Coenzyme Q and gastrointestinal health -
Intense exercise also makes coenzyme Q turn over faster. This lowers its levels. Organ meats are good sources of coenzyme Q These include the heart, lung, kidney, spleen, liver, pancreas, and adrenals. Coenzyme Q has been studied for its role in heart failure.
Coenzyme Q is claimed to help prevent LDL oxidation. This reduces the risk of atherosclerosis. And the risk of re-perfusion injury after open-heart surgery.
It also lowers the risk of liver injury from cholesterol-lowering medicines. These include statins. Coenzyme Q has also been used to boost exercise tolerance and athletic performance.
It may also help blood sugar control in people with diabetes. It may also boost the immune system to fight disease when used alone or with vitamin B It may also help increase fat metabolism.
Some claims say that coenzyme Q may also treat periodontal diseases and gingivitis. Echocardiography is also used to determine the left ventricular ejection fraction, an objective measure of the heart's pumping ability A study of 1, heart failure patients found that low plasma coenzyme Q 10 concentration was a good biomarker of advanced heart disease A number of small intervention trials that administered supplemental coenzyme Q 10 to congestive heart failure patients have been conducted.
Pooling data from some of the trials showed an increase in serum coenzyme Q 10 concentrations three studies but no effect on left ventricular ejection fraction two studies or exercise capacity two studies The heart muscle may become oxygen-deprived ischemic as the result of myocardial infarction or during cardiac surgery.
Increased generation of reactive oxygen species ROS when the heart muscle's oxygen supply is restored reperfusion might be an important contributor to myocardial damage occurring during ischemia-reperfusion Pretreatment of animals with coenzyme Q 10 has been found to preserve myocardial function following ischemia-reperfusion injury by increasing ATP concentration, enhancing antioxidant capacity and limiting oxidative damage , regulating autophagy , and reducing cardiomyocyte apoptosis Another potential source of ischemia-reperfusion injury is aortic clamping during some types of cardiac surgery, such as coronary artery bypass graft CABG surgery.
In a small randomized controlled trial in 30 patients, oral administration of coenzyme Q 10 for 7 to 10 days before CABG surgery reduced the need for mediastinal drainage, platelet transfusion, and positive inotropic drugs e.
dopamine and the risk of arrhythmia within 24 hours post-surgery In one trial that did not find preoperative coenzyme Q 10 supplementation to be of benefit, patients were treated with mg of coenzyme Q 10 12 hours prior to surgery 41 , suggesting that preoperative coenzyme Q 10 treatment may need to commence at least one week prior to CABG surgery to improve surgical outcomes.
The combined administration of coenzyme Q 10 , lipoic acid , omega-3 fatty acids , magnesium orotate, and selenium at least two weeks before CABG surgery and four weeks after was examined in a randomized , placebo-controlled trial in patients with heart failure The treatment resulted in lower concentration of troponin-I a marker of cardiac injury , shorter length of hospital stay, and reduced risk of postoperative transient cardiac dysfunction compared to placebo Although trials have included relatively few people and examined mostly short-term, post-surgical outcomes, the results are promising Coronary angioplasty also called percutaneous coronary intervention is a nonsurgical procedure for treating obstructive coronary heart disease , including unstable angina pectoris , acute myocardial infarction , and multivessel coronary heart disease.
Angioplasty involves temporarily inserting and inflating a tiny balloon into the clogged artery to help restore the blood flow to the heart. Periprocedural myocardial injury that occurs in up to one-third of patients undergoing otherwise uncomplicated angioplasty increases the risk of morbidity and mortality at follow-up.
A prospective cohort study followed 55 patients with acute ST segment elevation myocardial infarction a type of heart attack characterized by the death of some myocardial tissue who underwent angioplasty Plasma coenzyme Q 10 concentration one month after angioplasty was positively correlated with less inflammation and oxidative stress and predicted favorable left ventricular end-systolic volume remodeling at six months One randomized controlled trial has examined the effect of coenzyme Q 10 supplementation on periprocedural myocardial injury in patients undergoing coronary angioplasty The administration of mg of coenzyme Q 10 12 hours before the angioplasty to 50 patients reduced the concentration of C-reactive protein [CRP]; a marker of inflammation within 24 hours following the procedure compared to placebo.
