Q10’s role in health and disease

Q10 is a unique compound with a key role in cellular energy turnover. It also serves as a powerful antioxidant. The body is able to synthesize most of the Q10 that it needs but as we grow older, our endogenous synthesis decreases, making us vulnerable in different ways. Cholesterol-lowering medicine and certain types of disease are also associated with lower levels of Q10 in the body. In a new review article, a group of scientists have scrutinized hundreds of Q10 studies that have been published in the years 2010-2020. They are able to conclude that Q10 is of particular importance to the heart, circulatory system, fertility, muscles, eyes and vision, and the ageing process. Things like migraines, chronic fatigue syndrome, and neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease are also addressed. The body has difficulty with absorbing Q10 from food and supplements so it is recommendable to always choose a pharmaceutical-grade Q10 preparation with documented bioavailability.

Ever since Q10 was discovered in 1957 by the American researcher Frederik Crane, Q10 science has evolved rapidly. Q10 is a lipid-soluble molecule that occurs in nature in two forms that interchange constantly, depending on the body’s need for the different types. One form is called ubiquinone and is primarily needed for cellular energy turnover, a process that takes place inside the mitochondria. The other form is called ubiquinol and serves as an antioxidant that protects mitochondria, cells, and cholesterol against free radical damage. In the last few decades, scientists have discovered that Q10 also has an influence on other mitochondrial functions such as fatty acid metabolism, gene activation, and the prevention of programmed cell death (apoptosis). Q10 therefore holds a key role in the metabolism and the antioxidant defense of cells.
Humans synthesize most of their own Q10. However, the endogenous production of the compound starts to decrease from the age of 20 years or so, and that makes us increasingly vulnerable in a number of different ways. Cholesterol-lowering medicine (statins) and various diseases has also been seen to impair the body’s Q10 synthesis. A Q10 deficiency may even be a result of genetic flaws.
Because of Q10’s vital importance to mitochondrial function and the prevention of oxidative stress, a deficiency of the compound may be associated with an increased risk of many diseases. This is particularly true for diseases in organs with a large energy turnover – including the heart, brain, muscles, and kidneys. In their new review article, the scientists look closer at 450 articles pulled from various databases and published during the period 2010-2020. The articles look at Q10’s role in health and disease. Their review article and earlier studies show that Q10 science has primarily concentrated on the following areas, which you can read in successive order or individually.

» Heart and cardiovascular system

» Fertility

» Muscles and physical performance

» Migraine headaches

» Parkinson’s disease, Alzheimer’s disease, and other neurodegenerative disorders

» Fibromyalgia and chronic fatigue syndrome

» Diabetes

» Eyes and vision

» The essential importance of Q10’s quality

The heart and cardiovascular system

Cardiovascular disease remains the leading cause of death so it is vital to take proper care of your circulatory system throughout life. The reason that ageing increases your risk of cardiovascular disease is that the cells gradually lose their ability to utilize oxygen. This generates more free radicals and oxidative stress. The body’s antioxidant defense also grows weaker with age. The increased oxidative stress, which is an imbalance between free radicals and antioxidants, causes free radicals to attack the vitally important cholesterol, causing it to oxidize. Instead of being a useful component, the cholesterol is embedded in the blood walls. It is oxidized cholesterol that sets the stage for atherosclerosis.
Ageing processes are also associated with chronic low-grade inflammation, stiff arteries, dysfunctions of the endothelial cells in blood vessels, and similar processes that can result in atherosclerosis and hypertension. Lifestyle factors such as smoking, excessive alcohol intake, overweight, unhealthy diets, and stress can also contribute to oxidative stress and the development of cardiovascular disease.
In their review article, the scientists explain how lack of Q10 increases the risk of oxidative stress and how this can result in inflammation, cell damage, and oxidation of LDL cholesterol. A Q10 deficiency also damages the hard-working heart that contracts rhythmically around the clock.
Numerous studies have demonstrated that supplementation with Q10 improves the energy turnover in the heart muscle, improves the function of the endothelial cells in blood vessels, and helps the calcium homeostasis and antioxidant defense in the body. A Q10 supplement can also lower levels of triglycerides and inflammation markers, and it can reduce elevated blood pressure by way of different mechanisms.
High-dosed Q10 supplementation seems to benefit heart failure patients in particular. The scientists write about Q-Symbio, among other studies, a trial of over 400 heart failure patients, all of whom were given conventional drug therapy for their condition. In addition, half of the patients were assigned to 300 mg of Q10 daily, while the other half got placebo. After two years of intervention, there were 43 percent fewer heart-related deaths in the Q10 group compared with the placebo group. Moreover, the Q10-supplemented patients had substantially better quality of life.
Another study that is mentioned is the Swedish KiSel-10 study. Here, a group of elderly men and women were randomly assigned to daily supplementation with 200 mg of Q10 and 200 micrograms of selenium yeast or matching placebo. The people in the supplemented group, as opposed to those who got placebo, had increased heart muscle strength and a 54% lower cardiovascular mortality rate.
Selenium was administered in combination with Q10 for two reasons: First of all, the farmland in Europe is low in selenium. Secondly, selenium helps Q10 change from one form to the other and vice versa.
Q10 supplementation is also relevant for people who take cholesterol-lowering statins, which is because statins inhibit the body’s endogenous Q10 synthesis. This can result in an impaired energy turnover and antioxidant defense.

