Q10’s potential in counteracting ageing, chronic disease, and drug side effects

Q10 is a unique and wonderful coenzyme with a key function in energy turnover and a role as a powerful antioxidant. The body produces the lion’s share Q10 for its own needs but the endogenous synthesis of the compound decreases with age. Moreover, cholesterol-lowering statins and bisphosphonates used to treat osteoporosis disrupt the body’s Q10 synthesis. Over the past decades, numerous studies have shown that Q10 supplementation can slow down the ageing process. Q10 is also useful in connection with heart failure and several other chronic ailments that typically occur in old age. This is described in a review article that is published in Mechanisms of Ageing and Development. With Q10 supplements, it’s important to choose pharmaceutical-grade products with documented quality and bioavailability.

Our cells produce Q10 in their endoplasmic reticulum. Q10 is a lipid-soluble coenzyme with a number of essential functions. It is important for our energy turnover that takes place inside the mitochondria. Here, Q10 serves as an essential component in the so-called electron transport chain.
Moreover, Q10 is a vital antioxidant that protects the mitochondria, cell membranes, cholesterol, and other lipids against oxidative stress caused by free radicals. Q10 is also involved in the activation of DNA and proteins that are important for cell signaling in relation to inflammatory processes and metabolism.
Lack of Q10 may be a result of ageing processes, genetic flaws, or the use of statins and/or bisphosphonates which is common in old age. Low levels of Q10 have been found in tissues and organs in connection with a variety of different diseases such as heart failure, fibromyalgia, and mitochondrial diseases. Supplementing with high doses of Q10 can raise levels of the nutrient in blood and cells, yet there are conflicting results with regard to the bioavailability of different Q10 preparations. In their review article, the scientists take a closer look at how Q10 deficiencies occur and the results of clinical trials where Q10 supplementation has been tested on ageing and chronic diseases linked to ageing.

The different forms of Q10

• Ubiquinone is the oxidized form of Q10 and is mainly involved in the body’s energy turnover that takes place inside the mitochondria. Ubiquinone has a yellowish color.
• Ubiquinol is the non-oxidized (reduced) form of Q10 and primarily serves as an antioxidant. It is milky white.
• Helped by different enzyme processes, ubiquinone and ubiquinol are constantly converted from one form to the other in step with the body’s need for the two forms of Q10

Q10 deficiency in connection with ageing processes

The endogenous Q10 synthesis gradually decreases, starting when we are around the age of 20 years. By the age of 80 years, the Q10 content in the heart has been reduced by half. In 1972, Dr. Harman proposed the theory that ageing is caused by damage to the mitochondria that impairs their oxygen turnover. As a result, the energy metabolism decreases. At the same time, it increases the free radical load and steps up the risk of oxidative stress. When the membranes and the DNA and mitochondria are attacked by free radicals it initiates a vicious cycle that speeds up the ageing process even more. This also increases the risk of different chronic diseases.

• Oxidative stress is when harmful free radicals outnumber the protective antioxidants
• Free radicals are generated naturally during oxidation processes. The number of free radicals goes up with age
• One of the most damaging effects of free radicals is when they attack unsaturated fatty acids in the cell membranes and set off a chain reaction in cells and tissues
• This is known as lipid peroxidation or rancidification

Q10 deficiency related the use of statins and bisphosphonates

Cholesterol-lowering statins are among the most widely prescribed medical drugs and are typically used to treat age-related disorders such as diabetes, or after people have suffered blood clots or stroke. Interestingly, cholesterol and Q10 are synthesized from the same compound (HMG-CoA). Statins work by blocking this compound so this effect also inhibits the body’s own synthesis of Q10. As a consequence of this, many people develop symptoms such as fatigue, aching muscles, and other types of discomfort caused by the energy shortage in cells. Also, cells become increasingly vulnerable to oxidative stress.
Bisphosphonates belong to another group of medical drugs used to prevent or treat osteoporosis. It is assumed that these drugs block the body’s endogenous Q10 synthesis by inhibiting the synthesis of farnesyl pyrophosphate (an intermediate in the synthesis of cholesterol and Q10). Users of statins or bisphosphonates can therefore benefit from supplementing with Q10 to prevent these side effects.

