Emailing: Coenzyme Q10 - other uses

[Guest guest]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Coenzyme Q10

 

Summary of Research

 

- CoQ10 Current Article

 

- Coenzyme Q10 - other uses

 

Relevant Publications

 

 

 

 

 

 

 

Coenzyme Q10 – its other uses

Coenzyme Q10 (CoQ10) is used in many other conditions besides those related to cardiovascular disease.

 

Migraine headache Parkinson’s disease Freidrich’s ataxia Mitochondrial myopathy Chronic obstructive pulmonary disease (COPD) Periodontal disease (gum disease) Sports supplements – as an ergogenic aid Reduce toxicity of chemotherapeutic drugs Amyotrophic lateral sclerosis (ALS) Renal failure

Discovery of Coenzyme Q10

The discovery of Coenzyme Q10 was not a simple accident but rather the result of a long train of tests by numerous researchers into the mechanisms and compounds involved in energy conversion (Crane F 2007).

CoQ10 was discovered in 1957 in the USA in beef hearts by Dr Frederick Crane and his team. A year later, Prof Folkers and co-workers at the University of Mississippi and pharmaceutical company Merck, Sharpe and Dohme identified the chemical structure and function of the new compound (Folkers et al 1966). This work became the lifelong passion of Folkers who organised a relentless campaign over the following 40 years to discover whether CoQ10 had nutritional significance and could be used in the treatment of disease (Crane F 2007). After several false starts, the first successful use of CoQ10 was in the treatment of heart failure in 1967.

Since then, a steady accumulation of studies have explored the effects of CoQ10 in a variety of conditions such as heart disease, gum disease, cancer, Parkinson’s disease, migraine headache and as a sports supplement.

 

Crane, F. Discovery of ubiquinone (CoQ10) and an overview of function. Mitochondrion 7S(2007)s2-s7 Folkers K, Moore H, Lenaz G, Szarkowska L. Organic structural specificity ofcoenzymeQ for biological activity. Biochemical and Biophysical Research Communications, Volume 23, Issue 4, 1966, 386-391

What does CoQ10 do in the body?

CoQ10 has several different actions in the body. Its most notable effects are:

 

Antioxidant – it scavenges free radicals Improves the efficiency of cellular energy production in the mitochondria (energy factories) of the cell Regulates genes concerned with energy production Stabilises membranes

Deficiencies of CoQ10 in humans occur with age, the use of certain medications, and with diseases including cancer (Roffe et al 2004). The incidence of CoQ10 deficiency has been found to be significantly higher in cancer patients than in healthy controls. Serum levels of CoQ10 may be depleted by statin drugs.

 

Roffe et al. Journal of Clinical Oncology , Vol 22, No 21 (November 1), 2004: pp. 4418-4424

Statin drugs and Coenzyme Q10

Statin drugs are widely prescribed by medical doctors to reduce the body’s production of cholesterol. Some examples are: simvastatin, lovastatin and pravastatin.

During this process, statins also reduce the body’s production of Coenzyme Q10. Studies have indicated that statins can reduce blood levels of Coenzyme Q10 by between 16-54%. Tests with experimental models show that levels of Coenzyme Q10 in the heart muscle and liver can also be reduced.

The most frequent and serious side effects associated with the use of statin drugs are muscle disorders which range in severity from mild muscle aches and pains to fatal muscle destruction. One of the theories proposed to explain these side effects relates to a reduction in muscle CoQ10.

Currently, it is unclear whether taking CoQ10 supplements together with statins will prevent people developing muscle side effects as the evidence available is confusing and contradictory.

There have been two human studies looking at CoQ10 as a treatment once the side effects have developed. One study treated 41 people with statin-induced muscle side effects with either vitamin E (400 IU/day) or CoQ10 (100mg/day) for 30 days. Of the 21 people receiving CoQ10, 18 experienced significant improvements in muscle pain whereas only 3 out of 20 people taking vitamin E experienced a reduction in symptoms. Another study of 22 people with elevated cholesterol levels and statin-induced muscle side effects found treatment with CoQ10 (200mg/day) was no better than placebo at reducing symptoms.