Fertility

Couples who have tried, unsuccessfully, to become pregnant for 1-2 years are considered to be involuntarily childless. In Denmark, one in seven couples is affected by this problem. On a global scale, it affects around 50-80 million people. There can be a number of underlying reasons for their infertility.
Poor sperm quality is often linked to a lower number of sperm cells, impaired sperm motility, and sperm cell deformities. Also, the sperm cell DNA can be damaged by something called DNA fragmentation. Even though the sperm cell is perfectly able to wiggle its way to the egg and fertilize it, the egg will not be able to develop normally and is therefore rejected by the body.
The tiny sperm cells are forced to complete the relatively long journey to reach the egg. This requires an enormous amount of energy. Besides, it is important that both the sperm cells and their DNA are protected against oxidative stress.
The authors refer to several studies showing that Q10 supplementation can improve the number of sperm cells, improve their motility, and prevent sperm cell deformation. At the same time, it strengthens their antioxidant defense and the integrity of their DNA:
Low fertility in women may be related to the quality of her eggs, which generally starts to deteriorate after she reaches 30 years of age. In addition, there is a woman’s biological clock and the race against time. As mentioned by the researchers in their review article, oxidative stress may be involved in the ageing of the ovaries and contribute to the deteriorating quality of the eggs. They even write about animal studies where Q10 has been seen to improve the quality of unfertilized eggs.
Various studies of male and female infertility have looked at the affect of giving between 30-200 mg of Q10 daily for up to six months. In some studies and at certain fertility clinics, Q10 has been used in combination with other antioxidants such as vitamin E, vitamin C, zinc, and selenium.

Muscles and physical performance

Everyone knows that it is good for you to exercise. However, excessive training and high-performance sport increase the risk of oxidative stress and that is very unhealthy. Training-related muscle injuries can occur in connection with the actual training session or at a later stage in the form of inflammatory injuries. Training steps up the endogenous synthesis of Q10 to adapt to the increased energy requirement in muscle tissue. Some studies have shown that a Q10 supplement in itself can increase physical performance and endurance in high-performance athletes. What is more, Q10 protects against oxidative stress.
Sarcopenia is the age-related loss of muscle mass that is seen in seniors. Here, mitochondrial change has been detected. Q10 supplements combined with physical training may be a good way to build and maintain muscle mass. One should also make sure to get plenty of protein, especially in old age.
Multiple studies have shown that statins can lower the body’s endogenous production of Q10 and cause mitochondrial dysfunction, which in turn can lead to aching and weak muscles. A double-blinded, placebo-controlled study showed that supplementation with 100 mg of Q10 daily for three months is able to reduce statin-induced side effects. People in statin therapy may benefit from Q10 to prevent adverse effects of their medicine.

Migraine headaches

It is believed that migraine headaches are caused by a dilation of the large blood vessels in the brain, but it is changes in the electric activity of neurons that start or stop an attack. Studies show that around one third of patients suffering from migraine have too little Q10 in their blood. One study of female migraine sufferers has shown that Q10 supplementation is able to reduce pain. One group got 400 mg of Q10 daily, while the other group got matching placebo. After three months, the women in the Q10 group had significantly fewer migraine attacks compared with the women in the other group. The few attacks they experienced were of shorter duration and with less pain. The study is published in the journal Nutritional Neuroscience. The researchers discovered that Q10 was able to reduce pain by lowering levels of CGRP, a peptide involved in pain impulses, and by reducing inflammation in the brain. The study supports earlier research that has looked at the effect of giving Q10 in daily doses of 150-300 mg to patients with migraine.

