Healthy Aging

The Power of CoQ10

CoQ10’s effects on fatigue, fertility, and the heart

Do you ever feel as if you don’t have enough energy? You’re not alone! Energy is not just a function of mood, positive thinking, or lack of sleep, although all those things play a role.  Energy is, literally, the power to do work. Within the body, the power to do work is provided by a substance known as ATP (adenosine triphosphate),[1],[2] which is produced when calories are burned. And the production of ATP requires Coenzyme Q10 (CoQ10).

When CoQ10 levels decline, so does the function of the mitochondria, and the energy for daily living declines as well.

A healthy person at rest produces their body weight in ATP each day![3] A large amount of ATP must be produced every second of every day, because ATP cannot be stored.[4] ATP synthesis occurs in the mitochondria, the powerhouses within cells, and CoQ10 has both bioenergetic and antioxidant properties that keep the mitochondria running smoothly.[5],[6] When CoQ10 levels decline, so does the function of the mitochondria, and the energy for daily living has been shown to decline as well.[4],[7]

“The flow of energy through mitochondria distinguishes the living person from the inert body; it enables mitochondrial functions required for life.” [8]

Certain rare mitochondrial disorders are associated with defects in CoQ10 synthesis, and can thus be corrected with supplemental CoQ10.[9],[10],[11],[12] More commonly, CoQ10 deficiencies occur in the general population as a result of environmental toxins, poor diet, oxidative stress (which depletes CoQ10), exercise, and the natural aging process.[4],[13],[14],[15] CoQ10 deficiency is also a secondary effect of cholesterol-lowering statin drugs, as is discussed below. But first, let’s take a look at the latest research on CoQ10 and fatigue, fertility, and the heart.

CoQ10 and fatigue

Low levels of CoQ10 are consistently associated with fatigue.

Chronic fatigue syndrome (CFS) is a debilitating condition that often goes undiagnosed. Although the average age of CFS onset is 33 years, the skeletal muscles of CFS patients show muscle damage and weakness similar to that seen in the elderly.[16] Low serum CoQ10 levels are associated with CFS.[7],[17],[18] Moreover, a review of the literature on fatigue, not limited to CFS, concluded that low levels of CoQ10 were consistently associated with fatigue.[7]

According to several studies, supplementation with CoQ10 may ameliorate some CFS symptoms.[19],[20],[21] One study evaluated the benefits of a combination of CoQ10 and nicotinamide adenine dinucleotide (NADH), a derivative of niacin (vitamin B3) that also participates in ATP production.[20],[22] Participants who took CoQ10 (200 mg per day) and NADH (20 mg per day) were found to have higher levels of ATP in their blood cells, and reported significantly less fatigue as compared to the placebo group.[20],[21]

Low CoQ10 levels have also been reported in people with fibromyalgia (FM),[23],[24] a disorder that affects up to 5% of the general population. FM is characterized by widespread musculoskeletal pain accompanied by fatigue, sleep disturbances, and other issues. Studies suggest that CoQ10 supplementation may help reduce some symptoms of FM.[23],[25],[26] A randomized, placebo-controlled study evaluated the effects of 40 days of CoQ10 supplementation (300 mg per day) in 20 FM patients and found that CoQ10 supplementation was associated with a prominent reduction in pain, fatigue, and morning tiredness as compared with placebo.[26]

CoQ10 and fertility

There is a correlation between the age-related decline in CoQ10 and the decline in fertility. In aging mice, supplementation with CoQ10 reverses most of these changes.

Female fertility is one of the first bodily functions affected by aging. Fertility begins to decline at age 32 and decreases more rapidly after age 37.[27] Oocytes (eggs) depend on CoQ10 for energy and protection, and there is a correlation between the age-related decline in CoQ10 and the decline in fertility.[28],[29],[30] In aging mice, supplementation with CoQ10 reverses most of these changes.[30] 

In women undergoing in vitro fertilization (IVF), CoQ10 levels in follicular fluids (the fluids that surround the egg) correlate with the chance for a successful pregnancy.[31],[32] These results have prompted studies of the effects of CoQ10 supplementation on IVF success. In one study, CoQ10 (200 mg per day) was associated with a significant increase in egg count and egg quality or grade, which is assessed by microscopy.[33] In another study, women receiving CoQ10 supplements had twice as many retrieved oocytes per IVF cycle, along with a 50% higher fertilization rate, compared with a control group.[34]

CoQ10 is necessary for energy production in sperm, and there is a correlation between CoQ10 levels and swimming ability.

Men (and women), take note: half of all infertility is attributable to the male partner.[35] For successful fertilization, sperm must swim long distances through the thick, sticky fluid of the female reproductive tract to reach the egg.[36],[37] CoQ10 is necessary for energy production in sperm,[38] and there is a correlation between CoQ10 levels and swimming ability![39],[40],[41],[42] In one study of male infertility, CoQ10 supplementation for 12 months improved sperm quantity and sperm motility (swimming) by 114% and 79%, respectively.[43] The overall pregnancy rate in the supplemented men’s partners was a healthy 34%.[43]

CoQ10 and heart health

The antioxidant function of CoQ10 helps protect the heart against damage.[44],[45],[46],[47],[48] In addition to skeletal muscle, the striated muscle cells of the heart also contain high levels of mitochondria.[49] Deficient levels of CoQ10 have been observed in individuals with congestive heart failure, angina pectoris, coronary artery disease, cardiomyopathy, and hypertension, as well as familial hypercholesterolemia, which raises the risk of early heart disease.[50],[51] CoQ10 supplementation has thus been suggested by some researchers as an adjunct to standard treatments for these conditions.[52],[53],[54]

In heart attack patients, supplementation with CoQ10 (120 mg per day for 24 weeks) was associated with better heart function than that seen in the placebo group.[48] In individuals with chronic heart failure, long-term supplementation with CoQ10 (100 mg three times daily for two years) was associated with a 40% decrease in mortality.[53]

Along with protecting against cardiac damage, CoQ10 supplementation may improve blood lipid profiles, including a decrease in low density lipoprotein cholesterol (LDL-C), total cholesterol, and/or triglyceride levels.

Along with protecting against cardiac damage, CoQ10 supplementation may improve blood lipid profiles, including a decrease in low density lipoprotein cholesterol (LDL-C), total cholesterol, and/or triglyceride levels.[55],[56],[57],[58],[59] CoQ10 also helps reduce the oxidation of LDL-C and levels of lipoprotein (a), which are factors that also contribute to cardiovascular disease.[60],[61]

People with high cholesterol levels are typically treated with statin drugs, which reduce LDL-C.[62] Although statin treatment is considered the standard of care, statins also reduce CoQ10, by blocking the enzyme that produces it as well.[63] The reduction of CoQ10 may contribute to side effects known as “statin-associated muscle symptoms” (SAMS), which include muscle pain, cramping and weakness.[64] Statin medications have been shown to potentially deplete CoQ10 by up to 40%.[65] Several studies have shown a benefit of CoQ10 supplementation on SAMS,[66],[67],[68] while others showed no effect.[69],[70]

Finally, statins may increase the risk of new-onset diabetes mellitus (NODM), a rare but serious statin side effect.[71],[72],[73] Very recent studies in animal models showed that the development of NODM could be prevented with CoQ10;[74] human studies are needed to confirm these findings.

Summary

Although CoQ10 is made within the body, it declines with age and its levels are often not sufficient to support the body’s needs. Low levels of CoQ10 are common in people experiencing fatigue, muscle weakness, declining fertility, and/or heart problems. If any of these apply to you, seek the help of a qualified health professional, and consider supplementing with CoQ10!

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