However, there was no difference in concentrations of two markers of myocardial injury creatine kinase and troponin-I or in the incidence of major adverse cardiac events one month after angioplasty between active treatment and placebo Additional trials are needed to examine whether coenzyme Q 10 therapy can improve clinical outcomes in patients undergoing coronary angioplasty.
Myocardial ischemia may also lead to chest pain known as angina pectoris. People with angina pectoris often experience symptoms when the demand for oxygen exceeds the capacity of the coronary circulation to deliver it to the heart muscle, e.
In most of the studies, coenzyme Q 10 supplementation improved exercise tolerance and reduced or delayed electrocardiographic changes associated with myocardial ischemia compared to placebo.
However, only two of the studies found significant decreases in symptom frequency and use of nitroglycerin with coenzyme Q 10 supplementation.
Presently, there is only limited evidence suggesting that coenzyme Q 10 supplementation would be a useful adjunct to conventional angina therapy. Very few high-quality trials have examined the potential therapeutic benefit of coenzyme Q 10 supplementation in the treatment of primary hypertension In contrast, a meta-analysis that used less stringent selection criteria included 17 small trials and found evidence of a blood pressure-lowering effect of coenzyme Q 10 in patients with cardiovascular disease or metabolic disorders The effect of coenzyme Q 10 on blood pressure needs to be examined in large, well-designed clinical trials.
Endothelial dysfunction: Normally functioning vascular endothelium promotes blood vessel relaxation vasodilation when needed for example, during exercise and inhibits the formation of blood clots.
Atherosclerosis is associated with impairment of vascular endothelial function, thereby compromising vasodilation and normal blood flow. Endothelium-dependent vasodilation is impaired in individuals with elevated serum cholesterol concentrations, as well as in patients with coronary heart disease or diabetes mellitus.
Evidence from larger studies is needed to further establish the effect of coenzyme Q 10 on endothelium-dependent vasodilation.
Recently published pooled analyses of these trials have given mixed results Larger studies are needed to examine the effect of coenzyme Q 10 supplementation on low-grade inflammation.
Blood lipids : Elevated plasma lipoprotein a concentration is an independent risk factor for cardiovascular disease. Other effects of coenzyme Q 10 on blood lipids have not been reported 51, 53, A therapeutic approach combining coenzyme Q 10 with other antioxidants might prove to be more effective to target co-existing metabolic disorders in individuals at risk for cardiovascular disease Diabetes mellitus is a condition of increased oxidative stress and impaired energy metabolism.
Plasma concentrations of reduced coenzyme Q 10 CoQ 10 H 2 have been found to be lower in diabetic patients than healthy controls after normalization to plasma cholesterol concentrations 56, Randomized controlled trials that examined the effect of coenzyme Q 10 supplementation found little evidence of benefits on glycemic control in patients with diabetes mellitus.
Maternally inherited diabetes mellitus-deafness syndrome MIDD is caused by a mutation in mitochondrial DNA , which is inherited exclusively from one's mother. Of note, the pathogenesis of type 2 diabetes mellitus involves the early onset of glucose intolerance and hyperinsulinemia associated with the progressive loss of tissue responsiveness to insulin.
Recent experimental studies tied insulin resistance to a decrease in coenzyme Q 10 expression and showed that supplementation with coenzyme Q 10 could restore insulin sensitivity 7. Coenzyme Q 10 supplementation might thus be a more useful tool for the primary prevention of type 2 diabetes rather than for its management.
Parkinson's disease is a degenerative neurological disorder characterized by tremors, muscular rigidity, and slow movements. Mitochondrial dysfunction and oxidative damage in a part of the brain called the substantia nigra may play a role in the development of the disease Decreased ratios of reduced -to- oxidized coenzyme Q 10 have been found in platelets of individuals with Parkinson's disease 61, Two recent meta-analyses of randomized, placebo-controlled trials found no evidence that coenzyme Q 10 improved motor-related symptoms or delayed the progression of the disease when compared to placebo 68, Huntington's disease is an inherited neurodegenerative disorder characterized by selective degeneration of nerve cells known as striatal spiny neurons.
