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Ubiquitous Ubiquinone CoQ10

  • Karina
  • Jun 8, 2018
  • 9 min read

When I first heard about CoQ10, I thought it was a computer code or a fancy new gadget. Instead, CoQ10, known as coenzyme 10, is an antioxidant that helps cells function. It is a ubiquinone found in the cells of plants, bacteria, animals, and people. Stored in the mitochondria of your cells, CoQ10 provides cells with energy to help them grow and be healthy (Semeco). CoQ10 is in every cell of your body, but higher amounts can be located in the heart, liver, kidneys, and pancreas. As we age, the amount of CoQ10 decreases (NCCIH).

There are claims that CoQ10 can maintain energy for our cells, reduce free radical damage, improve heart health, offset effects of statin drugs, aid in reproductive health, slow down the effects of aging, and help individuals with Parkinson’s disease. Now let’s take a look at the evidence I’ve found.

 

The Research

One claim of CoQ10 is that it can reduce the effects of aging. In the 2015 study by Dayong Zhang et. al published in the journal Oxidative Medicine and Cellular Longevity, the aim was to determine if CoQ10 can reduce the effect of aging in mesenchymal stem cells. Reactive oxygen species is the main factor in causing stem cell aging. D-galactose is a reactive oxygen species promotor and was used in this study to induce aging in the mesenchymal stem cells. Several 7-day-old rats were recruited and bone marrow was removed to isolate and culture the mesenchymal stem cells. There were 4 groups of cells, which were (1) a control group with no treatment, (2) D-galactose treatment group which contained 1, 10, or 100 g/L D-galactose, (3) CoQ10 treatment group with concentrations of 1, 10, and 100 mmol/L, and (4) control plasmid group. On the D-galactose treatment groups, CoQ10 lessened the effect of the D-galactose induced aging. As the CoQ10 concentration increased, the number of aged cells decreased, which was significant. The results suggest that CoQ10 can be an effective way to reduce aging in mesenchymal stem cells.

Another claim of CoQ10 is that it can improve heart health. One way to reduce the risk of getting cardiovascular disease (CVD) is to have normal ranges in your lipid profile, including total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. A 2014 study by Hoda Zahedi et. al published in the Journal of Diabetes and Metabolic Disorders was done to determine if CoQ10 supplementation can improve the lipid profiles and glycemic control of individuals with type 2 diabetes. In a double-blind randomized control trial, 50 adults with type 2 diabetes, aged less than 75 years, were randomly allocated to treatment and control groups. They received either 150 mg CoQ10 or placebo daily for 12 weeks. The final sample size was 40 adults. After 12 weeks, LDL cholesterol and total cholesterol were significantly higher in the CoQ10 group compared to the placebo group. Interestingly, triglyceride and HDL cholesterol decreased in the CoQ10 group compared to the placebo group after intervention. After 12 weeks, the CoQ10 group had significantly lower fasting blood glucose and hemoglobin A1C compared to the placebo group, but there were no significant differences in serum insulin and insulin resistance. A high hemoglobin A1C indicates there is a high concentration of blood glucose. These results indicated that supplementation of CoQ10 may improve glycemic control but does not positively affect the lipid profiles of adults with type 2 diabetes.

Another 2014 study by Svend Mortensen et. al published in the Journal of the American College of Cardiology: Heart Failure examined the effects of CoQ10 on morbidity and mortality in chronic heart failure. 420 adults between ages 50-75 years were enrolled from 17 European, Asian, and Australian centers from 2003-2010 and were randomly assorted to control or treatment groups. They received either 100 mg of CoQ10 or placebo 3x/day for 106 weeks. Adults’ symptoms by New York Heart Association functional class, functional status with visual analogue scale for symptoms, a 6-minute walk test, and echocardiography were also evaluated. By the end of the 106-week intervention, there were significantly fewer major adverse cardiovascular events in the CoQ10 group than in the placebo group. The CoQ10 group showed significant improvement in New York Heart Association functional classification compared to the placebo group. The total number of cardiovascular deaths and number of hospital stays within the 106 weeks were lower in the CoQ10 group than the placebo group. Supplementation of CoQ10 was shown to reduce major adverse cardiovascular events and cardiovascular deaths by 43% and all-cause mortality by 42%. These results indicated that supplementation of CoQ10 could be a complementary therapy for patients with moderate to severe heart failure and associated with a reduction in symptoms and major adverse cardiovascular events.