Parkinson’s disease, Alzheimer’s disease, and other neurodegenerative disorders

The new review article mentions studies that have looked at high-dosed Q10 supplements given to people with neurodegenerative diseases like Parkinson’s disease, Alzheimer’s disease, and sclerosis. Here, Q10 turned out to protect neurons and mitochondria against damage caused by oxidative stress. Parkinson’s disease causes tremor because of damaged nerve cells and lack of the neurotransmitter dopamine. According to a Japanese study, daily supplementation with 300 mg of Q10 can relieve the symptoms in some Parkinson’s patients and is therefore a potential adjuvant. Alzheimer’s disease is the leading cause of dementia. The condition is caused by accumulated plaque from beta-amyloid, a protein that deteriorates brain cells, eventually causing them to perish. Experimental studies have suggested that Q10 supplements may be useful as therapy in the early stages of Alzheimer’s disease by preventing the build-up of harmful proteins in the brain.

Fibromyalgia and chronic fatigue syndrome

Fibromyalgia is associated with lack of Q10, inflammation, and alterations in the number of certain neurotransmitters that are relevant for pain perception and stress reactions. A Spanish doctor named Maria Cordero and a group of colleagues conducted a study with a group of female fibromyalgia patients. For 40 days, half the women got 100 mg of Q10 three times daily, while the other half got matching placebo.
The Q10-treated women had 65% less pain, and the number of painful tender points was reduced by 44% compared with the other group.
Chronic fatigue syndrome, which is most prevalent among women, can be triggered by infection, food intolerance, and stress. According to Danish researchers and the English doctor, Sarah Myhill, the disease may also be a result of having a mitochondrial defect. Autoantibodies and low levels of Q10 have also been observed in patients with chronic fatigue syndrome. Depending on levels of Q10 in the patients, Sarah Myhill recommends taking 200-600 mg of Q10 daily as a supplement. In order to get the best effect, she also recommends magnesium and the amino acid L-carnitine.

Diabetes

Diabetes harms the cardiovascular system in many different ways and is associated with reduced quality of life and early death. A meta-analysis has shown that Q10 supplementation helps reduces the risk of cardiovascular disease in type 2 diabetics by lowering their levels of total cholesterol and LDL cholesterol. Another positive effect of Q10 is linked to its role as an antioxidant that combats oxidative stress, a major contributor to atherosclerosis and cardiovascular damage.
In a study, diabetics were given 200 mg of Q10 daily for three months. Here, the scientists noted that the patients had lower levels of HbA1c – a measure of average blood sugar levels over the past 8-12 weeks. In other words, the diabetics’ glucose uptake was improved, which resulted in lower blood sugar levels. The study supports similar studies of diabetics.
It is also a good idea to reduce your carbohydrate intake and follow the new dietary guidelines to help stabilize blood sugar levels.

Eyes and vision

Eye diseases that are caused by local disorders in the cardiovascular system and cause sudden loss of vision are quite common. Local circulatory disorders are able to affect the retinal blood supply, the optic nerve and other areas, or cause lesions in the nerve branches that lead to the visual center of the brain.
The risk of contracting different types of eye diseases increases with age. Other risk factors are smoking, type 2 diabetes, hypertension, atrial fibrillation, lesions, stroke, and cataracts. For years, antioxidant supplementation has been recommended for eye diseases that are caused by oxidative stress and disorders in the retinal blood supply. Still, there is not solid proof for their efficacy. It does, however, appear that daily supplementation with 100 mg of Q10 together with antioxidants such as vitamins A, B, C, and E, plus selenium, zinc, manganese, lutein, and zeaxanthin in combination with conventional therapy may help improve vision. This was seen in a Spanish study that is published in Nutrients.

