CoQ What? An Antioxidant Story
Coenzyme Q10, also known as CoQ10 and Ubiquinone, is an antioxidant as well as a coenzyme. A coenzyme is a substance that helps an enzyme do its job. Without a coenzyme, the enzyme would not be able to generate enough energy to initiate a reaction. There are many coenzymes in the body, but without CoQ10 we would die within minutes. That is a pretty bold statement. Think about this for a minute. Without this enzyme, we would die. So what happens if our body’s production of CoQ10 decreases?
Without sufficient CoQ10 your mitochondria (energy-producing organelles of the cell) cannot produce energy and will not function optimally. Every single cell in the body excluding red blood cells contains mitochondria. Organs and tissues that are more active like the heart, liver, and muscle contain the most mitochondria because they are the most energy demanding components of the body.
It takes a lot of energy to beat your heart consistently without stopping. It takes a lot of energy to detoxify your blood and metabolize food and waste products. It also takes a lot of energy to move your body. All this energy production comes at a cost. CoQ10 is essential for generating energy but also works as an antioxidant inside the mitochondrial cell wall. On a biochemical level, energy production also produces damaging byproducts like reactive oxygen species. If these reactive oxygen species, ROS, are not quenched by electron donors or antioxidants, then they are free to damage mitochondrial cell walls and membrane proteins that are involved in energy production. Your DNA is especially vulnerable to oxidative damage. Reactive species like hydrogen peroxide are typically not a problem and in fact, can be used to catalyze enzyme reactions, but when there is an imbalance between oxidative byproducts and antioxidant function, then oxidative damage occurs.
Aging all by itself is an impairment in mitochondria function caused by a decrease in antioxidant activity and an increase in oxidative stress. Diseases associated with aging are marked by an increase in oxidative stress. Adequate production of CoQ10 improves symptoms of mitochondrial diseases and aging because it improves the health and function of the mitochondrial themselves. The purpose of the mitochondria is energy production, therefore any nutrient designed to maintain efficient energy production balanced with damage control is absolutely essential to age well.
Where does CoQ10 come from?
CoQ10 is found in all plants and animal cells. It is a small lipophilic structure that we can make on our own through the mevalonic acid pathway, which is also responsible for cholesterol synthesis. For the average person, eating a balanced diet with plenty of vegetables and lean animal proteins will ensure adequate CoQ10 consumption. However, insufficient CoQ10 comes from our ability to produce or not to produce Ubiquinone within the cell. Everyone hoping to age well should be well aware of how this breakdown in manufacturing can occur. Drugs are the most common culprit as well as lifestyle choices that generate too much oxidative damage on a daily basis.
Cholesterol may already be a term you are well aware of as it is commonly vilified by doctors and the medical community. In fact, you may already be on a cholesterol-lowering medication. I bet your doctor didn’t tell you that by stopping the production of “bad” cholesterol production you are essentially stopping energy production in your cells. Cholesterol medications like the commonly prescribed class of statins, do lower cholesterol and save lives in the short term. But are the long-term side effects such as decreased energy, muscle dysfunction, hormone imbalance, dementia, and Alzheimer's worth it?
Statins inhibit an enzyme called 3-hydroxy-3methyl-glutaryl-coenzyme A (HMG-CoA) reductase. This inhibition happens at a key regulatory step in the mevalonic acid pathway. Other molecules besides CoQ10 also use this same pathway. Cholesterol itself is a precursor for all steroid hormones. When you combine a natural decrease in the production of CoQ10 as we age with a medically induced dramatic decrease then you get severe functional imbalances across the whole system. I find it ironic that one of the top 5 prescribed drugs in America for heart disease can also create heart disease.
Energy
CoQ10 improves blood pressure, shortness of breath, muscle and exercise endurance, and energy levels. CQ10 makes the body run more efficiently because it assists in hundreds of reactions. It forms a critical component of the electron transport chain by transporting electrons between protein complexes embedded in the mitochondrial wall. The transport of electrons from one side of the inner wall to the other side results in an electrical gradient that creates ATP. ATP is the energy molecule that every cell must have in order to function. Without CoQ10 there is no ATP. Remember when I said we would die within minutes with CoQ10. Your heart would literally stop beating without it.
A critical concept to understand is that we may be surviving on very little CoQ10 production but that means the result is accelerated aging and cellular breakdown. I don’t know about you, but I don’t want to accelerate the aging process. As a pharmacist, I do not condone the use of statins and other medications that deplete CoQ10 without adequate supplementation and patient education.
