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CoQ-10

$29.90 for 60 Capsules 30mg | Order |

| Description / Source / Components |  | History |  | Proponent/Advocate Claims
| Professional Evaluation/Critique |  | Toxicity/Risks |  | Heart Disease |

CoQ-10 is a fat-soluble quinone that is structurally similar to vitamin K and commonly known as Ubiquinone. Found in most living organisms, it is essential to the production of cellular energy and can be both synthesized in the body and derived from dietary sources. CoQ-10 is important because it lies within the membrane of a cell organelle called the mitochondria. Mitochondria are affectionately known as the "power house" of the cell because of their ability to produce cellular energy, or ATP, by shuttling protons derived from nutrient breakdown through the process of aerobic (oxygen) metabolism. CoQ-10 also has a secondary role as an antioxidant. Several clinical trials have shown CoQ-10 to be effective in supporting blood pressure and cholesterol levels*. Furthermore, CoQ-10 has also been shown to improve cardiovascular health*. These facts lead many to believe that CoQ-10 supplementation is vital to any dietary supplementation program

Active Ingredients:
(Amount per 1 capsule, 30 mg)
Ubiquinone (Coenzyme Q-10)
(USP Pharmaceutical Grade )

* These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease.

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Description / Source / Components

Coenzyme Q is also known as Ubiquinone.

"Co-Q10 (2,3 dimethyl-5 methyl-6-decaprenyl benzoquinone) is an endogenous antioxidant found in small amounts in meats and seafood. Although Co-Q10 is found in all human cells, its highest concentrations occur in the heart, liver, kidneys, and pancreas. It is found naturally in the organs of many mammalian species." (Fetrow)

"CoQ10 can be synthesized in vivo [in a living body]. Situations may arise, however, when the need for CoQ10 surpasses the body's ability to synthesize it. CoQ10 is well-absorbed by oral supplementation as evidenced by significant increases in serum CoQ10 levels after supplementation."(Anonymous)

"CoQ10, due to the involvement in ATP [cellular energy] synthesis, affects the function of all cells in the body, making it essential for the health of all human tissues and organs. CoQ10 particularly effects the cells that are the most metabolically active: heart, immune system, gingiva, and gastric mucosa."(Anonymous)

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History

"Coenzyme Q10 was discovered in 1957 by Fred Crane, M.D., from the University of Wisconsin, who isolated it from beef hearts." The research was carried out by Dr. Karl Folkers. (Whitaker)

Dr. Folkers became interested when his next-door neighbour with terminal metastatic lung cancer started taking CoQ10 and had a complete remission. (Whitaker)

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Proponent / Advocate Claims

It is believed by proponents that cancer patients lack CoQ10 in their blood. (Lockwood 1994)

Folkers reported several case histories of cancer patients with prolonged survival on therapy with CoQ10. (Folkers)

It is claimed by some that "the action of CoQ on the immune system is profound. It promotes bioenergetic processes in the human immune cells." (Bliznakov)

"More recent findings substantiate the view that supplementation with CoQ10 can cause complete regression of tumors in advanced breast cancer, including one patient with numerous metastases to the liver." (Diamond)

"Mechanisms in cancer include immune system enhancement and antioxidant activity." (Anonymous)

Cardiac toxicity of the anthracyclines may be ameliorated by using low doses or concomitant treatment with coenzyme Q 10. (Berkarda)

"Coenzyme Q-10 is a nontoxic natural substance that reduces the damage done to the heart by the chemotherapy agent Adriamycin and may increase its antitumor activity. Co-Q-10 also protects the liver from the toxic effects of various chemotherapy drugs. I recommend that people undergoing chemotherapy take 300mg [milligrams] of CO-Q-10 daily."(Weil)

"Treatment with ubiquinone (coenzyme Q 10) reversed lovastatin-induced myopathy [disease of a muscle] in one patient in whom tumor response was maintained. In 22 additional patients, prophylactic administration of ubiquinone prevented the development of rhabdomyolysis [disintegration or dissolution of muscle] without adversely affecting tumor growth.... Drug-associated rhabdomyolysis is treatable and preventable with oral ubiquinone supplements which do not appear to nullify the antitumor activity of lovastatin."(Thibault)

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Professional Evaluation / Critique

There has been some evidence that Coenzyme Q has efficacy when used in combination with other cancer treatments to ameliorate harmful side effects of those treatments (refer to proponent claims/beliefs section). However, it should be noted that it has not been proven that CoQ is effective as a cancer treatment in itself.