The essential importance of Q10’s quality

Many people use Q10 as a natural shortcut to increased energy. Also, it improves the body’s antioxidant defense, although this is not something that can be felt directly. In the case of diseases that are linked directly to Q10 deficiency it is best if you start supplementing in the early phases of the disease. Although Q10 has a great potential in connection with ageing and a variety of chronic diseases, the authors behind the review article do mention the importance of finding a supplement that has the right quality. Clinical studies of Q10 should always be made with pharmaceutical-grade Q10 that has documented bioavailability.
In any type of Q10 raw material, the Q10 molecules will tend to aggregate in large, insoluble crystals. Inferior Q10 supplements typically feature capsules with a mixture of such Q10 crystals and oil. In products like these, the Q10 molecules are locked in these crystal formations and pass through the digestive system. Only a tiny fraction of the molecules is absorbed this way. Unless the preparation undergoes a special treatment that frees the Q10 molecules, enabling them to pass through the intestinal membrane, they are of little use. Q10 in tablet form or as powder in hard gelatin capsules has extremely low absorption (as little as one percent is absorbed.) It is of vital importance to select a Q10 preparation with documented absorption and bioavailability to make absolutely sure that the Q10 molecules reach the cells. Take the Q10 capsules with breakfast. Because the absorption of Q10 reaches a cut-off point at around 100 mg, doses higher than this should ideally be divided into several smaller doses for optimal effect.

References:

Illenia Cirilli et al. Role of Coenzyme Q10 in Health and Disease: an Update on the last 10 years (2010-2020). Antioxidants 2021

Lain Hargreaves et al. Disorders of Human Coenzyme Q10 Metabolism: An Overview. International Journal of Molecular Sciences. 2020

Will Chu. Co enzyme Q10 has potential to help chronic condition symptoms, review finds. NUTRAingredients.com 2020

Alehagen U, et al. Cardiovascular mortality and N-Terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation. Int J Cardiol. 2012

Schagdarsurengin U, Steger K. Epigenetics in male reproduction: effect of paternal diet on sperm quality and offspring health. Nature Reviews Urology 2016

Jessica A. Grieg et al. Maternal Selenium, Copper and Zinc Concentrations in Early Pregnancy and association with Fertility. Nutrients 2019

Christina Nocella et al. Impairment between Oxidant and Antioxidant Systems: Short- and Long-term Implications for Athletes´ Health. Nutrients 2019

Joachim Nielsen et al. Plasticity in mitochondrial cristae density allows metabolic capacity modulation in human skeletal muscle. The Journal of Physiology, 2016

Deichmann RE et al: Impact of coenzyme Q-10 on parameters of cardiorespiratory fitness and muscle performance in older athletes taking statins. Phys Sportsmed. 2012

Dahri M et al. Oral Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers. Nutritional Neuroscience 2018

Stephanie Carter. CoQ10 Targets the Cause of Migraine Headaches. Life Extension Magazine 2019

Yoritaka A et al. Randomized, double-blind, placebo-controlled pilot trial of reduces coenzyme Q10 for Parkinson´s disease. PubMed 2015

Cordero MD et al. NLRP3 inflammasome is activated in fibromyalgia: the effect of coenzyme Q10. Antioxid redox Signal 2014

Cordero MD et al. Can Coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal 2014

Alcocer-Gómez E et al. Effect of coenzyme Q10 on Psychopathological Symptoms in Fibromyalgia patients letter. CNS Neurosci Ther 2017

Ringgard A. Kronisk træthed kan skyldes dysfunktionelle celler. Videnskab.dk 2017

Myhill Sarah et al; Chronic fatigue syndrome and mitochondrial dysfunction. International Journal of Clinical and Experimental Medicine 2009

Yoana Rabanal-Ruiz, Emilio Lianos-Gonzáles and Francisco Javier Alcain. The Use of Coenzyme Q10 in Cardiovascular Diseases. Antioxidants 10 May 2021

Phiwayinkosi V. Dludia et al. The impact of coenzyme Q10 on metabolic and cardiovascular disease profiles in diabetic patients: A systematic review and meta-analysis of randomized controlled trials. Endocrinology, Diabetes & Metabolism 2020

Bispebjerg Hospital. Færre kulhydrater forbedrer type-2 diabetikeres evne til at regulere blodsukkeret. Nyhedsbrev 10. august 2019

Beatriz Fernandez-Vega et al. The use of Vitamins and Coenzyme Q10 for the Treatment of Vascular Occlusion Diseases Affecting the Retina. Nutrients March 2020

Pernille Lund: Q10 – fra helsekost til epokegørende medicin. Forlaget Ny Videnskab. 2014