Coenzyme Q10 (CoQ10)

Jamie Eske wrote . . . . . . . . .

Coenzyme Q10, or CoQ10, is a naturally occurring chemical that exists in almost every cell of the human body. CoQ10 carries out several vital roles, including promoting energy production and neutralizing harmful particles called free radicals.

A deficiency in CoQ10 can adversely affect a person’s health. People can get CoQ10 through foods and supplements.

What is CoQ10?

CoQ10 is an essential nutrient present in almost every cell of the human body. The following foods also contain CoQ10:

  • oily fish
  • organ meats
  • eggs
  • nuts
  • whole grains

CoQ10 plays a vital role in energy production and DNA replication and repair. It also acts as an antioxidant, neutralizing harmful free radicals.

Several factors can lower CoQ10 levels in the body. These include:

  • aging
  • taking statins, which are cholesterol-lowering medications
  • genetic mutations that affect the production of CoQ10
  • disorders of the mitochondria, which are the parts of the cell that generate energy
  • CoQ10 deficiency is associated with numerous diseases, including:
    • heart disease
    • cancer
    • Alzheimer’s disease

How does it work

For the body to use CoQ10, it must convert it from its inactive form, ubiquinone, into it its active form, ubiquinol.

Mitochondria are responsible for powering the body’s cells. To do this, they use CoQ10 to produce the chemical adenosine triphosphate (ATP). This process is known as ATP synthesis. ATP is the primary source of energy for the body’s cells.

However, mitochondria produce free radicals during ATP synthesis.

Under normal conditions, free radicals regulate communication between cells and defend the body against infectious microbes. However, excess free radicals cause DNA damage, which can lead to the following:

  • inflammation
  • DNA mutations
  • tissue damage

CoQ10 acts as an antioxidant by neutralizing free radicals. In this way, CoQ10 helps protect cells from the harmful effects of DNA damage.

What is the correct dosage?

The exact recommended dose of CoQ10 will vary according to the following factors:

  • a person’s age
  • a person’s health
  • the condition receiving treatment

Standard daily doses of CoQ10Trusted Source range from 60 milligrams (mg) to 500 mg. The highest recommended dose is 1,200 mg. However, clinical trials have used dosages as high as 3,000 mg per day.

Different types of CoQ10 supplements may also require different dosages. Most supplements contain the inactive form of CoQ10, ubiquinone, which is harder to absorb than ubiquinol.

A 2018 randomized trial compared the effects of 200 mg daily doses of ubiquinone and ubiquinol supplements on CoQ10 levels in older men. Ubiquinol supplementation led to a 1.5-fold increase in the amount of CoQ10 in the blood. Supplements containing ubiquinone did not have a significant effect on CoQ10 levels.

Benefits of CoQ10

CoQ10 protects cells against oxidative damage. It also plays a vital role in producing the body’s primary source of energy, ATP. CoQ10 could, therefore, provide a range of health benefits. Some examples include:

Improving heart health

The heart contains some of the highest concentrations of CoQ10 in the body. The vast majority of people with heart disease also have low CoQ10 levels. ResearchersTrusted Source now consider low CoQ10 levels to be an indicator of the severity and long term outcome of various heart diseases.

In one 2018 pilot studyTrusted Source, ten children with cardiac muscle dysfunction received 110–700 mg of liquid ubiquinol per day. At weeks 12 and 24 of treatment, the children had significantly higher CoQ10 plasma levels and improved heart function.

Reducing muscle pain from statin use

Cardiovascular disease (CVD) is an umbrella term for conditions that affect the heart or blood vessels. Doctors often prescribe statins to treat CVD. These drugs work by reducing the cholesterol production that can contribute to the disease.

Although statins reduce cholesterol production, they also lower CoQ10 levels. Reduced CoQ10 levels can lead to mitochondrial dysfunction, which can cause muscle painTrusted Source, or myopathy.

CoQ10 supplements may help relieve muscle pain related to statin use.

A 2019 randomized controlled trialTrusted Source investigated the effect of CoQ10 on statin-related muscle pain. The study involved 60 participants who had previously reported muscle pain while taking statins. Over 3 months, each participant received daily doses of either 100mg of CoQ10 supplement or a placebo.

