Two-time Nobel laureate Prof. Dr. Linus Pauling called coenzyme Q10 one of the greatest enrichments among natural substances that can promote human health. Numerous studies not only prove the positive effects of Q10 in the therapy of various diseases, such as tumor diseases, heart failure (cardiac insufficiency), myocardial infarction (heart attack), hypertension (high blood pressure) and myasthenia gravis (neurological disease associated with muscle weakness), but also show that the healthy organism is dependent on a sufficient supply of this coenzyme. With the help of various scientific studies, the following effects of Q10 have been demonstrated.
Energy provision
Coenzyme Q10 is part of the indispensable work, survival and regeneration program of every cell – it is the most important substance in mitochondrial energy production. Due to its ring-shaped quinone structure, the vitaminoid can accept electrons and transfer them to cytochromes, especially cytochrome c, an electron-transporting protein of the respiratory chain. Electron transport in mitochondria leads to the formation of adenosine triphosphate – ATP, which is the universal form of immediately available energy in every cell and also an important regulator of energy-producing processes. Finally, coenzyme Q10 plays a key role in the biochemical process of oxidative phosphorylation or respiratory chain phosphorylation. Ubiquinone is thus an important component in the conversion of dietary energy into endogenous energy, with 95% of total body energy activated by Q10. Consequently, in the case of coenzyme Q10 deficiencies, significant disturbances in oxidative energy metabolism occur, which in turn has negative effects on the energy balance of energy-rich organs. The heart, liver and kidneys are particularly affected. With a sufficient supply of coenzyme Q10, the cells can be optimally supplied with energy. A good energy supply to the immune system strengthens the body’s defenses, making the human organism more resistant overall – especially to free radicals.
Antioxidant effect
Coenzyme Q10, along with vitamin E, carotenoids and lipoic acid, is an important fat-soluble antioxidant in lipid membranes. By acting as a free radical scavenger, ubiquinone protects lipids, particularly LDL cholesterol, from oxidative changes. In addition to lipids, free radical targets include proteins, nucleic acids, and carbohydrates. Free radicals can arise exogenously as unstable reaction products in the mitochondria from cellular respiration and can act on our organism both in chemical form – food components, environmental toxins, drugs – and in physical form – UV radiation, ionizing radiation. Our current living conditions – high physical and mental stress, unbalanced diet – too little fresh fruit and vegetables and too much high-fat products -, increased alcohol and nicotine consumption and negative environmental influences – promote the formation of free radicals. In the case of increased exposure or existing antioxidant deficiency, free radicals can put biological tissue under oxidative stress – imbalance between the pro- and antioxidant systems in favor of the former – and destroy it by triggering a chain reaction as an initiator, whereby reactive oxidants are formed. These are capable of damaging DNA through strand breaks, base modifications, or deoxyribose fragmentation. Furthermore, oxidants can structurally alter proteins, leading to changes in primary, secondary, and tertiary structure, as well as modification of amino acid side chains, which in turn can be accompanied by loss of function. The increased occurrence of free radicals puts a strain on the Q10 pool in individual organs.Low Q10 concentrations increase the risk of oxidative changes of various cellular compartments. Caution. Oxidative cellular damage may eventually lead to the development of degenerative diseases, such as:
- Atherosclerosis (arteriosclerosis, hardening of the arteries).
- Tumor diseases
- Diabetes mellitus
- Heart disease, such as coronary artery disease (CAD), cardiomyopathy and heart failure (cardiac insufficiency).
- Alzheimer’s disease
Free radicals also play a major role in aging – high oxidative stress accelerates the aging process.Studies on radical-associated vascular diseases concluded that atherosclerotically altered vessel walls show a more than 300% increase in oxidized coenzyme Q10. This high concentration probably indicates an increased coenzyme Q10 requirement during oxidative stress. Coenzyme Q10 prevents the damaging effects of free radicals by “disposing” of them before they interact with essential cellular components. As a result of absorbing radical reactivity, antioxidants often deplete themselves. For this reason, adequate intake of coenzyme Q, among others, is of considerable importance in maintaining the antioxidant protection system against free radicals. In addition to Q10, the most important antioxidant substances include vitamins A, C, E, beta-carotene, flavonoids and polyphenols. Furthermore, it must be mentioned that low molecular weight antioxidants represent only a part of the antioxidant protection strategies and a deficit of individual antioxidants can be partially compensated by others. Thus, an isolated deficiency of antioxidant protection does not necessarily lead to symptoms or disturbances in metabolism. In addition, coenzyme Q10 exerts a “vitamin E saving effect” together with its redox partner ubiquinol. By this is meant that Q10 is significantly involved in the reconversion of the tocopheryl radical into the active vitamin E. In addition, ubiquinone promotes the regeneration of vitamin E through direct radial scavenging properties.
