Wednesday, May 13, 2015

Wisdom Wednesday: Coenzyme Q-10

Coenzyme Q-10 (CoQ-10) is a very popular supplement. Many people use CoQ-10 for heart conditions, chest pain, diabetes, breast cancer, Parkinson’s disease, muscular dystrophy, chronic fatigue syndrome (CFS), Lyme disease and increasing exercise tolerance.

The chemistry of Co Q-10 is well understood. In the mitochondria of every cell, it facilitates electron transport. This is the process by which energy is transferred from the Krebs’s Citric Acid Cycle (glucose metabolism) to make ATP, the energy molecule of the body. Deficiencies of Co Q-10 impair electron transport severely limiting energy production for all body functions.

Your body produces 75% of the Co Q-10 it needs. The rest comes from the diet. Co Q-10 is found in small amounts in most animal foods. Co Q-10 is a fat and requires other fats in the diet for absorption. So a vegan vegetarian restricting their fat intake might develop a deficiency.

However, the overwhelming cause of Co Q-10 deficiency comes from using statin drugs to lower cholesterol. Drugs like Lipitor inhibit the synthesis of Co Q-10 in the same manner as they inhibit cholesterol synthesis. The symptoms of Co Q-10 deficiency are low energy, fatigue, leg weakness and leg pain. The cardiac myopathy (heart muscle damage) that occurs in 10% of patients taking statin drugs is thought to be a result of Co Q-10 deficiency.

In Canada, all prescriptions for statin drugs come with a warning that the drug will cause a deficiency and a Co Q-10 supplement is given to the patient along with the drug. In the U.S. the side effects of statin drugs are well known, but generally ignored or down played by the prescribing physician.

In my practice I recommend Co Q-10 daily as such a large percentage of the U.S. population takes a statin drug. I also use it frequently in the treatment of congestive heart failure and on occasion to lower high blood pressure. It is quite rare to find a need for Co Q-10 supplementation in a patient that is not taking prescription medication.

Because Co Q-10 is a fat, it should be taken with meals that contain fat to aid in absorption. Good quality supplements will contain some additional fat, often in the form of vitamin E, to increase absorption. Taken alone, rate of absorption from the digestive tract is about 1%. When combined with adequate fat, absorption rates vary from 3-7%.

Many of my new patients list Co Q-10 as one of their OTC (over the counter) supplements. Unfortunately, few of them know why they are taking it, it just one of those things you take.

The Bottom Line:
If you are on a statin drug, you must supplement Co Q-10. If you have congestive heart failure, you probably need Co Q-10. If you have high blood pressure you might benefit from Co Q-10. If you don’t fall into one of these categories, you don’t need it.

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