentiating
activity in cancer patients with some evidence of increased survival. In a
Danish trial,(20,21) 32 women were given routine chemotherapy,
radiotherapy, surgery, vitamins, minerals and coenzyme Q10. Six of the
women showed partial or complete cancer regression. The authors concluded
that, statistically, six women would normally have died, but during the
two years of the trial there were no deaths. However, the multiplicity of
nutritional supplements used in the study prevents identification of
coenzyme Q10 as the dominant factor. In two patients with metastatic
breast cancer whose coenzyme Q10 dose was increased from 90 to 360 mg
daily, liver metastases and pleural cavity metastases apparently
disappeared.(22)
Exercise Performance
Controlled
studies investigating the effects of coenzyme Q10 supplementation in
exercise performance have not generally shown positive results. A dose of
1 mg coenzyme Q/kg/day had no effect on exercise performance in trained
cyclists and athletes.(23) Coenzyme Q10 did not improve performance in
either aerobic exercise(24) or
cyclists.(25)
Miscellaneous
Case reports and small
trials have shown beneficial effects of coenzyme Q10 in periodontal
disease,(26-28) AIDS(29,30) and Parkinson's disease.(31) Several other
claims have been made for coenzyme Q10, including improved energy levels,
reduced menopausal symptoms, improved immunity and as an aid to slimming,
though there is limited evidence for these claims.
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| | | Research | | | "Coenzyme Q10 and Parkinson's Disease"
"Coenzyme Q10 Lessens Muscle-Related Side Effects of Statins"
"CoQ10 Slows Functional Decline in Parkinson's Disease"
"Coenzyme Q10 Again Found Safe, Well Tolerated in ALS"
"Coenzyme Q10 Improves High Blood Pressure"
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| | | Precautions / Contraindications | | | Coenzyme Q10 should not be used to treat cardiovascular disorders without
medical supervision.
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| | | Interaction with Medications | | | Coenzyme Q10 may reduce the effect of warfarin; decreases in international
normalised ratio (INR) have been reported.(32)
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| | | Possible Side Effects | | | No serious side effects have been reported from the use of coenzyme Q10.
Some patients using coenzyme Q10 have experienced mild insomnia (inability
to sleep), elevated levels of liver enzymes, rashes, nausea, and upper
abdominal pain. Other reported side effects have included dizziness,
visual sensitivity to light, irritability, headache, heartburn, and
fatigue.
Patients should talk with their health care provider about
possible interactions between coenzyme Q10 and prescription drugs they may
be taking. Certain drugs, such as those that are used to lower cholesterol
or blood sugar levels, may reduce the effects of coenzyme Q10. Coenzyme
Q10 may also alter the body's response to warfarin (a drug that prevents
the blood from clotting) and insulin.
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| | | Deficiency | | | Normal blood and tissue levels of coenzyme Q10 have been well established
by numerous investigators around the world. Significantly decreased levels
of coenzyme Q10 have been noted in a wide variety of diseases in both
animal and human studies. Coenzyme Q10 deficiency may be caused by
insufficient dietary coenzyme Q10, impairment in coenzyme Q10
biosynthesis, excessive utilization of coenzyme Q10 by the body, or any
combination of the three. Decreased dietary intake is presumed in chronic
malnutrition and cachexia(12).
The relative contribution of
coenzyme Q10 biosynthesis versus dietary coenzyme Q10 is under
investigation. Karl Folkers takes the position that the dominant source of
coenzyme Q10 in man is biosynthesis. This complex, 17 step process,
requiring at least seven vitamins (vitamin B2 - riboflavin, vitamin B3 -
niacinamide, vitamin B6, folic acid, vitamin B12, vitamin C, and
pantothenic acid) and several trace elements, is, by its nature, highly
vulnerable. Karl Folkers argues that suboptimal nutrient intake in man is
almost universal and that there is subsequent secondary impairment in
coenzyme Q10 biosynthesis. This would mean that average or
"normal" levels of coenzyme Q10 are really suboptimal and the
very low levels observed in advanced disease states represent only the tip
of a deficiency "ice berg".
