“Functioning on low levels of Coenzyme Q10 would be similar to running a car on low-octane fuel. The energy available to drive the car would be inadequate, and would result in misfiring pistons and sluggish, undependable performance”, a quotation taken from Stephen Sinatra’s book ‘The Sinatra Solution’ on the importance of Coenzyme Q10 (CoQ10) for the optimal functioning of the human body.
Indeed, there are believed to be in excess of 30,000 citations on the internet alone attesting the benefits of CoQ10 in supporting a wide variety of diseases. In this week’s blog, we look at these benefits, the role that CoQ10 plays at cellular level and some of the research and factors that can often lead to an increased need.
What is CoQ10?
Coenzyme Q10 (CoQ10) is a fat soluble compound synthesised in all the tissues in the body; and this endogenous synthesis is the main source in humans. Its synthesis involves a complex process requiring the amino acid tyrosine and a number of vitamin and trace mineral cofactors. Inadequate tyrosine or cofactors impairs endogenous formation. In addition, levels naturally decline with age and statin medications deplete levels.
The functions of CoQ10 in the body
All chemical reactions within the body require substances known as enzymes. These enzymes act as catalysts for the biochemical reactions. Enzymes are protein molecules that usually require a mineral cofactor (e.g. magnesium or zinc) and a non-protein organic chemical, called a coenzyme. Examples of coenzymes are B vitamins (eg B6, B12, folate) and CoQ10.
CoQ10 functions as a coenzyme in the energy producing mitochondrial pathways, specifically in the electron transport chain where it is involved in electron transfer. Every cell in the human body must produce its own energy in order to carry out its specific functions. Cells produce most of their energy in the mitochondria by metabolising carbohydrates and fats in a process referred to as ‘aerobic respiration’ and over 90% of the oxygen we breathe in is used for this process. CoQ10 has a specific role in the mitochondria acting as a mobile messenger between the various enzymes involved in the ‘electron transport chain’. Each pair of electrons that is processed by the chain must first interact with CoQ10 and there is no substitute for CoQ10 in this chemical reaction. Therefore optimal electron transport to generate energy (i.e. ATP molecules) depends on there being optimal levels of CoQ10 in the mitochondrial membrane.
Thus CoQ10 is an integral part of energy metabolism inside our cells. It has been shown to increase the level of energy in muscles and is especially important for cardiac function.
CoQ10 has antioxidant activity inhibiting lipid peroxidation by free radicals in both cell membranes and low density lipoproteins (LDL) as well as protecting DNA and proteins from oxidative damage. It also regenerates other antioxidants such as vitamin E.
Free radicals are unstable, highly reactive molecules with an odd, unpaired electron, for example, reactive oxygen species (ROS). Most ROS are generated as by-products during mitochondrial electron transport. Environmental factors such as pollution, radiation, cigarette smoke and herbicides can also generate free radicals. Free radicals react very quickly with other compounds trying to capture the needed electron to gain stability.
Generally, free radicals attack the nearest stable molecule “stealing” its electron. When the “attacked” molecule loses its electron, it becomes a free radical itself, beginning a cascade chain reaction which can result in the disruption of the cell. The body uses ‘antioxidants’ to stop this cascade and quench free radicals. Free radicals also perform important functions, for example related to immunity, but if there is an excess then they can damage the mitochondrial membrane, mitochondrial DNA, and the outer membranes of cells.
The antioxidant nature of CoQ10 derives from its energy carrier function. As an energy carrier, the CoQ10 molecule continuously goes through an oxidation–reduction cycle. Becoming reduced as it accepts electrons and becoming oxidised as it gives them up. In its reduced form, it can give up one or both electrons quite easily and, thus, act as an antioxidant.
It also has a role in gene expression and has been shown to decrease hepatic expression of inflammatory cytokines. A 2017 meta-analysis of randomised controlled trials (RCTs) concluded that supplementation with CoQ10 significantly reduces CRP, IL-6 and TNF-α.
Free radicals and inflammation contribute to the aging process, as well as a number of health problems, including cardiovascular disease and cancer.
Much of the research on CoQ10 and its supplementation relates to cardiovascular health and its role in energy production and antioxidant protection.
