Healthy Body
 CoQ10 & High Blood Pressure

Coenzyme Q10 Information & Benefits
Michael T. Murray, N.D.

Introduction

Coenzyme Q10 (CoQ10) is an essential component of the mitochondria - the energy producing unit of the cells of our body. CoQ10 is involved in the manufacture of ATP, the energy currency of all body processes. A good analogy for CoQ10's role is similar to the role of a spark plug in a car engine. Just as the car cannot function without that initial spark, the human body cannot function without CoQ10.

Although CoQ10 can be synthesized within the body, there are a number of circumstances where the body simply does not make sufficient amounts. As the heart is one of the most metabolically active tissues in the body, a CoQ10 deficiency affects the heart the most and can lead to serious problems there. Deficiency could be a result of impaired CoQ10 synthesis due to nutritional deficiencies, a genetic or acquired defect in CoQ10 synthesis, or increased tissue needs. Examples of diseases that require increased tissue levels of CoQ10 are primarily heart and vascular diseases including high cholesterol levels and high blood pressure. In addition, people over the age of 50 may have increased CoQ10 requirements as CoQ10 levels are known to decline with advancing age.

Are there food sources of CoQ10?

Yes, but the level of CoQ10 in food is relatively low.¹ For example, the typical daily intake of CoQ10 from dietary sources is only about 3-5 mg per day - nowhere near the level required to significantly raise blood and tissue levels when CoQ10 supplementation is needed. Meat, poultry and fish provide the majority of dietary CoQ10.

What are the principal uses of CoQ10?

CoQ10 supplementation is used primarily in the treatment of cardiovascular diseases such as elevated cholesterol levels, high blood pressure, congestive heart failure, cardiomyopathy, mitral valve prolapse, coronary artery bypass surgery, and angina. Considerable scientific studies have validated these uses.^2-4 CoQ10 has also been shown to be helpful in diabetes; periodontal disease; immune deficiency; cancer; as a weight-loss aid; and muscular dystrophy. Since the response of CoQ10 can take time, a noticeable improvement might not occur until 8 or more weeks after therapy is begun.

How does CoQ10 improve heart function?

By improving energy production in the heart muscle and by acting as an antioxidant.^5,6 The therapeutic use of CoQ10 in cardiovascular disease has been clearly documented in both animal studies and human trials. CoQ10 deficiency is common in patients with heart disease. Biopsy results from heart tissue in patients with various cardiovascular diseases showed a CoQ10 deficiency in 50-75% of cases.⁶ Correction of a CoQ10 deficiency can often produce dramatic clinical results in patients with any kind of heart disease.^7-11

Can CoQ10 lower blood pressure?

Yes. CoQ10 deficiency has been shown to be present in 39% of patients with high blood pressure. This finding alone suggests a need for CoQ10 supplementation. However, CoQ10 appears to provide benefits beyond correction of a deficiency. In several studies CoQ10 has actually been shown to lower blood pressure in patients with hypertension.^12-14 The effect of CoQ10 on blood pressure is usually not seen until after 4-12 weeks of therapy. Typical reductions in both systolic and diastolic blood pressure with CoQ10 therapy in patients with high blood pressure are in the 10% range.

How does CoQ10 help periodontal disease?

Periodontal disease (gum disease) affects 60% of young adults and 90% of individuals over age 65. Healing and repair of periodontal tissue requires efficient energy production, a metabolic function dependent on an adequate supply of CoQ10. CoQ10 deficiency has been reported in gingival tissue of patients with periodontal disease.^15-17 The frequency of CoQ10 deficiency in several studies ranged from 60 to 96%. The beneficial effect of CoQ10 in periodontal disease may be the result of an improvement in the energy-dependent processes of healing and tissue repair.¹⁴

How does CoQ10 boost the immune system?

Tissues and cells involved with immune function are highly energy-dependent and therefore require an adequate supply of CoQ10 for optimal function. Several studies have documented an immune-enhancing effect of CoQ and a benefit in cancer patients.^18-20 Also, CoQ10 should definitely be used by cancer patients taking any chemotherapy drug that is associated with heart toxicity (e.g., adriamycin, athralines, etc.).²¹

Since CoQ10 is needed for the burning of fat, can it promote weight loss?