Overall, CoQ10 is a safe and well tolerated supplement which could possibly reduce the risk of statin-induced muscle side effects and treat side effects once established however further research is required to confirm these effects.

 

Marcoff and Thompson 2007; The role of CoQ10 in statin-associated myopathy – a systematic review. J AM Coll Cardiol 49(23)

CoQ10 research in various health conditions

1. Migraine headache

What is it ?

A migraine headache is throbbing, moderate to severe pain, usually on one side of the head, that is made worse by physical activity, light, sounds, or smells and is sometimes associated with nausea and vomiting. Some people also experience changes in vision, balance and mood. Migraine headaches tend to start between the ages of 10 and 40 years and in most people, they recur periodically until the age of 50-60 years.

Migraine treatment aims to prevent the frequency of attacks, blunt the severity of the attack and reduce the intensity of the pain associated with the headache.

Coenzyme Q10 and migraine headache

The exact cause of migraine headaches is unknown and there are several theories. One theory is that for some individuals, migraine is caused by a fault in the cell’s production of energy (mitochondrial impairment). Since CoQ10 is involved in cellular energy production, some studies have been performed to see whether CoQ10 supplements will be beneficial in migraine.

One study involving 32 migraine sufferers found that CoQ10 supplements (150mg daily) reduced the frequency of migraine headaches and reduced the number of days of each attack. In other words, people had less migraine headaches and if they did develop one, it was shorter than usual.

More specifically, the average number of days all sufferers experienced migraine was 7.34 days in the non-treatment period compared with 2.95 days by the end of the trial.

Nearly all people experienced some degree of benefit. Just over 9 out of ten people experienced at least a 25% reduction in the number of days with migraine compared to no treatment and nearly 2/3rds of people experienced a 50% reduction in the number of days with migraine. Additionally, CoQ10 significantly reduced the frequency of migraine attacks as the average number of attacks prior to treatment was 4.85 (in the previous 60 days) which decreased to 2.81 by the end of the trial.

According to this study, treatment with CoQ10 needs to be long term as at least 4 weeks of treatment was required before benefits were seen. With continued use, the beneficial effects grew stronger with maximal effects seen between 5-12 weeks. (Rozen et al 2002).

In another study, CoQ10 was compared to an inactive capsule (placebo) to see whether the benefits were occurring by chance or not. The dose used was also larger, 300mg daily. Once again, after three months of treatment, CoQ10 began to reduce the frequency of migraine headaches, reduce the number of headache days and days with nausea (Sandor et al 2005).

Based on these two studies, it seems that CoQ10 supplements decrease the frequency and of migraine headaches and the number of days of each attack however results are not immediate and at least 1-3 months of treatment is required.

Should I start taking it?

CoQ10 is not effective in all migraine sufferers and it is difficult to predict who will respond. If you are going to try this approach, it is suggested you take CoQ10 daily for 4-5 months. The daily dose should be between 150mg – 300mg. If migraines start to become less frequent and last for less time, then you are responding well and should continue with the treatment. However, if you experience no changes after this time then your body is not responding and this approach is not working for you. It is also important to tell your doctor that you are taking CoQ10.

 

Rozen, TD et al. Open label trial of coenzyme Q10 as a migraine preventive. Cephalalgia 22 , pp. 137–141; 2002 Sandor PS et al. Efficacy of coenzyme Q10 in migraine prophylaxis, a randomised controlled trial. Neurology 64; 713-15; 2005

2. Parkinson’s disease

What is it?

Parkinson's disease is a slowly progressive disorder where there is degeneration of the nerve cells within a specific part of the brain. People with the disease have a muscle tremor, slower voluntary movements and increased muscle tone (rigidity). It tends to be an older person’s disease and most commonly begins between the ages of 50 and 79 years. The symptoms of Parkinson’s disease are caused by a loss of nerve cells and a decrease of the neurotransmitter dopamine in the basal ganglia in the brain.