In the 2014 systematic review by Nadine Flowers et. al Cochrane Library, the aim was to determine the effects of CoQ10 supplementation as a single ingredient for the primary prevention of CVD. 6 completed randomized controlled trials with a total of 218 participants were reviewed. All these trials were conducted on adults at high risk of CVD. These trials were small and short-term. Two trials examined CoQ10 supplementation alone on blood pressure while the other four trials examined CoQ10 supplementation in adults on statin therapy. For the 2 trials examining the effect of CoQ10 on blood pressure, one trial found no effect on systolic blood pressure while the other trial had a statistically significant reduction in systolic blood pressure. For the 4 trials examining the effect of CoQ10 in adults on statin therapy, 3 trials showed that CoQ10 supplementation did not significantly influence lipid levels or systolic blood pressure between control and intervention groups. One trial did have a significant increase in the change in total cholesterol and LDL cholesterol, but based on the data, reviewers were unable to determine if there was any significant difference between the CoQ10 only and placebo groups. There was no significant difference in the change of HDL cholesterol and triglycerides in the four trials.

Now let’s discuss the research regarding the relationship between CoQ10 and fertility.

In the 2016 study by Pinar Özcan et. al published in the Journal of Assisted Reproduction and Genetics, the effectiveness of CoQ10 supplementation on the prevention of reactive oxygen species-induced ovarian damage and protective effect against reactive oxygen species-related DNA damage was evaluated. 24 adult female rats, aged 65-75 days, were used for this study. The rats were divided into 3 groups, which were control group, cisplatin group, and cisplatin and CoQ10 group. Oocytes and somatic cells of growing follicles in the ovary would be more susceptible to the damaging effects of cisplatin. The anti-Mullerian hormone (AMH) is associated with fertility and response rates to fertility treatments. The CoQ10 treatment group had a higher number of AMH-positive granulosa cells. There was no difference among AMH serum concentrations among the three groups. Follicle counts indicate ovarian reserve. The cisplatin group had the lowest antral follicle count (formed oocytes) and the highest atretic follicle count (breaking down oocytes). The cisplatin plus CoQ10 group had the lowest atretic follicle count and a higher antral follicle count than the cisplatin-only group. The results showed that CoQ10 supplementation may protect ovarian reserve by improving mitochondrial function, counteracting both mitochondrial and physiological ovarian aging.

In the 2013 meta-analysis by Rafael Lafuente et. al published in the Journal of Assisted Reproduction and Genetics, the objective was to evaluate the effect of CoQ10 treatments in male infertility, specifically in live birth, pregnancy rates, CoQ10 seminal concentration, sperm concentration, and sperm motility. 3 trials were included, which consisted of 149 males in the CoQ10 group and 147 males in the placebo group. The results of the meta-analysis indicated that for infertile men, CoQ10 supplementation does not increase pregnancy rates. On the other hand, in the CoQ10 group, there were statistically significant increase in CoQ10 seminal concentration, sperm concentration, and sperm motility. This suggested that CoQ10 could improve sperm parameters.

Furthermore, there is interesting evidence about whether CoQ10 can improve Parkinson’s Disease.

In the 2014 study published in the Journal of the American Medical Association Neurology, the goal was to examine if CoQ10 could slow disease progression in early Parkinson’s Disease. 600 participants were in the final sample size and were randomly assigned to receive placebo, 1200 mg/day of CoQ10, or 2400 mg/day of CoQ10. All adults received 1200 IU/day of Vitamin E. Participants were observed for 16 months or until an incident requiring dopaminergic treatment. Moreover, the study investigators were informed on May 6, 2011 that the study was terminated for futility. No safety concerns happened. For all groups, there were no improvements in total Unified Parkinson’s Disease Rating Scale (UPDRS) scores. The results showed that CoQ10 was safe and well tolerated for this population, but it did not have any evidence of clinical benefit for early Parkinson’s disease.

Similar results were seen in this 2015 study by Asako Yoritaka et. al published in Parkinsonism and Related Disorders. The objective was to analyze the efficacy of ubiquinol-10 in Japanese adults with Parkinson’s Disease. Ubiquinol-10 is the reduced form of CoQ10. 64 participants were divided into 2 groups; Group A who had exhibited wearing-off of levodopa and group B who had not been previously medicated with levodopa. Group A had 31 adults with Parkinson’s Disease with wearing-off. Group B had 33 adults with very early Parkinson’s Disease not medicated with levodopa. Participants were randomized into treatment and control groups and received 300 mg of ubiquinol-10 or placebo. Group A took capsules for 48 weeks while group B took capsules for 96 weeks. In group A, total UPDRS scores decreased in the intervention group, suggesting improvement in symptoms. In group B, UPDRS scores increased in both intervention and placebo group. The results indicate that ubiquinol-10 may improve symptoms in adults with Parkinson’s Disease with wearing off and no effect was seen in very early Parkinson’s Disease.

 

The Take-Home Message

In terms of aging, more research needs to be done to determine the mechanisms of CoQ10 involved in stem cell aging. Zhang et. al’s study was performed on rats and a study like this needs to be replicated on human stem cells to determine if the same effect of CoQ10 can be repeated.

