Active CoQ10

The benefits of Coenzyme Q10 have become increasingly well-known. This important nutrient has been shown in clinical trials to improve heart function, reduce the side effects of certain drugs used to treat cancer, and slow the progression of serious brain diseases such as Parkinson’s disease. Now research has opened a new chapter in the CoQ10 story, highlighting the benefits of ubiquinol, the active form of CoQ10, to increase energy and stamina, and reduce some of he physical signs of aging.

In this issue of Ask the Doctor we will review the benefits of Coenzyme Q10, and discuss the differences between CoQ10 and its active form –ubiquinol.

Q. What is CoQ10?

A. CoQ10 is a natural, fat-soluble nutrient present in virtually all cells. CoQ10 also is known as ubiquinone. That’s because CoQ10 is ubiquitious and exists everywhere there is life. CoQ10 is vital to adenosine triphosphate (ATP) production. ATP is the energy-rich compound used for all processes requiring energy in the body. Although CoQ10 is produced by the body and exists in some limited dietary sources, these levels may be insufficient to meet the body’s requirements. CoQ10 levels diminish with age and as a result of dietary inadequacies and various disease states. Also, some drugs, especially a group of cholesterol lowering prescription drugs known as “statins,” (Pravachol, Zocor, Lipitor, etc.) significantly reduce CoQ10 levels in the body.

Q. What is ubiquinol? Is it the same or different from CoQ10?

A. Ubiquinol and CoQ10 are very closely related. Ubiquinone, or CoQ10, is the oxidized form of the molecule. This means it has to be converted to a non-oxidized form before it can perform its work. Ubiquinol is the active form of this nutrient. Our bodies convert CoQ10 to ubiquinol – which is the form needed to produce cellular energy. Until recently, it was not possible to use ubiquinol as a supplement because it is very unstable outside the human body. But research has now found a way to keep this molecule stable so it can be successfully taken in supplement form.

Q. If CoQ10 gets converted to ubiquinol anyway, can’t I just take CoQ10?

A. While it is true that our bodies can convert CoQ10 to ubiquinol, it isn’t true that we all do this equally well. In fact, as we age, our ability to convert CoQ10 to ubiquinol declines. And some people even have a gene that makes them less effective at this conversion than the majority of the population. IN fact, several common health issues have been associated with less than optimal ratios of CoQ10 to QH. For healthy people the ideal ratio is approximately 97% Ubiquinol to 3% CoQ10. But in people with diabetes, for example, the ratios have been found to range from 43% ubiquinol to 47% CoQ10 in mild diabetes, to only 24% ubiquinol to 76% CoQ10 in severe diabetes. These numbers are for men; the numbers for women vary by 2 to 5 percentage points.

So for older folks, the 30-50% of people who have the gene that impairs CoQ10 conversion, or for people who have serious health concerns, supplementing with ubiquinol instead of CoQ10 might be the smart choice.

Q. What are the health benefits of CoQ10 and Ubiquinol?

A. There have been many studies showing that CoQ10 is beneficial in treating and preventing heart disease and conditions such as high blood pressure atherosclerosis (hardening of the arteries), angina, and congestive heart failure (CHF). It’s been shown that heart attacks tend to occur when CoQ10 levels are low in the body. Exciting new research has found that CoQ10 in a unique delivery system supplementation may slow the progression of symptoms associated with neurological diseases such as Parkinson’s disease, ALS, Huntington’s disease and Alzheimer’s disease.

In addition, CoQ10 is beneficial for diabetes, immune dysfunction, cancer, periodontal disease, prostate cancer, and neurological disease. While the research on ubiquinol is still very new, it is reasonable to expect that its benefits will be equal to or perhaps even better than CoQ10, because it is the more active form.

Q. Why is CoQ10 especially important for preventing and treating heart disease, and for neurological diseases like Parkinson’s disease?

A. The heart and brain are some of the most metabolically active tissues in the body. Both require large amounts of uninterrupted energy, which means these tissues also need increased amounts of ubiquinol. Research has shown that many people with heart of brain diseases have serum CoQ10 levels that are lower than those of healthy people. Correcting such deficiencies often can produce significant results. However, these diseases become more common as we age – right at the time our ability to convert CoQ10 to its active form, ubiquinol, declines.

Q. How might ubiquinol be important for the heart?

A. Heart Health: A study on patients admitted to the hospital with an acute myocardial infarction (AMI) found that CoQ10 can provide rapid protective effects in patients with a heart attack if administered within three days of the onset of symptoms. Seventy-three patients received CoQ10 (120 mg/d). The study’s control group consisted of 71 similarly matched patients with acute AMI. After treatment, angina pectoris (severe chest pain signifying interrupted blood flow to the heart), total arrhythmias (dangerously irregular heartbeats), and poor function in the left ventricle (the essential chamber of the heart) were significantly reduced in the CoQ10 group compared to the placebo group. Total deaths due to sudden cardiac failure and nonfatal heart attacks also were significantly reduced in the CoQ10 group compared with the placebo group.

In another study, CoQ10 was studied in 109 patients with high blood pressure (hypertension). The patients were given varying doses of supplemental CoQ10 with the goal of attaining a certain blood level (greater than 2.0 mcg/l). Most patients were on medications to treat hypertension. Half the patients were able to stop taking some or all of their prescription drugs at an average of 4.4 months after starting CoQ10. The 9.4% of patients who had echocardiograms, performed both before and during treatment, experienced a highly significant improvement in heart wall thickness and function. This improvement was directly attributed to CoQ10 supplementation.

