Life Extension Magazine®
Doctor listening to heart beat boosted by CoQ10

Issue: Sep 2018

Boosting CoQ10’s Protective Effects

Research shows that people with higher blood levels of CoQ10 and pyridoxal 5’-phosphate have reduced coronary risks. Most readers of this magazine obtain this bioactive vitamin B6 (pyridoxal 5’-phosphate) in their nutrient formulas.

Scientifically reviewed by: Dr. Gary Gonzalez, MD, on February 2020. Written By Janet Seiken.

Coenzyme Q10 (CoQ10) has been reported to reduce cardiovascular risk factors, including improvement of outcomes after a heart attack.

Congestive heart failure patients have shown significant enhancement of clinical measures in response to higher dose CoQ10 supplementation.

Those who rely solely on CoQ10 may be missing a nutrient that most Life Extension® readers obtain in their multi-ingredient formula. This nutrient is the bioactive form of vitamin B6 called pyridoxal 5’-phosphate.

One case-control study found that those with the highest blood levels of CoQ10 and pyridoxal 5’-phosphate had a reduced risk of coronary artery disease.

They also found that coronary artery disease patients had significantly lower levels of CoQ10 and pyridoxal 5’-phosphate compared to controls.1

Pyridoxal 5’-phosphate costs so little that it can readily be obtained in more advanced multinutrient formulas.

What you need to know

  • Cardiovascular disease remains the leading killer around the world.
  • Supplementation with coenzyme Q10 (CoQ10) may help to reduce the risk of coronary artery disease and improve outcomes after heart attack and stroke.
  • Recent studies show that people with higher levels of active B6 have greater CoQ10 levels, and that P5P facilitates normal synthesis of CoQ10 in the body.
  • Human studies show that taking CoQ10 and P5P boosts the availability of CoQ10.

CoQ10, Mitochondrial Function and Heart Health

CoQ10, Mitochondrial Function and Heart Health  

Low blood levels of CoQ10 have been correlated with increased risks for cardiovascular disease along with two of its risk factors: diabetes and obesity.2,3

CoQ10 is a critical co-factor for biochemical reactions that take place in mitochondria, the energy-manufacturing organelles that inhabit all human cells.4

A common contributor for diabetes and obesity is mitochondrial dysfunction. When mitochondria are excessively bombarded with food, as seen in obesity, there is an increased production of reactive oxygen species that lead to mitochondrial dysfunction, worsening of insulin resistance, and ultimately type II diabetes.5

CoQ10 helps scavenge free-radicals in mitochondria. Research shows that a deficiency of CoQ10 may impair the body’s defense mechanism against oxidative stress induced by high glucose levels.5-7

Supplemental CoQ10 has been shown to reduce the risks and improve the outcomes for people with coronary artery disease, heart attacks, and congestive heart failure.4,8-19 A large meta-analysis of 14 randomized controlled trials involving 2,149 heart-failure patients revealed that CoQ10 supplementation decreased mortality by 31% compared with placebo.20

Given the high energy needs of the heart muscle, it makes sense that low CoQ10 would impair heart-muscle function.

Recent publications show that better benefits occur when people have adequate levels of vitamin B6, whose bioactive form is pyridoxal 5’-phosphate (P5P).

CoQ10 and P5P Boost Cardio Protection

Researchers evaluated blood levels of CoQ10 and pyridoxal 5’-phosphate (P5P) in 45 people with coronary artery disease and compared them with the blood levels in 89 healthy subjects.1

The study found that subjects with coronary artery disease had significantly lower levels of CoQ10 and P5P, compared to the healthy people.1 It also showed that higher levels of CoQ10 resulted in higher levels of P5P. The opposite was also found—lower levels of CoQ10 showed lower levels of P5P.

But the key finding of this study was that people with higher CoQ10 and P5P levels had lower risks of coronary artery disease.1

This study points to the connection between CoQ10 and P5P.1 It also suggests that supplementation with both nutrients would be sensible in people with or at risk for coronary artery disease.

How it Works

Image with Caption

How do CoQ10 and B6 levels interact to provide improved protection against coronary artery disease?