"Groups of tumors that received Q10 and radiotherapy had a significantly lower specific growth delay (SGD) than the radiotherapy-only groups... We conclude that systemic Q10 reduces the response to single dose tumor irradiation in xenotransplanted human SCLS (small-cell lung cancer) tumors. The magnitude of this potentially adverse effect is dose-dependent. We feel that the present experimental data justify a warning against concurrent use of Q10 during radiotherapy."(Lund)

"It was found that coenzyme Q . . . significantly delayed growth arrest" (did not stop cancer cells from growing) in human mammary epithelial cells (HMEC), and two human breast cancer cell lines Hs578T and MDA231. (Larsson)

"It was found that addition of either coenzyme Q or dolichol induces a partial but significant stimulation of DNA synthesis in breast cancer cells" (actually stimulated cancer cell growth). (Larsson)

Lockwood et al. (1995) report the remission of breast cancer in three patients who were being treated with doses of Coenzyme Q10. I t should be noted that in all three cases the Q10 treatment was provided during the same time that the patients were undergoing conventional treatments (mastectomy, X-ray treatment, appropriate anti-cancer drugs). The remission of breast cancer in these patients cannot be attributed with any certainty to the Q10 treatment that was provided.

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Toxicity / Risks

"CoQ produces no toxic effect in animal models." (Bliznakov)

Fetrow's list of adverse reactions to Co-Q10 includes anorexia, diarrhea, epigastric discomfort, ischemic tissue damage [tissue damage due to a deficiency in blood in a specific part of the body] (during intense exercise), and mild nausea. (Fetrow)

Author: Langsjoen-P-H. Folkers-K. Lyson-K. Muratsu-K. Lyson-T. Langsjoen-P.

Title: Effective and safe therapy with coenzyme Q10 for cardiomyopathy.

Source: Klin-Wochenschr. 1988 Jul 1. 66(13). P 583-90.

Journal Title: KLINISCHE WOCHENSCHRIFT.

Abstract: Coenzyme Q10 (CoQ10) is indispensable in mitochondrial bioenergetics and for human life to exist. 88/115 patients completed a trial of therapy with CoQ10 for cardiomyopathy. Patients were selected on the basis of clinical criteria, X-rays, electrocardiograms, echocardiography, and coronary angiography. Responses were monitored by ejection fractions, cardiac output, and improvements in functional classifications (NYHA). Of the 88 patients 75%-85% showed statistically significant increases in two monitored cardiac parameters. Patients with the lowest ejection fractions (approx. 10%-30%) showed the highest increases (115 delta %-210 delta %) and those with higher ejection fractions (50%-80%) showed increases of approx. 10 delta %-25 delta % on therapy. By functional classification, 17/21 in class IV, 52/62 in class III, and 4/5 in class II improved to lower classes. Clinical responses appeared over variable times, and are presumably based on mechanisms of DNA-RNA-protein synthesis of apoenzymes which restore levels of CoQ10 enzymes in a deficiency state. 10/21 (48%) of patients in class IV, 26/62 (42%) in class III, and 2/5 (40%) in class II had exceptionally low control blood levels of CoQ10. Clinical responses on therapy with CoQ10 appear maximal with blood levels of approx. 2.5 micrograms CoQ10/ml and higher during therapy.

Author: Langsjoen-P-H. Vadhanavikit-S. Folkers-K.

Title: Response of patients in classes III and IV of cardiomyopathy to therapy in a blind and crossover trial with coenzyme Q10.

