By Dr. Mercola
According to the industry publication New Hope,1 coenzyme Q10 (CoQ10) and the reduced version, ubiquinol, are among the most popular supplements for mitochondrial health.
Between 2000 and 2016, the number of Americans using CoQ10 increased
from an estimated 2 million to 24 million, and the number of brands
featuring CoQ10 has increased from 18 brands to 125.
This rapid growth suggests people are becoming increasingly aware of
the importance of mitochondrial health, which is really great news.
Ubiquinol plays an important role in the electron transport chain of
your mitochondria, where it facilitates the conversion of energy
substrates and oxygen into the biological energy needed by your cells
for life, repair and regeneration.
It's a fat-soluble antioxidant, meaning it works in the fat portions of
your body, such as your cell membranes, where it mops up potentially
harmful byproducts of metabolism known as reactive oxygen species (ROS).
Taking this supplement helps protect your mitochondrial membranes from
oxidative damage, and this in turn has been shown to be helpful for a
number of health conditions and chronic diseases.
This is to be expected, since many conditions, including heart disease
and migraines — for which CoQ10 has been found beneficial — appear to be
rooted in mitochondrial dysfunction.
Low CoQ10 levels have even been detected in people with certain types of cancer,2
including lung, breast and pancreatic cancer, as well as melanoma
metastasis, further strengthening the metabolic theory of cancer.
CoQ10 Versus Ubiquinol
Ubiquinol is the fully reduced version of CoQ10. It's the same molecule,
but when CoQ10 is reduced it takes on two electrons, which turns it
into what we call ubiquinol.
In your body, this conversion occurs thousands of times every second
inside your mitochondria — the "engine" of nearly every cell. The
conversion of CoQ10 to ubiquinol is part of the process that allows your
body to convert food into energy.
Ubiquinol is the only fat-soluble antioxidant that is actually
generated within your body and does not need to be obtained from food.
The downside is that by the time you hit your 30s, your body starts to
produce less and less of it.
With age, many also start to lose their ability to convert CoQ10 to
ubiquinol, and this is why ubiquinol is typically recommended for older
people while younger folk can do quite well by taking CoQ10.
Many Health Conditions Stand to Benefit From CoQ10
Researchers have identified a number of conditions and health
concerns where CoQ10 or ubiquinol can be of great benefit, including the
following:
Heart disease (ideally in combination with selenium)
Mitral valve prolapse (ideally in combination with magnesium)
Arrhythmia
Ubiquinol is particularly important if you're taking a statin, as
these cholesterol-lowering drugs deplete your body of CoQ10, which can
have serious consequences for your heart and other muscles.
Research has also shown CoQ10 can improve exercise performance,
improving your overall energy status, peak power production and muscle
recovery when taken in doses of 200 to 300 milligrams (mg) per day.3 World class athletes who need extra ATP turnover may go as high as 300 to 600 mg per day.
Heart-Healthy Benefits of CoQ10
CoQ10 is perhaps most well-known for supporting heart and
cardiovascular health, as your heart is one of the most energy-hungry
muscles in your body. Without sufficient energy, your heart will not be
able to function properly.
Chronic nutrient deficiencies can lead to a number of heart problems,
such as cardiomyopathy (a condition characterized by inflammation, loss
of elasticity and enlargement of your heart), diastolic dysfunction,
heart valve diseases, arrhythmia (irregular heartbeat) and heart
failure.
Besides CoQ10, other examples of nutrients that are important for
heart health include (but are not limited to) B vitamins (including folate or B9 and B12), carnitine, taurine, magnesium, vitamin K2 and animal-based omega-3. All of these play important roles in keeping your mitochondria working properly.
Since ubiquinol also acts as an antioxidant, part of its benefits can
be attributed to its ability to quench inflammation. Two markers for
inflammation are gamma-glutamyl transferase (GGT) — which is an early
marker of heart failure — and NT-proBNP.
There is in fact an association between the levels of these two
markers and ubiquinol. When ubiquinol is supplemented, both these
markers go down and genes associated with them are downregulated,
thereby lowering your risk for heart problems and other conditions
rooted in chronic inflammation.
Beware, Statins Compromise Your Heart and Health in Many Ways
At present, at least 1 in 4 American adults over the age of 40 are taking a statin — ostensibly to protect their heart health.
Unfortunately, these drugs deplete, inhibit or interfere with a number of really important heart nutrients, including CoQ10,4
vitamin K2 and glutathione peroxidase (a selenium-containing protein),
which helps explain why statins may actually increase your risk of heart
failure.
If you're on a statin, it's really important to make sure you're
supplementing with ubiquinol and keeping an eye on your vitamin K2 and
selenium intake.
Moreover, statin drugs also diminish your liver's ability to produce
ketones, because the enzyme that produces ketones is the same enzyme
that produces cholesterol, namely HMG-CoA reductase.
This is the enzyme inhibited by statin drugs. This means that, in
addition to lowering your cholesterol, the drug also compromises your
body's ability to benefit from a healthy and cleaner-burning fuel (fat).
As a result, your ability to optimally metabolize fat can become
severely compromised and this too will have cardiovascular consequences,
since depriving your cardiac tissue of fuel will impair your heart
health.
