Beyond Heart Health
The Systemic Benefits of CoQ10January 2019
By Jake Thacker
In 1990, pharmaceutical giant Merck was granted a patent on combinations of statin drugs and coenzyme Q10.
The patent reveals that statin drugs deplete CoQ10 in the body and how taking the combination could yield considerable benefits.
Here is a quote from a Merck patent written in 1989:
"Since CoQ10 is of benefit in congestive heart failure patients, the combination with HMG-CoA reductase inhibitors [statins] should be of value in such patients who also have the added risk of high cholesterol levels."1
Merck never made a combination statin and CoQ10 drug. It was up to patients or their physician to figure out they could benefit with CoQ10 when taking a drug like Zocor® (simvastatin) that was made by Merck.
Physicians are finally catching on. A reported 71% of cardiologists prescribe CoQ10 to certain heart disease patients. 2 But the importance of CoQ10 doesn't stop there.
What you need to know
- In addition to its use to treat and prevent statin-induced CoQ10 deficiency, the widespread benefits of ample CoQ10 are increasingly being documented.
- CoQ10 is an important coenzyme in the processes that supply energy to cells.
- Increasing CoQ10 intake has been linked to protection from cardiovascular disease, neurological conditions, age-related bone loss, metabolic disorders such as obesity, diabetes, and more.
- While the intake of CoQ10 from a typical diet is small, it can easily be augmented by supplementation and is well-tolerated even at high doses.
CoQ10 is a component of the energy supply system of all cells in the body, critical for many aspects of our health.
Aging itself is associated with low levels of CoQ10 in the body.3,4 The typical modern diet only supplies about 3–6 milligrams of CoQ10 per day, mostly from meat and fish.5
While CoQ10 is best known for heart health, researchers are finding benefits for brain, bone, and metabolic health including reduced mortality.
The medical literature continues to show a vast range of benefits of CoQ10 for cardiovascular health.6-9
One recent study found that, even without a statin drug, CoQ10 alone (120 mg daily) decreased blood pressure, triglycerides, and LDL cholesterol.9 After 24 weeks, subjects with abnormal lipid profiles benefited from a 20% reduction of triglycerides, 7% reduction of LDL, and 6%-8% reduction in blood pressure.
Although the mechanisms of these changes were not specifically assessed, they may be partially related to improvements in insulin metabolism that were also observed in the study.
In experimental animal models, CoQ10 has been found to improve markers of blood vessel health and protect the heart muscle.10,11 In a rat model of myocardial infarction (heart attack), control animals that did not receive CoQ10 displayed damage to over 65% of the heart surface. CoQ10-supplemented animals reduced this damage to only 26%.10
Studies show that CoQ10 is protective in patients with a history of heart disease, specifically heart failure. In meta-analyses of available studies, researchers found that, compared to control patients without supplementation, CoQ10 decreased mortality, presumably by reducing the incidence of serious cardiac events.6,12 Furthermore, CoQ10 supplementation was associated with improved heart ejection fraction and improved exercise capacity.12
A long-term study evaluated people supplementing with CoQ10 plus selenium compared with placebo.
Individuals receiving 200 mg of CoQ10 and 200 mcg of selenium daily exhibited a significant 41% reduction in cardiovascular-related mortality 12 years later.7
Statin medications are associated with diminished levels of CoQ10 in the body. For this reason, many physicians now recommend that their patients increase their intake of CoQ10 during statin treatment. Also, it is believed that CoQ10 supplementation helps reduce the occurrence and severity of some of the most common side effects of statin drugs, in particular muscle pain.3,13,14
The brain is one of the most metabolically active organs in the body.
For this reason, the brain requires an ample supply of energy to function optimally.
So it should come as no surprise that CoQ10 has been found to offer several benefits to the nervous system, including protection from several types of disease.
Several animal studies have found CoQ10 to be neuroprotective.15-17
In traumatic head injuries, the brain suffers from ongoing damage even after the initial trauma. This is due to oxidative stress, inflammation, and impaired mitochondrial function. CoQ10 appears to alleviate these insults.
In a study of rats exposed to a head injury, CoQ10 protected mitochondria from damage and reduced cell death in the brain.17 These same mechanisms of brain injury occur in human traumatic brain injury as well, making CoQ10 a promising management strategy for head trauma.
Rodent models of stroke also showed benefit from CoQ10, mitigating the damage seen in the brain and reducing markers of oxidative stress, inflammation, and cell death in affected tissues.15,16
Protection Against Brain Damage Caused by Stroke
Promising data from humans link higher CoQ10 levels with reduced brain damage caused by ischemic stroke and perhaps lower risk of stroke.
