Cheap Coenzyme Q10 in some hospital pharmacies?

Some drug wholesalers may be providing Coenzyme Q10 supplements to the hospital pharmacy based on lowest price instead of based on documented absorption and health effects.  In that case, the chronic heart failure patients will not be getting the absorption and health benefits documented in the Q-Symbio trial.

Imagine my surprise, recently, when I heard from a reliable source that some hospital pharmacies are stocking cheap powder-based Coenzyme Q10 products for use with hospitalized heart failure patients.

I was shocked.

The most important thing about the Coenzyme Q10 supplement is its formulation.  Without a good formulation, there will very poor absorption.  Without good absorption, there can be no real benefit to heart failure patients.

Powder-based Coenzyme Q10 supplements are not going to do the job optimally.

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Factors affecting the absorption of Coenzyme Q10

The Andalusian Center for Developmental Biology at the Pablo de Olavide University in Sevilla, Spain,  has become an important center for Coenzyme Q10 research. Shown here:  a picture of the Plaza de España in Sevilla.

The absorption of Coenzyme Q10 is even more complicated than we realized.  Absorption of Coenzyme Q10 from supplements is difficult.  Okay, we know that.  Dr. William Judy, SIBR Research Institute, has explained why that is.  The formulation and composition of the Coenzyme Q10 capsule are the most important factors in the absorption of the Coenzyme Q10 molecules.

Recently, I watched a video of a presentation by Professor Guillermo López Lluch, University of Sevilla, Spain.  Dr. López Lluch was addressing the members of the International Coenzyme Q10 Association at a symposium in Bangkok, Thailand. He enumerated several factors that may affect the absorption of Coenzyme Q10.

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Coenzyme Q10: head-to-head comparison study of ubiquinone and ubiquinol absorption

What are we looking for in a Coenzyme Q10 nutritional supplement?  We want “full-range documentation” – documentation for good absorption, good response rate, and for health benefits. There is much variation in the formulation and absorption of Coenzyme Q10 supplements. It is best to select one with documented heart health benefits.

What we have been missing until now is a good study comparing the absorption of the more stable ubiquinone Coenzyme Q10 supplements with the absorption of the newer and less stable ubiquinol Coenzyme Q10 supplements head-to-head.  Now, the Coenzyme Q10 researchers at the University of Sevilla in Spain have carried out a direct comparison study in which the same study participants have been tested, with appropriate wash-out periods, on both ubiquinone and ubiquinol supplements.

The result:  One well-formulated ubiquinone Coenzyme Q10 preparation – the same preparation used in the Q-Symbio study, the KiSel-10 study, and the Gulf War Illness study –  has tested out significantly better than the ubiquinol preparation.  This particular ubiquinone Coenzyme Q10 supplement had nearly twice the absorption response as did the ubiquinol supplement in the study.

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Coenzyme Q10 and the energy starved heart

The number of bean-shaped mitochondria in our cells varies according to the energy needs of the various organs. The cells in organs with high energy needs, e.g. the heart, the liver, the skeletal muscle, will have greater numbers of mitochondria than will the cells of less active organs, e.g. the skin.  Adequate supply of Coenzyme Q10 is necessary to keep the mitochondria actively producing ATP molecules.

Cellular respiration is the name for the process by which the ATP molecules are produced inside the mitochondria in our cells.  Coenzyme Q10 in its oxidized form is an essential component in this process of energy production.

Fewer Coenzyme Q10 molecules in the mitochondria inevitably mean less ATP energy production.  Fewer ATP molecules mean less energy for our cells. 

Heart muscle cells with low Coenzyme Q10 concentrations and with fewer ATP molecules produced make for an energy starved heart.

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Coenzyme Q10 improves chronic fatigue syndrome symptoms

Tired woman at computer
Fatigue.  Loss of memory and concentration. Sleep that does not refresh you.   Feeling of exhaustion lasting 24 hours or more.  These are symptoms of chronic fatigue syndrome. Supplementation with a well-documented Coenzyme Q10 supplement can help.

Some very interesting studies of the treatment of chronic fatigue syndrome patients with oral Coenzyme Q10 supplements have revealed improved symptoms for as long as the treatment continued. What happened in these studies?

The chronic fatigue syndrome patients in these studies had abnormally low plasma and tissue (leg muscle) Coenzyme Q10 concentrations at baseline.  Oral administration of a well-formulated Coenzyme Q10 dissolved in vegetable oil resulted in significant increases in plasma and tissue Coenzyme Q10 levels.

