COENZYME Q10: Benefits, Side Effects, Uses, Dosage, Warnings?
Other names: CoQ10, ubiquinone, ubiquinol 10 Ubidecarenone, mitoquinone.
Reduce hypertension (moderate effect, adjuvant treatment).
See legend of symbols
Treat mild to moderate heart failure (adjuvant treatment).
Improve physical performance; reduce blood sugar; reduce the toxicity of some cancer treatments.
The coenzyme Q10 is free shipping in North America, except in Quebec, where its sale is regulated by Annex II of the Regulation respecting the terms and conditions of sale of drugs in Quebec. Under this regulation, only pharmacists can sell coenzyme Q10 providing 10 mg or more per dose, and they must keep them behind the counter so we can properly educate people who want to buy. The College of Pharmacists concerned that free access to this supplement encourages patients to reduce their use of prescription drugs, especially against high blood pressure or heart failure.
Dosage of coenzyme Q10
The diagnosis and treatment of hypertension and heart failure require the supervision of a healthcare professional. Self-medication is not recommended .
Hypertension and heart failure
The dosages used in the study ranged from 60 mg to 100 mg, two times a day.
Note. Since CoQ10 is better absorbed in the presence of fat, it is best to take with a meal or as a soft gelatin capsule in a fatty base.
Description of coenzyme Q10
A close relative of vitamin K in chemical structure, coenzyme Q10 (CoQ10) is an antioxidant that is to say, it protects the body from damage by free radicals (oxidative stress).
This coenzyme, which acts as a vitamin in the body, the active energy production at the cellular level. All physiological processes that require an energy expenditure need CoQ10 . It is also present throughout the body, especially in the heart, in the gums and mucous membranes of the stomach tissue in all organs playing a role in the immune system, liver, kidneys and prostate. Hence its other name "ubiquinone" (which has the same root as the word "ubiquity", which means "ubiquitous").
Until recently, the majority of supplements CoQ10 commercially available were made in Japan. Now, much of which comes from China, where there are several production plants.
The manufacturing process developed by the Japanese is to ferment the sugar beet and sugar cane using specific yeast strains. The environment created by these yeasts is particularly rich in CoQ10. At the end of the process, the whole is heated to inactivate the yeast, is dried and the culture medium is reduced to powder, which is used to prepare extracts.
The CoQ10 is considered a dietary supplement and not a drug, mainly because it is a natural molecule that can not therefore be the subject of a pharmaceutical patent.
Dietary sources of coenzyme Q10
In theory, the body is able to synthesize CoQ10 it needs and, therefore, the dietary intake of this substance, estimated at 10 mg or less, represent a tiny proportion of the amounts of CoQ10 found in the body . Meat, fish and canola oils and soybeans are the best sources of CoQ10. Nuts and seeds also contain.
The dosages required for therapeutic uses which are mentioned in this card can not be achieved without resorting to supplements CoQ10 .
Coenzyme Q10 deficiency
As the body is able to synthesize CoQ10 according to its needs, it is not considered an essential nutrient. It was therefore not determined recommended daily intake of CoQ10 and it is not in common practice to check the levels in the body. However, it was observed that with age, the body produces less. It was also found that patients with heart or cardiovascular disease, certain cancers, gum disease, high blood pressure, AIDS, muscle disorders or macular degeneration consistently had low levels of CoQ10.
Some medications can reduce the rate of CoQ10 in the body: see below Interactions section in this sheet.
. Note In Japan and Europe, it is now prescribed more often of CoQ10 simultaneously with statins (to lower blood fats) or beta blockers (to lower blood pressure) - in order to avoid a deficiency of CoQ10, also associated with heart disease.
History of Coenzyme Q10
The CoQ10 was discovered and isolated in 1957 in the United States, but it was the Japanese who discovered the therapeutic properties in the early 1960s after observing that people with congestive heart failure had low levels. In this country where, since 1974, CoQ10 is approved for the treatment of congestive heart failure , millions of patients take daily. It is also used for this purpose in Europe, Russia and Israel. Its use prescription for heart failure is much less common in North America.