HMG-CoA reductase inhibitors
used to treat elevated blood cholesterol levels by blocking cholesterol
biosynthesis also block coenzyme Q10 biosynthesis(13). The resulting
lowering of blood coenzyme Q10 level is due to the partially shared
biosynthetic pathway of coenzyme Q10 and cholesterol. In patients with
heart failure this is more than a laboratory observation. It has a
significant harmful effect which can be negated by oral coenzyme Q10
supplementation(14).
Increased body consumption of coenzyme Q10 is
the presumed cause of low blood coenzyme Q10 levels seen in excessive
exertion, hypermetabolism, and acute shock states. It is likely that all
three mechanisms (insufficient dietary coenzyme Q10, impaired coenzyme Q10
biosynthesis, and excessive utilization of coenzyme Q10) are operable to
varying degrees in most cases of observed coenzyme Q10 deficiency.
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| | | Dosage | | | Adult levels of supplementation are usually 30-90 mg per day, although
individuals with specific health conditions may supplement with higher
levels, such as 100 mg 3-4 times per day. Most of the research on heart
conditions has used 90-150 mg of coenzyme Q10 per day. Coenzyme Q10 is
normally present in every cell of your body.
As an adjunct to
conventional treatment in cardiovascular disorders (with medical
supervision only), doses of 150-300 mg daily have been used; dietary
supplements generally provide 15-60 mg per dose.
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| | | References | | | 1. Kamei M, Fujita T, Ranke T, et al. The distribution and content of
ubiquinone in foods. Int J Vit Nutr Res 1986; 56: 57-64.
2. Kalen A,
Appelkvist EL, Dallner G. Age related changes in the lipid composition of
rat and human tissue. Lipids 1989; 24: 579-584.
3. Soderberg M, Edlund
C, Kristensson K, Dallner G. Lipid composition of different regions of the
brain during aging. J Neurochem 1990; 54: 415-423.
4. Mortensen SA,
Vadhanavikit S, Baandrup U. Long term co-enzyme Q10 therapy: A major
advance in the management of resistant myocardial failure. Drugs Exp Clin
Res 1985; 11: 581-593.
5. Greenberg S, Frishman WH. Co-enzyme Q10: A
new drug for cardiovascular disease. J Clin Pharmacol 1990; 30:
596-608.
6. Kamikawa T, Kobayashi A, Tamashita T. Effects of co-enzyme
Q10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol
1985; 56: 247-251.
7. Kuklinski B, Weissenbacher E, Fahnrich A.
Co-enzyme Q10 and antioxidant in acute myocardial infarction. Mol Aspects
Med 1994; 15 (suppl.): S143-S147.
8. Lampertico M, Comis S. Italian
multicenter study on the efficacy and safety of co-enzyme Q10 as adjuvant
therapy in heart failure. Clin Invest 1993; 71: 129-133.
9. Mortensen
SA. Perspectives on therapy of cardiovascular disease with co-enzyme Q10
(Ubiquinone). Clin Invest 1993; 71: 116-123.
10. Baggio E, Gandini R,
Plancher AC. Italian multicenter study on the safety and efficacy of
co-enzyme Q10 as adjunctive therapy in heart failure (interim analysis).
Clin Invest 1993; 71: 145-149.
11. Langsjoen PH, Langsjoen PH, Folkers
K. Long-term efficacy and safety of co-enzyme Q10 therapy for idiopathic
dilated cardiomyopathy. Am J Cardiol 1990; 65: 521-523.
12. Langsjoen
PH, Folkers K, Lyson K. Effective and safe therapy with co-enzyme Q10 for
cardiomyopathy. Klin Wochenschr 1988; 66: 583-590.
13. Ishiyama T,
Morita Y, Toyama S. A clinical study of the effect of co-enzyme Q on
congestive heart failure. Jpn Heart J 1976; 17: 32-42.
14. Khatta M,
Alexander BS, Kritchen CM, et al. The effect of co-enzyme Q10 in patients
with congestive heart failure. Ann Intern Med 2000; 132: 636-640.
15.
Soja AM, Mortensen SA. Treatment of congestive heart failure with
co-enzyme Q10 illuminated by meta-analyses of clinical trials. Mol Aspects
Med 1997; 18 (suppl.): S159-S168.