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Coenzyme Q10 for diabetes patients

diabetes-picture
Some 21 million Americans have diabetes. Diabetes increases the inflammation that is associated with hardening of the arteries (called atherosclerosis). Atherosclerosis increases the risk of heart attack or stroke and the risk of chronic heart failure. Prolonged supplementation with Coenzyme Q10 may have beneficial health effects for diabetes patients.

Twelve weeks of supplementation with Coenzyme Q10 can significantly reduce the levels of oxidative stress associated with diabetes.

Recently, Swedish researchers reported the results of a study of the effects of daily Coenzyme Q10 supplementation on type-1 and type-2 diabetes patients.  Twice a day for a period of 12 weeks, the 22 diabetes patients in the study received 100 milligrams of oral Coenzyme Q10 in the form of ubiquinone.

The patients averaged 57 years of age (type-1 diabetes patients) and 63 years of age (type-2 diabetes patients). They were predominantly male patients [Montano].

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Coenzyme Q10 and chronic low-grade inflammation

Researcher
Long-term adjunctive treatment of chronic heart failure patients with Coenzyme Q10 supplements is safe and has improved the patients’ symptoms and has reduced the patients’ risk of major adverse cardiovascular events.  Now, researchers have begun to investigate whether adjunctive treatment with Coenzyme Q10 reduces chronic low-grade inflammation.

Chronic, low-grade, systemic inflammation is common in many diseases: cardiovascular disease, metabolic syndrome, non-alcoholic fatty liver disease, obesity, type-2 diabetes [Zhai 2017].  Anti-inflammatory drugs give modest improvement at best and are associated with long-term adverse effects [Esser 2015].  Some researchers have begun to investigate whether Coenzyme Q10 as an adjunctive treatment has anti-inflammatory health benefits.

The results of the KiSel-10 study have shown that daily supplementation with 200 milligrams of Coenzyme Q10 and 200 micrograms of SelenoPrecise® selenium significantly reduced the levels of sP-selectin and hs-CRP, both markers for inflammation, as compared to placebo supplementation.

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Coenzyme Q10 and fibromyalgia

Fibromyalgia woman
Fibromyalgia patients have low Coenzyme Q10 levels and low serotonin levels.  Studies done in the Faculty of Medicine at the University of Sevilla, Spain, show that Coenzyme Q10 supplements can restore both Coenzyme Q10 and serotonin levels and can improve the symptoms of depression. Other studies show that Coenzyme Q10 supplementation can inhibit the inflammatory process and reduce oxidative stress damage.

Can we make a convincing argument for fibromyalgia patients to take a daily Coenzyme Q10 nutritional supplement?  If so, what is the basis for the argument?

Fibromyalgia is a complex disorder.  It causes pain, joint stiffness, debilitating fatigue, and difficulty thinking and remembering.  Its cause is not known; its treatment is uncertain.  It affects as many as five million Americans above the age of 18 years.  It affects many more women than men.

Coenzyme Q10 status and fibromyalgia
The first thing to know is that fibromyalgia is associated with low plasma Coenzyme Q10 levels [Garrido-Maraver 2014].

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Coenzyme Q10 and healthy ageing

Elderly couple on the beach
Given the importance of Coenzyme Q10 in the process of cellular energy production and in the process of neutralizing harmful free radicals, it is very important to take a daily Coenzyme Q10 supplement as we grow older.

Coenzyme Q10 is an essential bio-nutrient that is made naturally in the human body.  It is a necessary co-factor in the process of cellular energy production.  It also functions as a lipid-soluble antioxidant protecting our cells against oxidative damage (oxidative damage = damage caused by free radicals that harm cell membranes and cell DNA and proteins and fats in the blood).

Unfortunately, as we pass through our 20s and move into our 30s and 40s and head towards senior citizen status, our cells produce less of this essential substance with increasing age [Kalén]. We know this.

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Coenzyme Q10, older athletes, and statins

woman-exercising
The more intensely and strenuously we exercise, the more quickly we reach the anaerobic threshold. A 2012 study has shown that 200 milligrams of Coenzyme Q10 daily can significantly delay the time to the anaerobic threshold. The Coenzyme Q10 supplementation was also associated with significant improvement in muscle strength in the study.

Older active adults who are taking a statin medication?  Shouldn’t they go right to the top of the list of people who need a good Coenzyme Q10 supplement?

That is the question that Dr. Richard Deichmann and his colleagues in the Department of Internal Medicine at the Ochsner Clinical School in New Orleans asked themselves. They tested whether daily supplementation with 200 milligrams of Coenzyme Q10 daily for six weeks would improve measures of cellular energy production, muscle function, and well-being in older active adults taking statin medications.

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