CoQ10 or Coenzyme Q10 is a vitamin-like substance produced in the body required in almost every single cell for many daily functions. It has a critical role in mitochondrial energy production in cells from foods like carbohydrates and fats. Coenzyme Q10 acts as a spark to fuel. Apart from that, it has also played a role as an antioxidant that gives protection to cells from reactive free radicals. Coenzyme Q10 has very important roles in the benefits of heart health and lowering the risk of heart disease. For its health beneficial effects coenzyme Q10 ranks among the top-selling supplements. (1)
Coenzyme Q10 for mitochondrial energy and heart health
Heart failure relates to the impairment of the heart’s ability to pump blood, which leads to shortness of breath, fatigue, difficulty exercising, and pooling of blood. Causes of heart failure include conditions like heart attack, diabetes, coronary artery disease, and high blood pressure.
Coenzyme Q10 has the highest concentration at in the heart, liver, kidneys, and pancreas. (2) It helps mitochondria in cells of heart muscles to produce energy for activities like pumping blood.
What research had found?
With cardiomyopathy, it makes harder for your heart muscle to pump blood to the rest of the body. In study patients with cardiomyopathy who were steadily worsening and expected to die within two years under conventional therapy showed an extraordinary improvement in health after CoQ10 supplementation. Researchers indicated CoQ10 therapy might extend the lives of such patients. This improvement could be due to the correction of a myocardial deficiency of CoQ10 and to enhanced synthesis of CoQ10-requiring enzymes. (3)
A nearly six years-long clinical study with supplementation of 100 mg of CoQ10 daily along with other treatment found 85% of patients improved by one or two NYHA (New York Heart Association) classes. In a study researchers also reported no positive evidence of toxicity or intolerance of CoQ10. (4)
A multi-center randomized study of 420 patients with moderate to severe heart failure was enrolled in a 2-year prospective trial to either CoQ10 100 mg 3 times daily or placebo, in addition to standard therapy. After completion researchers found taking CoQ10 reduced deaths in patients with severe HF by nearly half, compared to a control group. (5) Another clinical study also concluded that CoQ10 safely reduced major adverse cardiovascular events, all-cause mortality, cardiovascular mortality, hospitalization and improvement of symptoms. (6)
Coenzyme Q10 may also reduce the risk of heart damage caused by cancer chemotherapy drugs.(2)
Coenzyme Q10 and cardiovascular health
Coenzyme Q10 may modestly reduce elevated cholesterol levels. A study on middle-aged people not taking cholesterol-lowering medication in China, 24 weeks Coenzyme Q10 supplementation 60mg twice daily decreased triglyceride and LDL cholesterol. (7)
Also read about 10 best foods to lower high cholesterol naturally
Atherosclerosis or plaque build-up inside your artery that makes artery narrow is a major risk factor in the development of Coronary Heart Disease. Substances found in plaque include cholesterol, calcium and some others in the blood. One way oxidation of LDL cholesterol, not native cholesterol contributes to the development of plaque build up in the artery. (8) Oxidative stress is viewed as an imbalance between the production of free radicals and their elimination by protective mechanisms. And that can lead to chronic inflammation a causative factor for many chronic diseases. (9) As the primary function of antioxidants, CoQ10 scavenges and reduces free radicals and thus prevents cellular damage as well as cholesterol oxidation. (10)
Also, read what to know to prevent heart disease.
A 2012 intervention study investigated the effects of CoQ10 supplementation on 51 patients with coronary artery disease with blockage of major artery to determine its oxidative stress and antioxidant enzyme activity. After the 12-week study period, researchers concluded CoQ10 supplements at a dose of 150 mg can decrease oxidative stress and increase antioxidant enzyme activity in patients with coronary artery disease. They concluded a higher dose of Coenzyme Q10 supplements than 150 mg/day might promote rapid and sustainable anti-oxidation in patients with coronary artery disease. (11) Coenzyme Q10 supplementation at a dosage of 150 mg also appears to decrease inflammation in patients with coronary artery disease. (12)
Also, know How vitamin K2 prevents calcium deposits in the inside of the artery. And why it is so important.
Hypertension or High blood pressure
Hypertension damages the artery wall and thus further leads to deposition in the artery wall. And therefore is recognized as a major risk factor for cardiovascular health. One way improving vascular health Coenzyme Q10 may help to lower the effort of the heart muscles and thus help lower the pressure. Although there are mixed results in findings CoQ10 might help to reduce blood pressure.(13,14)
Also, read about the best foods to lower high blood pressure.
Which Form of CoQ10?
