Scientific Name: Coenzyme Q-10 Other Names: Co Q 10, Ubiquinol, Q 10, Ubidecarenone, Ubiquinone, Vitamin Q Who is this for?
Coenzyme Q-10 is used extensively in Japan, and its use is more common in Europe and western Asia than it is in theUnited States. However, specific coenzyme Q-10 products have been given orphan drug status in the United States. An orphan drug has received FDA approval because it shows effectiveness for treating severe or rare diseases thatusually have few other treatment options. In the United States, designated coenzyme Q-10 products are used to treatHuntington’s disease, childhood heart failure, and rare, inherited defects in mitochondria, which are tiny structureswithin body cells. Huntington’s disease (also called Huntington’s chorea) is an hereditary condition that involvesincreasing loss of muscle control and decreasing mental function. Generally not apparent until adulthood, Huntington’sdisease may be passed to children before parents realize they have it. Because mitochondria are responsible forenergy production by each cell, many of them are found in cells that use lots of energy – such as muscle cells. Cellsthat use little energy have few mitochondria. If the mitochondria do not function properly, progressively worseningsymptoms that may include muscle weakness, nerve damage, seizures, stroke-like episodes, and eventually deathmay result. Although coenzyme Q-10 seems to be an effective treatment to prevent, delay, or decrease the symptomsof inherited mitochondrial defects in some individuals, it may take 6 months or longer to produce a noticeable response.
In other countries, coenzyme Q-10 is used widely to treat heart conditions – particularly heart failure (HF), but alsoangina, heart rhythm disorders, and high blood pressure. Heart failure was formerly called congestive heart failure(CHF). In Japan, coenzyme Q-10 has been prescribed for treating HF since 1974. In several published studies ofindividuals with HF, taking coenzyme Q-10 has generally reduced symptoms such as shortness of breath, sleepproblems, and swelling that are associated with HF. It is believed that coenzyme Q-10 may increase energy productionin the heart muscle, which may cause the heart to beat with more force. However, results from other human studiescontradict these findings, with little or no improvement seen in the actual pumping action of the heart or in theindividual’s ability to perform everyday tasks. The best overall results occurred for individuals who took coenzyme Q-10along with other prescription drugs for HF. Even though coenzyme Q-10 may not affect heart function, it does appear topromote relaxation in both arteries and veins. Therefore, taking it may help relieve angina and reduce high bloodpressure. It cannot replace prescription medications, however, and it may interfere with medications that your doctorprescribes. Before taking coenzyme Q-10 for HF or any serious condition, talk to your health care provider.
Based on results from several studies, coenzyme Q-10 appears to be safe for treating heart diseases in individuals with diabetes; but whether it affects blood sugar levels is not known conclusively. Results from some studies may show a slight decrease in blood sugar levels when coenzyme Q-10 is taken by individuals with diabetes, but other studies have found no effects on insulin production or utilization. Coenzyme Q-10 may be slightly effective for individuals with an inherited type of diabetes known as maternally inherited diabetes mellitus and deafness (MIDD).
Low levels of natural coenzyme Q-10 have been observed in individuals with muscle-wasting diseases (conditions thatresult in decreased muscle size and efficiency). Therefore, coenzyme Q-10 is being studied as a possible treatment forconditions, such as Parkinson’s disease (PD), that affect muscle function. Coenzyme Q-10’s possibleenergy-enhancing effects may prevent the deterioration of muscle activity. Additionally, in animal and human studies,increasing amounts of coenzyme Q-10 also seemed to increase levels of a neurotransmitter known as dopamine. Neurotransmitters are chemicals that carry messages from nerve cells to other cells. Individuals with PD generally havelow dopamine in levels, so raising dopamine may relieve their PD symptoms. Additionally, coenzyme Q-10 may reduceother factors, such as inflammation and damage by oxygen free radicals, that may cause or worsen PD. Studies areless conclusive, however, for coenzyme Q-10’s possible effectiveness for other muscle-wasting conditions such asHuntington’s disease and muscular dystrophy. While these and similar conditions may have a connection to lowcoenzyme Q-10 levels, it is not known if the lowered levels of coenzyme Q-10 are a cause or a result of the conditions. Much more research is needed in these areas.
