Orthomolecular - Coenzyme Q10

Question 1

Coenzyme Q10

Answer 1

Coenzyme Q10 (CoQ10) is present in each cell’s mitochondria and plays a key role in ATP production.
* CoQ10 is also known as ubiquinone.
* It exists in the body in an oxidised form (ubiquinone) and a reduced form (ubiquinol) and the two forms interconvert.
* It is usually synthesised in the body in sufficient amounts to meet physiological requirements.
* CoQ10 is reduced by:
o Ageing
o Drugs (e.g. statins)
o Smoking
o Certain diseases (e.g. cardiovascular disease).
reduced= gained electrons
oxidised= lost electrons

Question 2

Food sources:

Answer 2

Dietary intake contributes around 3 to 6 mg per day.

Food sources:
* Plant sources: Nuts (e.g. peanuts, pistachios), sesame seeds, olive oil, fruit and vegetables including oranges, strawberries, avocado, broccoli, cauliflower,
* Animal sources: Meat, poultry, fish (e.g. herring, sardines, mackerel, trout) and eggs.

Question 3

Energy Production

Answer 3

Functions:
* CoQ10 is needed for the electron transport chain (for complex 2 of 4 in this process) —review biochemistry 2. This supports mitochondrial function and energy production.
* The highest quantities are found in muscle cells (including skeletal and cardiac muscle) due to the high ATP demand for muscle contraction.
Therapeutic uses:
* Fatigue.
* Fibromyalgia:
* Daily use (300 mg in divided doses; i.e. 3 x 100 mg per day).

Exercise:
What other nutrients could you use to support an individual’s cellular ATP production? How do they work?
* Magnesium: Joins with ATP to help it work more effectively
* B-vitamins: Encorporated into glycolysis and Krebs cycle

Question 4

Antioxidant

Answer 4

Functions:
* CoQ10 is a potent fat-soluble antioxidant that inhibits the peroxidation of cell membrane lipids. It neutralises free radicals produced by mitochondria.
* CoQ10 naturally decreases with age; the ageing process involves ROS and impaired mitochondrial function.
* Depletion of CoQ10 can result in mitochondrial dysfunction, which is associated with conditions including fibromyalgia, Type2 diabetes, CVD, neurodegenerative diseases and cancer.
Therapeutic Uses:
* Healthy ageing: 100–200 mg per day.
* Preventative measures or for directly addressing mitochondrial dysfunction (e.g. fibromyalgia etc.)
Peroxidation = oxidation
ROS = Reactive Oxygen Species

Question 5

Periodontal health

Answer 5

Functions:
* Diseased gum tissues have significantly lower levels of CoQ10 in comparison with healthy gum tissue. This is thought to be a result of the lipopolysaccharides from the bacteria Porphyromonas gingivalis, triggering oxidative stress and mitochondrial dysfunction.
Therapeutic uses:
* Periodontitis. Daily 50–80 mg
* Combine with periodontal care routine.

Question 6

Male and female fertility

Answer 6

Functions:
* CoQ10 protects sperm from oxidative stress (to which they are vulnerable).
* Impaired mitochondrial performance (low CoQ10) can drive age-associated oocyte (egg cell) deficits = infertility.
Therapeutic uses:
* 200–300 mg for 6 months increases sperm health.
* 100–600 mg for ovarian health.

Question 7

Cardiovascular health

Answer 7

Functions:
* Crucial for cardiac muscle function.
* Protects against endothelial dysfunction and hence atherosclerosis.
* CoQ10 reduces LDL oxidation.
* It inhibits the NF-kB activation that is secondary to ROS.
* Increases superoxide dismutase activity (an anti-oxidant) which is known to preserve the activity of nitric oxide (NO) as a potent vasodilator.
Therapeutic uses:
* Hypertension, angina pectoris, congestive heart failure, post-myocardial infarction.
* Typical dosage: 60–300 mg / day.
NF-κB= a protein that controls inflammatory cytokine production

Question 8

Statins and CoQ10

Answer 8

Statins are drugs used to reduce cholesterol synthesis but they also reduce CoQ10 because both compounds are synthesised via the same pathway.
* Cholesterol and CoQ10 have vital functions in the body and their loss contributes to the adverse effects caused by statins.
* Low CoQ10 levels increase the risk of various illnesses including cardiovascular disease, myopathy and depression.
* 90–300 mg / day of CoQ10 greatly reduces this risk.
myopathy = muscle disease

Question 9

The Mevalonate Pathway:

Answer 9

This metabolic pathway is required for the production of cholesterol and CoQ10 —two crucial molecules for health.
Statins act on this pathway as seen on the image. See notes.
Mevalonate = an intermediate in the synthesis of cholesterol and other compounds
Recap Exercise: What are the functions of cholesterol
* Cell membrane integrity – fluidity
* Cell membrane signaling
* Steroid hormone production
* Bile production

Question 10

Ubiquinol or Ubiquinone.

Answer 10

It is suggested that ubiquinol is a better supplemental form for CoQ10 status enhancement than ubiquinone. However:
* Results are mixed with very little research supporting this claim.
* Bioavailability is influenced more by the composition of the raw material, which for supplemental purposes is generally synthesised using a yeast-fermentation method.
* This produces a crystalline form which is difficult to digest.
* The crystals needs to be dissociated into individual CoQ10 molecules and remain in the shelf-life of the product.
* Thus, solubilised products appear to have the greatest bioavailability.

Question 11

Supplementation:

Answer 11

• Safety: CoQ10 has a remarkable safety profile. There have been no reports of significant adverse side effects of oral CoQ10 supplementation at doses as high as 1200 mg / day for up to 16 months. There have been no safety studies in pregnant and lactating women.
• Mild adverse effects: GIT symptoms such as nausea, diarrhoea, appetite suppression, heartburn, and abdominal discomfort have been reported. These may be minimised if daily doses higher than 100 mg are divided into two or three doses.
• Interactions: CoQ10 may decrease the effects of warfarin.