So, if you're on a statin, even if you're taking vitamin K2 and
ubiquinol you still have to address the fact that you cannot make
ketones.
CoQ10 + Selenium = A Winning Combo for Heart Health
Recent research found that taking CoQ10 in combination with selenium
improves heart function and cuts cardiovascular mortality by nearly 50
percent in elderly people. The study in question used 200 mg of CoQ10
and 200 micrograms (mcg) of selenium per day.5
CoQ10 and selenium work in tandem to reduce oxidative stress,
minimize mitochondrial damage and increase the generation of new
mitochondria. While CoQ10 is known to do all of those things by itself,
selenium helps your body produce and accumulate CoQ10, so it's an
important "booster" in that regard.
Animal studies have shown that selenium-deficiency reduces the animals' ability to generate CoQ10 by as much as 33 percent.6 As noted by Life Extension:7
"It has now been shown that a vital selenocysteine-containing
enzyme called thioredoxin reductase actively recycles exhausted CoQ10
(ubiquinone) molecules and turns them into active, oxidative
stress-fighting ubiquinol molecules. In other words, selenium improves
the efficacy of CoQ10.8
But just as we need ample selenium to produce and accumulate CoQ10,
we also need ample CoQ10 to make the selenocysteine-containing enzymes.9 Thus, there appears to be an important reciprocal relationship between CoQ10 and selenium."
CoQ10 May Be Important for Migraine and Dementia Prevention and Treatment
CoQ10 also shows significant promise in the treatment of migraines — a debilitating kind of head pain that strikes approximately 38 million Americans10 and 1 billion people worldwide.11 While migraines are the third most prevalent illness in the world,12 researchers have long struggled to identify their cause.
In more recent years, scientists have started leaning toward
migraines being a mitochondrial disorder, and studies suggest certain
nutritional deficiencies may play a significant role. CoQ10 is on this
list. In one recent study, a high percentage of children, teens and
young adults who struggled with migraines were found to have mild CoQ10
and riboflavin (vitamin B2) deficiencies.13,14
Interestingly, girls were more likely to be deficient in CoQ10,
whereas boys were more deficient in vitamin D. These and similar
findings lend support to the theory that migraines are in fact a
mitochondrial disorder.15 Other studies showing the link between CoQ10 and migraines include the following:
In 2005, a double-blind, placebo-controlled, randomized clinical
trial found that those who took 100 mg of CoQ10 three times a day (for a
total of 300 mg per day) had 48 percent fewer migraines after three
months. The placebo group only had 14 percent fewer migraines.16
Another early study found that pediatric and adolescent patients
with low CoQ10 levels who received 1 to 3 mg of CoQ10 per kilo (2.2
pounds) of body weight had a nearly 50 percent reduction in migraines.17
A 2011 study found that taking 100 mg of CoQ10 for about 7 months
reduced migraine frequency, severity and duration compared to placebo.
Beneficial effects were noticeable after the first month of
supplementation.18
More recently, a 2015 study using a commercial formula containing
150 mg of CoQ10 in combination with 400 mg of riboflavin (B2), 600 mg of
magnesium and other nutrients, found it decreased migraine frequency by
about 50 percent and significantly reduced intensity, compared to
placebo.19
Studies also suggest CoQ10 can be helpful for other brain-related
disorders beyond the treatment of migraines. For example, research
published in 2014 found that people with the highest CoQ10 levels had a
77 percent lower risk of dementia than those with the lowest levels.20,21
How to Regenerate CoQ10 Naturally
Recent research shows you can improve your body's conversion of CoQ10 to
ubiquinol by eating lots of chlorophyll-rich vegetables in combination
with sun exposure. Once chlorophyll is consumed it gets transported into
your blood. Then, when you expose significant amounts of skin to
sunshine, that chlorophyll absorbs the solar radiation and facilitates
the conversion of CoQ10 to ubiquinol.
You can also improve absorption of CoQ10 from food or supplements by
taking it with a small amount of healthy fat, such as some olive oil,
coconut oil, MCT oil or avocado. Foods particularly rich in CoQ10
include:22
General dosing recommendations vary from 100 to 600 mg per day, and as a
general rule, the sicker you are, the more you need. A good place to
start is to begin by taking 200 to 300 mg of CoQ10 or ubiquinol per day.
Within three weeks your plasma levels will typically plateau to its
optimum level.
After that, you can go down to a 100 mg/day maintenance dose. This is
typically sufficient for healthy people. Splitting your dose up so that
you take it two or three times a day (rather than taking it all at
once) will result in higher blood levels.
If you have an active lifestyle, exercise a lot, struggle with a
chronic health condition or are under a lot of stress, you may want to
increase your dose to 200 to 300 mg/day. Remember, if you're on a statin
drug you MUST take at least 100 to 200 mg of ubiquinol or CoQ10 per
day, or more. To address heart failure and/or other significant heart
problems you may need around 350 mg per day or more.
Ideally, you'll want to work with your physician to determine your
ideal dose. Your doctor can do a blood test to measure your CoQ10
levels, which would tell you whether your dose is high enough to keep
you within a healthy range. Also keep in mind that CoQ10 supplements can
interact with certain drugs, including beta-blockers, certain
antidepressants and chemotherapy drugs, so be sure to consult with your
doctor if you're on medication.
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