16. Sinatra ST. Refractory
congestive heart failure successfully managed with high dose co-enzyme Q10
administration. Mol Aspects Med 1997; 18 (suppl.): S299-S305.
17.
Folkers K, Drzewoski J, Richardson PC. Bioenergetics in clinical medicine,
XVI: Reduction of hypertension in patients by therapy with co-enzyme Q10.
Res Commun Chem Pathol Pharmacol 1981; 31: 129-140.
18. Yamaagami T,
Shibata N, Folkers K. Bioenergetics in clinical medicine, XVIII:
Administration of co-enzyme Q10 to patients with essential hypertension.
Res Commun Chem Pathol Pharmacol 1976; 14: 721-727.
19. Folkers K,
Brown R, Judy WV, Morita M. Survival of cancer patients on therapy with
co-enzyme Q10. Biochem Biophys Res Commun 1993; 192: 241-245.
20.
Lockwood K, Moesgaard S, Folkers K. Partial and complete regression of
breast cancer in patients in relation to DOSE of co-enzyme Q10. Biochem
Biophys Res Commun 1994; 199: 1504-1508.
21. Lockwood K, Moesgaard S,
Hanioka T. Apparent partial remission of breast cancer in `high risk'
patients supplemented with nutritional antioxidants, essential fatty acids
and co-enzyme Q10. Mol Aspects Med 1994; 10 (suppl.): S231-S240.
22.
Lockwood K, Moesgaard S, Hanioka T. Progress on therapy of breast cancer
with vitamin Q10 and the regression of metastases. Biochem Biophys Res
Commun 1995; 212: 172-177.
23. Weston SB, Zhou S, Weatherby RP, et al.
Does exogenous co-enzyme Q10 affect aerobic capacity in endurance
athletes. Int J Sports Nutr 1997; 7: 197-206.
24. Malm C, Svensson M,
Ekblom B, et al. Effects of ubiquinone-10 supplementation and high
intensity training on physical performance in humans. Acta Physiol Scand
1997; 161: 379-384.
25. Braun B, Clarkson PM, Freedson PS, Kohl RL.
Effects of co-enzyme Q10 supplementation on exercise performance, VO2max
and lipid peroxidation in trained cyclists. Int J Sport Nutr 1991; 1:
353-365.
26. Iwamoto Y, Nakamura R, Folkers K. Study of periodontal
disease and co-enzyme Q. Res Commun Chem Pathol Pharmacol 1975; 11:
265-271.
27. Wilkinson EG, Arnold RM, Folkers K. Bioenergetics in
clinical medicine, VI: Adjunctive treatment for periodontal disease with
co-enzyme Q10. Res Commun Chem Pathol Pharmacol 1976; 14: 715-719.
28.
Wilkinson EG, Arnold RM, Folkers K. Bioenergetics in clinical medicine,
II: Adjunctive treatment for periodontal disease with co-enzyme Q10. Res
Commun Chem Pathol Pharmacol 1975; 12: 111-124.
29. Folkers K,
Shizukuishi S, Takemura K. Increase in levels of IgG in serum of patients
treated with co-enzyme Q10. Res Commun Chem Pathol Pharmacol 1982; 38:
335-338.
30. Folkers K, Langsjoen P, Nara Y. Biochemical deficiencies
of co-enzyme Q10 on HIV-infection and exploratory treatment. Biochem
Biophys Res Commun 1988; 2: 88-96.
31. Shultz CW, Beel MF, Fontaine D,
et al. Absorption, tolerability and effects on mitochondrial activity of
oral co-enzyme Q10 in parkinsonian patients. Neurology 1998; 50:
793-795.
32. Spigset O. Reduced effect of warfarin caused by
ubidecarone. Lancet 1994; 344: 1372-1373.
Our thanks to the
following information resources: Medicinescomplete.com, National
Cancer Institute.com, Faculty.Washington.edu.
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CoEnzyme Q10 - Health - Coenzyme Q10 - 150 mg - Extra Strength
30 softgels
28.03 US
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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.
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