Coenzyme Q10
coenzyme Q10When a 19-year-old college student from Houston experienced shortness of breath and a racing heartbeat, his doctors diagnosed dilated cardiomyopathy, a condition characterized by an enlarged and weakened heart. They also told him that he would someday need a heart transplant.
Then he went to see Peter Langsjoen, M.D., a cardiologist in Tyler, Texas, who recommended a little-known substance called coenzyme Q10 (coQ10). Within a few weeks of starting to take coQ10, the student required fewer prescription heart medications. Eventually, his heart size and function returned to normal.
"This is someone who, before coQ10 came along, would most certainly have gone downhill," says Dr. Langsjoen. "It’s clearly lifesaving."
Similar stories, coming directly from medical practitioners, have drawn public attention to this naturally occurring compound that our cells need to produce energy. Proponents credit coQ10 with protecting the heart, strengthening the immune system, boosting energy and endurance, normalizing blood pressure, and healing periodontal disease.
Before you spend as much as $60 for a bottle of supplements, though, consider this: Many cardiologists have never even heard of coQ10, much less recommended it to their patients.
Getting to the Heart of the Matter
CoQ10 is made by the body and stored in the liver, kidneys, pancreas, and heart. We also get it from a variety of foods, especially liver and other organ meats. It is found in all cells, but it’s most highly concentrated in heart muscle cells because they use the greatest amount of energy.
Most of us have plenty of coQ10 in our bodies until around the age of 30. About then, our bodies lose the ability to manufacture it at the same levels, so the natural supply begins to diminish.
Apart from the decline in production that accompanies aging, there are other reasons for a shortage of coQ10. Certain conditions, such as viral illnesses and shock, can rob us of this compound, says Dr. Langsjoen.
CoQ10 deficiency is especially common in people with various types of heart disease. In fact, the more severe the heart disease, the lower the levels of coQ10 found in heart muscle cells. Doctors don’t know, though, whether the deficiency is one of the contributing causes or whether the reduced level of coQ10 is the result of heart disease, says Dr. Langsjoen.
"CoQ10 is definitely a factor in heart health because we know without a doubt that when you replenish it and restore levels to where they should be, heart function improves. If you let levels slide down again, heart function worsens," he explains.
This substance may improve the function of the heart by enhancing energy production, improving the ability of the heart to contract, and providing powerful antioxidant protection. The activity of coQ10 helps prevent the buildup of oxidized LDL cholesterol, the "bad" kind of cholesterol that starts to block arteries when it’s exposed to certain kinds of oxygen molecules. Because coQ10 provides antioxidant protection, it helps prevent this oxidizing process, and in so doing, it helps keep LDL cholesterol from blocking your blood vessels.
SUPPLEMENTSNAPSHOT
May help: Gingivitis, chronic fatigue syndrome, Parkinson’s disease, heart disease, high blood pressure, high cholesterol, congestive heart failure, mitral valve prolapse, angina, and arrhythmia; may provide some protection during heart surgery; may boost immunity and improve physical performance.
Special instructions: Take supplements, preferably gelcaps, with food. Take tablets or capsules with a little peanut butter or other food that contains fat to aid absorption.
Good food sources: Liver and organ meats are possible sources but are not recommended because of their high fat and cholesterol content.
Cautions and possible side effects: Rarely, a slight decrease in the effectiveness of the blood thinner warfarin (Coumadin) has been observed. No other known side effects.
It may also speed recovery after heart surgery. When patients take coQ10 for several days prior to surgery, they recover faster and better, with fewer complications, according to Dr. Langsjoen.
Unfortunately, some of the medications that are beneficial for heart disease patients actually deplete the body’s supply of coQ10. Among the thieves are cholesterol-lowering drugs such as lovastatin (Mevacor) and beta-blockers such as propranolol (Inderal) and metoprolol (Toprol XI).
For prevention and recovery—and to counteract the depletion due to heart drugs—a number of doctors are now advocating the many benefits of coQ10. It can help almost any disease related to the heart muscle, they say, including such problems as recurrent chest pain (angina) or irregular heart rate (arrhythmia). Some studies also suggest that it may enhance the benefits of cholesterol-lowering drugs, help lower blood pressure, and improve heart health for those with congestive heart failure, a condition in which the heart is unable to maintain normal blood circulation.
The Q10 Controversy
Critics and skeptics argue that many studies of coQ10 have been flawed or poorly controlled. Many of them have not been double-blind, for example. Considered the definitive form of medical research, a double-blind study is one in which neither the researchers nor the subjects know who is receiving the actual treatment. That’s ideal because neither of them can influence the outcome by wishing for a positive result.
In experiments that don’t use the double-blind method—like the coQ10 studies—there’s a lot of room for bias. Another criticism of the research is that some study periods have been too short to be conclusive.
"The information about coQ10 is purely anecdotal," says Robert Di Bianco, M.D., director of cardiology research at Washington Adventist Hospital in Takoma Park, Maryland, and associate professor at Georgetown University in Washington, D.C. "To date, I have not seen any convincing scientific data that suggest a benefit with coQ10 in a clinical situation. And I have honestly kept my eyes and ears open to this." More than 10 years ago, Dr. DiBianco took part in a study investigating whether coQ10 relieved angina. "We turned up very little," he says.
One popular use for the supplement is as a booster for aerobic endurance, especially among younger adults. It actually provides little in the way of benefit to athletes. If you’re young and healthy, chances are that your body already has all the coQ10 it needs, says Dr. Langsjoen.
On the other hand, there’s no question that your body’s supply of coQ10 is depleted with aging. It seems to make sense that—all other things being equal—you would continue to have a "younger" heart if you used a supplement that provides some of the missing ingredient. It’s prohibitively expensive, however, so it may not be widely available to many people.
How to Get Your CoQ10
If you decide to give coQ10 a try, stick with the gel caps that come mixed with oil for better absorption. If you do buy tablets or capsules, taking them with a small amount of peanut butter or other food that contains fat will help absorption, suggests Dr. Langsjoen.
As for the recommended dosage, Dr. Langsjoen says that most people have a good response with 60 to 120 milligrams twice a day. The appropriate individual dosage can best be determined by measuring blood levels of coQ10, although there are currently few commercial laboratories that offer this test. To determine your dosage, ask your physician, who should also test your heart function at least twice a year if you’re taking coQ10.
Coenzyme Q10
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