Source: Proc-Natl-Acad-Sci-U-S-A. 1985 Jun. 82(12). P 4240-4.

Journal Title: PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA.

Abstract: Coenzyme Q10 (CoQ10), a biochemically established redox component of respiration including the coupled mechanisms of electron transfer and oxidative phosphorylation, is naturally present in the human myocardium. A double-blind and double-crossover trial has been conducted by administering CoQ10 and a matching placebo orally to two groups of patients having class III or IV cardiomyopathy (classification according to criteria of the New York Heart Association). Group A received CoQ10 and then placebo; group B received placebo and then CoQ10. Blood levels of CoQ10 and cardiac function were determined at 0 and 4 weeks (control stabilization period) and at 16 and 28 weeks (after the 12-week CoQ/placebo-treatment periods). For group A, significant increases in CoQ10 blood levels and cardiac function occurred during CoQ10 treatment and then decreased during crossover to placebo. For group B, there was no change in CoQ10 blood levels and cardiac function during placebo treatment, but increases in both parameters occurred in crossover to CoQ10. These patients, steadily worsening and expected to die within 2 years under conventional therapy, generally showed an extraordinary clinical improvement, indicating that CoQ10 therapy might extend the lives of such patients. This improvement could be due to correction of a myocardial deficiency of CoQ10 and to enhanced synthesis of CoQ10-requiring enzymes.

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More on CoQ-10 from the NIH web site.

Author: Langsjoen-P-H. Vadhanavikit-S. Folkers-K.

Title: Effective treatment with coenzyme Q10 of patients with chronic myocardial disease.

Source: Drugs-Exp-Clin-Res. 1985. 11(8). P 577-9.

Journal Title: DRUGS UNDER EXPERIMENTAL AND CLINICAL RESEARCH.

Abstract: Nineteen patients with chronic myocardial disease (NYHA Classes III and IV) were given Coenzyme Q10 in a controlled double-blind cross-over study. All had either low or borderline levels of CoQ10 in their blood, and showed a significant change into the normal range with oral CoQ10 replacement. Eighteen patients reported improvement in activity tolerance with replacement therapy. Combined clinical observations, stroke volume measured by impedance cardiography, and ejection fractions calculated from systolic time intervals, all showed significant improvement in parallel with CoQ10 administration. This application of the principles of bioenergetics introduces a promising new dimension to the study and treatment of the complex problem of myocardial failure.

Author: Folkers-K. Langsjoen-P. Langsjoen-P-H.

Title: Therapy with coenzyme Q10 of patients in heart failure who are eligible or ineligible for a transplant.

Source: Biochem-Biophys-Res-Commun. 1992 Jan 15. 182(1). P 247-53.

Journal Title: BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS.

Abstract: Twenty years of international open and seven double blind trials established the efficacy and safety of coenzyme Q10 (CoQ10) to treat patients in heart failure. In the U.S., ca. 20,000 patients under 65 years are eligible for transplants, but donors are less than 1/10th of those eligible, and there are many more such patients over 65, both eligible and ineligible. We treated eleven exemplary transplant candidates with CoQ10; all improved; three improved from Class IV to Class I; four improved from Classes III-IV to Class II; and two improved from Class III to Class I or II. After CoQ10, some patients required no conventional drugs and had no limitation in lifestyle. The marked improvement is based upon correcting myocardial deficiencies of CoQ10 which improve mitochondrial bioenergetics and cardiac performance. These case histories, and very substantial background proof of efficacy and safety, justify treating with CoQ10 patients in failure awaiting transplantation.

 

Author: Langsjoen-P-H. Langsjoen-P-H. Folkers-K.

Title: A six-year clinical study of therapy of cardiomyopathy with coenzyme Q10.

Source: Int-J-Tissue-React. 1990. 12(3). P 169-71.

Journal Title: INTERNATIONAL JOURNAL OF TISSUE REACTIONS.