Current pharmaceutical treatments provide effective control of symptoms in the early stages however there is a need to identify or develop substances which will protect nerves and either slow or stop further degeneration and ideally reverse pre-existing damage.

Coenzyme Q10 and Parkinson’s disease

In 2002, new research was published which suggests CoQ10 may have benefits in this disease. Various doses of CoQ10 were compared to an inactive treatment (placebo) in a study involving 87 people with early stages of Parkinson’s disease. When the different doses were compared to placebo, it was found that people taking the highest dose (CoQ10 1200mg daily) developed significantly less disability than the people using inactive treatment. This was seen for mental and movement symptoms and activity of daily living (Shults CW et al 2002).

These results suggest that high dose CoQ10 may slow the progression of the disease and/or improve symptoms. Future studies are required to clarify the exact benefits of CoQ10.

 

Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q 10 in early Parkinson disease. Evidence in slowing of the functional decline. Arch Neurol 2002;59:1541–1550.

3. Freidrich’s ataxia

What is it?

Friedreich's ataxia (FRDA) is a rare hereditary disorder in which the sufferer progressively loses the ability to move their limbs, speak without slurring and may also suffer mental deterioration. The first symptoms may be seen between the ages of 5 – 15 years and by the late 20’s, often people are confined to a wheelchair. The disease is usually fatal by middle age due to abnormal heart rhythm or heart failure. There are no known treatments for the disease.

Currently, the exact cause remains unknown however it is suspected that impaired mitochondrial function (cellular energy production) and increased oxidative stress are likely to play a role and lead to loss of nerve cells. For some people with the disease, there may also be CoQ10 and vitamin E deficiencies and both have been implicated in ataxia.

Freidrich’s ataxia and CoQ10

In 2005, results of a 4-year study were published which showed a combination of vitamin E (2100 IU daily) and CoQ10 (400mg daily) could potentially improve some symptoms of FRDA (Cooper and Schapira 2007). Therapy had a significant and prolonged benefit on defective cellular energy production (mitochondrial function) in heart and skeletal muscles after 3 months. Of the ten people treated, 6 people had a better level of physical functioning than expected after this time. It is suspected that therapy may have improved the function of nerve cells, or slowed down further loss of nerve cells thereby slowing progression of the disease. Whilst these are exciting results, large studies are required to clarify the exact benefits of CoQ10 and vitamin E in this group of people.

 

Cooper JM, Schapira AHW. FRDA: coenzyme q10 and vitamin E therapy. Mitochondrion; 2007, 7(suppl 1); pg2127-135

4. Mitochondrial myopathy

What is it?

Mitochondrial myopathies such as myocolonic epilepsy and Kearns-Sayre Syndrome are very rare in the community. They are a group of neuromuscular diseases caused by damage to the mitochondria within cells. These diseases are usually characterised by multi-organ abnormalities (especially muscle, heart and brain) and a high degree of free radical production.

According to a study of 44 people with various mitochondrial myopathies, treatment with CoQ10 (2mg/kg/day) orally over 6 months can partially decrease post-exercise lactate levels in some people. The 16 people experiencing this result were considered responders. It remains unclear why some people respond to this treatment and other do not and further tests failed to identify a reason.

 

Bresolin et al. Journal of the Neurological Sciences ;Volume 100, Issues 1-2, December 1990, Pages 70-78

5. Diabetes mellitus

What is it?

Diabetes is a chronic condition which arises because there is a reduction or failure in the body’s ability to handle sugar. Type 2 diabetes is the most common form and is also known as ‘adult onset’ diabetes. Type 1 diabetes is the form more commonly seen in younger people and requires treatment with insulin.

CoQ10 and diabetes

Overall, human studies with CoQ10 suggest that supplementation lowers high blood pressure, and improves blood vessel function and blood flow in people with diabetes. It may also have a beneficial effect on blood sugar control. The dose used in most studies of people with diabetes is 200mg/day.

