The Importance of Co-Q10

by: Ladd McNamara, M.D.

 

In my book, The Cholesterol Conspiracy, I emphasized how important co-enzyme Q10 (Co-Q10) is in promoting heart health: preventing cardiovascular disease, and apparently even reversing the signs of cardiovascular disease.  However, the benefits of Co-Q10 are not limited to the heart, but are extended to the entire body, in particular to the brain, the skin, and most importantly to the reduction of cancer development and apparently as an adjunctive therapy in the treatment of cancer itself!

Co-Q10 is a cofactor (or co-enzyme) essential for the functioning of an enzyme system that creates 90% of the molecules needed for cellular energy (ATP molecules).   Co-Q10 is the only fat-soluble vitamin produced by our body, however, as we get older we produce less and less. It is found in the mitochondria of cells where energy is created from oxygen and glucose (sugar).   Organs that require more energy have more mitochondria, and therefore require more co-Q10, the heart requiring and using more energy, and thus requiring more co-Q10, than any other organ in the body. 

The downside of creating ATP energy molecules within the mitochondria is the generation of free radicals, which if unchecked can wreak incredible damage through oxidation.  Co-enzyme Q10 is the first-line antioxidant in the defense against excessive oxidation both within and outside the mitochondria.

Patients with congestive heart failure are found to have a deficiency of co-Q10, and as mentioned above, our bodies make less co-Q10 as we age.  (Skin health is affected by the amount of co-Q10 available, and as we age the levels decrease, and elasticity is loss, along with an increased risk of skin cancer.  A topic for another update.)   

The theme of The Cholesterol Conspiracy is that statin drugs reduce co-Q10 levels (and nutritional supplements are an effective means to maintain heart health), and the consequences of co-Q10 deficiency can be devastating; one of which can be the development of congestive heart failure.  When statin drugs first came on the market in 1987 (the first being Mevacor, lovastatin), clinicians who followed co-Q10 levels of their patients saw a dramatic drop, and a worsening of heart functioning, including failure; one requiring a heart transplant.  The patients showed an improvement in their co-Q10 levels and heart functioning once the statin drugs were discontinued.   All statin drugs block co-Q10 production, and cause depletion in the body, and results in detrimental effects on the heart, as well as the rest of the body (fatigue, depression, foggy thinking, memory loss, and many other effects, including an apparent increase in cancer). 

Do statin drugs reduce LDL cholesterol levels?  Yes, they do, AND, they do reduce the risk of heart attack by as much as 16 to 24%.   However, the studies showing these benefits ALSO show that those taking statin drugs are having other problems; not just a decrease in cardiac function (congestive heart failure), but also dying of other causes.  For example, the  study a few years ago in the New England Journal of Medicine touting the “incredible, undeniable benefits of high-dose Lipitor” which was supposed to be the break-through treatment for those at risk for heart disease if looked at closely actually showed no net saving of lives at all!  In this 2005 "TNT" study, 10,001 people received either high-dose Lipitor or low-dose Lipitor.  High-dose Lipitor brought down LDL cholesterol levels to an average of 77 mg/dl, and the low dose Lipitor brought LDL down to just about 110 mg/dl.  (N Engl J Med.  2005  Apr  4;352(14):1425-35) 

Over the next 5 years 8.7% of the high-dose group had a repeat heart attack, and among the low-dose group 10.9% of the people experienced a repeat heart attack.  There were 29 fewer deaths from high-dose Lipitor due to heart attack!  So, one could conclude that everyone at risk for heart disease should go on high-dose Lipitor, right?  Well, that’s exactly the campaign that Pfizer pushed upon physicians.  However, this “benefit” was COMPLETELY offset by 31 MORE deaths from people taking high-dose Lipitor who died from OTHER CAUSES (not heart attacks).  The conclusion:  80 mg of Lipitor did NOT save ANY lives; in fact maximum dose Lipitor INCREASED one's risk of death due to non-cardiovascular causes (10 of these deaths were from cancer)!   Oh, and every one of the eleven authors of this study were either a Pfizer employee or a paid “Pfizer consultant.”  The worst part about this, ..the campaign by Pfizer to spin the information that prescribing statin drugs is not only safe but the BEST TREATMENT for all patients at risk for heart disease has still left a deep impression on physicians today, and is so entrenched in the medical psyche' that it is very difficult for doctors to even think that nutritional supplements have any place at all in the health maintenance or prevention of heart disease. 

