By Barbara Day, M.S., R.D., C.N.
Coenzyme Q10 (CoQ10) also known as ubiquinone (which means found everywhere) , is an anti-oxidant compound that is manufactured by our bodies in the heart, liver, kidney and pancreas. Every cell in the body needs CoQ10 and the body typically produces enough CoQ10 for energy production. There is no dietary requirement for CoQ10 because the body readily produces it. CoQ10 works at the cellular level in the mitochondria, the cell’s powerhouse, producing energy from glucose and fatty acids. Research suggests that CoQ10 might be helpful in assisting the heart muscle in times of stress by helping to use energy more effectively. In addition, CoQ10 may also enhance the immune system since it acts as an antioxidant.
CoQ10 is available in small amounts in beef, soy oil, sardines, mackeral and peanuts but the main source of CoQ10 comes from its manufacture in the body. According to Duane Graveline, MD, MPH, the adult human body pool is 2 grams and needs replacement of about 0.5 gram per day. Peter Langsjoen, MD, a leading cardiologist who has researched CoQ10 for years, suggested eating one pound of sardines, two pounds of beef or one-half pound of peanuts provides only 30 mg CoQ10. Also, the body’s manufacture of CoQ10 progressively decreases after age 21.
One of the main problems with CoQ10 is the fact that some medications like statins may interfere with the body’s manufacture. Nearly 60 million people will take a statin medicine each year. Some of the side effects of taking statins like Lipitor®, Crestor® and Zocor® (generic names: lovastatin, pravastatin, simvastatin) are muscle pain, fatigue, dyspnea, memory loss and peripheral neuropathy. The University of Maryland Medical School website (www.umm,edu/…/coenzyme-q-10) acknowledges that statins deplete natural levels of CoQ10 in the body. Research also suggests side effects such as fatigue and muscle pain may actually be reversed with supplementing the diet with CoQ10. In other countries including Canada, CoQ10 supplementation is strongly recommended when statins are prescribed but routine supplementation is not currently recommended in the US.
Dr. Graveline reported in his column, Statins and CoQ10 Deficiency, “the heart is usually the first to feel statin associated CoQ10 depletion because of its extremely high energy demands. Physicians are seeing this as cardiomyopathy and congestive heart failure but chronic fatigue is also being reported and we must remember that every cell in the body is dependent on adequate energy reserves.” (www.spacedoc.net_statinsCoQ10.htm)
If you and/or your physician decide you should take a CoQ10 supplement, the next question is what supplement should you purchase?
CoQ10 comes as a tablet or soft gelatin capsule. Research suggests your body may absorb CoQ10 more effectively in a gelatin capsule which is suspended in oil. If you choose a tablet form, take with a meal containing moderate amounts of fat.
ConsumerLab.com is a reliable internet source of information you can utilize when looking for the right brand of supplement to purchase for your personal use. ConsumerLab.com does not determine whether the supplement is effective or not but does determine that the supplement contains the correct amount of the supplement as labeled. They take the supplements for analysis directly off the retail shelf and analyze them to determine what is actually in the supplement.
The usual dose is 200 milligrams (mg) per day. Michael Rozien, MD, and Mehmet Oz, MD in their book, You Staying Young, suggest 200 mg per day if you are taking a statin or if you are over 60. The absolute maximum dose is 3 grams or 3000 mg per day. Research suggests doses over 2,400 mg per day does not provide any extra benefit.
Three specific supplements that they have been approved by ConsumerLab.com are: CVS Pharmacy CoEnzyme Q-10 200 mg (1 softgel). Each oil based softgel costs about $0.17 according to www.ConsumerLab.com. Member’s Mark CoQ-10 100 mg [Sam’s Club] (1 softgel). Each oil based softgel costs about $0.15; Kirkland Signature CoQ10 300 mg (1 softgel) [sold at Costco]. Each oil based softgel costs about $0.11. For more information about these and other supplements, you can go to www.consumerlab.com. Prices may vary regionally.
Side Effects of CoQ10 Supplements
According to Stacy Wiegman, PharmD, side effects of CoQ10 are uncommon and generally very minor. Possible side effects include diarrhea, indigestion and nausea. Supplemental CoQ10 may lower blood pressure, blood sugar and raise dopamine levels.
Dr. Wiegman suggests consulting your physician if you are taking blood pressure drugs like ACE inhibitors (captopril, enalapril, fosinopril, lisinopril), angiotensin-2 receptor blockers (Avapro, Cozaar, & Diovan), beta blockers (atenolol, metoprolol, propranolol), calcium channel blockers (amlodipine, nifedipine, verapamil), diuretics (Dyazide, furosemide, hydrochlorothiazide) and propranolol (Inderal) regarding the potential interaction with the CoQ10 supplement.
Dr. Wiegman also suggests consulting your physician if you are taking diabetes medications. Diabetes drugs that lower blood sugar which include insulin, Symlin, Byetta, acarbose, Actos, Avandia, glimeperide, glipizide, glyburide, Glyset, metformin and Prandin, may cause hypoglycemia if taken along with CoQ10 supplements. In addition, using herbal products that lower blood sugar like eleuthero, fenugreek, ginger (in high amounts), kudzu and panax ginseng, along with CoQ10 supplements may have a doubling effect of hypoglycemia as well. Be sure to discuss taking CoQ10 with your physician if you are taking any of these drugs or herbs to help lower your blood sugar.
Research suggests CoQ10 supplements can raise your ability to clot so check with your physician about taking CoQ10 if you are taking anticoagulants such as warfarin (Coumadin) or heparin. In addition, check with you physician if you are taking dopamine-increasing drugs used to treat Parkinson’s disease like bromocriptine (Parlodel), carbidopa-levodopa (Dopar, Sinemet) Dostinex, Mirapex, pergolide and ropinrole.
Here’s a note From Elizabeth Lundy which appeared on my other website: www.DayByDayNutrition.com.
I’ve suspected that statins were causing major muscle problems and stopped taking them, until another doctor made me try it again last October, 2010. I had major muscle problems again and sought out a new doctor which put me back on Zetia and Niacin. My new doctor also recommended I start taking CoQ10 which has given me so much relief it’s unbelievable. I am currently taking 200mg and went online tonight to see if taking more would help me (I also have Fybromyalgia) and I did not want to take more than what is recommended. Thanks to your article, I feel comfortable trying 2 gel caps per day to see if it might help me eliminate more pain, and I plan to take one in the am and the other in the pm. If more is not any better, than I definitely will cut back to one per day. Again, thank you for this wonderful article.
Barbara Day, M.S., R.D., C.N., is a registered dietitian with a Master’s Degree in clinical nutrition. The former publisher of Kentuckiana HealthFitness Magazine, Kentuckiana Healthy Woman magazine and radio show host of Health News You Can Use, Barbara has over 30 years of experience in promoting healthy lifestyles to consumers. Barbara worked as Nutrition Consultant to the Navy SEALs (8 years) and the University of Louisville Athletic Department (10 years). Barbara has private practice, DayByDay Nutrition, www.DayByDayNutrition.com, where she counsels clients on weight loss, cholesterol management, performance nutrition and an array of other medical issues. Visit Barbara’s new website which is an on-line health & wellness magazine, www.KentuckianaHEALTHWellness.com. Barbara writes nutrition and health columns for www.LiveStrong.com as well as a weekly nutrition column for the Southeast Outlook. She also designs and presents employee wellness programs to small and large businesses. Barbara is a runner, cyclist, hiker and a mother and grandmother to 11 grandchildren.