 

Andersen CB, Henriksen JE, Hother-Nielsen O et al: The effect of coenzyme Q10 on blood glucose and insulin requirement in patients with insulin dependent diabetes mellitus. Mol Aspects Med 1997; 18(suppl):S307-S309. Eriksson JG, Forsen TJ, Mortensen SA et al: The effect of coenzyme Q10 administration on metabolic control in patients with type 2 diabetes mellitus. BioFactors 1999; 9(2-4):315-318. Hodgson JM, Watts GF, Playford DA et al: Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr 2002; 56(11):1137-1142 Playford DA, Watts GF, Croft KD et al: Combined effect of coenzyme Q10 and fenofibrate on forearm microcirculatory function in type 2 diabetes. Atherosclerosis 2003; 168:169-179 Watts GF, Playford DA, Croft KD et al: Coenzyme Q10 improves endothelial dysfunction of the brachial artery in Type II diabetes mellitus. Diabetologia 2002; 45:420-426.

6. Periodontal disease

What is it?

Periodontal disease is also known as gum disease. It is a condition characterised by chronic inflammation and infection of the gums and surrounding tissue and is the major cause of adult tooth loss. Gum disease tends to develop when plaque is allowed to build up along the gum line.

Periodontal disease and CoQ10

There has been relatively little research conducted with CoQ10 in periodontal disease however a small study exists which produced promising results.

A study of 10 people with peridontitis found that topical application of CoQQ10 to the affected areas for 3 weeks resulted in significant improvements in gum health and healing (Hanioka et al, 1994).

 

Hanioka T, Tanaka M, Ojima M et al: Effect of topical application of coenzyme Q10 on adult peridontitis. Mol Aspects Med 1994; 15(suppl):S241-S248

7. Chronic Obstructive Pulmonary Disease (COPD)

What is it?

Chronic obstructive pulmonary disease (COPD) is characterised by chronic inflammation and irreversible limitation of the airways. It causes long-term morbidity and disability. COPD is caused by an inflammatory response to inhaled toxins, most often cigarette smoke. Due to the increasing incidence of smoking in developing countries, COPD is predicted to be the fifth most frequent cause of death in the world by 2020.

The first sign of COPD is usually a productive cough which eventually leads to breathlessness and wheezing which becomes more severe over time. People who continue to smoke with COPD experience a quicker deterioration of health.

COPD and Coenzyme Q10

At least 2 clinical studies have investigated the use of CoQ10 supplements in people with COPD. Although the studies were small, they indicate a possible role for CoQ10 in COPD which needs to be further clarified in larger studies.

In one study, people were assigned CoQ10 (50mg/d) or placebo as part of their pulmonary rehabilitation program. Treatment with CoQ10 resulted in a 13% increase in maximal oxygen consumption and a 10% increase in maximum expired volume which were both significant (Satta et al 1991).

In a smaller trial, CoQ10 (90mg/d) taken over 8 weeks found treatment improved hypoxemia at rest but did not change overall pulmonary function (Fujimoto et al 1993).

 

Satta et al. Clin Ther 13.6(1991);754-7 Fujimoto et al. Clin Invest 71.8 suppl (1993); s162-6

Other areas of investigation

Sports supplement

Because CoQ10 is essential for energy production within the cell, researchers have suspected it may be of benefit in enhancing physical performance amongst athletes.

At least eight clinical studies have investigated CoQ10 supplements in various sports people. Overall, the results have been mixed with the majority showing no clear benefits in physical capacity (Braun and Cohen 2007). The doses used in the studies varied from 60mg to 150mg daily and lasted between 1 to 2 months.

 

Braun L, Cohen M. Herbs and Natural Supplements – an evidence based guide 2nd edition.2007 Elsevier Australia

Coenzyme Q10 and cancer

There have been three small studies using CoQ10 in women with breast cancer after they have received standard treatment. The results suggest some may be helped by the treatment however because the studies were small and the results were poorly reported, further studies are required to clarify the effect of CoQ10.

