As consumers of Coenzyme Q10 supplements, we must be ultra-careful in evaluating the marketing claims for CoQ10 absorption and efficacy.  The nutritional supplements market is a largely unregulated one.  It is up to us to do due diligence before buying a CoQ10 product.

Dr. William V. Judy in a white-coat standing

In 2008 and again in 2013, SIBR Research did small but legitimate comparison studies of ubiquinone and ubiquinol absorption. SIBR Research’s results indicated that the single-dose absorption of the ubiquinol product appeared to be no better than the absorption of the ubiquinone Coenzyme Q10 in a lipid-based soft-gel capsule. Pictured here: Dr. William V. Judy, president of SIBR Research.

All of the CoQ10 products on the market are not equally good.  There is very considerable variability in the formulation and solubilization of Coenzyme Q10 with the result that there is also great variability in the absorption and bio-availability of Coenzyme Q10.  It is important to remember that the less expensive CoQ10 product is not a good buy if we do not absorb any or much of the active ingredient.

There are too many unfounded and undocumented claims in the marketing and advertising of Coenzyme Q10 products.  We consumers need to have references to published studies of Coenzyme Q10 absorption or health effects that we can follow up on.

CoQ10 Supplementation Necessary in the Middle and Senior Years

For those of us in middle age and in our senior years, Coenzyme Q10 clearly belongs in the top tier of nutritional supplements along with vitamin D and fish oil and vitamin B12.

Why is that?

  • Because our cells synthesize less and less Coenzyme Q10 with increasing age once we reach maturity.  The Swedish researchers Kalén, Appelkvist, and Dallner have demonstrated this convincingly [Kalén].
  • Because, as Dr. William Judy explains in his Insider’s Guide to Coenzyme Q10, it is practically impossible to make up for the loss in endogenous Coenzyme Q10 by eating more food or by eating wisely [Judy 2018].

Coenzyme Q10 for Energy Production and Antioxidant Protection

We need to supplement our dietary intake of Coenzyme Q10 as we age because Coenzyme Q10 has the following documented biological functions [Alehagen]:

  • an essential bio-nutrient for the cellular process of ATP energy generation
  • an important fat-soluble antioxidant protecting the cells against damage by harmful free radicals
  • anti-inflammatory effects

Which CoQ10 Marketing Claims Should We be on Guard Against?

Claims for Ubiquinol Supplements

First, there are many misleading claims for a supposed better absorption of the reduced form of Coenzyme Q10, the ubiquinol form, over the more stable and much more documented oxidized form, the ubiquinone form.

In two WholeFoods magazine interviews conducted by Dr. Richard Passwater, Dr. William Judy has addressed the illegitimacy of the claims for better absorption of ubiquinol. Dr. Judy points out that the claims come not from parallel group studies and not from crossover studies but from comparisons of results from studies different in every imaginable way [Passwater]:

  • different periods (different decades even) and different locations
  • different researchers and different research methods
  • different sets of study participants with different demographics
  • different formulations (dry powder vs dissolved in oils)
Men talking at a conference

Professor Guillermo Lopez-Lluch (left) is a senior researcher at the Universidad Pablo de Olavide in Sevilla, Spain. His special interest is in ageing-related metabolism. He is the lead author of a double-blind crossover study of the absorption and bio-availability of various formulations of Coenzyme Q10 supplements. His research shows that the formulation (the right oil mix and the right heating and cooling process) of the supplement is more important than the form (whether ubiquinone or ubiquinol).

Simply put, the marketing claims of x times better absorption of ubiquinol are based upon unfair comparisons.  It is puzzling that the marketers have gotten away with this deception [Passwater].

In 2019, Dr. Lopez-Lluch and a team of researchers in Sevilla, Spain, reported the results of a double-blind crossover study comparing the absorption of a patented ubiquinone CoQ10 formulation with a ubiquinol formulation and five other different ubiquinone formulations.

The patented ubiquinone formulation was absorbed significantly better than the ubiquinol formulation and the other ubiquinone formulations.  The results showed the importance of the formulation (the mix of the carrier oils and solubilization of the CoQ10 raw material) to absorption [Lopez-Lluch].

Claims for Water-Soluble Coenzyme Q10

Please beware of companies claiming to sell you a water-soluble CoQ10 product with a better absorption.  Briefly put, the so-called water-soluble Coenzyme Q10 is no longer the real Coenzyme Q10 if the manufacturers have shortened or otherwise modified the CoQ10 molecules’ hydrophobic tail to make the molecules “water-soluble.”