Abstract: One hundred and forty-three cases of chronic, stable, non-secondary, non-hypertrophic cardiomyopathy, 98% of whom were in NYHA Classes III and IV, were given 100 mg of coenzyme Q10** orally in addition to their conventional medical programme in an open-label long-term study. Blood CoQ10 levels, clinical status, myocardial function and survival have been recorded now for almost 6 years. Mean control/CoQ10 levels of 0.85 micrograms/ml rose to 2 micrograms/ml in 3 months and remained stable at that level. Mean ejection fraction of 44% measured by systolic time interval analysis rose to 60% within 6 months and stabilized at that level with 84% of patients showing statistically significant improvement. Eighty-five percent of patients improved by one or two NYHA Classes. Survival figures were encouraging with an 11.1% mortality in 12 months and 17.8% mortality in 24 months, comparing favourably with several reports in the literature. There was no positive evidence of toxicity or intolerance in a total of 368.9 patient-years of exposure. Coenzyme Q10 is safe and effective long-term therapy for chronic cardiomyopathy. (**Ely estimate: $1/day retail!)

Author: Langsjoen-P-H. Folkers-K. Lyson-K. Muratsu-K. Lyson-T. Langsjoen-P.

Title: Pronounced increase of survival of patients with cardiomyopathy when treated with coenzyme Q10 and conventional therapy.

Source: Int-J-Tissue-React. 1990. 12(3). P 163-8.

Journal Title: INTERNATIONAL JOURNAL OF TISSUE REACTIONS.

Abstract: During 1982-86, 43/137 patients with cardiomyopathy, Classes II, III and IV, had ejection fractions (EF) below 40%, and a mean EF of 25.1 +/- 10.3%. During treatment of these 43 patients with coenzyme Q10 (CoQ10), EF increased to 41.6 +/-14.3% (p less than 0.001) over a mean period of 3 months (range, 2-4 months). At four subsequent periods up to 36 months. EF ranged from 43.1 +/- 13.3 to 49.7 +/- 6.4% (each period, p less than 0.001). The mean CoQ10 control blood level was 0.85 +/- 0.26 micrograms/ml which increased on treatment to 1.7 to 2.3 micrograms/ml for five periods up to 36 months (each period, p less than 0.001). The survival rates for all 137 patients treated with CoQ10 and for the 43 patients with EF below 40% were both about 75%/46 months. These two survival rates were comparable between 24 and 46 months, which is of extraordinary significance and importance when compared to** survival of about 25%/36 months for 182 patients with EF below 46% on conventional therapy without CoQ10. The improved cardiac function and pronounced increase of survival show that therapy with CoQ10 is remarkably beneficial due to correction of CoQ10 deficiency in mechanisms of bioenergetics.(**Ely: Survival 3:1 !)

Author: Lockwood-K. Moesgaard-S. Yamamoto-T. Folkers-K.

Title: Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases.

Source: Biochem-Biophys-Res-Commun. 1995 Jul 6. 212(1). P 172-7.

Journal Title: BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS.

Abstract: Over 35 years, data and knowledge have internationally evolved from biochemical, biomedical and clinical research on vitamin Q10 (coenzyme Q10; CoQ10) and cancer, which led in 1993 to overt complete regression of the tumors in two cases of breast cancer. Continuing this research, three additional breast cancer patients also underwent a conventional protocol of therapy which included a daily oral dosage of 390 mg of vitamin Q10 (Bio-Quinone of Pharma Nord) during the complete trials over 3-5 years. The numerous metastases in the liver of a 44-year-old patient "disappeared," and no signs of metastases were found elsewhere. A 49-year-old patient, on a dosage of 390 mg of vitamin Q10, revealed no signs of tumor in the pleural cavity after six months, and her condition was excellent. A 75-year-old patient with carcinoma in one breast, after lumpectomy and 390 mg of CoQ10, showed no cancer in the tumor bed or metastases. Control blood levels of CoQ10 of 0.83-0.97 and of 0.62 micrograms/ml increased to 3.34-3.64 and to 3.77 micrograms/ml, respectively, on therapy with CoQ10 for patients A-MRH and EEL.