 

Progress on Therapy of Breast Cancer with Vitamin Q10 and the Regression of Metastases. Lockwood K., Moesgaard S., Yamamoto T. and Folkers K. Biochemical and Biophysical Research Communications Volume 212, Issue 1, 6 July 1995, Pages 172-177 Partial and Complete Regression of Breast Cancer in Patients in Relation to Dosage of Coenzyme Q10 . Lockwood K., Moesgaard S. and Folkers K. Biochemical and Biophysical Research Communications Volume 199, Issue 3, 31 March 1994, Pages 1504-1508

Reducing side effects caused by chemotherapy (anthracyclines)

There is some research suggesting that coenzyme Q10 may help to reduce heart and liver toxicity caused by the anthracycline group of anticancer drugs.

a. Animal models

Several studies conducted with animal models have shown that CoQ10 might prevent the heart damage side effects caused by the cancer drug adriamycin (Kishi et al 1976; Kishi et al 1984; Usui et al 1982).

 

Tadao Usui , Hiroto Ishikura, Yoichiro Izum, Hiroshi Konishi, Naochika Dohmae, Hiroyoshi Sawada, Haruto Uchino, Hiroko Matsuda and Tomotsugu Konishi. Possible prevention from the progression of cardiotoxicity in adriamycin-treated rabbits by coenzyme Q10 . Toxicology Letters Volume 12, Issue 1, June 1982, Pages 75-82. Kishi et al., 1976. T. Kishi, T. Watanabe and K. Folkers , Bioenergetics in clinical medicine. VII. Prevention by forms of coenzyme Q of the inhibition by adriamycin (NSC-123127) of coenzyme Q10 enzymes in mitochondria of the myocardium. Proc. Natl. Acad. Sci. USA 73 (1976), pp. 4653–4656. Kishi et al., 1984. T. Kishi, K. Takahasi, T. Mayumi and T. Hama , Protective effect of Coenzyme Q on adriamycin toxicity in beating heart cells. In: K. Folkers and Y. Yamamura, Editors, Biomedical and Clinical Aspects of Coenzyme Q 4, Elsevier, Amsterdam (1984), pp. 181–188.

b. Human studies

In 2004, a review was published which analysed the results of 6 human studies which sued CoQ10 supplements together with cancer drugs. Overall theresults indicated that CoQ10 may provide some protection against heart and liver toxicity associated with some cancer treatments. Three of the 6 studies were randomised clinical trialsand 3 were nonrandomised clinical trials. Patients in five out of six studies received anthracyclines. the CoQ10 dosage used in the studies ranged from 90mg/day to 240mg/day and duration of treatment varied according to an individuals cancer treatment. no side effects were reported. Unfortunately, poor reporting of details in the studies mean the results cannot be seen as conclusive and further investigation is required to confirm the results.

 

Liz Roffe, Katja Schmidt, Edzard Ernst. Efficacy of Coenzyme Q10 for Improved Tolerability of Cancer Treatments: A Systematic Review ;Journal of Clinical Oncology , Vol 22, No 21 (November 1), 2004: pp. 4418-4424; 2004 American Society of Clinical Oncology.

CoQ10 and tamoxifen

Tamoxifen is a drug which is used in breast cancer. It has been shown to be effective not just as an adjuvant therapy after surgery, chemotherapy or radiation therapy in early and advanced breast cancer cases, but also in chemoprevention in high-risk pre- and postmenopausal women.

As a side benefit, tamoxifen also reduces cholesterol levels however this does not translate into heart protective effects because the drug increases triglyceride levels which are a risk factor for heart disease.

A study using CoQ10, riboflavin (vitamin B2) and niacin (vitamin B3) supplements together with tamoxifen found the vitamins prevented the increase in triglyceride levels but did not hamper the beneficial effects on cholesterol levels (Yuvaraj et al 2007).

 

Srinivasan Yuvaraj, Vummidi Giridhar Premkumar, Kothandaraman Vijayasarathy, Sitthu Govindaswamy Dinakaran Gangadaran and Panchanatham Sachdanandam. Clinical Biochemistry Volume 40, Issues 9-10, June 2007, Pages 623-628.