Symptoms, such as movement disorders and impaired cognitive function, typically develop in the fourth decade of life and progressively deteriorate over time.
Animal models indicate that impaired mitochondrial function and glutamate -mediated neurotoxicity may be involved in the pathology of Huntington's disease. Interestingly, co-administration of coenzyme Q 10 with remacemide an NMDA receptor antagonist , the antibiotic minocycline, or creatine led to greater improvements in most biochemical and behavioral parameters To date, only two clinical trials have examined whether coenzyme Q 10 might be efficacious in human patients with Huntington's disease.
All dosages were generally well tolerated, with gastrointestinal symptoms being the most frequently reported adverse effect. Blood concentrations of coenzyme Q 10 at the end of the study were maximized with the daily dose of 2, mg The trial was prematurely halted because it appeared unlikely to demonstrate any health benefit in supplemented patients — about one-third of participants completed the trial at the time of study termination Although coenzyme Q 10 is generally well tolerated, there is no evidence that supplementation can improve functional and cognitive symptoms in Huntington's disease patients.
Friedreich's ataxia FRDA : FRDA is an autosomal recessive neurodegenerative disease caused by mutations in the gene FXN that encodes for the mitochondrial protein , frataxin.
Frataxin is needed for the making of iron -sulfur clusters ISC. ISC-containing subunits are especially important for the mitochondrial respiratory chain and for the synthesis of heme -containing proteins Frataxin deficiency is associated with imbalances in iron-sulfur containing proteins, mitochondrial respiratory chain dysfunction and lower ATP production, and accumulation of iron in the mitochondria, which increases oxidative stress and oxidative damage to macromolecules of the respiratory chain Clinically, FRDA is a progressive disease characterized by ataxia , areflexia , speech disturbance dysarthria , sensory loss, motor dysfunction, cardiomyopathy , diabetes , and scoliosis Follow-up assessments at 47 months indicated that cardiac and skeletal muscle improvements were maintained and that FRDA patients showed significant increases in fractional shortening, a measure of cardiac function.
Moreover, the therapy was effective at preventing the progressive decline of neurological function Large-scale, randomized controlled trials are necessary to determine whether coenzyme Q 10 , in conjunction with vitamin E, has therapeutic benefit in FRDA.
At present, about one-half of patients use coenzyme Q 10 and vitamin E supplements despite the lack of proven therapeutic benefit Spinocerebellar ataxias SCAs : SCAs are a group of rare autosomal dominant neurodegenerative diseases characterized by gait difficulty, loss of hand dexterity, dysarthria, and cognitive decline.
SCA1, 2, 3, and 6 are the most common SCAs In vitro coenzyme Q 10 treatment of forearm skin fibroblasts isolated from patients with SCA2 was found to reduce oxidative stress and normalize complex I and II-III activity of the mitochondrial respiratory chain Early interest in coenzyme Q 10 as a potential therapeutic agent in cancer was stimulated by an observational study that found that individuals with lung, pancreas , and especially breast cancer were more likely to have low plasma coenzyme Q 10 concentrations than healthy controls Two randomized controlled trials have explored the effect of coenzyme Q 10 as an adjunct to conventional therapy for breast cancer.
Supplementation with coenzyme Q 10 failed to improve measures of fatigue and quality of life in patients newly diagnosed with breast cancer 84 and in patients receiving chemotherapy There is little evidence that supplementation with coenzyme Q 10 improves athletic performance in healthy individuals.
Most did not find significant differences between the group taking coenzyme Q 10 and the group taking placebo with respect to measures of aerobic exercise performance, such as maximal oxygen consumption VO 2 max and exercise time to exhaustion Two studies actually found significantly greater improvement in measures of anaerobic 87 and aerobic 86 exercise performance with a placebo than with supplemental coenzyme Q More recent studies have suggested that coenzyme Q 10 could help reduce both muscle damage-associated oxidative stress and low-grade inflammation induced by strenuous exercise Studies on the effect of supplementation on physical performance in women are lacking, but there is little reason to suspect a gender difference in the response to coenzyme Q 10 supplementation.
