Coenzyme Q10 and MS (multiple sclerosis)

What do we know about MS?  It is a disabling disease of the brain and spinal cord.  It is two to three times more common in women than in men. Depending on the nerve damage, people with MS may lose the ability to walk independently.  There is no cure. Fatigue and depression are common symptoms. Now, a study shows that large daily doses of Coenzyme Q10 can reduce the extent of depression and fatigue in MS patients.

Pilot study news:  A new study shows that Coenzyme Q10 supplementation reduces depression and fatigue in multiple sclerosis patients.  This is good news indeed.  Moreover, these are research results that make sense.

We know that Coenzyme Q10 supplementation improves the symptoms of both chronic fatigue syndrome patients [Castro-Marrero 2016] and fibromyalgia patients [Cordero 2013].  At least one study has shown that Coenzyme Q10 supplementation improves the symptoms of depression [Forester 2012].

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More about Coenzyme Q10 and breast cancer

Pink awareness. Very important. Awareness of the risk of breast cancer. We want to be aware, also, of the need for daily Coenzyme Q10 supplementation. Our bodies produce less Coenzyme Q10 as we get older. Breast cancer patients need Coenzyme Q10’s energy producing function and its antioxidant role.

Breast cancer is doubly frightening.  First, there is the fear that the tumor will metastasize, leading to more deadly cancers.  Secondly, there is the dread of the chemotherapy and its adverse effects: the hair loss, the sores in the mouth, the nausea and vomiting, the diarrhea.  But Coenzyme Q10 supplements may help.

How can Coenzyme Q10 help in the fight against breast cancer?  There is research evidence for beneficial effects of Coenzyme Q10 supplements:

  • delay the progression of the tumor [Folkers; Lockwood, Hertz & Lister]
  • reduce levels of oxidative stress and inflammation [Premkumar 2007]
  • reduce the levels of biological markers for breast cancer tumors [Premkumar 2007]
  • increase the number of DNA repair enzymes {Premkumar 2008]

Coenzyme Q10 delays the growth of breast cancer tumors
The Danish ANICA study and the Danish End-Stage Cancer study have shown that daily supplementation with Coenzyme Q10 in combination with other antioxidant nutritional supplements is associated with significant health benefits [Lockwood; Hertz & Lister]:

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Coenzyme Q10 for brain and muscle tissue

Supplementation with Coenzyme Q10 can increase brain mitochondrial concentrations and increase neuro-protective effects.   In addition to providing antioxidant defense against free radical damage, Coenzyme Q10 is essential for the process of cellular energy production.

So, it seems clear that Coenzyme Q10 supplementation is not needed when we are young and healthy, in our teenage years and in our early 20’s.  But … definitely … from our 20s onward, and increasingly as we get older, we need a well-formulated daily Coenzyme Q10 (preferably taken twice daily with meals) … or we need to take nutritional supplements that will enhance our bodies’ bio-synthesis of Coenzyme Q10.  Or both.

Because there is no doubt that we need to maintain functional levels of Coenzyme Q10 in the cell membranes and in the mitochondria, particularly in the brain and muscle tissue.  Coenzyme Q10 is essential in the process of cellular ATP energy production, and Coenzyme Q10 is the most important fat-soluble antioxidant protector of the cells [Littarru].

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Drugs that deplete Coenzyme Q10

Many different prescription drugs, the statin medications prominent among them, inhibit the bio-synthesis and/or absorption of Coenzyme Q10. And Coenzyme Q10 is vital to life.  We must be mindful of the need for a well-formulated Coenzyme Q10 supplement whenever we are taking a Coenzyme Q10 depleting medication.

There are surprisingly many prescription drugs that inhibit the body’s bio-synthesis of Coenzyme Q10 or inhibit the body’s absorption of Coenzyme Q10 from supplements or both.  Of course, there are many drugs that inhibit the uptake of other nutrients as well, but it is difficult to think of any one supplement that is more important to us as we age.

Coenzyme Q10 is “the essential bio-nutrient” (in the words of the chemist Dr. Karl Folkers), and our bodies produce less and less of it as we get older.  It is practically impossible to make up for the decreased bio-synthesis from food alone.  We, all of us, need a well-formulated Coenzyme Q10 supplement.

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Coenzyme Q10 and end-stage cancer

Actually, the best cocktail to reach for may be an antioxidant cocktail made with Coenzyme Q10, selenium, antioxidant vitamins, and omega-3 fatty acids.  Clinical studies have shown an anti-cancer effect associated with such a daily adjuvant treatment.

Coenzyme Q10 in combination with selenium and other antioxidant supplements can help to prevent cancer or slow the progression of cancer.  There are several plausible mechanisms that could explain an anti-cancer effect of supplementation with Coenzyme Q10, selenium, and other antioxidants:

  • beneficial effect on cell signaling molecules (cytokines) that are important in immune system response
  • anti-inflammation effect
  • modulating effects on the expression of the tumor suppressor gene p53
  • inhibiting effect on gene mutation
  • inhibiting effect on tumor angiogenesis (angiogenesis = the development of new blood vessels that would feed tumor cells and help them spread)
  • inhibiting effect on oxidative stress [Hertz & Lister]

The results of the ANICA study – the Adjuvant Nutritional Intervention in Cancer study – showed that adjuvant treatment of high-risk breast cancer patients with a cocktail of nutritional supplements including Coenzyme Q10 and selenium can slow the development of the cancer and permit the patients to live longer with the cancer under control [Lockwood].

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Coenzyme Q10 and selenium and breast cancer

Sven Moesgaard, Pharma Nord technical director (left), introduced Dr. Knud Lockwood (right) to Dr. Karl Folkers (center). Dr. Folkers had evidence of low Coenzyme Q10 status in cancer patients. Dr. Lockwood was treating breast cancer patients. The meeting led to the start of the ANICA breast cancer study.

The ANICA study – the Adjuvant Nutritional Intervention in Cancer study – was an open clinical study conducted in Denmark in the 1990s.  It was an interesting study with thought-provoking results.  Its design reflected outside-the-box thinking.

The ANICA study enrolled 32 typical breast cancer patients who were classified high risk because their tumors had spread to the lymph nodes.  The 32 women received the standard breast cancer treatment at the time.  In addition, they were treated with an adjuvant therapy in the form of a combination of various micronutrients.

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The safety of Coenzyme Q10 supplements

Healthy eating
To stay as young as we can as late in life as possible, we need to eat right, exercise, and get a good night’s sleep. Then, a well-tested and well-documented Coenzyme Q10 supplement should be right at the top of the list of nutritional supplements that we take. As we get older, our bodies produce less and less Coenzyme Q10, and we cannot make up the difference through food alone.

Coenzyme Q10 supplements are so safe that I have not spent much time writing about their safety.  It would not be much of an exaggeration to say that Coenzyme Q10 supplements are as safe as water.  In fact, in study after study, there is no difference in side effects between the Coenzyme Q10 active treatment group and the placebo control group. 

We need a good Coenzyme Q10 status.  There are two primary reasons why Coenzyme Q10 supplementation provides heart health benefits:

  • Coenzyme Q10 is essential to the process of cellular energy production.
  • Coenzyme Q10 works as an antioxidant to protect the cells against the damage caused by harmful free radicals.

Let’s look at some of the studies.

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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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