Co-enzyme Q 10 (Co-Q10)

It’s everywhere, it’s everywhere…

“Q 10” was first discovered in 1957. Co-Q 10 is also called a ubiquinone (found everywhere) since it is present in virtually all cells of the body, with the largest concentration found in the mitochondria. The mitochondria are the energy factory units for the body and the fundamental energy unit produced by the factory is ATP (adenosine tri-phosphate). The most numbers of mitochondria are found in the liver, the heart, and skeletal muscle as these are the largest “users” of body energy.

Co-Q 10 is produced naturally in the body and has two major functions – one to be an essential catalyst to the production of ATP and the other is as probably the most powerful antioxidant in the body (much more so than vitamin E or vitamin C, which the body does not produce and must come from food or supplements). Co-Q 10 does have a chemical structure similar to vitamin K, but cannot technically be called a vitamin since the body produces adequate supplies in health. It has been shown to be the preferred antioxidant when present and provides a sparing action to the breakdown of vitamin E. Blood levels appear to peak by age 21 or so and then fall by 2/3 by age 80; this appears to be part of the natural aging process.

Co-Q 10 production by the liver may be compromised by various HMG Co-A reductase cholesterols drugs (collectively called “statins”) due to competitive inhibition for another chemical, acetyl CoA, which is essential for both cholesterol production and Co-Q 10 production. Patients taking statin-type cholesterol lowering drugs (the most popular of all such drugs) may then have reduced natural antioxidant ability. Some have suggested that the muscle aches and muscle weakness not uncommonly associated with statin use can be reversed with Co-Q 10 oral supplementation. Oral doses of Co-Q 10 have been shown to aid in lowering blood pressure and in improving energy and heart function in patients with congestive heart failure.

Finally, Co-Q 10 blood levels can be inadequate to support its major anti-oxidant role in situations in which oxidative stress (inflammation) is unusually high. I recommend that supplementation with Co-Q 10 be considered in patients who have multiple sources of oxidative stress, such as the factors of the Metabolic Syndrome, or in patients who are taking statin drugs.

There are differences in the Co-Q 10 preparations and those in solution rather than crystalline form have been shown to have better absorption and bio-availability. Co-Q 10 in doses of 50-100 mg, divided into twice daily, taken with meals (improves absorption), provides likely adequate general preventive therapy.

Our gold standard EBT imaging can identify high risk individuals and guide proper LDL goals and stratify the aggressiveness of clinical risk reduction strategies. Better clinical outcomes begin with better diagnostic evaluation - so the right patient gets the right treatment. .

John A. Rumberger, M.D. FACC

Medical Director, PrevaHealth