Of similar interest is the very recent release of the results of the ENHANCE study, a two-year trial of people with high cholesterol taking Zetia or Zocor alone.   (Zetia is the brand name for ezemtimbe, which is also found in Vytorin, ...and the results may very well apply to this drug as well.)  Although Zetia, which is prescribed to about 1 million Americans at this time, did lower cholesterol, this study revealed it provided absolutely no benefit.  Worse, not only did it not provide a benefit, but the rate at which arteries thickened with plaque almost DOUBLED with those taking Zetia (ezemtimbe, also found in Vytorin, which at least another million Americans are taking)!  In other words, this increased the rate of atherosclerosis, i.e., coronary artery disease!  This study was just two years long, imagine the results over ten years use of this drug.  The results were just announced so they are not yet published in a medical journal, but they were reported in several media outlets.  Interestingly, it did not make a big splash on TV.  If such “bad news” about vitamins would have been released it would have created a tidal wave on the “controversy” of nutritional supplementation, yet this “deadly news” barely made a ripple regarding the issue over cholesterol-lowering drugs’ dark side.   

There have been 22 placebo-controlled studies of co-Q10 among people with congestive heart failure.  Of those, only 3 studies have failed to shown significant benefit, which means 19 have shown significant heart benefits among those with failing hearts, …that is reversal of heart disease!   So, why would three studies not have shown a benefit?  One study failed to measure co-Q10 levels at all, so there was no way to even know if the patients even obtained therapeutic levels. (Eur Heart J. 1992 Nov;13(11):1528-33), and although the other two studies measured co-Q10 levels in patients, the co-Q10 levels were sub-therapuetic; i.e., the patients did not get enough co-Q10 to be effective!  Despite this, these three studies are the most often quoted in discounting the benefits of co-Q10!  Why?  (Med J Aust. 2001 Oct 15;175(8):447;author reply 447-8 and Ann Intern Med. 2000 Apr 18;132(8):636-40) 

Why not refer to the 19 other studies showing the significant benefits of co-Q10?  If these were studies done by a pharmaceutical company, they would more than qualify: the patients were given the correct therapeutic doses; and 19 powerful studies would be proof positive of the benefits of the substance being studied.  There would be no question for its use in patients with congestive heart failure.  Why, it's almost as if there is some group with a financial interest who does not want us to know about the benefits of co-Q10 because they want us to remain uninformed and taking their products ...to our detriment.

It is clear that therapeutic blood levels, i.e., in order to see improvement in heart functioning in those with congestive heart failure, the blood level of co-Q10 should be at least 3.5 micrograms/ml (mcg/ml) or greater.   Of all the studies showing cardiac benefits using co-Q10 there has been absolutely no harmful side-effects or negative drug interactions.  Since this has been shown to be true, why aren't more doctors aware of this?  The studies are there!  All benefit, no harm.  With the drugs, ...little benefit (or none in some cases), with much harm.  Hmmm?  Well, at least some people are getting the message, and others are delivering it.

Co-Q10 offers numerous benefits, not only for people with congestive heart failure, but also those with coronary artery disease, atherosclerosis, and those with cancer (again, a topic for another update).   In a placebo-controlled study in 2007 of 38 patients using 300 mg /day of Co-Q10, researchers found an increased production of the powerful antioxidant enzyme superoxide dismutase (which has been shown to reverse atherosclerosis, or plaque in the arteries), and vasodilation (blood vessel widening, …which allows blood to flow freely to the heart, brain, muscles, etc. to deliver oxygen to organs, rather than being constricted as with a heart attack).  Eur Heart J.  2007 Jul 19;[Epub ahead of print.] 

The people supplementing with co-Q10 also showed increased peak consumption of oxygen and oxygen pulse, meaning more efficient and effective use of oxygen, which is significant for athletes and those with compromised hearts and lungs.

Regarding the effect of statin drugs on cholesterol, cholesterol on heart health, co-Q10 on heart health and the prevention of heart disease, there are many good books in addition to my own book, The Cholesterol Conspiracy.  In my other books, Prostate Cancer and Breast Cancer I write about the role of co-Q10 in cancer (with references).   There are so many benefits to co-Q10 for those who are concerned about these health issues, however, for those who are healthy (and for athletic performance enhancement) and just want more energy and vitality in life I would highly suggest considering looking into a high-quality, pharmaceutical-grade, highly absorbable gel formulation of co-Q10. 

There is no known toxic dose to co-Q10, and it is clear that for maximum benefit in those with heart disease therapeutic doses must be achieved.