Coenzyme Q10 is a fat-soluble nutrient also known as CoQ10, vitamin Q10, ubidecarenone, or ubiquinone. It is a natural product of the human body that is primarily found in the mitochondria, which are the cellular organelles that produce energy. It occurs in most tissues of the human body; however, the highest concentrations are found in the heart, liver, kidneys, and pancreas. Ubiquinone takes its name from a combination of the word ubiquitous, meaning something that is found everywhere, and quinone 10. Quinones are substances found in all plants and animals. The variety found in humans has a 10-unit side chain in its molecular structure. Apart from the important process that provides energy, CoQ10 also stabilizes cell membranes and acts as an antioxidant. In this capacity, it destroys free radicals, which are unstable molecules that can damage normal cells.
General use
CoQ10 is used extensively in Canada, Western Europe, Japan, and Russia to treat congestive heart failure. It is available as a prescription medication almost everywhere it is sold, although it is sold over-the-counter as a nutritional supplement in the United States. Some studies have shown it to be effective for as many as 70% of patients with congestive heart failure. It appears to improve patient health and wellbeing, and to increase cardiac efficiency. The dosage generally recommended for this condition is 100–300 mg a day, preferably in divided doses. According to Dr. Karl Folkers in Prevention's Healing with Vitamins, it takes one to three months to achieve desired results from supplementation, and as long as six months to attain maximum benefit.
CoQ10 may also help people with some forms of cardiomyopathy. Patients should consult their physician about the possible benefits of supplementation for this condition.
The usefulness of CoQ10 in lowering blood pressure is not well documented. One study suggests that the supplement is helpful for hypertension, but the results are in question as it was not a double-blind, controlled research project. The dose recommended is 200–250 mg a day, with results taking several months to appear. It is possible that some patients with essential hypertension who are initially low in CoQ10 may eventually be able to decrease the amount of their other blood pressure medications. This must be done under the care of a health care provider.
Oral supplementation of CoQ10 has been shown to improve periodontal disease, as it decreases the size of abnormally deep pockets in the gums, and also reduces the extent of bacterial contamination. Other possible benefits of CoQ10 are to decrease angina symptoms, improve immune function in patients with AIDS and other immune deficiencies, improve control of blood sugar, lower cholesterol, improve physical stamina, and help people with muscular dystrophy and Huntington's disease. A group of researchers at the University of California at San Diego reported in 2002 that coenzyme Q10 appears to slow the progress of Parkinson's disease, Friedreich's ataxia, and other conditions marked by degeneration of the central nervous system. The supplement can also reduce the toxicity of some types of chemotherapy. Doxorubicin, a chemotherapeutic agent, is known to sometimes damage the heart. Concomitant supplementation seems to reduce this toxic effect. The possible benefits of CoQ10 should be discussed with a nutritionally-oriented health care provider.
Since 1961, when it was first noticed that cancer patients in Sweden and the United States had low levels of the enzyme, coenzyme Q10 has been studied as a possible cancer treatment. Researchers believe that coenzyme Q10 may protect against cancer by stimulating the immune system, and functioning as an antioxidant. Although animal studies have been conducted, as of early 2004 no report of a randomized clinical trial involving human subjects whose survival times were lengthened by using coenzyme Q10 in addition to a traditional cancer treatment has been reported in a peer-reviewed medical journal.
Deficiency
Patients with certain conditions tend to have lower levels of CoQ10, and may benefit from supplements. Some diseases that are associated with decreased amounts of this nutrient are AIDS, chronic fatigue, congestive heart failure, cardiomyopathy, and inflammatory gum disease. Levels of CoQ10 tend to decrease with age; tests for its presence in the body are not widely available. Adverse effects from this supplement are rare and mild, so anyone suffering from one of the listed conditions should consider discussing supplementation with a health care provider.