Congestive heart failure (CHF) is a debilitating disease that affects 5 million people in the U.S. It causes edema, difficult breathing, and impaired circulation. In another study, CoQ10 restored healthy heart function in CHF patients. Patients received 100 mg of CoQ10 or a placebo twice daily for 12 weeks. Before and after the treatment period, the investigators introduced a catheter into the right ventricle of patients’ hearts to determine the degree of CHF damage to the heart muscle. The patients’ heart muscles at rest and work improved significantly. The researchers concluded CHF patients would greatly benefit from adjunctive CoQ10 treatment. Since ubiquinol is the active form of CoQ10, it may be able to overcome the hurdles to providing maximum impact, most importantly, age and genetic related inefficiencies in converting CoQ10 to active CoQ10 (Ubiquinol).

And Neurological Health?: A study sponsored by the National Institutes of Health showed that supplementing with CoQ10 in a unique delivery system was associated with a slowing of the progression of Parkinson’s disease. Participants were divided into 4 groups and their physical skills (coordination, walking, etc) and mental skills were evaluated. Each group then received 300 mg, 600 mg, or 1200 mg of a special form of chewable CoQ10, or a placebo. The researchers evaluated the participants after 1, 4,8, 12, and 16 months of treatment. Each participant was again scored on motor, mental, and activities of daily living skills.

The results of the study showed that the people who took the highest dosage of CoQ10-1200 mg-experienced the least decline in their physical abilities. The results were so encouraging that the researchers will be continuing with new studies, suing higher dosages to see if the results can get even better.

Huntington’s disease (HD) is a devastating and degenerative inherited disease that is always fatal. In fact, no other medication, drug, or nutritional supplement has ever been shown to cause a decline in the progression of this terrible disease. A study compared CoQ10 against remacemide (an investigational HD drug made by AstraZeneca Pharmaceuticals), in 347 HD patients who were in the early stages of the disease. Remacemide blocks glutamate, the neurotransmitter scientists think may cause the death of brain cells that occurs in Huntington’s disease. While remacemide had no effect on the progression of HD, CoQ10 showed a trend toward slowing the disease by an average of 15%. This meant the HD group taking CoQ10 was able to handle every day activities of life a little longer than the patients taking remacemide or a placebo. They also were able to focus their attention better, were less depressed, and less irritable.

The 15% slowing of decline can result in about one more year of independence of HD patients. Needless to say, the gift of an additional year of health in the lives of HD patients is incredibly significant.

Because of these impressive results, researchers are hopeful that supplemental CoQ10 will have beneficial effects for people with other neurological diseases such as ALS and Alzheimer’s disease, too. Studies are under way to confirm these effects.

Using the active form of CoQ10 helps to assure that, regardless of age or illness, the CoQ10 can have the greatest impact.

Q. What have been the results of research studies with Ubiquinol?

A. One of the most interesting effects of Ubiquinol that has been reported so far is its ability to slow the physical signs of aging. In laboratory studies, administration of stable ubiquinol to mice forestalled the changes associated with aging – rounded spine, patchy fur and irritated eyes. While the mice who received ubiquinol did not necessarily live longer than the mice that didn’t, they lived better. But it is important to note that these mice were bred to die at a young age. Human studies are needed to determined true impact on longevity.

Additionally, supplemental, stable ubiquinol has been shown to increase physical energy and stamina. In an animal study, the length of time rats were able to run on a treadmill before getting tired was measured. The same rats were then given ubiquinol and the treadmill test was repeated. The length of time the rats were able to run before tiring increased 150 times.

Q. How can one supplement have applications for neurological diseases, heart health, and even the immune system?

A. Supplements often have more than one function, especially when it’s a substance like CoQ10, which is present in all parts of the body. All nucleated cells (most cells other than red blood cells) have mitochondria and all cells require energy to function. CoQ10 is vital to ATP production. Thus, CoQ10 has applications not only in neurological (neurons or nervous system cells) and cardiac health (myocardium or heart tissue), but also for the immune system.

Q. Should I take CoQ10 or ubiquinol? How much should I take?

A. While everyone can benefit from CoQ10 or ubiquinol supplementation, it appears that ubiquinol should be the first choice for older adults, people with known genetic inefficiencies in converting CoQ10 to ubiquinol, and for people with serious heart disease or neurological diseases such as Parkinson’s disease, who are otherwise supplementing with high levels of CoQ10. For people in overall good health, a high quality CoQ10 supplement with proven absorption is a good choice.

Take 200 to 300 mg of CoQ10 or 100 mg ubiquinol daily, depending on your health history. The safety of both forms has been tested, and no significant side effects reported. Occasional mild stomach upset may occur. Taking your CoQ10 or ubiquinol with meals usually alleviates this rare effect.

Conclusion
CoQ10 is not the only answer to the complex issues of heart disease, neurological diseases, or immune dysfunction; however, research indicates that it’s a bigger piece of the puzzle than physicians and scientists ever imagines. The more we study this naturally occurring compound, the more benefits we find. And with this new ability to provide CoQ10 in its active form, ubiquinol, for the first time, even greater benefits may be derived.