Coenzyme Q 10 is synthesized in most human tissues. The biosynthesis of coenzyme Q 10 involves three major steps: 1 synthesis of the benzoquinone structure from 4-hydroxybenzoate derived from either tyrosine or phenylalanine, two amino acids; 2 synthesis of the polyisoprenoid side chain from acetyl-coenzyme A CoA via the mevalonate pathway; and 3 the joining condensation of these two structures to form coenzyme Q In the mevalonate pathway, the enzyme 3-hydroxymethylglutaryl HMG -CoA reductase, which converts HMG-CoA into mevalonate, is common to the biosynthetic pathways of both coenzyme Q 10 and cholesterol and is inhibited by statins cholesterol-lowering drugs; see Drug interactions 1.
Of note, pantothenic acid formerly vitamin B 5 is the precursor of coenzyme A, and pyridoxine vitamin B 6 , in the form of pyridoxal-5'-phosphate, is required for the conversion of tyrosine to 4-hydroxyphenylpyruvic acid that constitutes the first step in the biosynthesis of the benzoquinone structure of coenzyme Q The extent to which dietary consumption contributes to tissue coenzyme Q 10 concentrations is not clear.
Rich sources of dietary coenzyme Q 10 include mainly meat, poultry, and fish. Other good sources include soybean, corn, olive, and canola oils; nuts; and seeds. Fruit, vegetables, eggs, and dairy products are moderate sources of coenzyme Q 10 Some dietary sources are listed in Table 1.
Coenzyme Q 10 is available without a prescription as a dietary supplement in the US. Coenzyme Q 10 is fat-soluble and is best absorbed with fat in a meal. Oral supplementation with coenzyme Q 10 is known to increase blood and lipoprotein concentrations of coenzyme Q 10 in humans 2 , 15 , Nonetheless, under certain physiological circumstances e.
During pregnancy, the use of coenzyme Q 10 supplements mg twice daily from 20 weeks' gestation was found to be safe Because reliable data in lactating women are not available, supplementation should be avoided during breast-feeding Concomitant use of warfarin Coumadin and coenzyme Q 10 supplements has been reported to decrease the anticoagulant effect of warfarin in a few cases An individual on warfarin should not begin taking coenzyme Q 10 supplements without consulting the health care provider who is managing his or her anticoagulant therapy.
HMG-CoA reductase is an enzyme that catalyzes a biochemical reaction that is common to both cholesterol and coenzyme Q 10 biosynthetic pathways see Biosynthesis. Statins are HMG-CoA reductase inhibitors that are widely used as cholesterol-lowering medications. Statins can thus also reduce the endogenous synthesis of coenzyme Q Therapeutic use of statins, including simvastatin Zocor , pravastatin Pravachol , lovastatin Mevacor, Altocor, Altoprev , rosuvastatin Crestor , and atorvastatin Lipitor , has been shown to decrease circulating coenzyme Q 10 concentrations However, because coenzyme Q 10 circulates with lipoproteins , plasma coenzyme Q 10 concentration is influenced by the concentration of circulating lipids , It is likely that circulating coenzyme Q 10 concentrations are decreased because statins reduce circulating lipids rather than because they inhibit coenzyme Q 10 synthesis In addition, very few studies have examined coenzyme Q 10 concentrations in tissues other than blood such that the extent to which statin therapy affects coenzyme Q 10 concentrations in the body's tissues is unknown , , Finally, there is currently little evidence to suggest that secondary coenzyme Q 10 deficiency is responsible for statin-associated muscle symptoms in treated patients.
In addition, supplementation with coenzyme Q 10 failed to relieve myalgia in statin-treated patients see Disease Treatment , Originally written in by: Jane Higdon, Ph. Linus Pauling Institute Oregon State University. Updated in February by: Victoria J.
Drake, Ph. Updated in March by: Victoria J. Updated in April by: Barbara Delage, Ph. Reviewed in May by: Roland Stocker, Ph. Centre for Vascular Research School of Medical Sciences Pathology and Bosch Institute Sydney Medical School The University of Sydney Sydney, New South Wales, Australia.