Author: Lockwood-K. Moesgaard-S. Hanioka-T. Folkers-K.

Title: Apparent partial remission of breast cancer in 'high risk' patients supplemented with nutritional antioxidants, essential fatty acids and coenzyme Q10.

Source: Mol-Aspects-Med. 1994. 15 Suppl. P s231-40.

Journal Title: MOLECULAR ASPECTS OF MEDICINE.

Abstract: Thirty-two typical patients with breast cancer, aged 32-81 years and classified 'high risk' because of tumor spread to the lymph nodes in the axilla, were studied for 18 months following an Adjuvant Nutritional Intervention in Cancer protocol (ANICA protocol). The nutritional protocol was added to the surgical and therapeutic treatment of breast cancer, as required by regulations in Denmark. The added treatment was a combination of nutritional antioxidants (Vitamin C: 2850 mg, Vitamin E: 2500 iu, beta-carotene 32.5 iu, selenium 387 micrograms plus secondary vitamins and minerals), essential fatty acids (1.2 g gamma linolenic acid and 3.5 g n-3 fatty acids) and Coenzyme Q10 (90 mg per day). The ANICA protocol is based on the concept of testing the synergistic effect of those categories of nutritional supplements, including vitamin Q10, previously having shown deficiency and/or therapeutic value as single elements in diverse forms of cancer, as cancer may be synergistically related to diverse biochemical dysfunctions and vitamin deficiencies. Biochemical markers, clinical condition, tumor spread, quality of life parameters and survival were followed during the trial. Compliance was excellent. The main observations were: (1) none of the patients died during the study period. (the expected number was four.) (2) none of the patients showed signs of further distant metastases. (3) quality of life was improved (no weight loss, reduced use of pain killers). (4) six patients showed apparent partial remission.

Author: Lockwood-K. Moesgaard-S. Folkers-K.

Title: Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10.

Source: Biochem-Biophys-Res-Commun. 1994 Mar 30. 199(3). P 1504-8.

Journal Title: BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS.

Abstract: Relationships of nutrition and vitamins to the genesis and prevention of cancer are increasingly evident. In a clinical protocol, 32 patients having -"high-risk"- breast cancer were treated with antioxidants, fatty acids, and 90 mg. of CoQ10. Six of the 32 patients showed partial tumor regression. In one of these 6 cases, the dosage of CoQ10 was increased to 390 mg. In one month, the tumor was no longer palpable and in another month, mammography confirmed the absence of tumor. Encouraged, another case having a verified breast tumor, after non-radical surgery and with verified residual tumor in the tumor bed was then treated with 300 mg. CoQ10. After 3 months, the patient was in excellent clinical condition and there was no residual tumor tissue. The bioenergetic activity of CoQ10, expressed as hematological or immunological activity, may be the dominant but not the sole molecular mechanism causing the regression of breast cancer.

Author: Folkers-K. Morita-M. McRee-J-Jr.

Title: The activities of coenzyme Q10 and vitamin B6 for immune responses.

Source: Biochem-Biophys-Res-Commun. 1993 May 28. 193(1). P 88-92.

Journal Title: BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS.

Abstract: Coenzyme Q10 (CoQ10) and vitamin B6 (pyridoxine) have been administered together and separately to three groups of human subjects. The blood levels of CoQ10 increased (p < 0.001) when CoQ10 and pyridoxine were administered together and when CoQ10 was given alone. The blood levels of IgG increased when CoQ10 and pyridoxine were administered together (p < 0.01) and when CoQ10 was administered alone (p < 0.05). The blood levels of T4-lymphocytes increased when CoQ10 and pyridoxine were administered together (p < 0.01) and separately (p < 0.001). The ratio of T4/T8 lymphocytes increased when CoQ10 and pyridoxine were administered together (p < 0.001) and separately (p < 0.05). These increases in IgG and T4-lymphocytes with CoQ10 and vitamin B6 are clinically important for trials on AIDS, other infectious diseases, and on cancer.

Author: Folkers-K. Brown-R. Judy-W-V. Morita-M.