Natural sources
Food products are a good source of CoQ10, and provide approximately half of the body's requirement. Cold-water fish such as mackerel, salmon, sardines, and tuna are particularly high in CoQ10. Vegetable oils and meats also provide good sources. The liver manufactures adequate amounts to fulfill the need not met in the diet. People who are deficient in B vitamins, selenium, vitamin C, and vitamin E may not be able to make as much CoQ10 as they need because these nutrients are required for production. Consumption of foods rich in CoQ10 and production of the nutrient in the liver will not provide the amounts needed to treat heart failure and other conditions that may contribute to a deficiency of this nutrient. In those cases, supplements are required.
Supplemental sources
Supplements of CoQ10 are widely available; however, its cost varies considerably. As of 2004, it is available in the United States, ranging in price from $7.79 for a bottle of 40 30-mg capsules to $38.95 for a bottle of 60 100-mg capsules. It is found in various forms including capsules, gelcaps, liquids, and tablets. The latter may be the best choice, as this form generally includes a source of fat that improves absorption. Vitamin E is a helpful stabilizing additive as well. Most of the CoQ10 products currently available on the market are manufactured in Japan. Like other supplements, Co10 is best kept in a cool, dry place, out of direct light, and out of the reach of children.
Precautions
As of 2004, the safety of CoQ10 for pregnant or breast-feeding women has not been established, and its use is not recommended under these conditions. It is also not recommended for young children. People diagnosed with heart failure, diabetes, kidney problems, or liver disease should use particular care with this supplement, as the dosage of other medications may require adjustment. These individuals should consult a physician before taking coenzyme Q10.
Side effects
Reported adverse effects related to supplemental CoQ10 use include diarrhea, irritation of the stomach, poor appetite, and nausea. These effects are rarely reported and are mild. CoQ10 is considered extremely safe for most people. If doses over 300 mg per day are taken, liver enzyme levels may be affected, and may need monitoring.
Interactions
It is possible that CoQ10 decreases the action of sodiumwarfarin (known by the brand name, Coumadin), which is prescribed to prevent the formation of blood clots in patients at risk of heart attack or stroke. Some oral diabetes medications may also interfere with the action of CoQ10. Cholesterol-lowering drugs in the statin group may have this effect as well.
BOOKS
Bratman, Steven, and David Kroll. Natural Health Bible. Roseville, CA: Prima Publishing, 2000.
Griffith, H. Winter. Vitamins, Herbs, Minerals & Supplements: The Complete Guide. Tucson, AZ: Fisher Books, 2000.
Pressman, Alan H., and Sheila Buff. The Complete Idiot's Guide to Vitamins and Minerals., 2nd ed. Indianapolis: Macmillan General Reference, 2000.
Therapeutic Research Faculty Staff. Natural Medicines Comprehensive Database. Stockton, CA: Therapeutic Research Faculty, 1999.
PERIODICALS
Baker, S. K., and M. A. Tarnopolsky. "Targeting Cellular Energy Production in Neurological Disorders." Expert Opinion on Investigational Drugs 12 (October 2003): 1655–79.
Naini, A., V., J. Lewis, M. Hirano, and S. DiMauro. "Primary Coenzyme Q10 and the Brain." Biofactors 18 (2003): 145–52.
Shults, C. W. "Coenzyme Q10 in Neurodegenerative Diseases." Current Medical Chemistry 10 (October 2003): 1917–21.
Shults, C. W., D. Oakes, K. Kieburtz, et al. "Effects of Coenzyme Q10 in Early Parkinson's Disease: Evidence of Slowing of the Functional Decline." Archives of Neurology 59 (October 2002): 1541–50.
Vedanarayanan, V. V. "Mitochondrial Disorders and Ataxia." Seminars in Pediatric Neurology 10 (September 2003): 200–9.
ORGANIZATIONS
Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857. (888) 463-6332. <http://www.fda.gov>.
National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse. P. O. Box 7923, Gaithersburg, MD 20898-7923. (888) 644-6226. Fax: (866) 464-3615. <http://nccam.nih.gov>.