Back in the early 1990s, researchers at the University of Texas at Austin were studying immune response in the midst of the AIDS epidemic and found that administering CoQ10 and B6 together increased blood CoQ10 concentrations.21

The combination also increased levels of protective antibodies called IgG and boosted levels of T-lymphocytes, which are immune cells necessary for fighting off infections and for healing.21

Activated T-cells also play an important role in healing heart tissue after a heart attack,22 making the CoQ10/B6 combination appealing for its cardioprotective potential.

In a second study, also from the University of Texas at Austin, researchers collected blood specimens from 29 people not supplemented with either CoQ10 or B6.

They found that people with greater B6 activity had higher levels of CoQ10, once again highlighting the relationship between CoQ10 and vitamin B6-induced biochemical activity.23 This finding suggested the wisdom of CoQ10 users ensuring they also obtain at least 75 mg a day of pyridoxal 5’-phosphate or P5P.

Of interest is research showing that adequate levels of P5P are required for the body’s own production (biosynthesis) of CoQ10.23 While this is not sufficient to counter the sharp drop in CoQ10 that occurs with aging (and statin drug use), it shows how common nutrients can work together to achieve better results.

Anti-Inflammatory Properties

Anti-Inflammatory Properties  

Critically ill patients have sharply elevated markers of systemic inflammation.

Each year, 250,000 Americans die from sepsis, which is a complex syndrome characterized by oxidative damage, hyperinflammation, immune dysfunction, poor tissue oxygenation, and hypercoagulation usually brought on by an infectious agent.

In critically ill patients undergoing extreme chemical stresses, higher P5P levels have been associated with elevated antioxidant enzyme activities.24 This may provide a hint as to how P5P supports the antioxidant functions of CoQ10, which is itself a component of cellular chemical protection systems.

P5P also has direct, independent impact on cardiovascular health. Studies show that people with coronary artery disease have on average 34.2% lower P5P blood levels compared to those without heart problems. This finding may relate to the nutrient’s role in helping to lower levels of homocysteine, a cardiotoxic protein metabolite.25-27

In one study, the combination of high homocysteine and low P5P raised the risk of coronary disease by 330%.26

The connection with homocysteine, which is associated with increased chronic inflammation, suggests that P5P contributes to lower levels of inflammation. This represents a protective response for the heart and blood vessels. Low P5P and high homocysteine are features of chronic inflammatory disorders such as rheumatoid arthritis, which all carry higher risks of heart disease as well.28

Low P5P is associated with chronic inflammation even in the absence of high homocysteine. This has been shown by studies in which mean P5P levels were significantly lower in subjects with the highest levels of inflammation.29 Other studies have shown that breakdown of P5P is higher under conditions of inflammation, a situation that increases coronary artery disease risk.30,31

One intriguing finding regarding P5P and inflammation is with regular use of nonsteroidal anti-inflammatory drugs (NSAIDs). This drug class includes widely used ibuprofen and naproxen and their use is linked to lower P5P levels in human and animal studies.32 This is a paradoxical finding, because the NSAIDs are intended to reduce inflammation, but their suppression of P5P potentially leads to worsening inflammation.

This shows the importance of supplementing with P5P as one good way to avoid the deficiency if NSAID use cannot be avoided. Those with elevated homocysteine should consider supplementing with 75-200 mg a day of P5P, in addition to bioactive folate (5-MTHF) and vitamin B12.

Finally, there is now strong evidence that P5P can directly modulate inflammation and thereby contribute to lower cardiovascular risk.

Canadian researchers have identified binding of P5P to cell surface receptors called PX2, which mediate nerve transmission of pain, as well as cell damage and inflammation.33 By inhibiting PX2 receptors, P5P reduced inflammatory responses and established itself as an important candidate for a PX2-inhibiting drug.


Coenzyme Q10  

Coenzyme Q10 is widely recognized for its potential abilities to reduce cardiovascular risks.

Recent research indicates CoQ10’s benefits may be augmented by ensuring one also supplements with P5P, the most active form of vitamin B6.

Vitamin B6 is required for the body to make adequate CoQ10,34 it boosts blood levels of CoQ10, and it makes CoQ10 available for longer to the many body systems that require it.

Both CoQ10 and vitamin B6 have independent value as heart disease risk-reducing supplements.

Using the two supplements together offers more comprehensive protection against America’s leading age-related killer, cardiovascular disease.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.


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