CoQ10 has two forms ubiquinone and ubiquinol. Ubiquinol is the active form of CoQ10 produced in the body from ubiquinone. Some people with specific health conditions or aged people may found difficulty in converting CoQ10 to active form ubiquinol. Therefore in such a case, an active form called ubiquinol can be beneficial as it offers better bioavailability. It has fat soluble property hence taking a small number of fats with supplement helps to absorb better.
Also read other health beneficial functions of CoQ10, deficiency symptoms and causes.
CoQ10 and vitamin E relationship
Coenzyme Q10 has a strange relationship with vitamin E. Vitamin E and coenzyme Q10 are two principal fat-soluble antioxidants in membranes and lipoproteins or cholesterol. But when vitamin E (alpha-tocopherol ) neutralizes a free radical it becomes oxidized itself and form α-TO.
In the test tube, that can, in turn, promote the oxidation of cholesterol under certain conditions. However, when coenzyme Q10 reacts with α-TO it regenerates alpha-tocopherol. But a semiquinone radical is formed which may react with oxygen to produce less reactive superoxide anion radical. However this semiquinone radical can also reduce α-TO· back to alpha-tocopherol. That can result in the formation of fully oxidized coenzyme Q10. (10) In fact, researchers found plasma delta-tocopherol form was associated with a higher risk of heart disease. (14) The above results were observed in the tocopherol class of vitamin E. Increased intake of alpha-tocopherol may also interfere with the lipid‐lowering effect. (15)
Naturally occurring vitamin E exists in eight different forms
Vitamin E has two classes as tocopherols and tocotrienols. Tocopherols have four forms as alpha, beta, gamma, and delta. Similarly, tocotrienols have also four forms as alpha, beta, gamma, and delta. But the biological activity of tocotrienol varies from tocopherol class. Although belongs to the same family tocotrienols have more antioxidant capacity than tocopherols. (16)
Cardioprotective role of tocotrienol
Interestingly, tocotrienols possess powerful neuroprotective, antioxidant, anti-cancer and cholesterol-lowering properties than that of tocopherols. (17) One of the most amazing effects of tocotrienol in preventing cardiovascular disease includes its ability to reverse an arterial blockage.(18)
A small percentage of hypercholesterolemia or high blood cholesterol is due to genetic conditions like familial hypercholesterolemia. Cholesterol is needed in cells for many functions. A receptor that binds with LDL cholesterol from the bloodstream plays a critical role in regulating circulating cholesterol levels. Genetic conditions reduce the number of low-density lipoprotein or LDL receptors produced within cells and or disrupt the receptors’ ability to remove low-density lipoproteins from the bloodstream. As the excess cholesterol circulates through the bloodstream, it is deposited abnormally in tissues such as the skin, tendons, and arteries that supply blood to the heart. (19)
Apart from other benefits the gamma/delta from tocotrienols also inhibits cholesterol production inside the body. In addition, these tocotrienols improve the number of LDL receptors which helps to reduce circulating LDL. They also exhibit anti‐oxidant protection to cholesterol. (15, 20)
Daily dose, the safety of tocotrienols
At present, there is no RDA value for tocotrienols. Earlier most researches had concentrated on tocopherol. The development of these important beneficial nutrients is comparatively new. Most researches had used a dosage of 200 mg daily. All the published clinical studies have no reporting of adverse events for daily dosage up to 400 mg for the duration of up to 2 years. (21) Tocotrienols are not evaluated for pregnant as well as breastfeeding women at present.
You can find tocotrienols in nuts, seeds, grains, oil from palm, wheat germ, rice bran, etc. However, you should avoid oxidation or high heat to such oils.
Daily dose, the safety of coenzyme Q10
The major food source of CoQ10 includes the heart and the liver from an animal source of food. Probably due to this reason ancestral hunters had eaten the heart of their pray in raw. Heating also lowers CoQ10 percentage from food. Other food sources contain a negligible amount of CoQ10. The best way is supplementing with CoQ10 if found necessary. In general, the body produces CoQ10 and does not need to supplement with it. However potential deficiency occurs as people age, health conditions like heart disease taking cholesterol-lowering medication statins. (10)
Evidence also suggests that CoQ10 offers protection against the adverse effects of statins drug-like liver problems and muscle pains. Side effects from CoQ10 seem to be rare and mild like diarrhea, nausea, and heartburn. (22)However pregnant as well as breastfeeding women, individuals taking medication, with specific health conditions should consult with healthcare providers. 90–200 mg per day of CoQ10 is as typical dose. However, your needs can vary depending on the person to person and health condition. (23) Other co-factors upon which effective mitochondrial function relies on include L-carnitine, alpha-lipoic acid.