Blood CoQ10 levels were evaluated in patients recovering from a stroke and compared to healthy controls.18
The stroke patients had significantly lower blood levels of CoQ10. There was also a correlation between low CoQ10 levels and greater severity of brain injury as measured by clinical scales, the NIH Stroke Scale and Modified Rankin Scale.
Degenerative Brain Diseases
Neurodegenerative disorders, such as Alzheimer's and Parkinson's disease, are common in older age.19
CoQ10 may be protective against these debilitating disorders.
In models of Alzheimer's dementia, CoQ10 has been found to improve memory and limit the damage caused by beta-amyloid, a harmful protein that builds up in the brain and is implicated in the deterioration of brain function. Furthermore, CoQ10 protects mitochondrial function and limits brain inflammation, all of which contribute to declining cognitive function.20-23
In animal models of Parkinson's, affected animals typically suffer from progressive loss of the control of movement. Treatment of these animals with CoQ10 leads to improvements in motor function as seen on tests of muscle coordination and motor tasks such as swimming. It also slows the progression of the disease.24,25
Recent statistics from the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention estimate that almost 40% of all U.S. adults are obese and close to 10% have diabetes.26,27 More than twice that many have elevated blood glucose and are at risk for diabetes in the future.
Supplementation with CoQ10 has been linked to prevention of the development and progression of both obesity and diabetes, along with improvement in markers of sugar and fat metabolism.28-30
A study evaluating a mouse model of obesity and diabetes showed several beneficial effects of CoQ10. Supplementation led to activation of an enzyme which helps boost the metabolism of fats, which prevented obesity and development of diabetes. Despite a similar overall food intake, those animals receiving CoQ10 had a 12% reduction in body weight and reduced deposition of fatty tissue.28
In the treatment of diabetes in human trials and animal models, the addition of CoQ10 improves glucose control and decreases resistance to insulin. Cellular resistance to insulin is a causative mechanism of high glucose levels in type II diabetics.29,30
In addition to its direct impact on diabetes, CoQ10 may also help to protect kidney function from various forms of injury.30-32 Toxic injury to the kidney was reduced from 21% to 7% with a combination treatment containing CoQ10. 31
Protection of kidney function is particularly important in individuals suffering from type II diabetes, as declining kidney function is a common complication. Studies in humans have seen improvements in systemic markers of inflammation and improved insulin and lipid metabolism in patients with diabetic renal disease.30,32
Aging is associated with a decline in bone density, including osteoporosis, which increases the risk for fractures. Osteoporosis is a major contributor to disability and mortality in the elderly.33-35
Although bones may appear to be inert structures, they are actually quite dynamic tissues. Throughout life, they require constant remodeling, a balance between bone reabsorption and new bone growth, to maintain peak condition. If the balance leans toward more reabsorption and less new bone formation, bones grow thin and fragile.
CoQ10 has demonstrated, in preclinical models, the ability to improve bone health. It has been observed to prevent age-related decline in bone density, decreasing reabsorption of bone while boosting new bone formation and stimulating the growth of cells that form new bone (osteoblasts).36,37
Along with other bone health vitamins and minerals, such as vitamin K and calcium, CoQ10 can be an important component of a comprehensive bone health strategy.
Over 100 clinical trials utilizing CoQ10 are currently registered with the National Institutes of Health (ClinicalTrials.gov), ranging from treatment of depression to healthy reproductive function.
Some studies have suggested CoQ10 may be a useful adjunct to chemotherapy and/or radiation in the management of cancer.38 It may act as a sensitizer, enhancing these treatments' effect of killing cancer cells in one model. It may even have activity against some cell types associated with development of cancer and other pathologies.39
For example, pancreatic stellate cells have been implicated in the pathogenesis of pancreatic cancer and other chronic conditions of the pancreas. When these cells are treated with CoQ10, the expression of genes associated with the formation of cancer are significantly reduced, potentially limiting the development and progression of these conditions.39
As part of a wellness strategy, CoQ10 has been found to decrease clinical markers of inflammation and contribute to reversal of age-related physiological changes. It helps reduce levels of compounds associated with systemic inflammation, such as C-reactive protein and tumor necrosis factor.4,40
Coenzyme Q10 has been used as an adjuvant to cholesterol-lowering statin medications to help limit their side effects, namely muscle soreness.
More widespread roles of CoQ10 are increasingly being recognized.
The typical dietary intake of CoQ10 is small, primarily from meat and fish. CoQ10 supplementation has been associated with various health benefits.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
- Available at: https://patents.google.com/patent/US4933165A/en. Accessed October 23, 2018.