Take patient A for example, who has high cholesterol and diabetes and complains of low energy while on a diabetic drug and a statin. Dr. Quick spends about 10 minutes listening to the patient but is only really concerned about the recent labwork obtained showing an increase in LDL (bad cholesterol). Dr. Quick does not really address the fatigue because patient A just happens to be a perimenopausal woman with 2 children and states she should probably just get more sleep. Dr. Quick doesn't address dietary choices or order a thyroid panel, which could be causing the low energy. What Dr. Quick does do is increase the statin drug and add a blood pressure medication since her blood pressure was just a little too high. Why does Dr. Quick brush low energy under the rug? Dr. Quick doesn’t understand nutritional science. In fact, Dr. Quick wasn’t taught anything about nutrition while in school. Dr. Quick also thinks many women this age complain too much and the energy problem is probably just in her head. Dr. Quick also forgets to think about the side effects of medications or basic biochemistry. Dr. Quick is concerned about keeping the numbers within the reference range, without considering the person in the office. Patient A continues with low energy and self medicates with sugar and caffeine (hmm, high blood pressure) to get moving.
No wonder many people suffer from chronic diseases such as diabetes, high cholesterol, metabolic syndrome, high blood pressure, and hypothyroid function. CoQ10 on its own won’t magically cure diabetes or high cholesterol, but dietary lifestyle interventions and titrating off medications that deplete nutrients will. CoQ10 supplementation could be the one thing to help increase energy levels enough to stimulate lifestyle changes.
Antioxidant
Antioxidants like Coq10 and the most important intracellular antioxidant glutathione, support clean energy production. They protect the cell from DNA damage. CoQ10 is located in every cell membrane, including neurons in your brain. CoQ10 can actually stabilize the membrane and protect the lipid layer from oxidation. Why does it matter? Because as lipids become oxidized they are less fluid and that decreases the ability to regulate nutrients in the cell interior. Poor cell membrane fluidity keeps damaging compounds in and nutrients like vitamins and minerals out. CoQ10 is also involved in recycling other antioxidants like Vitamin E and C. Recycling allows those molecules to be used again. CoQ10 may also enhance the activity of antioxidant proteins like superoxide dismutase and glutathione peroxidase. CoQ10 may also keep LDL from oxidizing which essentially keeps it from damaging the lining of the arterial wall. Is anyone finding this cholesterol situation ironic yet?
Depletion: A Sad story
Depletion of CoQ10 is epidemic, primarily because of popular drugs prescribed today. Some are even over-the-counter and many people are unknowingly trying to stop one disease state while causing another. Common drugs that deplete CoQ10 are blood pressure medications like beta-blockers, diabetic meds like Metformin, and the most insidious nutrition depleter drug class of all time, proton pump inhibitors. Other classes of medications that deplete CoQ10 include antiarrhythmics, antidepressants, antibiotics, and other classes of blood pressure lowering mediations. There are many people who take one medication from each class! Imagine what that does to cellular energy production? When energy production breaks down, so does the cell. Our body just doesn’t run well. These medications are known to deplete nutrients vital for cellular survival, yet people are prescribed these meds daily and some are on 3 to 4 of these medications. A vicious cycle is at play within these disease states.
Supplementation
Taking a supplement can be helpful for many people. Considerable evidence exists for supplementing in those with heart failure, cardiopulmonary disease, age-related degenerative diseases like Alzheimer's, and of course if you already take a medication that depletes CoQ10. Recent studies who improvement in lipid profiles when supplementing with CoQ10. Generally speaking, the ubiquinol form of CoQ10 is superior because it is absorbed better. It is hard to overdo CoQ10, but you can get stomach upset, headache, insomnia, and dizziness. For general health, a dose of 30–50mg 1 to 2 times a day is appropriate. Those taking medications and with chronic illnesses may need 50–200mg 1 to 2 times daily to have an effect.
Food quality is also very important when it comes to adequate supplementation. Foods like seeds, nuts, broccoli, cauliflower, fish, spinach, beef, and chicken, all are good sources of CoQ10. Minimizing inflammatory foods will result in a net CoQ10 balance because less CoQ10 is wasted on cellular clean-up.
One powerful step
Many studies to date have supported the safety and potential of CoQ10 in reducing oxidative stress and increasing energy efficiency within the mitochondria. Since CoQ10 makes the body run more efficiently because it is a powerful coenzyme, and your body‘s general health improves, you may even be able to lower the dosage of some meds or even stop them. CoQ10 can reduce the side effects of certain drugs and protect your most active tissues like your heart, liver and muscle, and brain from damage. CoQ10 is essential for life. Without sufficient CoQ10 we will not have optimal health and our risk for chronic disease will increase as we age. One powerful step you can take today is to review your medications with your doctor or pharmacist and find out how you can make lifestyle changes to reduce your medication list.