Disclaimer: Information provided here are generalized information for educational purpose only, not intended to provide one to one health consultation or replace practice of a qualified practitioner. Different people may have different health condition and may have different reaction to the same food. Hence it has been advised to consult with health care provider before application of any of above guidelines. 1. https://www.globenewswire.com/news- release/2014/12/01/687479/10110350/en/Coenzyme-Q10-CoQ10-Market-By- Application-Dietary-Supplements-Pharmaceuticals-Cosmetics-Is-Expected-To- Reach-USD-849-5-Million-By-2020-New-Report-By-Grand-View-Research-Inc.html 2.https://nccih.nih.gov/health/coq10 3. P H Langsjoen, S Vadhanavikit, and K Folkers,Response of patients in classes III and IV of cardiomyopathy to therapy in a blind and crossover trial with coenzyme Q10, Proc Natl Acad Sci U S A. 1985 Jun; 82(12): 4240– 4244 4.Langsjoen PH, Langsjoen PH, Folkers K., A six-year clinical study of therapy of cardiomyopathy with coenzyme Q10, Int J Tissue React. 1990;12(3):169-71 5.Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators, The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial, JACC Heart Fail. 2014 Dec;2(6):641-9. 6.Mortensen AL, Rosenfeldt F, Filipiak KJ.,Effect of coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-SYMBIO randomized double-blind trial, Cardiol J. 2019;26(2):147-156. 7.Peiwen Zhang et al., Treatment of coenzyme Q10 for 24 weeks improves lipid and glycemic profile in dyslipidemic individuals, Journal of Clinical Lipidology, Volume 12, Issue 2, March–April 2018, Pages 417-427.e5 8. Geovanini GR, Libby P,Atherosclerosis and inflammation: overview and updates, Clin Sci (Lond). 2018 Jun 21;132(12):1243-1252 9.Tarique Hussain,Bie Tan, Yulong Yin, Francois Blachier, Myrlene C. B. Tossou, and Najma Rahu,Oxidative Stress and Inflammation: What Polyphenols Can Do for Us?, Oxidative Medicine and Cellular Longevity,Volume 2016, Article ID 7432797, 9 pages 10.https://lpi.oregonstate.edu/mic/dietary-factors/coenzyme-Q10 11.Lee BJ, Huang YC, Chen SJ, Lin PT. Coenzyme Q10 supplementation reduces oxidative stress and increases antioxidant enzyme activity in patients with coronary artery disease. Nutrition. 2012;28(3):250-255. 12. Lee BJ, Huang YC, Chen SJ, Lin PT., Effects of coenzyme Q10 supplementation on inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, and homocysteine) in patients with coronary artery disease, Nutrition. 2012 Jul;28(7-8):767-72 13. Rosenfeldt FL, Haas SJ, Krum H, Hadj A, Ng K, Leong JY, Watts GF., Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials, J Hum Hypertens. 2007 Apr;21(4):297-306 14. Nasheen Naidoo, Rob M. van Dam, Woon-Puay Koh, Cynthia Chen,Yian-Ping Lee, Jian-Min Yuan, and Choon-Nam Ong, Plasma Vitamin E and Coenzyme Q10 Are Not Associated with a Lower Risk of Acute Myocardial Infarction in Singapore Chinese Adults, J Nutr. 2012 Jun; 142(6): 1046–1052 15.Mark Houston, The Role of Nutraceutical Supplements in the Treatment of Dyslipidemia, The Journal of Clinical Hypertension,Volume14, Issue 2, February 2012, Pages 121-132 16.Serbinova E, Kagan V, Han D, Packer L, Free radical recycling and intramembrane mobility in the antioxidant properties of alpha-tocopherol and alpha-tocotrienol, Free Radic Biol Med. 1991;10(5):263-75 17.Chandan K. Sen, Savita Khanna, and Sashwati Roy, Tocotrienols: Vitamin E Beyond Tocopherols, Life Sci. 2006 Mar 27; 78(18): 2088–2098. 18.Hannah R. Vasanthi, R. P. Parameswari, and Dipak K. Das, Multifaceted role of tocotrienols in cardioprotection supports their structure: function relation,Genes Nutr. 2012 Jan; 7(1): 19–28 19.https://ghr.nlm.nih.gov/condition/hypercholesterolemia#genes 20.Chia-Wen Chen, Hsing-Hsien Cheng, A Rice Bran Oil Diet Increases LDL- Receptor and HMG-CoA Reductase mRNA Expressions and Insulin Sensitivity in Rats with Streptozotocin/Nicotinamide-Induced Type 2 Diabetes, The Journal of Nutrition, Volume 136, Issue 6, June 2006, Pages 1472–1476 21.https://tocotrienol.org/en/toxicology/ 22.https://www.webmd.com/diet/supplement-guide-coenzymeq10-coq10#1 23.Juan Garrido-Maraver et. al, Coenzyme Q10 Therapy, Mol Syndromol. 2014 Jul; 5(3-4): 187–197.