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Anti-atherogenic effect of coenzyme Q10 in apolipoprotein E gene knockout mice. Thomas SR, Leichtweis SB, Pettersson K, et al. Dietary cosupplementation with vitamin E and coenzyme Q 10 inhibits atherosclerosis in apolipoprotein E gene knockout mice. Arterioscler Thromb Vasc Biol.
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Uses Some studies suggest that coenzyme Q10 supplements, either by themselves or in with other drug therapies, may help prevent or treat the following conditions: After Heart Attack One clinical study found that people who took daily CoQ10 supplements within 3 days of a heart attack were less likely to have subsequent heart attacks and chest pain.
Heart failure HF There is evidence that CoQ10 may help treat heart failure when combined with conventional medications.
High blood pressure Several clinical studies involving small numbers of people suggest that CoQ10 may lower blood pressure. High cholesterol People with high cholesterol tend to have lower levels of CoQ10, so CoQ10 has been proposed as a treatment for high cholesterol, but scientific studies are lacking.
Diabetes CoQ10 supplements may improve heart health and blood sugar and help manage high blood pressure in people with diabetes. Heart damage caused by chemotherapy Several clinical studies suggest that CoQ10 may help prevent heart damage caused by certain chemotherapy drugs, adriamycin, or other athracycline medications.
Heart surgery Clinical research indicates that introducing CoQ10 prior to heart surgery, including bypass surgery and heart transplantation, can reduce damage caused by free radicals, strengthen heart function, and lower the incidence of irregular heart beat arrhythmias during the recovery phase.
Gum Periodontal disease Gum disease is a common problem that causes swelling, bleeding, pain, and redness of the gums. Other Preliminary clinical studies also suggest that CoQ10 may: Improve immune function in people with HIV or AIDS Increase sperm motility, improving male fertility Be used as part of the treatment for Parkinson disease Improve exercise ability in people with angina Help prevent migraines Scientific studies are needed to see whether CoQ10 can be safely and effectively used for these health problems and needs.
Dietary Sources Primary dietary sources of CoQ10 include oily fish such as salmon and tuna , organ meats such as liver , and whole grains.
Available Forms CoQ10 is available as a supplement in several forms, including soft gel capsules, oral spray, hard shell capsules, and tablets. How to Take It Pediatric DO NOT give CoQ10 to a child under 18 except under the supervision of a health care provider.
Adult For adults 19 years and older: The recommended dose for CoQ10 supplementation is 30 to mg daily. Precautions Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.
Possible Interactions If you are being treated with any of the following medications, you should not use CoQ10 without first talking to your health care provider.
Other: Medications that can lower the levels of CoQ10 in the body include: Statins for cholesterol, including atorvastatin Lipitor , lovastatin Mevacor , pravastatin Pravachol , and simvastatin Zocor Fibric acid derivatives for cholesterol, including gemfibrozil Lopid Beta-blockers for high blood pressure, such as atenolol Tenormin , labetolol Normodyne , metoprolol Lopressor or Toprol , and propranolol Inderal Tricyclic antidepressant medications, including amitriptyline Elavil , doxepin Sinequan , and imipramine Tofranil.
Supporting Research Aguilaniu H, Durieux J, Dillin A. Coenzyme Q a review.
Coenzyme Q10 CoQ10 is a substance that helps Nitric oxide and inflammation reduction Conzyme Coenzyme Q and gastrointestinal health qnd. CoQ10 is found in Metabolism and exercise every cell in the body, and healtth is a powerful healyh. Antioxidants fight damaging particles hea,th the body known as free ahd, which damage cell membranes, tamper with DNA, and even cause cell death. Scientists believe free radicals contribute to the aging process, as well as a number of health problems, including heart disease and cancer. Antioxidants, such as CoQ10, can neutralize free radicals and may reduce or even help prevent some of the damage they cause. Some researchers believe that CoQ10 may help with heart-related conditions, because it can improve energy production in cells, prevent blood clot formation, and act as an antioxidant.
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