In the 1960s, it was also found that patients with various cancers (breast, lung, prostate, pancreas, colon, kidney, etc.) generally had high CoQ10 abnormally low. CoQ10 supplements are aware, since these discoveries, some success for patients with cancer or those at risk of contracting one.
Research on coenzyme Q10
Recognized medical uses. Japan, as well as in several European countries, the protocols of conventional medicine include the administration of coenzyme Q10 to treat heart failure, various cardiac or cardiovascular disorders, as well as to help control the hypertension. The Food and Drug Administration has granted orphan drug status to certain products of coenzyme Q10 for the treatment of Huntington's disease and mitochondrial encephalomyopathy (rare neuromuscular disorders associated with mitochondrial dysfunction).
Likely effectiveness Hypertension. Authors of a meta-analysis published in 2007 polled 12 trials (362 subjects total). They concluded that in patients with hypertension, CoQ10 may reduce systolic pressure of 17 mmHg and diastolic pressure of 10 mmHg without significant adverse effects 1 . The dosages used in the study ranged from 60 mg to 100 mg, two times a day.
Potential Effectiveness Heart failure (class I-III). Employment of CoQ10 as adjuvant to conventional treatments for heart failure is part of the current treatment protocols in Japan and some European countries.
The authors of a meta-analysis published in 2006 looked at 11 clinical trials (319 subjects in total) 2 . While acknowledging that most of the trials included a small number of subjects, they concluded that CoQ10 has a beneficial effect in patients with congestive heart failure. The effect is more pronounced when the disease is mild or moderate (grade I-III) and when patients do not take of enzyme inhibitors of angiotensin converting (ACE) inhibitors. The dosages used in the study ranged from 60 mg to 200 mg, two times a day.
The authors of a summary published in 2007 also concluded that trials of CoQ10 have yielded interesting results, but its effect on the reduction of mortality in patients with heart failure has not been established, unlike conventional treatments 3 . These authors and other experts believe that the therapeutic effects of CoQ10 have to be confirmed by testing, double-blind placebo larger and of better quality than those currently available 3-5 . Such a trial is underway (Q-Symbio study) of 550 subjects with heart failure class III and IV will be followed for 2 years. It is designed to test the effect of CoQ10 (100 mg, 3 times daily) on complications and mortality from this disease 6 .
Other heart problems
During various preliminary trials, it was observed that CoQ10 could be useful in treating certain types of cardiomyopathy (heart muscle malfunction) 7-11 .
The results of early clinical trials and case studies indicate that CoQ10 may prevent recurrence and the occurrence of atherosclerosis in people who have suffered a myocardial infarction 12-14 .
Statins and muscle pain
10% to 15% of patients taking statins complain of muscle pain (according to some sources this figure rose to 22% 57 ). We hypothesized that these disorders are caused by the fact that taking statins lowered the rate CoQ10 in muscles 15 . Some tests were conducted to determine whether supplementation with CoQ10 could counter this problem, but they have yielded conflicting results 15,16 . Since CoQ10 is safe, an author specifies that it can be tested in patients on statins muscle pain resistant to conventional treatments 16 .
Uncertain effectiveness Enhanced physical performance and recovery from exercise. Due to its beneficial effect on the heart and the muscles in general, it was assumed that CoQ10 could facilitate cardiovascular and muscular effort (ergogenic effect).
The results of a placebo without trial involving subjects with chronic respiratory failure have left thinking that CoQ10 can improve the ability of these patients to provide physical labor 17 , probably by helping the heart to meet the demand.
Furthermore, some clinical trials in healthy people or well-trained athletes have been mixed or even negative 18-23 . It appears that supplementation do increase the concentration of CoQ10 in the blood and heart 24.25 , but not necessarily in skeletal muscle 26 . One trial involving 25 skiers, has yielded positive results in terms of athletic performance 27 .