As an antioxidant, coenzyme Q-10 may also have potential as an anticancer and immune-stimulating agent. Antioxidants are thought to protect body cells from damage caused by a chemical process called oxidation. Oxygenfree radicals, natural chemicals that may also suppress immune function, are produced during oxidation. In one study,coenzyme Q-10 levels were found to be low in women who have cancer of the cervix or who have conditions that maylead to cervical cancer. As shown in case reports of women with breast cancer, supplementing prescription cancertreatments with coenzyme Q-10 may have helped to slow or stop the cancer from growing. In some cases, the spreadof cancer to other parts of the body appeared to be prevented. Separate studies of people living with AIDS, may show
that the numbers of certain white blood cells reached levels that are more normal when coenzyme Q-10 was taken. Ingeneral, white blood cells, especially the kind known as T cells, are responsible for attacking abnormal substances –such as cancer cells. This apparent strengthening of the immune system may help prevent and treat AIDS and otherinfectious diseases. The antioxidant effects of coenzyme Q-10 may also protect the liver from some of the damagecaused by certain drugs or chemicals or by chronic alcohol abuse. Some additional evidence from recent studies mayalso show that coenzyme Q-10 has potential to prevent or lessen the severity of migraine headaches. All thesepossible effects need further study to prove or disprove them.
Coenzyme Q-10 has also been used, both topically and orally, to treat periodontal (gum) disease. Increasing levels of coenzyme Q-10, which are usually low in individuals with gum disease, appeared to improve symptoms such as looseness and inflammation of the teeth in small studies of individuals with gum disease related to low coenzyme Q-10 levels. These studies were conducted nearly 30 years ago, though, and more recent research has failed to show a definite effect on periodontal disease from coenzyme Q-10 supplementation. When should I be careful taking it?
Individuals with diabetes should avoid using large amounts of coenzyme Q-10 because it can lower blood sugar levels, potentially resulting in hypoglycemia (blood sugar that is too low). Symptoms of low blood sugar include shakiness, sweating, confusion, distorted speech, and loss of muscle control. If not corrected, low blood sugar can lead to unconsciousness and even death.
Results from a recent small study done in Italy suggest that coenzyme Q-10 may pass from a mother to her infant in breast milk, but not in blood before birth. Very little other information is available on how coenzyme Q-10 might affect a developing fetus, an infant, or a small child. Therefore, its use is not recommended during pregnancy, while breast-feeding, or during early childhood. What side effects should I watch for?
No serious side effects have been associated with taking coenzyme Q-10, although some individuals have reported minor gastrointestinal disturbances such as diarrhea, indigestion, and nausea while taking it. What interactions should I watch for? Prescription Drugs
Due to its possible blood sugar-lowering effects, coenzyme Q-10 may interfere with insulin and oral drugs for diabetes, such as:
ActosAmarylAvandiaglipizide (Glucotrol XL)glyburide (Glynase)Glysetmetformin (Glucophage)PrandinPrecose
Due to its potential ability to lower blood pressure, coenzyme Q-10 may increase the effects of drugs that also lower blood pressure. Some blood pressure-lowering drugs are:
ACE inhibitors such as captopril, enalapril, lisinopril, and MonoprilBeta blockers such as atenolol, metoprolol, and propranololCalcium channel blockers such as nifedipine, Norvasc, and verapamilDiuretics such as Dyazide, furosemide, and hydrochlorothiazide
Because coenzyme Q-10 is similar in structure to vitamin K, which increases the blood's ability to clot, coenzyme Q-10 may interfere with anti-clotting medications such as warfarin or heparin.
Coenzyme Q-10 may increase the effects of dopamine, so taking it may also increase the effectiveness of drugs that increase dopamine. Dopamine-enhancing drugs often are used to treat Parkinson's disease. They include:
bromocriptine (Parlodel)cabergoline (Dostinex)
levodopa (Dopar, Sinemet)pergolide (Permax)pramipexole (Mirapex)ropinirole (Requip)
Taking certain cholesterol-lowering drugs known as HMG Co-A reductase inhibitors or statins, seems to lower coenzyme Q-10 levels in the body. The consequences of this effect are not completely understood, but this interaction may account in part for severe muscle deterioration that is rarely associated with taking statins. Statins thought to affect coenzyme Q-10 include:
lovastatin (Mevacor)pravastatin (Pravachol)Zocor
Propranolol (Inderal), a drug often used to treat hypertension, and doxorubicin (Adriamycin, Doxil, Rubex), an anticancer drug; may also limit or block the energy-producing activity of coenzyme Q-10.
Because coenzyme Q-10 may decrease blood sugar levels, taking it with other blood sugar-lowering herbal products may result in hypoglycemia -- blood sugar that is too low. Herbals that may reduce blood sugar include:
EleutheroFenugreekGinger (in high amounts)KudzuPanax Ginseng
Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how coenzyme Q-10 interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions. Should I take it?