Likewise, packing the fat-soluble CoQ10 molecules into hydrophilic liposomes or micelles does not make the Coenzyme Q10 itself cease being fat-soluble.  The molecules will still have to be absorbed as fat-soluble molecules once they are released from the liposomes or micelles.

Claims for Recommended Number 1 by Cardiologists

As with any claims of this nature – e.g. more dentists recommend Crust toothpaste – we want to know who did the survey, how was the sample selected, how was the question phrased, etc.

At the present time (December 2019), there is a company claiming to sell the number one cardiologists’ recommended form of Coenzyme Q10.

There are several disturbing things about this claim:

  • based on a survey done by a company paid to do the survey (potential conflict of interest)
  • done with a very small number of cardiologists in a self-selected sample that cannot possibly be considered as representative of all cardiologists in the US
  • no information about how the survey question was phrased

Summary: Important that CoQ10 Claims are Documented

A good Coenzyme Q10 supplement has documented beneficial effects:

A good Coenzyme Q10 supplement is documented safe and effective in peer-reviewed published reports.

Coenzyme Q10 supplements are affordable but only if they are formulated in a way that gives a good absorption.  Without documentation of their absorption, most Coenzyme Q10 supplements are a gamble.

Why gamble with the health of your heart muscle cells?

Sources

Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and Coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.

Alehagen, U., Lindahl, T. L., Aaseth, J., Svensson, E., & Johansson, P. (2015). Levels of sP-selectin and hs-CRP Decrease with Dietary Intervention with Selenium and Coenzyme Q10 Combined: A Secondary Analysis of a Randomized Clinical Trial. Plos One, 10(9), e0137680.

Fedacko, J., Pella, D., Fedackova, P. & Hanninen, O. (2013). Coenzyme Q10 and selenium in statin-associated myopathy treatment. Can J Physiol Pharmacol; 91:165-70.

Golomb, B.  CoQ10 and Gulf War illness.  Neural Computation 2014 Nov; Vol. 26 (11), pp. 2594-651.

Judy, W. V. (2018). The Substance that Powers Life: Coenzyme Q10, An Insider’s Guide. Ny Videnskab. ISBN 978-87-7776-186-7. Available from amazon.com.

Judy, W. V. (2015, Oct. 11). Coenzyme Q10 absorption research. Paper presented at the 8th conference of The International Coenzyme Q10 Association, Bologna, Italy.

Kalén, A., Appelkvist E.L., Dallner G. (1989). Age-related changes in the lipid compositions of rat and human tissues. Lipids, 24(7):579–584.

López-Lluch, G., Del Pozo-Cruz, J., Sánchez-Cuesta, A., Cortés-Rodríguez, A. B., & Navas, P. (2019). Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition, 57, 133–140.

Passwater, R. A. (2019, February 27) Coenzyme Q10: Research Confirms Ubiquinone and Ubiquinol are nearly equally-absorbed compounds. The physical form and companion ingredients make the bioavailability and absorption difference in Coenzyme Q10 supplements. Part 1: The functions and absorption of Ubiquinone and Ubiquinol. An interview with Dr. William V. Judy, Ph.D. WholeFoods Magazine. Retrieved from https://wholefoodsmagazine.com/columns/vitamin-connection/coenzyme-q10-research-confirms-ubiquinone-and-ubiquinol-are-nearly-equally-absorbed-compounds-the-physical-form-and-companion-ingredients-make-the-bioavailability-and-absorption-difference-in-coenz/

Passwater, R. A. (2019, March 20). Coenzyme Q10: Research Confirms Ubiquinone and Ubiquinol are nearly equally-absorbed compounds. The physical form and companion ingredients make the bioavailability and absorption difference in Coenzyme Q10 supplements. Part 2: The absorption of Ubiquinone and Ubiquinol forms of Coenzyme Q10. WholeFoods Magazine. Retrieved from https://wholefoodsmagazine.com/columns/vitamin-connection/coenzyme-q10-research-confirms-ubiquinone-and-ubiquinol-are-nearly-equally-absorbed-compounds-the-physical-form-and-companion-ingredients-make-the-bioavailability-and-absorption-difference-in-coenz-2/

The information presented in this review article is not intended as medical advice and should not be used as such.

13 December 2019

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