Title: Survival of cancer patients on therapy with coenzyme Q10.

Source: Biochem-Biophys-Res-Commun. 1993 Apr 15. 192(1). P 241-5.

Journal Title: BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS.

Abstract: Over ca. 25 years, assays in animal models established the hematopoietic activities of coenzyme Q's in rhesus monkeys, rabbits, poultry, and children having kwashiorkor. Surprisingly, a virus was found to cause a deficiency of CoQ9. Patients with AIDS showed a-"striking"-clinical response to therapy with CoQ10. The macrophage potentiating activity of CoQ10 was recorded by the carbon clearance method. CoQ10 significantly increased the levels of IgG in patients. Eight new case histories of cancer patients plus two reported cases support the statement that therapy of cancer patients with CoQ10, which has no significant side effect, has allowed survival on an exploratory basis for periods of 5-15 years. These results now justify systematic protocols.

 

References

Anonymous. Coenzyme Q10. Alternative Medicine Review 1998;3:58-61.

O'Brien R. BC Cancer Agency verbal communication, 2000.

Berkarda B. The problems of chemotherapy in the treatment of malignant tumors. Clinical chemotherapy. Volume III: Antineoplastic chemotherapy. New York: Thieme-Stratton, 1984:555-557.

Bliznakov EG, Hunt GL. The miracle nutrient: coenzyme Q10. Toronto: Bantam Books, 1987.

Diamond WJ, et al. An alternative medicine definitive guide to cancer. Tiburon: Future Medicine Publishing, Inc., 1997:767.

Fetrow CW, Avila JR. Professional's handbook of complementary and alternative medicines. Springhouse, Pennsylvania: Springhouse Corporation 1999:178-80.

Folkers K, et al. Survival of cancer patients on therapy with coenzyme Q10. Biochemical and Biophysical Research Communications 1993 Apr 15;192(1):241-245.

Larsson O. Effects of isoprenoids on growth of normal human mammary epithelial cells and breast cancer cells in vitro. Anticancer Research 1994;14:123-128.

Lockwood K, et al. Partial and complete regression of breast cancer in patients in relation to dosage of coenzyme Q10. Biochemical and Biophysical Research Communications 1994 Mar 30;199(3):1504-1508.

Lockwood K, et al. Progress on therapy of breast cancer with vitamin Q10 and the regression of metastases. Biochemical and Biophysical Research Communications 1995;212:172-177.

Lund EL, et al. Effect of radiation therapy on small-cell lung cancer is reduced by ubiquinone intake. Folia Microbiologica 1998;43:505-506.

Thibault A, et al. Lovastatin, an inhibitor of the mevalonate pathway, has activity against high-grade gliomas. Proc Annu Meet Am Soc Clin Oncol 1994;13:A490.

Weil A. Dr. Andrew Weil's self healing: creating natural health for your body and mind. (Newsletter) Jan 1998:6-7.

Whitaker J. Coenzyme Q10: new hope for cancer. Health & Healing 1994 July;4(7):1-2.

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Ubiquinone (coenzyme Q-10) (CoQ) use in cardiovascular disease

Brian E. Gulbis, Pharmacy student, Ohio Northern University

Ubiquinone (coenzyme Q-10) (CoQ) is a naturally occurring coenzyme found in aerobic organisms. It was given the name ubiquinone because of its universal, or ubiquitous, occurrence in animal tissues. Since its isolation in 1957, CoQ has been studied throughout Japan, Russia, Europe, and the United States.1 It is found mostly in the inner mitochondrial membrane, especially in the heart, liver, kidney, and pancreas.2 CoQ plays an important role in the mitochondrial electron transport chain. NADH and succinate dehydrogenases, and other flavoproteins, donate electrons to CoQ, which transfers them to non-heme iron proteins. The oxidation-reduction reactions that CoQ undergoes during electron transport are an essential part of the proton pumping mechanism which leads to the generation of ATP in the mitochondria.3 In addition to its role in the electron transport chain, ubiquinone is also an antioxidant and free radical scavenger, and it is believed to possess membrane-stabilizing properties.2,4