The participants who took the CoQ10 supplements had significantly reduced statin-related muscle pain. Those who received the placebo reported no change in muscle pain.

However, the authors of a 2015 meta-analysis evaluated the efficacy of CoQ10 supplementation for treating statin-related muscle pain. The meta-analysis included six studies with a combined total of 302 patients. The authors found no evidence that CoQ10 significantly improves statin-related muscle pain.

Further large-scale RCTs are necessary to determine whether CoQ10 is a viable treatment for people experiencing statin-related muscle pain.

Treating migraines

Chronic migraines may be due to inflammation of neurons and cells in a part of the brain called the trigeminovascular system.

A 2018 clinical trial investigated whether coQ10 supplements could reduce inflammation in 45 women with episodic migraines. The women took 400 mg daily doses of either a CoQ10 supplement or a placebo. The women who took the CoQ10 supplements had fewer and less intense migraines when compared to the placebo group.

Women who took the CoQ10 supplements also showed lower levels of certain inflammatory biomarkers. Inflammatory biomarkers are substances in the blood that indicate the presence of inflammation somewhere in the body.

A 2018 meta-analysis reexamined five studies investigating the use of CoQ10 supplements for migraines. The meta-analysis concluded that CoQ10 is more effective than a placebo at reducing the duration of migraines. However, CoQ10 did not appear to affect migraine severity or frequency.

Protecting against age-related diseases

Mitochondrial function decreases as the body’s CoQ10 levels naturally deplete with age.

ResearchTrusted Source suggests that mitochondrial dysfunction can contribute to age-related neurodegenerative diseases, including Alzheimer’s disease and Parkinson’s disease. These diseases are associated with free radical damage.

A 2015 study investigated the effect of a Mediterranean diet combined with CoQ10 supplementation on metabolism in elderly adults. This combination led to an increase in antioxidant biomarkers in the urine.

The authors concluded that taking CoQ10 and eating a diet low in saturated fat may help protect against diseases caused by free radical damage.

In another 2015 studyTrusted Source, older adults received CoQ10 and selenium supplements for 48 months. The participants reported improvements in vitality, physical performance, and overall quality of life.

Risks of too much CoQ10

CoQ10 supplements appear to be safe, and most people tolerate them even at high doses. However, CoQ10 supplements can cause the following side effects:

  • nausea
  • stomach pain
  • heartburn
  • headache
  • dizziness
  • fatigue
  • light sensitivity
  • insomnia
  • skin rash

CoQ10 supplements may interfere with certain medications, including:

  • blood-thinners, such as warfarin
  • insulin
  • some types of chemotherapy medication

People should consult a doctor before taking any new medications or dietary supplements, including CoQ10.

Source: Medical News Today

Supplements Touting Brain Benefits May Contain Unauthorized Ingredient

Lisa Rapaport wrote . . . . . . . . .

Many supplements marketed for brain health may contain piracetam, an ingredient not proven effective for preventing or easing dementia or cognitive impairment and not approved for sale in the U.S., researchers say.

In an analysis of five products purchased online, researchers found that four contained piracetam, sometimes in dangerously high amounts. The fifth, which was labeled and sold as piracetam, contained no detectable amount of the drug.

The U.S. Food and Drug Administration (FDA) warned last February that so-called cognitive enhancement supplements may be ineffective, unsafe and could prevent patients from getting the correct diagnosis and treatment.

“Any products making unproven drug claims could mislead consumers to believe that such therapies exist and keep them from accessing therapies that are known to help support the symptoms of the disease, or worse as some fraudulent treatments can cause serious or even fatal injuries,” then-FDA Commissioner Dr. Scott Gottlieb said in a statement.

While the FDA didn’t single out piracetam, it’s one of the more common and worrisome ingredients in unapproved cognitive enhancement supplements, researchers note in JAMA Internal Medicine.

For the study, Dr. Pieter Cohen of Somerville Hospital Primary Care in Massachusetts and colleagues searched online for supplements with piracetam in the description or ingredient list, then ordered samples to test in a lab and see how much of the ingredient they contained.

They tested a total of 10 samples from four manufacturers. The amount of piracetam contained in the recommended servings ranged from 831 mg to 1,542 mg. In the four products that contained the ingredient, the amount of piracetam ranged from 85% to 188% of the amount claimed on the label.