According to the pharmacist Jean-Yves Dionne, the CoQ10 can have no direct effect on improving performance. However, its effect antioxidant , reducing cellular damage caused by intensive training, would promote recovery after exercise. The results of two recent trials in Japan indicate that indeed CoQ10 reduces muscle injuries of athletes practicing kendo, and fatigue caused by intense exercise 28.29 .
Uncertain effectiveness Diabetes. Based on the mode of action of CoQ10 metabolism and animal tests, some experts have suggested that CoQ10 can help lower blood sugar in people with diabetes. However, two early clinical trials showed no effect in patients with type 1 30 and type 2 31 . However, CoQ10 has had a positive effect on insulin resistance in subjects with hypertension 32 . The results of a study of 74 subjects indicate that CoQ10 (100 mg, 2 times daily for 1 year) also had long-term, a hypoglycemic effect in patients with type 2 diabetes 33 .
Uncertain effectiveness Reduced toxicity of cancer treatments. Certain drugs against cancer, including anthracyclines, have adverse effects on the heart. Tests on animals and preliminary clinical studies indicate that CoQ10 (30 mg to 240 mg per day) may have a protective effect against these toxic effects. The data are promising but still preliminary 34.35 .
Furthermore, it was reported several anecdotal cases of stabilization, regression or remission of cancer attributed to CoQ10 (90 mg to 390 mg per day, in addition to conventional treatments) 36-39 . Recent preliminary clinical trials suggest that CoQ10 combined with conventional treatments may reduce the recurrence of melanoma 40 and slow the progression of tumors in women with breast cancer 41 .
Miscellaneous. Preliminary tests suggest that CoQ10 may be useful in migraine 42-44 and could slightly reduce the symptoms of Huntington's disease 45,46 , of Parkinson's disease 46-48 , from Friedrich's ataxia 46 , muscular dystrophy 52 and fibromyalgia 50.51 .
Given its antioxidant effect, the CoQ10 is also sold as an anti-aging supplement. However, a long-term study in mice suggests that taking CoQ10 did not increase their antioxidant defenses, or their life 56 . In humans, it has only short-term data and indirect from a conducted with 25 women in good aged 45 to 65 health test 52 .
The CoQ10 is considered very safe, even in the long term 53 .
The safety of CoQ10 has not been established for pregnant women and nursing mothers.
People with heart disease who are considering treatment with CoQ10 must do so under medical supervision.
Diabetics. Like CoQ10 may reduce blood glucose levels, blood glucose should be monitored closely when you start taking it. If necessary, consult your doctor to adjust the dosage of conventional hypoglycemic drugs.
Rare and generally mild gastrointestinal.
With plants or supplements
The hypotensive effects of CoQ10 could be added to those drugs used to treat hypertension.
Patients receiving cancer chemotherapy should consult their doctor before taking a supplement of CoQ10 .
Because of its chemical similarity to vitamin K, CoQ10 theoretically could counteract the effect of warfarin, an anticoagulant. However, in a crossover trial with 24 subjects, this interaction was not observed 54 . The margin of safety of warfarin is limited, it is still better if we also take CoQ10, to notify their physician.
Some medications can reduce the rate of CoQ10 in the body (not exhaustive):
- statins (cholesterol)
- beta-blockers, methyldopa, hydrochlorothiazide, clonidine, hydralazine (hypertension)
- glyburide, phenformin (diabetes)
- tricyclic antidepressants (imipramine, by example)
- antipsychotic drugs in the phenothiazine family.
On the shelves
Most supplements of CoQ10 is present in the form of soft gelatin capsules containing a base oil. Some are chewable tablets.
In 2009, ConsumerLab.com tested 41 CoQ10 supplements: all except one contained the amount of CoQ10 their labeled 55 .
CoQ10 supplements containing as little as 10 mg per dose are offered by some manufacturers, but it seems that the minimum dose for an antioxidant effect in the body is 90 mg 58 .
There is also the CoQ10 in several beauty products in Europe but also in North America.