Since its discovery, coenzyme Q-10 has been used to aid in the treatment of many cardiovascular diseases, such as congestive heart failure (CHF), cardiac arrhythmias, and hypertension. Although it has not been approved for therapeutic use in the United States, ubiquinone is the primary treatment for cardiovascular disease in approximately 12 million Japanese.1 Grounds for the use of CoQ in cardiovascular therapy was established in the early 1970s by Folkers et al., who found evidence of decreased levels of coenzyme Q-10 in patients with heart disease.5 Subsequent studies have shown that there is a correlation between cardiovascular disease and low tissue levels of ubiquinone.6 However, it is not yet known if the lowered CoQ levels are the cause of or a result of the disease states.

In the early 1990s, a multicenter, randomized, double-blind, placebo-controlled clinical trial was performed by Morisco, Trimarco, and Condorelli to study the effects of coenzyme Q-10 on patients with congestive heart failure. Patients were randomly assigned by a computer-generated allocation schedule, that matched age, sex, New York Heart Association class, and treatment used for hemodynamic stabilization. A total of 641 patients were enrolled in the study among thirty-three centers, with 319 patients placed in the coenzyme Q-10 group, and 322 patients in the placebo group. During the study, 16 patients died in the CoQ group, and 21 in the placebo group. Twenty-three patients in the CoQ group dropped out of the study, while 18 patients in the control group dropped out. Neither the number of deaths nor the number of patients who dropped out are statistically significant. There also were no statistically significant differences in the age, sex, weight, cardiovascular drug therapy, or noncardiovascular drug therapy of the two groups. The CoQ group was then given 2 mg/kg per day of coenzyme Q-10, in addition to the cardiovascular drug therapy required to reach hemodynamic stabilization. The other group received a placebo in addition to their regular drug therapy. Patients were then examined after 3, 6, and 12 months of the additional therapy. Evaluation of the efficacy of therapy was based on changes in the functional class of patients in the two groups. There was a statistically significant reduction in the class of the patients in the coenzyme Q-10 group. This means there was an overall improvement in functional status of patients in the CoQ group. There were no significant changes in functional class of patients in the placebo group. In addition, physicians and patients were asked to rate the effects of treatment on a scale of 1 to 3. The mean score given by physicians and patients in the placebo group remained unchanged throughout the study. However, there was a continual increase in the mean score given by physicians and patients in the coenzyme Q-10 group. There was also a statistically smaller incidence of cardiovascular complications, including acute pulmonary edema (p<0.001), cardiac asthma (p<0.001), and arrhythmias (p<0.05) in the CoQ group compared to the placebo group. A final observation showed that about 40% of patients in the placebo group required one or more hospitalizations during the follow-up period, whereas only 20% of the patients in the coenzyme Q-10 group required hospitalization (p<0.01).7

In a different multicenter study, by Lampertico and Comis, the efficacy and safety of coenzyme Q-10 as supplementary therapy in patients with heart failure was examined. The study took place in Italy, with 378 physicians participating in the trial. Of those 378 physicians, 201 were cardiologists and 165 were interns. Physicians were asked to choose no more than five of their patients suffering heart failure who had been stabilized on cardiovascular therapy for at least three months to participate in the study. In all, 1715 patients were chosen, with 804 being male and 911 female. Coenzyme Q-10 was added to the traditional cardiovascular therapy at a dose of 50 mg per day in 1423 patients, while 192 patients received CoQ as their only therapy. Treatment was given over a four week period. In addition to reporting basic patient data, physicians were asked to evaluate a series of subjective and objective symptoms before treatment began, after 15 days, and after 30 days of therapy. Emphasis was placed on adverse events, and the physician was additionally asked to give their opinion on the efficacy of the therapy. The results of the trial showed a statistically significant subjective and objective improvement in the 1423 patients who received CoQ in addition to their conventional medication. Analysis showed an overall reduction in the intensity of symptoms after two and four weeks of treatment (p<0.01), and statistically significant differences in systolic and dyastolic blood pressure and heart rate were found (p<0.01). Also of note, the incidence of clinical improvement in the group of patients which received only coenzyme Q-10 was the same as the group receiving CoQ in addition to their conventional medication. Incidence of adverse effects decreased from 2.2% after two weeks, to 0.4% at the end of four weeks. Physicians’ opinion of treatment efficacy was rated as excellent to good for 71.1% of the patients. A limitation of the study is its focus on people of Italian ethnicity.2