Following the manufacturers’ recommendations, consumers could be exposed to quantities ranging from 831 mg to 11,283 mg of piracetam per day, depending on the brand consumed, the researchers note.

In Europe, where piracetam is prescribed for disorders including dementia and cognitive impairment, tablets are typically 800 mg or 1,200 mg and daily dosing tends to be 2,400 mg to 4,800 mg, the study team notes.

At doses lower than researchers found in some supplements available for purchase in the U.S., side effects of piracetam include anxiety, insomnia, agitation, depression, drowsiness and weight gain, the authors write.

Side effects may be worse at higher doses, although the precise risks are unknown, they point out.

Beyond the small number of samples tested, other limitations of the study include the possibility that amounts of piracetam in the supplements might vary over time, the study authors note.

Even so, consumers should steer clear of piracetam supplements, given the lack of evidence that it helps cognition and the potential harmful side effects, the researchers conclude.

“Clinicians should advise patients that supplements marketed as cognitive enhancers may contain prohibited drugs at supratherapeutic doses,” the study authors warn.

Source: Reuters

Study: A Minimum Dose of Hydromethylthionine Could Slow Cognitive Decline

In a paper published in today’s online issue of the Journal of Alzheimer’s Disease, TauRx has reported unexpected results of a pharmacokinetic analysis of the relationship between treatment dose, blood levels and pharmacological activity of the drug hydromethylthionine on the brain in over 1,000 patients with mild-to-moderate Alzheimer’s disease. These results showed that, even at the lowest dose of hydromethylthionine previously tested in two Phase 3 global clinical trials (8 mg/day), the drug produced concentration-dependent effects on cognitive decline and brain atrophy.

Hydromethylthionine, taken as a tablet, is the WHO-approved non-proprietary name for the compound previously referred to by TauRx as LMTM. This drug blocks abnormal aggregation of tau protein in the brain [2,3], which is increasingly recognised as an important driver of clinical dementia [1]. In Phase 3 global clinical trials conducted in almost 1,700 patients with mild-to-moderate Alzheimer’s disease between 2012–2016, hydromethylthionine was tested at doses of 150–250 mg/day against a low dose of 8 mg/day, which was intended only as a control to mask the discolouration of urine that can sometimes occur with the drug. The study designs were based on the findings from an earlier trial that used a different variant of the drug [6]. Surprisingly, there was no difference between the high doses and the low dose of hydromethylthionine on any of the clinical outcomes in the trials [4,5].

To further explore these results, the researchers conducted a new pharmacokinetic population analysis using plasma concentration data from 1,162 of the patients who participated in either of the two completed Phase 3 hydromethylthionine trials to measure how blood levels of the drug relate to its effects on the brain. Using a new assay, the researchers found that the effects of hydromethylthionine at the 8 mg/day dose were determined by the blood level, and that the majority of patients had high enough blood levels of the drug at this dose to produce meaningful reductions in cognitive decline and brain atrophy. They concluded that a slightly higher dose of hydromethylthionine of 16 mg/day would ensure that all patients would have the blood levels needed to maximise the drug’s activity, since its effects plateau at higher concentrations and doses. The pharmacokinetic profile they found, typical of many drugs, now explains why the pharmacological effects of hydromethylthionine at the high doses tested in the trials were no better than those seen in patients with high blood levels at the 8 mg/day dose.

The analysis also showed that whilst hydromethylthionine has a similar concentration-response profile in patients taking the drug as an add-on therapy to the routinely used symptomatic treatments in Alzheimer’s disease, the maximum effect in these patients was reduced by half. This finding supports the hypothesis that symptomatic drugs for this condition interfere with the disease-modifying treatment effects of hydromethylthionine. This hypothesis was initially proposed on the basis of the drug’s Phase 3 trial results [4,5].

“Since we already have a substantial database supporting the safety and tolerability of hydromethylthionine in clinical trials of patients with mild-to-moderate Alzheimer’s disease, the additional results of this analysis have given us the confidence to expand the scope of the new TauRx Lucidity clinical trial to confirm the potential efficacy of the hydromethylthionine 16 mg/day dose in these types of patients,“ said Prof. Claude Wischik, of Aberdeen University and executive chairman of TauRx Therapeutics Ltd.