Q10 supplements for older people postpone ageing and death

In the groundbreaking KiSel-10 study, Q10 was administered in combination with selenium to a group of healthy seniors. It was essential to include selenium because this nutrient is crucial for allowing Q10 to interchange between its two forms (ubiquinone and ubiquinol). Selenium also plays a role in supporting the important antioxidant, GPX. Our endogenous Q10 synthesis decreases with age, and our diets are very low in selenium. Therefore, it made perfect sense to give the two nutrients together.
One group got pharmaceutical-grade Q10 (200 mg) and selenium (200 micrograms) each day, while the other group got placebo. After five years, the following changes were observed in the active treatment group: 54% lower cardiovascular mortality, increased cardiac strength, and improved quality of life.
A 12-year follow-up showed that the treatment with Q10 and selenium had a notable long-term impact on heart function and lifespan. It is also worth mentioning that the combination of Q10 and selenium lowers levels of glycosylated plasma protein and D-dimer, both of which are risk factors in connection with blood clots and cardiovascular death (Alehagen et al., 2020)

Cardiovascular diseases

In chronic heart failure, the heart becomes less effective at pumping blood, a condition that is potentially life-threatening. Patients with heart failure often suffer from oxidative stress caused by free radicals. This can be assuaged with antioxidant supplements.
In a systematic review (Flowers et. Al, 2014), the authors analyzed the effect of taking Q10 in connection with cardiovascular disease. No other changes were made to the participants’ lifestyle. The results indicate that Q10 can lower systolic blood pressure. Another meta-analysis shows that Q10 supplementation in connection with cardiac surgery helps reduce subsequent heart rhythm disturbances.
The Q-Symbio study documented, for the first time, that Q10 has an effect on chronic heart failure. In this study, where the participants were given 300 mg of Q10 daily, their heart function had improved after as little as 16 weeks. After two years of treatment, there were 43% fewer heart-related deaths in the active treatment group compared with the placebo group. Moreover, the hospitalization rate in the active treatment group was 43% lower.

Chronic inflammation and chronic disease

Chronic inflammation and oxidative stress occur in many age-related diseases such as cardiovascular disease, diabetes, and chronic kidney ailments. A meta-analysis has shown that supplementation with Q10 (60-500 mg/day) in periods anywhere from one week to four months significantly lowers levels of CRP and pro-inflammatory cytokines such as interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α).

Diabetes

Patients with type-2 diabetes can also benefit from Q10. In a study where diabetes patients were given 200 mg of Q10 daily for three months, the researchers observed that the treatment lowered levels of HbA1c, an indicator of blood glucose over several weeks or months. In other words, the diabetics’ glucose uptake and blood sugar levels were improved. This study supports other studies of diabetics.

Fibromyalgia and chronic fatigue syndrom

Fibromyalgia, a condition characterized by fatigue, aching muscles, and stiff joints, is associated with low levels of Q10. It has also been seen that patients suffering from this disease have increased oxidative stress in their mitochondria. This fits in well with the low levels of Q10. A smaller study (Cordero et al., 2011) has shown that 300 mg of Q10 daily can relive the clinical symptoms.
It has also been seen that Q10 combined with NADH, a niacin derivative, can help relieve symptoms of chronic fatigue syndrome (Campagnolo et al., 2017).

Neurological disorders

According to a review article (Illenia Cirilli et al., 2021), taking high quantities of Q10 may improve neurodegenerative conditions such as Parkinson’s disease, Alzheimer’s disease, and sclerosis. Apparently, Q10 protects neurons and mitochondria against damage caused by oxidative stress. Other studies, however, do not indicate that Q10 can delay Alzheimer’s disease or Huntington’s disease from progressing. It may be a result of using Q10 that has inferior quality, which means it is unable to penetrate the blood-brain-barrier.

The quality of Q10 supplements is vital

Q10 has huge potential in relation to ageing and chronic disease, but it is vital to use supplements that have the right quality. Q10 is a lipid-soluble substance but it does not automatically become absorbable by mixing it with oil. The problem is that the Q10 molecules tend to aggregate in the form of large, insoluble crystals. Unless you expose these crystals to a special treatment that enables them to dissolve completely in the digestive system, the crystals merely pass through the digestive tract, and just a small fraction of Q10 is effectively absorbed. The absorption of Q10 preparations in tablet form or as powder in hard gelatin capsules is often less than one percent. It is therefore crucial to choose pharmaceutical-grade Q10 with documented bioavailability to make sure that the active ingredient effectively reaches the cells.
A Q10 supplement is typically taken with breakfast. Because there is a cut-off point for the body’s Q10 absorption (at 100 mg), it is normally best to divide larger doses of Q10 into several smaller portions and take them at different times of the day.

Q10 protects against ageing in several ways

• Involved in the mitochondrial energy turnover (ATP)
• Serves as an antioxidant that protects lipids, cells, and mitochondrial against free radicals
• Counteracts oxidative stress
• Involved in the activation of DNA and proteins that are important for cell signaling
• Counteracts inflammatory processes that occur in the majority of chronic diseases, even though we do not necessarily notice
• The effect of Q10 is improved by taking selenium because this nutrient enables Q10 to convert into its two different forms (as ubiquinone and ubiquinol)

References:

Jan Aaset, Jan Alexander, Urban Alehagen. Coenzyme Q10 supplementation – In ageing and disease. Mechanisms of Ageing and Development. 2021

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

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

Mortensen SA et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-Symbio: a randomized double-blind trial. Journal of the American College of Cardiology, heart Failure 2014

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

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

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

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

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