While clinical studies provide scientific data to assess the efficacy of coenzyme Q-10 use, most people do not have the results of these studies readily available to them, nor do they have the ability to effectively analyze these results. Therefore, people turn to other resources for product information. Over the past few years, the Internet has become one of the fastest growing sources of information on anything and everything. People use the Internet to find news on world events, the latest sports scores, and information about new products, including natural products.

A query of any major search engine for information on ubiquinone will easily yield over one thousand results. One company  has a rather extensive site on coenzyme Q-10. The company describes ubiquinone as "a vital catalyst required for the creation of the energy needed to maintain life."  Coenzyme Q-10 functions as a proton and electron carrier which "sparks the mitochondrial energy production which runs all vital body functions."  The page claims that the use of their coenzyme Q-10 supplement will, "Increase energy levels, increase your VO2 reading without exercise, lower high blood pressure, detoxify your body, reduce free radicals dramatically and aid the function of all living cells…." Other sites make similar claims. Another company selling ubiquinone supplements, alleges that use of their CoQ supplement will result in "energy increase, improvement of heart function, prevention and cure of gum disease, a boost to the immune system and possible life extension."

There is limited scientific evidence to support some of the claims made by these companies. Several clinical trials have shown that ubiquinone supplements probably improve heart function and aid in the treatment of cardiovascular disease. However, there is not yet any conclusive evidence to support the allegations made by these companies. More studies need to be done, and more data needs to be collected and analyzed before the claims of some companies can be either proved or disproved.

Although no dosage guidelines have been established, the administration of 50 - 150 mg of coenzyme Q-10 daily is considered to have therapeutic benefits. No major adverse effects have been associated with CoQ use at this dosage level.2 Rare side effects include nausea, epigastric discomfort, loss of appetite, diarrhea, and skin rash. These adverse events have occurred in less than 1% of patients taking coenzyme Q-10 supplements.1,8

The results of studies have shown that the use of coenzyme Q-10 supplements appears to be effective in the treatment of cardiovascular diseases such as congestive heart failure, cardiac arrhythmias, and hypertension. The safety of CoQ has been established in studies, and no major side effects have been associated with CoQ use. Based on its safety and apparent efficacy, the use of coenzyme Q-10, in combination with conventional medications, can be recommended for the treatment of cardiovascular disease.

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References

 

  1. Ubiquinone. Rev Nat Prod 1997; Aug.
  2. Lampertico M, Comis S. Italian multicenter study on the efficacy and safety of coenzyme Q10 as adjuvant therapy in heart failure. Clin Investig 1993; 71:S129-S133.
  3. Marks DB, Marks AD, Smith CM. Basic medical biochemistry: a clinical approach. Baltimore: Williams & Watkins, 1996:315-316.
  4. Ernster L, Dallner G. Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta 1995; 1271:195-204.
  5. Folkers K, Littarru GP, Ho L, Runge TM, Havanonda S, Cooley D. Evidence for a deficiency of coenzyme Q10 in human heart disease. Int Z Vitaminforsch 1970; 40(3):380-390.
  6. Mortensen SA. Perspectives on therapy of cardiovascular diseases with coenzyme Q10 (Ubiquinone). Clin Investig 1993; 71:S116-S123.
  7. Morisco C, Trimarco B, Condorelli M. Effect of conezyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Investig 1993; 71:S134-S136.
  8. Anon. Ubidecarenone. DRUGDEX® System. Englewood, CO: MICROMEDEX, Inc., (Edition expires Feb 1999).

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