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Beyond heart health: the systemic benefits of CoQ10

In 1990, pharmaceutical giant Merck was granted a patent on combinations of statin drugs and coenzyme Q10.

The patent reveals that statin drugs deplete CoQ10 in the body and how taking the combination could yield considerable benefits.

Here is a quote from a Merck patent written in 1989:

“Since CoQ10 is of benefit in congestive heart failure patients, the combination with HMG-CoA reductase inhibitors [statins] should be of value in such patients who also have the added risk of high cholesterol levels.”1

Merck never made a combination statin and CoQ10 drug. It was up to patients or their physician to figure out they could benefit with CoQ10 when taking a drug like Zocor® (simvastatin) that was made by Merck.

Physicians are finally catching on. A reported 71% of cardiologists prescribe CoQ10 to certain heart disease patients.2 But the importance of CoQ10 doesn’t stop there.

CoQ10 is a component of the energy supply system of all cells in the body, critical for many aspects of our health.

Aging itself is associated with low levels of CoQ10 in the body.3,4 The typical modern diet only supplies about 3–6 milligrams of CoQ10 per day, mostly from meat and fish.5

While CoQ10 is best known for heart health, researchers are finding benefits for brain, bone, and metabolic health including reduced mortality.

 

Heart health

The medical literature continues to show a vast range of benefits of CoQ10 for cardiovascular health.6-9

One recent study found that, even without a statin drug, CoQ10 alone (120 mg daily) decreased blood pressure, triglycerides, and LDL cholesterol.9 After 24 weeks, subjects with abnormal lipid profiles benefited from a 20% reduction of triglycerides, 7% reduction of LDL, and 6%-8% reduction in blood pressure.

Although the mechanisms of these changes were not specifically assessed, they may be partially related to improvements in insulin metabolism that were also observed in the study.

In experimental animal models, CoQ10 has been found to improve markers of blood vessel health and protect the heart muscle.10,11 In a rat model of myocardial infarction (heart attack), control animals that did not receive CoQ10 displayed damage to over 65% of the heart surface. CoQ10-supplemented animals reduced this damage to only 26%.10

Studies show that CoQ10 is protective in patients with a history of heart disease, specifically heart failure. In meta-analyses of available studies, researchers found that, compared to control patients without supplementation, CoQ10 decreased mortality, presumably by reducing the incidence of serious cardiac events.6,12 Furthermore, CoQ10 supplementation was associated with improved heart ejection fraction and improved exercise capacity.12

A long-term study evaluated people supplementing with CoQ10 plus selenium compared with placebo. Individuals receiving 200 mg of CoQ10 and 200 mcg of selenium daily exhibited a significant 41% reduction in cardiovascular-related mortality 12 years later.7

Statin medications are associated with diminished levels of CoQ10 in the body. For this reason, many physicians now recommend that their patients increase their intake of CoQ10 during statin treatment. Also, it is believed that CoQ10 supplementation helps reduce the occurrence and severity of some of the most common side effects of statin drugs, in particular, muscle pain.3,13,14

 

Brain health

The brain is one of the most metabolically active organs in the body. For this reason, the brain requires an ample supply of energy to function optimally.

So it should come as no surprise that CoQ10 has been found to offer several benefits to the nervous system, including protection from several types of disease.

Several animal studies have found CoQ10 to be neuroprotective.15-17

In traumatic head injuries, the brain suffers from ongoing damage even after the initial trauma. This is due to oxidative stress, inflammation, and impaired mitochondrial function. CoQ10 appears to alleviate these insults.

In a study of rats exposed to a head injury, CoQ10 protected mitochondria from damage and reduced cell death in the brain.17 These same mechanisms of brain injury occur in human traumatic brain injury as well, making CoQ10 a promising management strategy for head trauma.

Rodent models of stroke also showed benefit from CoQ10, mitigating the damage seen in the brain and reducing markers of oxidative stress, inflammation, and cell death in affected tissues.15,16

 

WHAT YOU NEED TO KNOW

 

CoQ10 and heart health

  • In addition to its use to treat and prevent statin-induced CoQ10 deficiency, the widespread benefits of ample CoQ10 are increasingly being documented.
  • CoQ10 is an important coenzyme in the processes that supply energy to cells.
  • Increasing CoQ10 intake has been linked to protection from cardiovascular disease, neurological conditions, age-related bone loss, metabolic disorders such as obesity, diabetes, and more.
  • While the intake of CoQ10 from a typical diet is small, it can easily be augmented by supplementation and is well-tolerated even at high doses.

Protection against brain damage caused by stroke

Promising data from humans link higher CoQ10 levels with reduced brain damage caused by ischemic stroke and perhaps lower risk of stroke. Blood CoQ10 levels were evaluated in patients recovering from a stroke and compared to healthy controls.18

The stroke patients had significantly lower blood levels of CoQ10. There was also a correlation between low CoQ10 levels and greater severity of brain injury as measured by clinical scales, the NIH Stroke Scale and Modified Rankin Scale.

 

Degenerative brain diseases

Neurodegenerative disorders, such as Alzheimer’s and Parkinson’s disease, are common in older age.19 CoQ10 may be protective against these debilitating disorders.

In models of Alzheimer’s dementia, CoQ10 has been found to improve memory and limit the damage caused by beta-amyloid, a harmful protein that builds up in the brain and is implicated in the deterioration of brain function. Furthermore, CoQ10 protects mitochondrial function and limits brain inflammation, all of which contribute to declining cognitive function.20-23

In animal models of Parkinson’s, affected animals typically suffer from progressive loss of the control of movement. Treatment of these animals with CoQ10 leads to improvements in motor function as seen on tests of muscle coordination and motor tasks such as swimming. It also slows the progression of the disease.24,25

 

Metabolic benefits

Recent statistics from the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention estimate that almost 40% of all U.S. adults are obese and close to 10% have diabetes.26,27 More than twice that many have elevated blood glucose and are at risk for diabetes in the future.