For the effect of CoQ10 on the prevention of CVD, there needs to be more high-quality trials with longer-term follow-up. According to the American Heart Association (AHA)/American College of Cardiology (ACC) Guideline for the Management of Heart Failure, these guidelines do not recommend the initiation of nutritional supplementation for the treatment of heart failure. From the 2016 “Coenzyme Q10 and Heart Failure: A State-of-the-Art Review” by Abhinav Sharma, MD et. al, CoQ10 can be a potential antioxidant and may be an adjunctive therapy for adults with heart failure reduced ejection fraction. However, starting CoQ10 supplementation can’t be currently recommended based on the AHA/ACC guidelines. More well-conducted randomized controlled trials will be needed to determine the efficacy and safety of CoQ10 for adults with heart failure.

Regarding fertility, it appears that CoQ10 can be beneficial, but more studies need to be conducted to determine the optimum dosage and duration for CoQ10 supplementation to enhance its protective effects. Future studies are required to understand the relationship between CoQ10 on ovaries in a human population. For male infertility, future studies are needed with larger patient populations for standardization on dosage and duration of CoQ10 supplementation.

For the effect of CoQ10 on Parkinson’s Disease, more studies need to be completed to safely say that CoQ10 can be considered for adjunctive therapy.

Overall, there needs to be more evidence for all the claims surrounding CoQ10. There is compelling information that CoQ10 is beneficial. All these studies showed that there is no harm in taking CoQ10, but it may not be worth purchasing until there is more conclusive evidence. CoQ10 can also be found in foods like:

  • Organ meats: heart, liver, kidney

  • Some muscle meats: pork, chicken, and beef

  • Fatty fish: trout, herring, mackerel, and sardine

  • Vegetables: spinach, cauliflower, and broccoli

  • Fruit: oranges and strawberries

  • Legumes: soybeans, lentils, and peanuts

  • Nuts and seeds: sesame seeds and pistachios

  • Oils: soybean and canola oil

(Semeco). If you plan on purchasing a CoQ10 supplement, the Food & Drug Administration branch (FDA) does not regulate supplements. This means that there are no guarantees when buying supplements that the products contain what they assert and are safe for human consumption.

 

References

  1. Semeco, Arlene. “9 Benefits of Coenzyme Q10 (CoQ10).” Healthline, Healthline Media, 12 Oct. 2017, www.healthline.com/nutrition/coenzyme-q10.

  2. “Coenzyme Q10 (CoQ10): In Depth.” National Center for Complementary and Integrative Health, U.S. Department of Health and Human Services, 24 Sept. 2017, nccih.nih.gov/health/supplements/coq10#refs.

  3. Zhang, D., Yan, B., Yu, S., Zhang, C., Wang, B., Wang, Y., … Pan, J. (2015). Coenzyme Q10 Inhibits the Aging of Mesenchymal Stem Cells Induced by D-Galactose through Akt/mTOR Signaling. , , 867293. http://doi.org/10.1155/2015/867293

  4. Zahedi, H., Eghtesadi, S., Seifirad, S., Rezaee, N., Shidfar, F., Heydari, I., … Jazayeri, S. (2014). Effects of CoQ10 Supplementation on Lipid Profiles and Glycemic Control in Patients with Type 2 Diabetes: a randomized, double blind, placebo-controlled trial. , , 81. http://doi.org/10.1186/s40200-014-0081-6

  5. Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014; 2:641–649. doi: 10.1016/j.jchf.2014.06.008.

  6. Flowers N, Hartley L, Todkill D, Stranges S, Rees K. Co-enzyme Q10 supplementation for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD010405. DOI: 10.1002/14651858.CD010405.pub2.

  7. Özcan, P., Fıçıcıoğlu, C., Kizilkale, O., Yesiladali, M., Tok, O. E., Ozkan, F., & Esrefoglu, M. (2016). Can Coenzyme Q10 supplementation protect the ovarian reserve against oxidative damage? , (9), 1223–1230. http://doi.org/10.1007/s10815-016-0751-z

  8. Lafuente, R., González-Comadrán, M., Solà, I., López, G., Brassesco, M., Carreras, R., & Checa, M. A. (2013). Coenzyme Q10 and male infertility: a meta-analysis. , (9), 1147–1156. http://doi.org/10.1007/s10815-013-0047-5

  9. The Parkinson Study Group QE3 Investigators. A Randomized Clinical Trial of High-Dosage Coenzyme Q10 in Early Parkinson Disease: . JAMA Neurol. 2014;71(5):543–552. doi:10.1001/jamaneurol.2014.131

  10. Yoritaka A, et al. Randomized, double-blind, placebo-controlled pilot trial of reduced coenzyme Q10 for Parkinson’s disease. 2015;:911–916. doi: 10.1016/j.parkreldis.2015.05.022.

  11. Yancy C. W., Jessup M., Bozkurt B, Butler J., Casey D. E., Colvin M. M., Drazner M. H., … Westlake C. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. Journal of the American College of Cardiology Aug 2017, 70 (6) 776-803; DOI: 10.1016/j.jacc.2017.04.025


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