Yes. Since CoQ10 is an essential cofactor for energy production, it is possible that CoQ10 deficiency is a contributing cause of some cases of obesity. Serum coenzyme Q10 levels were found to be low in 52% of the obese subjects tested.²² When the subjects with low CoQ10 levels were given 100 mg/day of CoQ10 significant weight loss was achieved.

What is the best form of CoQ10?

Coenzyme Q10 is available primarily in tablet or capsules. Based on bioavailability studies, the best preparations appear to be soft-gelatin capsules that contain CoQ10 in an oil base or in a soluble form.^23-25 In order to further enhance absorption, CoQ10 should be taken with food.

In order to enhance the absorption and utilization of CoQ10, some manufacturers have looked to synthetic compounds to enhance the solubility of CoQ10. Instead of following this approach, formulas that dissolved CoQ10 in the purest form of natural vitamin E (natural d-alpha tocopheryl) are best. The result is that the CoQ10 is biologically enhanced due to increased absorption, utilization, and function. By providing the CoQ10 dissolved in the vitamin E, absorption is not only enhanced, but also the likelihood that the CoQ10 will remain in its active form. CoQ10 is present in the blood in both oxidized (inactive) and reduced (active) form. During times of increased oxidative stress or low vitamin E levels, more CoQ10 will be converted to its oxidized (inactive form). Thus, by providing high levels of pure vitamin E the biological activity and function of CoQ10 is enhanced. In addition, the CoQ10 actually enhances vitamin E activity as well.^26-28

How much CoQ10 should I take?

While the usual dosage recommendation for CoQ10 is 50 to 150 mg/day, there are a lot of variables to consider when trying determining whether this amount is really ideal. First of all, as mentioned above it appears that the ultimate judge of whether CoQ10 is going to be effective is whether or not CoQ10 blood levels rise above 2.5 mcg/ml and are maintained at this level for a prolonged period. Since the normal blood level for CoQ10 is roughly 1 mcg/ml, it is often difficult to achieve this therapeutic blood level especially if using poorly absorbed forms of CoQ10.

Is CoQ10 safe?

Coenzyme Q10 is very safe and there have been no serious adverse effects ever reported even with long-term use. Because safety during pregnancy and lactation has not been proven, CoQ10 should not be used during these times unless the potential clinical benefit (as determined by a physician) outweighs the risks.

Does CoQ10 interact with any drugs?

There are no known adverse interactions between CoQ10 and any drug or nutrient. While there are no adverse drug interactions many drugs adversely affect CoQ10 levels or CoQ10 is able to reduce the side effects of the drug. In addition to adriamycin (discussed above), CoQ10 supplementation has been shown to counteract some of the adverse effects of certain cholesterol-lowering, beta-blocker, and psychotrophic drugs.

The drugs lovastatin (Mevacor), pravastin (Pravachol), atorvastatin (Lipitor) and simvastatine (Zocor) are widely used to lower blood cholesterol levels. They work by inhibiting the enzyme (HMG CoA reductase) that is required in the manufacture of cholesterol in the liver. Unfortunately, in doing so these drugs also block the manufacture of other substances necessary for body functions including CoQ10. Supplementing CoQ10 (50 mg per day) is necessary to prevent the depletion of CoQ10 in body tissues while on these drugs.²⁹

References:

1. Weber C. Bysted A, and Holmer G: The coenzyme Q10 content of the average Danish diet. Int J Vit Nutr Res 1997;67:123-9.

2. Gaby AR. The role of coenzyme Q10 in clinical medicine: part II. Cardiovascular disease, hypertension, diabetes mellitus and infertility. Alt Med Rev 1996;1:168-75

3. Thomas SR, Witting PK, Stocker R: A role for reduced coenzyme Q in atherosclerosis? Biofactors. 1999;9:207-24.

4. Overvad K, et al.: Coenzyme Q10 in health and disease. Eur J Clin Nutr. 1999;53:764-70.

5. Weber C, et al.: Effect of dietary coenzyme Q10 as an antioxidant in human plasma. Mol Aspects Med 1994;15 (Suppl.):s97-102.

6. Folkers K, Vadhanavikit S and Mortensen SA: Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with coenzyme Q10. Proc Natl Acad Sci 1985;82:901.

7. Langsjoen H, et al.: Usefulness of coenzyme Q10 in clinical cardiology: a long-term study. Mol Aspects Med 1994;15(Suppl.):s165-75.

8. Hofman-Bang C, Rehnquist N, and Swedberg K: Coenzyme Q10 as an adjunctive treatment of congestive heart failure. J Am Coll Cardiol 1992;19:216A.