He noted that hydromethylthionine is taken in a convenient oral form at home and does not require patients to attend clinics for intravenous infusions or injections, unlike various other Alzheimer’s disease treatments currently being tested in clinical trials.

“In addition to the reduction in brain atrophy, we were surprised to see the large cognitive effects of treatment in the patient group with the higher blood levels of hydromethylthionine at the 8 mg daily dose,” he added. “According to scores from the ADAS-cog scale, the effect was around 7.5 points, or three times that seen from current routine Alzheimer’s treatments, and would be equivalent to an 85% reduction in cognitive decline over 65 weeks.” The Alzheimer’s Disease Assessment Scale–cognitive subscale (ADAS-Cog) is the standard cognitive scale used to measure neuropsychological changes in Alzheimer’s disease clinical trials. A 4-point change is generally considered as indicating a clinically meaningful difference1.

Professor George Perry, Editor-in-Chief of Journal of Alzheimer’s Disease, commented: “The extensive data, experience, and now pharmacokinetics, highlight the potential of hydromethylthionine treatment as an important new avenue forward in Alzheimer’s disease. The clinical benefit and reduction in brain atrophy greatly exceed those reported for other therapeutic routes.”

Professor Serge Gauthier, Director of the Alzheimer Disease Research Unit, McGill Center for Studies in Aging, commented: “The researchers are aiming to confirm what they have found so far in the placebo-controlled trial that is now ongoing. Hydromethylthionine is the best hope we have right now for a disease-modifying drug acting on the tau pathology associated with Alzheimer’s disease.”

Source: Journal of Alzheimar’s Disease

Today’s Comic

Fish Oil Is Good Medicine for Heart Failure

Amy Norton wrote . . . . . . . . .

Fish oil might help people with heart failure avoid repeat trips to the hospital, a new study suggests.

The findings come from an analysis of a clinical trial first published last year, where researchers tested the effects of fish oil and vitamin D on people’s risk of heart disease and cancer.

That main trial — called the Vitamin D and Omega-3 Trial (VITAL) — had some encouraging results. Healthy older adults given a fish oil supplement were less likely to suffer a heart attack over the next several years, especially if they had never been big fish eaters.

The current analysis looked at whether supplements had any effect on participants’ risk of being hospitalized for heart failure.

Heart failure is a chronic condition in which the heart gradually loses its ability to efficiently pump blood to the body. Often, it stems from heart-muscle damage caused by a heart attack — which raised the question of whether the benefits seen in the trial might extend to heart failure, explained Dr. Luc Djousse.

Djousse, of Brigham and Women’s Hospital and Harvard Medical School in Boston, led the current study.

Overall, his team found, neither vitamin D nor fish oil curbed the risk of first-time hospitalization for heart failure over five years. But people using fish oil were somewhat less likely to need repeat hospital stays.

The finding offers a “signal” that the supplements might help prevent heart failure hospitalizations, Djousse said.

But, he stressed, that still needs to be backed up by further study.

Fish oil is rich in omega-3 fatty acids, which are known to help lower triglycerides, lessen inflammation and blood clotting, and help stabilize heart rhythm.

The American Heart Association (AHA) recommends that people eat fish twice a week — preferably fatty varieties higher in omega-3, such as salmon, mackerel, sardines and albacore tuna.

Djousse advised following that recommendation. “But don’t fry your fish,” he added. “Have it broiled or baked.”

The findings, published Nov. 11 in Circulation, come from a trial involving nearly 26,000 adults aged 50 and older who were initially free of heart problems. They were randomly assigned to take either 1 gram of prescription-grade fish oil (Omacor), 2,000 IU of vitamin D, or a placebo every day.

Over five years, the fish oil group was 28% less likely to suffer a heart attack compared to the placebo group. The effect was more pronounced among people whose diets had been low in fish: They were 40% less likely to have a heart attack than placebo users.

When Djousse’s team looked at heart failure hospitalizations, there was no clear effect of either fish oil or vitamin D on first-time admissions. But fish oil users were 14% less likely to have repeat hospitalizations: There were 326 recurrent hospital stays in that group and 379 in the placebo group.