Effects on the heart
According to clinical studies of cardiovascular disease, the heart is the most susceptible organ to oxidative stress and premature aging. Since the heart is one of the organs with the highest Q10 concentrations, a diet rich in coenzyme Q10 protects against various heart diseases, such as coronary artery disease (CAD), heart failure (heart muscle weakness), and cardiomyopathy. Ubiquinone is essential for the energy supply of the heart muscle cells. Among other things, it optimizes cardiac output and ejection volume, cardiac index, and end-diastolic volume index and ejection fraction. Extensive studies revealed decreased levels of ATP and coenzyme Q10 in some heart diseases. Q10 supplementation had a positive effect on cardiac function in affected individuals – discontinuation of the supplements eventually led to a deterioration of cardiac performance again. The following effects are referred to as secondary effects:
- Stabilization of membranes and increase in membrane motility – due to its highly lipophilic properties, coenzyme Q10 can move back and forth in the cell membrane; Q10 also ensures membrane permeability for vital substances.
- Inhibition of intracellular phospholipases.
- Influences on sodium–potassium ATPase activity and stabilization of the integrity of calcium-dependent channels According to current knowledge, it is not clear how large the daily requirement for coenzyme Q10 really is. It is also unclear how much coenzyme Q10 is produced by the body itself and how much it contributes to a supply that meets the needs of the body. According to some authors, the ability to produce coenzyme Q10 itself decreases with age. As a result, Q10 plasma contents as well as Q10 concentrations of individual organs decrease. Low coenzyme Q10 levels are particularly seen after the age of 30. In older people, coenzyme Q10 concentrations – especially in the heart muscle – have been found to be 50-60% lower than in middle age.
Reasons for low coenzyme Q10 levels in old age could be the following:
- An increased consumption in old age
- The decrease of mitochondrial mass in the musculature.
However, scientific proof of this has yet to be provided.
The heart – among all other organs – is particularly affected by this age-related decrease in coenzyme Q10 concentration. The decreased self-synthesis of Q10 with age represents a significant risk factor. As a result of decreasing Q10 levels, the organism’s energy supply is deficient and the organs are more susceptible to free radicals. This increases the risk both for the development of degenerative diseases and for the appearance of age-related degeneration symptoms. Even a Q10 deficit of 25% can impair many bodily functions.Finally, with increasing age – especially after the age of 40 – the prevention of coenzyme Q10 deficiency through adequate dietary Q10 intake is of greater importance for the levels of this vitaminoid in organs such as the heart, liver, lungs, spleen, adrenal gland, kidney, and pancreas – pancreas. Trends in coenzyme Q10 levels by age.
| Organ | Q10 levels in 20-year-olds (baseline 100). | Q10 value decrease in % in 40-year-olds | Q10 value decrease in % in 79-year-olds |
| Heart | 100 | 32 | 58 |
| Kidney | 100 | 27 | 35 |
| Adrenal gland | 100 | 24 | 47 |
| Spleen | 100 | 13 | 60 |
| Pancreas | 100 | 8 | 69 |
| Liver | 100 | 5 | 17 |
| Lungs | 100 | 0 | 48 |
Drug interaction – statins
Patients with hypercholesterolemia who must take statins regularly should pay special attention to their dietary coenzyme Q10 intake. The limited self-synthesis of Q10 using statins increases the risk of coenzyme Q10 deficiency in combination with low dietary Q10 intake. Statins are so-called cholesterol synthesis inhibitors and are among the most important lipid-lowering drugs. They block the formation of cholesterol in the liver via inhibition of the enzyme HMG-CoA reductase, which is necessary for this process – statins are therefore also called cholesterol synthesis enzyme (CSE) inhibitors. By blocking HMG-CoA reductase, statins additionally prevent the endogenous synthesis of coenzyme Q10. There is also evidence that the side effects of CSE inhibitors can be substantially reduced by using Q10.