Mitochondrial dysfunction has long been linked to cardiovascular health and CoQ10 is found at high levels in cardiac cells. Patients with heart failure have lower plasma levels of CoQ10 and levels of CoQ10 are an independent predictor of mortality. Supplementation has been shown to improve measures related to heart failure including stroke volume, cardiac output and others. In addition, CoQ10 has been shown to slow the progression of atherosclerosis and prevent the oxidation of LDL (low density lipoprotein). Results on its effects on blood pressure have been mixed and a 2016 Cochrane review concluded that more trials are needed.
Jankowski (2016) concludes “clinical trials indicate that CoQ10 can significantly reduce morbidity and mortality of heart failure patients in addition to guideline recommended pharmacotherapy”.
Other areas of health being investigated
Studies on CoQ10 and physical exercise have confirmed its effect in improving subjective fatigue sensation and physical performance and reducing exercise related damage.
CoQ10 has also been shown to improve measures related to male infertility including sperm count; decrease preeclampsia incidence in pregnancy and reduce symptoms of headache in adults.
Sources of CoQ10
CoQ10 is found in small quantities in foods such as red meats, especially organ meat, and fish; it is also found in most fruit and vegetables, albeit at lower levels. Although it is widely available in food the amounts are too small to produce any significant clinical benefit and we rely mainly on synthesis within the body to maintain adequate levels.
Indeed, our bodies are designed to make all of the CoQ10 that they need, but may not manage to meet requirements due to lack of substrates or lifestyle factors increasing needs.
What can lead to lack of CoQ10?
Reduced biosynthesis and increased use by the body can lead to deficiency. The body’s manufacture of CoQ10 is very complex and its synthesis requires support from other nutrients such as folate, vitamins C, B12, B6, pantothenic acid and selenium. A clinical study of hospitalised patients showed that blood levels of CoQ10 plummeted by around 50 percent when no nutritional support was administered. Therefore a lack of any of these components will likely impair a cell’s ability to make CoQ10. Mutations in genes that code for proteins that synthesise CoQ10 can also reduce synthesis.
Lifestyle and environmental factors an increase requirements. For example, high-intensity exercise – studies have suggested that low levels of CoQ10 have been observed in athletes (most probably the consequence of an excess of free radicals in the body).
Cholesterol lowering drugs (statins) have also been identified as perhaps playing a role in CoQ10 deficiency. These drugs work by inhibiting the function of the enzyme responsible for the synthesis of cholesterol; HMG-CoA reductase. Unfortunately, this enzyme is also responsible for the body’s production of CoQ10.
CoQ10 deficiency results in reduced energy production and excessive reactive oxygen species formation. The Mayo Clinic website lists symptoms of deficiency as including heart failure, high blood pressure and chest pain. Fatigue, muscle weakness and many other disease states have also been associated with a need for CoQ10. As we age we may gradually become more susceptible to low levels of CoQ10. This is simply because our body’s demand for cellular energy remains high however our ability to produce this coenzyme becomes reduced.
Relevant Cytoplan products
Our supplements with CoQ10 contain ubiquinol, the reduced form of CoQ10 which has increased bioavailability.
Our most comprehensive Wholefood Multivitamin and mineral formula available incorporating antioxidant CoQ10, Beta Glucan for immune support, and good all round vitamin & mineral levels including optimal levels of vitamin D3 & vitamin B12.
Cyto-Renew is a product that helps to support healthy cell metabolic activity, containing Acetyl-L-Carnitine, Alpha Lipoic Acid, Ginkgo Biloba, CoQ10, N-Acetyl-L-Cysteine and Rosemary extract 5:1.
A Food State vitamin and mineral antioxidant formula containing co-enzyme CoQ10 and excellent nutrient levels of vitamin C, vitamin E and selenium.
Red Rice Yeast Plus
Red Rice Yeast contains a number of beneficial constituents including naturally occurring, metabolites (including monacolin K), flavonoids, unsaturated fatty acids and sterols. These gluten-free capsules also include CoQ10 and hawthorn berry extract.
Related Cytoplan blogs
If you have any questions regarding the health topics that have been raised please don’t hesitate to get in touch with me (Clare) via e-mail (firstname.lastname@example.org).
Cytoplan Editorial Team: Clare Daley and Joseph Forsyth.
References available upon request.