Supplementation with CoQ10 has been linked to prevention of the development and progression of both obesity and diabetes, along with improvement in markers of sugar and fat metabolism.28-30

A study evaluating a mouse model of obesity and diabetes showed several beneficial effects of CoQ10. Supplementation led to activation of an enzyme which helps boost the metabolism of fats, which prevented obesity and development of diabetes. Despite a similar overall food intake, those animals receiving CoQ10 had a 12% reduction in body weight and reduced deposition of fatty tissue.28

In the treatment of diabetes in human trials and animal models, the addition of CoQ10 improves glucose control and decreases resistance to insulin. Cellular resistance to insulin is a causative mechanism of high glucose levels in type II diabetics.29,30

In addition to its direct impact on diabetes, CoQ10 may also help to protect kidney function from various forms of injury.30-32 Toxic injury to the kidney was reduced from 21% to 7% with a combination treatment containing CoQ10.31

Protection of kidney function is particularly important in individuals suffering from type II diabetes, as declining kidney function is a common complication. Studies in humans have seen improvements in systemic markers of inflammation and improved insulin and lipid metabolism in patients with diabetic renal disease.30,32

 

WHAT IS COENZYME Q10?

CoQ10 is a crucial component of the electron transport chain within the mitochondria inside all our living cells. Mitochondria are essentially our cellular “power generators,” converting the energy stored in nutrients into a form that can be used by the cell to do various forms of work.

Without CoQ10, cellular energy supply fails, and cells cannot function normally. Additionally, this coenzyme is a potent scavenger of potentially harmful free radicals, protecting cells from the oxidative stress that contributes to dysfunction and many diseases.

 

Better bones

Aging is associated with a decline in bone density, including osteoporosis, which increases the risk for fractures. Osteoporosis is a major contributor to disability and mortality in the elderly.33-35

Although bones may appear to be inert structures, they are actually quite dynamic tissues. Throughout life, they require constant remodeling, a balance between bone reabsorption and new bone growth, to maintain peak condition. If the balance leans toward more reabsorption and less new bone formation, bones grow thin and fragile.

CoQ10 has demonstrated, in preclinical models, the ability to improve bone health. It has been observed to prevent age-related decline in bone density, decreasing reabsorption of bone while boosting new bone formation and stimulating the growth of cells that form new bone (osteoblasts).36,37

Along with other bone health vitamins and minerals, such as vitamin K and calcium, CoQ10 can be an important component of a comprehensive bone health strategy.

 

COQ10, MITOCHONDRIA, AND CELLULAR ENERGY SUPPLY

All cells require energy to function. While this energy initially comes from nutrients obtained through the diet, such as carbohydrates and fats, it must be converted into a universal form that each cell can utilize, a high-energy molecule called adenosine triphosphate (ATP).

The great majority of ATP is formed in cellular structures called mitochondria. In the mitochondria, the energy stored in nutrients is passed through several intermediates in the process that is known as the electron transport chain, ultimately leading to the synthesis of new ATP. CoQ10 is one of these critical intermediates. Without it, this process grinds to a halt and the production of ATP is compromised.

CoQ10 is vital to the metabolism of all living cells.

 

Other benefits

Over 100 clinical trials utilizing CoQ10 are currently registered with the National Institutes of Health (ClinicalTrials.gov), ranging from treatment of depression to healthy reproductive function.

Some studies have suggested CoQ10 may be a useful adjunct to chemotherapy and/or radiation in the management of cancer.38 It may act as a sensitizer, enhancing these treatments’ effect of killing cancer cells in one model. It may even have activity against some cell types associated with development of cancer and other pathologies.39

For example, pancreatic stellate cells have been implicated in the pathogenesis of pancreatic cancer and other chronic conditions of the pancreas. When these cells are treated with CoQ10, the expression of genes associated with the formation of cancer are significantly reduced, potentially limiting the development and progression of these conditions.39

As part of a wellness strategy, CoQ10 has been found to decrease clinical markers of inflammation and contribute to reversal of age-related physiological changes. It helps reduce levels of compounds associated with systemic inflammation, such as C-reactive protein and tumor necrosis factor.4,40

 

COQ10 IMPROVES RESPONSE OF BRAIN CANCER CELLS TO TREATMENT

Glioblastoma multiforme is the most aggressive and deadly form of primary brain cancer. Despite years of research, treatment for this rapidly growing tumor is rarely capable of containing its spread.

However, a study released in 2018 provides hope that CoQ10 may be a useful tool in the management of glioblastoma.38

Researchers found that human glioblastoma cells treated with CoQ10 were much more sensitive to radiation, commonly used as a treatment for this brain cancer. Furthermore, when used along with temozolomide, the most common chemotherapy drug used against glioblastoma, the two compounds together showed a strong effect, further amplifying the treatment effect of radiation.

These results suggest that CoQ10 is a promising adjunct to the medical management of glioblastoma, amplifying the effect of current standard treatments.

 

Summary

Coenzyme Q10 has been used as an adjuvant to cholesterol-lowering statin medications to help limit their side effects, namely muscle soreness.

More widespread roles of CoQ10 are increasingly being recognized.

The typical dietary intake of CoQ10 is small, primarily from meat and fish. CoQ10 supplementation has been associated with various health benefits.

 

 

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