Why wouldn’t fish oil prevent a first hospitalization? It’s not clear. But Djousse said there were fewer first-time hospital stays, so the numbers might have been too small to detect an effect.

That is a possibility, agreed Dr. David Siscovick, a senior research scientist with the New York Academy of Medicine who was not involved in the study.

More research is needed, Siscovick said. But, he added, at this point, there is no evidence that fish oil can prevent heart failure from developing.

There is, however, evidence that patients with existing heart failure may benefit.

Siscovick chaired an AHA committee that, in 2017, issued an advisory on omega-3 supplements and heart disease.

The advisory said it was “reasonable” for doctors to prescribe omega-3 to heart failure patients, based on an Italian clinical trial called GISSI. In that trial, researchers randomly assigned heart failure patients to either take an omega-3 supplement or a placebo (olive oil). Over four years, patients on omega-3 had a 9% lower risk of being hospitalized or dying.

The current study, Siscovick said, is “very consistent” with that evidence.

He also stressed, though, that heart failure is a complex condition, with different forms and different underlying causes. So if people with heart failure are curious about fish oil, he said, they should talk to their doctor about whether a prescription is right for them.


Today’s Comic

Testosterone Supplements Double Men’s Odds for Blood Clots: Study

Dennis Thompson wrote . . . . . . . . .

Testosterone therapy appears to double a man’s risk of suffering a potentially life-threatening blood clot, a new study warns.

Men had twice the risk for a deep vein blood clot if they’d been receiving testosterone during the previous six months, researchers reported in the online edition of JAMA Internal Medicine.

The increased risk occurred whether or not a man had the low-testosterone condition known as hypogonadism, but appeared to be more pronounced in middle-aged men than in seniors, the findings showed.

These findings should cause men to think twice about asking for testosterone treatments to battle normal symptoms of aging, said lead author Rob Walker, a graduate research assistant at the University of Minnesota School of Public Health, in Minneapolis.

“If a potential patient reads this and maybe is seeking out testosterone therapy for some kind of common symptoms, like weight gain or sexual function, maybe they should seek out behavioral changes or lifestyle changes that will improve their health without a prescription,” Walker said.

The “low-T” fad caused testosterone prescriptions to soar early in the 21st century, increasing more than 300% between 2001 and 2013, the study authors said in background notes.

The fad faded in 2014, after the U.S. Food and Drug Administration warned that testosterone therapy increases a man’s risk of heart attack and stroke.

Still, more than 1 million U.S. men over 30 received testosterone therapy in 2016, the researchers noted. Evidence suggests it’s still being prescribed to some who don’t suffer hypogonadism, a condition in which the body isn’t producing enough of the male hormone.

To further investigate the risk of testosterone treatment, Walker and his team analyzed insurance claims for nearly 40,000 men filed between 2011 and 2017.

The investigators focused on men who experienced either deep vein thrombosis or pulmonary embolism. Pulmonary embolism occurs when a deep vein clot breaks free and travels into the lungs, blocking some or all of their blood supply.

Men without a low-testosterone condition who took the hormone had 2.3 times the risk of developing a deep vein clot within six months, the results showed. Men diagnosed with hypogonadism had 2 times the risk.

The results also indicated that risk might be even greater in middle-aged men taking testosterone to battle aging, although those findings were not statistically significant, Walker said.

“In men without hypogonadism, men under 65 almost had a tripling of risk versus men 65 years and older, whose risk was only about 1.5 times greater,” he said.

Testosterone poses this risk because it “revs up the consistency of the clotting factors in the blood,” said Dr. Umesh Gidwani, an associate professor of cardiology, critical care and pulmonology at the Icahn School of Medicine at Mount Sinai in New York City.

The hormone increases red blood cell count, which thickens blood and makes it flow more sluggishly, Gidwani said. Testosterone also amps up the action of platelets, the blood cells responsible for forming clots.

The study “seems to suggest it would be safer to refrain from testosterone use in patients who do not have hypogonadism,” Gidwani said.

Walker agreed, adding that men who must receive testosterone therapy due to hypogonadism should be closely monitored for blood clots.

Source: HealthDay