- Available at: https://www.nutraceuticalsworld.com/contents/view_online-exclusives/2016-04-07/more-education-needed-to-bolster-coq10-market/. Accessed April 25, 2018.
- Deichmann R, Lavie C, Andrews S. Coenzyme q10 and statin-induced mitochondrial dysfunction. Ochsner J. 2010 Spring;10(1):16-21.
- Hernandez-Camacho JD, Bernier M, Lopez-Lluch G, et al. Coenzyme Q10 Supplementation in Aging and Disease. Front Physiol. 2018;9:44.
- Pravst I, Zmitek K, Zmitek J. Coenzyme Q10 contents in foods and fortification strategies. Crit Rev Food Sci Nutr. 2010 Apr;50(4):269-80.
- Lei L, Liu Y. Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials. BMC Cardiovasc Disord. 2017 Jul 24;17(1):196.
- Alehagen U, Aaseth J, Alexander J, et al. Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly. PLoS One. 2018;13(4):e0193120.
- Toth S, Sajty M, Pekarova T, et al. Addition of omega-3 fatty acid and coenzyme Q10 to statin therapy in patients with combined dyslipidemia. J Basic Clin Physiol Pharmacol. 2017 Jul 26;28(4):327-36.
- Zhang P, Yang C, Guo H, et al. Treatment of coenzyme Q10 for 24 weeks improves lipid and glycemic profile in dyslipidemic individuals. J Clin Lipidol. 2018 Mar - Apr;12(2):417-27 e5.
- Khan NA, Abid M, Ahmad A, et al. Cardioprotective Effect of Coenzyme Q10 on Apoptotic Myocardial Cell Death by Regulation of Bcl-2 Gene Expression. J Pharmacol Pharmacother. 2017 Jul-Sep;8(3):122-7.
- Molinari C, Morsanuto V, Polli S, et al. Cooperative Effects of Q10, Vitamin D3, and L-Arginine on Cardiac and Endothelial Cells. J Vasc Res. 2018;55(1):47-60.
- Fotino AD, Thompson-Paul AM, Bazzano LA. Effect of coenzyme Q(1)(0) supplementation on heart failure: a meta-analysis. Am J Clin Nutr. 2013 Feb;97(2):268-75.
- Skarlovnik A, Janic M, Lunder M, et al. Coenzyme Q10 supplementation decreases statin-related mild-to-moderate muscle symptoms: a randomized clinical study. Med Sci Monit. 2014 Nov 6;20:2183-8.
- Littlefield N, Beckstrand RL, Luthy KE. Statins' effect on plasma levels of Coenzyme Q10 and improvement in myopathy with supplementation. J Am Assoc Nurse Pract. 2014 Feb;26(2):85-90.
- Abd El-Aal SA, Abd El-Fattah MA, El-Abhar HS. CoQ10 Augments Rosuvastatin Neuroprotective Effect in a Model of Global Ischemia via Inhibition of NF-kappaB/JNK3/Bax and Activation of Akt/FOXO3A/Bim Cues. Front Pharmacol. 2017;8:735.
- Nasoohi S, Simani L, Khodagholi F, et al. Coenzyme Q10 supplementation improves acute outcomes of stroke in rats pretreated with atorvastatin. Nutr Neurosci. 2017 Sep 26:1-9.
- Pierce JD, Gupte R, Thimmesch A, et al. Ubiquinol treatment for TBI in male rats: Effects on mitochondrial integrity, injury severity, and neurometabolism. J Neurosci Res. 2018 Jun;96(6):1080-92.
- Simani L, Ryan F, Hashemifard S, et al. Serum Coenzyme Q10 Is Associated with Clinical Neurological Outcomes in Acute Stroke Patients. J Mol Neurosci. 2018 Sep;66(1):53-8.
- Available at: https://www.alz.org/media/HomeOffice/Facts%20and%20Figures/facts-and-figures.pdf. Accessed October 10, 2018.
- Kumar A, Singh A. A review on mitochondrial restorative mechanism of antioxidants in Alzheimer's disease and other neurological conditions. Front Pharmacol. 2015;6:206.
- Li L, Xu D, Lin J, et al. Coenzyme Q10 attenuated beta-amyloid25-35-induced inflammatory responses in PC12 cells through regulation of the NF-kappaB signaling pathway. Brain Res Bull. 2017 May;131:192-8.