9. Morisco C, Trimarco B and Condorelli M: Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Investig 1993;71(Suppl.8):S134-6.

10. Baggio E, et al.: Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 1994;15(Suppl.):s287-94.

11. Kamikawa T, et al.: Effects of coenzyme Q10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol 1985;56:247.

12. Digiesi V, et al.: Mechanism of action of coenzyme Q10 in essential hypertension. Curr Ther Res 1992;51:668-72.

13. Langsjoen P, et al.: Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;15(Suppl.):S265-72.

14. Digiesi V, et al.: Coenzyme Q10 in essential hypertension. Mol Aspects Med 1994;15(Suppl.):s257-63.

15. Nakamura R, Littarru GP, Folkers K. Deficiency of coenzyme Q in gingiva of patients with periodontal disease. Int J Vitam Nutr Res 1973;43:84-92.

16. Wilkinson EG, et al.: Bioenergetics in clinical medicine. VI. Adjunctive treatment of periodontal disease with coenzyme Q10. Res Commun Chem Pathol Pharmacol 1976;14:715-9.

17. Hanioka T, et al.: Effect of topical application of coenzyme Q10 on adult periodontitis. Mol Aspects Med 1994;15(Suppl):S241-8.

18. Folkers K, et al.: Increase in levels of IgG in serum of patients treated with coenzyme Q10. Res Comm Pathol Pharmacol 1982;38:335-8.

19. Lockwood K, Moesgaard S, Folkers K. Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochem Biophys Res Comm 1994;199:1504-8.

20. Lockwood K, Moesgaard S, Yamamoto T, Folkers K. Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases. Biochem Biophys Res Comm 1995;212:172-7.

21. Iarussi D, et al.: Protective effect of coenzyme Q10 on anthracyclines cardiotoxicity: control study in children with acute lymphoblastic leukemia and non-Hodgkin lymphoma. Mol Aspects Med 1994;15(Suppl.):s207-12.

22. van Gaal L, de Leeuw ID, Vadhanavikit S, and Folkers K: Exploratory study of coenzyme Q10 in obesity. In: Folkers K, Yamamura Y, eds: Biomedical and Clinical Aspects of Coenzyme Q, Vol 4. Elsevier Science Publ, Amsterdam, 1984. pp369-73.

23. Weiss M, et al.: Bioavailability of four oral coenzyme Q10 formulations in healthy volunteers. Molec Aspects Med 1994;15:273-80.

24. Chopra RK, et al.: Relative bioavailability of coenzyme Q10 formulations in human subjects. Internat J Vit Nutr Res 1998;68:109-13.

25. Malqvist ML, et al.: Bioavailability of two different formulations of coenzyme Q10 in healthy subjects. Asia Pacific J Clin Nutr 1998;7:37-40.

26. Zhang Y, Turunen M, and Appelkvist EL: Restricted uptake of dietary coenzyme Q is in contrast to the unrestricted uptake of alpha-tocopherol into rat organs and cells. J Nutr 1996;126:2089-97.

27. Ibrahim WH, et al.: Dietary coenzyme Q10 and vitamin E alter the status of these compounds in rat tissues and mitochondria. J Nutr 2000;130:2343-8.

28. Kaikkonen J, et al.: Antioxidative efficacy of parallel and combined supplementation with coenzyme Q10 and d-alpha-tocopherol in mildly hypercholesterolemic subjects: a randomized placebo-controlled clinical study Free Radic Res 2000;33:329-40.

29. Bargossi AM, et al.: Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med 1994;15(Suppl.):s187-93.

Author Profile: Michael T. Murray, N.D. is widely regarded as one of the world's leading authorities on natural medicine. He is a graduate, faculty member, and serves on the Board of Trustees of Bastyr University in Seattle, Washington. Dr. Murray is the co-author of A Textbook of Natural Medicine, the definitive textbook on naturopathic medicine for physicians, as well as the consumer version - Encyclopedia of Natural Medicine. He has also written over 20 other books including How to Prevent and Treat Cancer with Natural Medicine; The Pill Book Guide to Natural Medicine; Dr. Murray's Total Body Tune-Up; 5-HTP: The Natural Way to Overcome Depression, Obesity, and Insomnia; The Healing Power of Herbs; and the Encyclopedia of Nutritional Supplements. http://www.doctormurray.com

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