Coenzyme Q-10 is a natural body chemical that was identified in the late 1950s. Small amounts of it are obtained fromeating meat and seafood, but the majority of the body’s supply is made within the body. Although nearly all body cellsmake it, coenzyme Q-10 concentrates in the muscles and in the heart, kidneys, liver, and pancreas. About half of thebody’s stores of coenzyme Q-10 are found in the mitochondria of the cells. Mitochondria are parts of body cells thatconvert dietary carbohydrates into energy. While coenzyme Q-10 is involved in strengthening body membranes, itsmain function is to carry electrons that are needed in the energy generation process. Various types of coenzyme Q arefound in most living organisms, including bacteria, but only humans produce coenzyme Q-10 naturally. Commercialcoenzyme Q-10 supplements are made by a fermentation process that includes beets, sugar cane, and specific yeasts.
Normal production of coenzyme Q-10 by humans is highest at about 20 years of age and then it declines gradually. Deficiencies of coenzyme Q-10 are rare, but they result in serious symptoms that include fatigue, muscle weakness, and seizures. Smoking cigarettes reduces the amounts of coenzyme Q-10 in the body, and taking certain drugs such as doxorubicin, some beta-blockers, or certain statins may also lower coenzyme Q-10 levels. Low levels of coenzyme Q-10 are associated with conditions ranging from AIDS and some cancers to periodontal disease. Generally, the extent of coenzyme Q-10 deficiency seems to correlate to the severity of the condition. That is, conditions affected by coenzyme Q-10 levels seem to worsen as coenzyme Q-10 decreases.
Athletes sometimes take supplemental coenzyme Q-10 in the belief that it may increase their ability to perform extended exercise, but study evidence has failed to support this belief. Dosage and Administration
Coenzyme Q-10 supplements are available in a number of oral dosage forms, including capsules and tablets made from dried, powdered coenzyme Q-10. However, only a small percentage of oral coenzyme Q-10 supplements are thought to be absorbed from the intestines, with large percentages eliminated in the bile. Because coenzyme Q-10 dissolves in fats, soft gelatin capsules that contain coenzyme Q-10 in soy bean oil may be absorbed more easily and more completely than dried, powdered forms of coenzyme Q-10 by the body. Taking coenzyme Q-10 with a meal that includes fats may increase its absorption, as well. For topical application, usually a soft gelatin capsule of coenzyme Q-10 is opened and the contents applied to the gums with a cotton swab.
Oral dosage recommendations for coenzyme Q-10 supplementation range from 100 mg per day to 3,000 mg (0.1 gram to 3 grams) per day or more, depending on the condition being treated. For HF, a common oral dose is 100 mg per day, taken as two or three doses. If you decide to take coenzyme Q-10, follow the directions on the package that you purchase.
Coenzyme Q-10 is a natural body chemical that is essential for the production of energy by cells. Low levels of it have been associated with a number of diseases. Coenzyme Q-10 supplementation is used to treat genetic coenzyme Q-10 deficiencies, heart conditions, and periodontal disease. It may be useful in delaying the progression of Parkinson's disease and other conditions that affect muscle function. Its antioxidant and immune stimulating effects may give it anti-AIDS, anticancer, and liver protectant properties.
Blood sugar levels may be lowered by taking coenzyme Q-10, so individuals with diabetes may want to avoid it. Not enough is known about its possible effects to recommend coenzyme Q-10 supplementation for pregnant or breast-feeding women. Side Effects
Mild occasional gastrointestinal disturbances are the only side effects that have been reported from taking coenzyme Q-10. Interactions
The risk of low blood sugar may increase if coenzyme Q-10 is taken with drugs or herbals that treat diabetes. Coenzyme Q-10 may increase the effects of drugs that lower blood pressure. Because it may increase amounts of dopamine in the body, coenzyme Q-10 may increase the effectiveness of drugs that raise dopamine levels. Doxorubicin, propranolol, and some statins may decrease body levels of coenzyme Q-10. References
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Yamagami T, Shibata N, Folkers K. Bioenergetics in clinical medicine. Studies on coenzyme Q10 and essential hypertension. Research Communications in Chemistry, Pathology and Pharmacology. 1975;11(2):273-288. Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.
In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.
This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.
McNeil Consumer Healthcare Announces Voluntary Recall of Certain OTC Infants’ and Children’s Products Fort Washington, PA (April 30, 2010) –McNeil Consumer Healthcare, Division of McNEIL-PPC, Inc., in consultation with the U.S. Food and Drug Administration (FDA), is voluntarily recalling all lots that have not yet expired of certain over-the-counter (OTC) Children’s and Infant
OH 1197 Thomas, John R., (1918-2008). Oral History Interview, 2008. User Copy: 2 sound cassette (ca. 70 min.), analog, 1 7/8 ips, mono. Master Copy: 2 sound cassette (ca. 70 min.), analog, 1 7/8 ips, mono. Abstract: John Thomas, a Beloit, Wisconsin native, discusses his World War II and Korean War service as a chaplain in the Navy. Thomas touches on junior ROTC in high school, his the