- Singh A, Kumar A. Microglial Inhibitory Mechanism of Coenzyme Q10 Against Abeta (1-42) Induced Cognitive Dysfunctions: Possible Behavioral, Biochemical, Cellular, and Histopathological Alterations. Front Pharmacol. 2015;6:268.
- Muthukumaran K, Kanwar A, Vegh C, et al. Ubisol-Q10 (a Nanomicellar Water-Soluble Formulation of CoQ10) Treatment Inhibits Alzheimer-Type Behavioral and Pathological Symptoms in a Double Transgenic Mouse (TgAPEswe, PSEN1dE9) Model of Alzheimer's Disease. J Alzheimers Dis. 2018;61(1):221-36.
- Attia HN, Maklad YA. Neuroprotective effects of coenzyme Q10 on paraquat-induced Parkinson's disease in experimental animals. Behav Pharmacol. 2018 Feb;29(1):79-86.
- Gupta BK, Kumar S, Kaur H, et al. Attenuation of Oxidative Damage by Coenzyme Q10 Loaded Nanoemulsion Through Oral Route for the Management of Parkinson's Disease. Rejuvenation Res. 2018 Jun;21(3):232-48.
- Available at: https://www.cdc.gov/nchs/products/databriefs/db288.htm. Accessed October 10, 2018.
- Available at: https://www.cdc.gov/diabetes/data/statistics/statistics-report.html. Accessed October 10, 2018.
- Xu Z, Huo J, Ding X, et al. Coenzyme Q10 Improves Lipid Metabolism and Ameliorates Obesity by Regulating CaMKII-Mediated PDE4 Inhibition. Sci Rep. 2017 Aug 15;7(1):8253.
- Sun IO, Jin L, Jin J, et al. The effects of addition of coenzyme Q10 to metformin on sirolimus-induced diabetes mellitus. Korean J Intern Med. 2017 Dec 13.
- Gholnari T, Aghadavod E, Soleimani A, et al. The Effects of Coenzyme Q10 Supplementation on Glucose Metabolism, Lipid Profiles, Inflammation, and Oxidative Stress in Patients With Diabetic Nephropathy: A Randomized, Double-Blind, Placebo-Controlled Trial. J Am Coll Nutr. 2018 Mar-Apr;37(3):188-93.
- Chen F, Liu F, Lu J, et al. Coenzyme Q10 combined with trimetazidine in the prevention of contrast-induced nephropathy in patients with coronary heart disease complicated with renal dysfunction undergoing elective cardiac catheterization: a randomized control study and in vivo study. Eur J Med Res. 2018 May 18;23(1):23.
- Heidari A, Hamidi G, Soleimani A, et al. Effects of Coenzyme Q10 Supplementation on Gene Expressions Related to Insulin, Lipid, and Inflammation Pathways in Patients With Diabetic Nephropathy. Iran J Kidney Dis. 2018 Jan;12(1):14-21.
- Colon-Emeric CS, Saag KG. Osteoporotic fractures in older adults. Best Pract Res Clin Rheumatol. 2006 Aug;20(4):695-706.
- Sozen T, Ozisik L, Basaran NC. An overview and management of osteoporosis. Eur J Rheumatol. 2017 Mar;4(1):46-56.
- Teng GG, Curtis JR, Saag KG. Mortality and osteoporotic fractures: is the link causal, and is it modifiable? Clin Exp Rheumatol. 2008 Sep-Oct;26(5 Suppl 51):S125-37.
- Zheng D, Cui C, Yu M, et al. Coenzyme Q10 promotes osteoblast proliferation and differentiation and protects against ovariectomy-induced osteoporosis. Mol Med Rep. 2018 Jan;17(1):400-7.
- Varela-Lopez A, Ochoa JJ, Llamas-Elvira JM, et al. Loss of Bone Mineral Density Associated with Age in Male Rats Fed on Sunflower Oil Is Avoided by Virgin Olive Oil Intake or Coenzyme Q Supplementation. Int J Mol Sci. 2017 Jun 29;18(7).
- Frontinan-Rubio J, Santiago-Mora RM, Nieva-Velasco CM, et al. Regulation of the oxidative balance with coenzyme Q10 sensitizes human glioblastoma cells to radiation and temozolomide. Radiother Oncol. 2018 Aug;128(2):236-44.
- Xue R, Yang J, Wu J, et al. Coenzyme Q10 inhibits the activation of pancreatic stellate cells through PI3K/AKT/mTOR signaling pathway. Oncotarget. 2017 Nov 3;8(54):92300-11.
- Fan L, Feng Y, Chen GC, et al. Effects of coenzyme Q10 supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2017 May;119:128-36.