Age-related Macular Degeneration

Age-related macular degeneration (AMDis a progressive neurodegenerative disease of the retina and it represents the leading cause of blindness in industrialised countries. Some research suggests that oxidative stress and mitochondrial dysfunction plays a central role in the development of the disease. As a result, antioxidants such as CoQ10 have been considered as potentially useful in preventing or slowing the disease.

To date, one study of 100 people with AMDhas been conducted which used CoQ10, L-carnitine, n-3 fatty acids. One hundred and six volunteers with AMDwere randomly assigned CoQ10 or placebo and asked to take their treatment for 12 months (Feher et al 2005). Treatment with the nutritional supplement improved visual function in the most affected eyes for people with early AMD. This result was observed after 6 months. The group receiving placebo experienced a worsening of visual function over the same time period which suggests that the nutritional combination slowed further disease progression.

 

J. Feher, B. Kovacs, I.Kovacs, M. Schveoller, et al. Improvement of Visual Functions and Fundus Alterations in Early Age-Related Macular Degeneration Treated with a Combination of Acetyl-L-Carnitine, n-3 Fatty Acids, and Coenzyme Q10. Ophthalmologica. Basel: May/Jun 2005. Vol. 219, Iss. 3; p. 154

Renal failure

People with renal failure tend to have higher oxidative stress and decreased function of the antioxidant network compared with healthy individuals. Increased oxidative stress appears to develop in the early phase of kidney disease (Gazdikova et al 2001).

A study of 48 patients on long-term hemodialysis and 15 uremic patients found that both groups had significantly lower levels of CoQ10 levels when compared with the normal group (Lippa et al 1994).

 

Gazdikova et al. Oxidative stress and plasma concentrations of CoQ10, alpha tocopherol and beta carotene in patients with a mild to moderate decrease of kidney function. Nephron. Basel: Jul 2001. Vol. 88, Iss. 3; pg. 285 S. Lippa, L. Colacicco, C. Callà, G. Sagliaschi and A. G. Angelitti ; Coenzyme Q10levels, plasma lipids and peroxidation extent in renal failure and in hemodialytic patients. Molecular Aspects of Medicine ; Volume 15, Supplement 1, 1994, Pages s213-s219

Kidney transplant

An animal model of kidney transplantation was used to determine whether CoQ10 had any favourable effects after surgery (Tatsukawa et al 1979). The study found that administration of CoQ10 enhanced the rate and extent of ATP resynthesis by the mitochondrion and increased survival rate in test animals. Research is now required to determine whether CoQ10 can produce similar beneficial effects in man.

 

Tatsukawa, Yukihiko Dohi, Kazuo Yamada and Takashi Kawasaki;The role of coenzyme Q10 for preservation of the rat kidney: A model experiment for kidney transplantation.Yorimitsu ; Life Sciences Volume 24, Issue 14, 2 April 1979, Pages 1309-1314

Amyotrophic Lateral Sclerosis (ALS)

This is a rare, progressive neurodegenerative disease which results in a loss of muscle function leading to paralysis and eventually death. Whilst the exact cause remains unknown, increased oxidative stress has been found in people with ALS.

A study using an animal model has found that CoQ10 supplements modestly increase life-expectancy (Matthews RT et al 1998). Research is now required to investigate its effects in humans.

 

Mathews RT et al. Nat Acad Sci, USA; 1998: 95,8892

Reduced sperm counts

An excess of free radicals is known to impair sperm cell function and play a negative role in male factor fertility. Since CoQ10 has an antioxidant function, it has been tested in infertile males to see whether treatment can improve semen quality and sperm function.

Twenty two males with low sperm mobility were treated with CoQ10 (200mg daily) for 6 months (Balercia G et al 2004). Although treatment did not improve sperm count, it did improve forward sperm motility and the wives of three patients achieved spontaneous pregnancy (13.6%) within 3 months of the discontinuation of therapy (a 2.4% pregnancy rate per cycle). Six months after discontinuing CoQ10 use, sperm motility reverted back to original levels. Currently, there is a larger study underway to test these effects again.

 

Balercia G et al. CoQ10 supplementation in infertile men with idiopathic asthenozoospermia : an open, uncontrolled study. Fertility and sterility