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This is a past iteration of our review of information related to Coenzyme Q10 and its relationship to the heart. Coenzyme Q10 Facts CoQ10 can be synthesized by the human body, and is also known as ubiquinone. Most CoQ10 supplements are manufactured by the fermentation of beets and sugar cane. Since 1974 the Japanese government has approved about 250 CoQ10 preparations for the treatment of cardiovascular disease indications. CoQ10 is lipid-soluble benzoquinone with a 10 isoprenyl unit side chain, found on the inner mitochondrial membrane and serves as an electron transport carrier. CoQ10 directly regulates NADH and succinate dehydrogenase. Health Tips Other heart helpful supplements include L-carnitine and creatine. Both aid in achieving improved exercise capacity in patients with HF in some studies. Click here for last month's Health Tip and Health Issue Review.
		Heart Health There has been quite a bit of discussion in the medical literature and the popular health media about the CoQ10. What is this interesting little molecule and what does it do? To help put things into perspective, we have reviewed articles published in respected, peer-reviewed health and medical journals. Before taking any supplements always consult your primary care physician or family doctor for potential interactions and/or side effects with your present medications. Role of Coenzyme Q10 in Chronic Heart Failure, Angina, and Hypertension. Tran MT, Mitchell TM, Kennedy DT, Giles JT. School of Pharmacy, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA. Pharmacotherapy 2001 Jul;21(7):797-806 PURPOSE: Coenzyme Q10 (CoQ10) has a pathophysiologic role in many disease states. The purpose of this review is to provide recommendations regarding the safety, efficacy, and dosing of CoQ10 in the management of chronic heart failure (CHF), angina, and hypertension. DATA SOURCES: Literature pertaining to the safety and efficacy of CoQ10 specifically in cardiovascular indications was reviewed. We used relevant clinical trials, articles, reviews, and letters that were selected from a literature search of the MEDLINE database (1974-2000), Micromedex Healthcare Series, and the Natural Medicines Comprehensive Database. FINDINGS: Coenzyme Q10 administered orally has favorable actions in the described cardiovascular conditions and appears to be safe and well tolerated in the adult population. Issues concerning optimum target dosages, potential interactions, monitoring parameters, and the role of CoQ10 as a monotherapeutic agent need to be investigated further. Favorable effects of CoQ10 on ejection fraction, exercise tolerance, cardiac output, and stroke volume are demonstrated in the literature; thus, the use of CoQ10 as adjuvant therapy in patients with CHF may be supported. CONCLUSIONS: Coenzyme Q10 therapy in angina and hypertension cannot be substantiated until additional clinical trials demonstrate consistent beneficial effects. However, CoQ10 may be recommended as adjuvant therapy in selected patients with CHE At this time, CoQ10 should not be recommended as monotherapy or first-line therapy in any disease state. What does this mean? This article in a pharmacology journal makes the cautious statement that although no conclusive evidence exists for continuing supplementation for hypertension and angina, there were positive effects in the parameters and symptoms used to assess chronic heart failure. There was a discussion of the possible interaction that may exist with a group of drugs called 'statins' (HMG CoA reductase inhibitors), that may act to decrease serum levels of CoQ10. This study is an assimilation of retrospective data and does present information on CoQ10's biochemistry, molecular mechanisms, indications and pharmacokinetics. Should you be taking Coenzyme Q10, L-carnitine or creatine? Talk to our doctor of chiropractic. to find out what's best for you. Other articles that suggest a benefit of CoQ10 adjunctive usage for chronic heart failure include the following. Langsjoen PH, Folkers K, Lyson K, Muratsu K, Lyson T, Langsjoen P. Effective and safe therapy with coenzyme Q10 for cardiomyopathy. Klin Wochenschr 1988 Jul 1;66(13):583-90 Mortensen SA, Vadhanavikit S, Muratsu K, Folkers K. Coenzyme Q10: clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chronic heart failure. Int J Tissue React 1990;12(3):155-62 Additional References Sole MJ, Jeejeebhoy KN. Conditioned nutritional requirements and the pathogenesis and treatment of myocardial failure. Curr Opin Clin Nutr Metab Care 2000 Nov;3(6):417-24 Overvad K, Diamant B, Holm, et al. Coenzyme Q10 in health and disease. Eur J Clin Nutr. 1999; 53:764-70. Jellin JM, Batz F, Hitchens K,. Coenzyme Q10. Pharmacist's Letter/prescriber's letter: natural medicines comprehensive database. Stockton, CA: Therapeutic Research Center, 1999:271-3. Levien TL, Baker DE. Coenzyme Q10. Pharmacist's letter. Stockton CA:Therapeutic Research Center, 1998;14(2):8-9 Witte KK, Clark AL, Cleland JG. Chronic heart failure and micronutrients. J Am Coll Cardiol 2001 Jun 1;37(7):1765-74.