IS YOUR MEDICATION DEPLETING THE CO-ENZYME Q10 IN YOUR BODY?
The functions of and research on Co-Q10
could fill books, so this is only an overview. Co-Q10 is an extraordinary vitamin-like substance found in every cell in your body. The chemical name is ubiquinone because it is an ubiquitous quinone. We depend upon it for life. It affects the functions of your every cell, where it is essential for multiple life sustaining processes.
Yet, many drugs deplete this vital nutrient. If you or a loved one are taking one or more of these drugs, you need to know and you need to add supplemental Co-Q10. The risk of depletion of Co-Q10 is not made clear in the drug info inserts and you are not advised to replace the lost Co-Q10 while you are using the drug. This practice needs to stop. Don’t blame your Dr, because the drug/Co-Q10 issue is not common knowledge, except for the statins. Any Dr who prescribes a statin should tell you to supplement Co-Q10.
Be sure to see the list of culprit drugs at the end of this newsletter .
Do not stop a prescription medicine without discussing options with your doctor.
Though always working in our bodies, Co-Q10 was only first isolated and described by Dr Frederick Crane in 1957. Dr Peter Marshall won the 1978 Nobel Prize in Chemistry for his discoveries of the mechanisms of energy transfer in the body, part of which involved the role of Co-Q10. In 1974 the Japanese incorporated it as a prescription item into their treatment for congestive heart failure & other heart disorders. Life Extension Foundation introduced Co-Q10 to the U.S. in 1983. It later became widely available as an OTC nutrient supplement.
Co-Q10 has and is still being extensively studied and is now the 3rd most sold dietary ingredient in the U.S. after the Omega-3’s and multivitamins.
Some of the research clinical trials using CoQ10 as adjunctive therapy involve myalgias & myopathies, statin induced myopathies, myopathic encephalopathies (ME), muscular dystrophy, Mitochondrial Disease, fatigue syndromes, depression, Parkinson’s Disease, Friedrich’s Ataxia, Amyotrophic Lateral Sclerosis, other neurodegenerative diseases, cardiomyopathy, heart failure, heart protection during heart surgery, heart arrhythmia, angina, mitral valve prolapse, heart protection for those on the anthracycline chemotherapeutic agents, hypertension, protection in stroke, LDL cholesterol, blood vessel dilation, migraine, cyclic vomiting syndrome, asthma, age-related macular degeneration, decreased sperm count & motility, chronic kidney failure, breast & other cancers, myelodysplastic syndrome, post surgical melanoma, chronic gum disease, immune function, AIDS, aging, and skin health.
HOW DOES THE BODY MAKE CO-Q10?
When we are under 30 years old, our body makes about 500 mg of CoQ10 daily. This is needed to maintain the general body pool of about 2000 mg. By age 65 most people have 50-60% less CoQ10 in their body, the decline of which may be among the myriad of factors contributing to the aging process. We also get about 10 mg of CoQ10 daily from our diet, with the most coming from fish, muscle meat, liver, kidney, nuts, soy & spinach.
In the miraculous functioning of the body we make our own CoQ10 from other “precursor” nutrients which we convert to CoQ10. Proper functioning of this process depends upon adequate amounts of all the precursors being present & the conversion processes working correctly. It all begins with my old favorites, the amino acids tyrosine
(which are the basis for my book on the natural treatment of depression
) and have numerous critical functions in the body. So no surprise that here again these amino acids are so important. These amino acids begin to transform to CoQ10 in the presence of the pyridoxal-5-phosphate
form of vitamin B6 (another old favorite). The vitamins B2, B3
, Folic acid
, vitamin C
, and several trace mineral elements must also be present. So you see for proper CoQ10 production we need to be well nourished enough to have sufficient precursors. Altogether there are 17 steps in the bio-synthesis of this remarkable vitamin-like fat soluble substance found in higher concentrations in high energy areas such as the heart, brain, liver, muscles, pancreas, immune cells, gums, stomach lining, but still in every cell.
CoQ10 primarily modulates disorders related to suboptimal cellular energy metabolism & oxidative injury. My opinion is this could almost relate to every disease state, as most diseases eventuate in a disruption of these primary processes.
Besides certain drugs, other factors leading to depletion of CoQ10 are:
- Poor diet/ malnutrition
- Poor digestion and absorption
- Excessive exertion
- Health conditions which increase the body’s energy needs such as hyperthyroidism, AIDS, cancer, acute shock.
CoQ10 is in all cell membranes (membranes separating the cells from the outside environment & controlling what moves in & out of the cells), and in lipoproteins (particles made of fats & proteins that allow the transport of fats through the blood).
WHAT ARE THE FUNCTIONS OF CO-Q10?
Now to the daunting task of "simply" explaining what Co Q10 does:
It helps create the chemical energy (ATP
, the body’s main energy storage molecules) for the metabolism or functioning of every cell in your body. The highest concentrations are found in the body areas requiring the most energy. This process is called oxidative phosphorylation , whereby proteins, carbohydrates, and essential fatty acids are broken down to produce energy in the energy factory of the cell called mitochondria.
This creation of energy has the side effect of forming unwanted combustion by-products (free radicals, oxidative or peroxidative by products). Co-Q10 then helps clean up these noxious molecules with its powerful anti-oxidant actions (neutralizes these highly reactive chemical oxygen &/or nitrogen containing by products which would otherwise react with surrounding molecules to create damaging changes). It exerts these effects in the membrane and DNA of every cell.
These antioxidant effects help modulate the aging process. A theory of aging is that a lifetime of free radical production gradually causes damage to cellular components such as decreasing the ability to produce the energy storing ATP, mitochondrial mutations which disable the energy processing capacity of the mitochondria, and oxidative damage to DNA.
It plays a role in transporting proteins across the cell membrane to maintain optimal pH balance.
It is a powerful antioxidant in lipoproteins . Co-Q10 & alpha lipoic acid
work to protect the lipids in all cell membranes & mitochondrial membranes. Alpha lipoic acid also helps to recycle/regenerate Co-Q10.
It works synergistically with Vitamin E
in its antioxidant functions and helps to conserve vitamin C
It works with the garbage collecting lysosomes to clean up & digest cellular debris.
It modulates prostaglandins to decrease inflammation
Inhibits intracellular phospholipases (inflammatory chemicals) found in neurological disorders associated with inflammation & oxidative stress such as Alzheimer’s disease, spinal cord injury, decreased blood flow injury. These are neuroprotective effects. High doses up to 1200 mg /d have been found to slow the progression of Parkinson's Disease.
It is a calcium channel & membrane stabilizer ( balancing of muscle contraction/relaxation)
Preserves heart muscle Na, K-ATPase (sodium, potassium, adenosine triphosphate) an enzyme performing the active transport of Na & K across the cell membrane to allow muscle contraction and relaxation.
Co-Q10 is highly concentrated in the heart muscle. Congestive heart failure is strongly correlated with low blood & tissue levels of Co-Q10. This Co-Q10 deficiency may well be an etiological factor in some types of heart muscle dysfunction. Multiple studies support that Co-Q10 significantly improves heart muscle function especially diastolic dysfunction (which occurs when the heart muscle stiffens interfering with its ability to pump blood).
This is not an exhaustive list of the functions of CoQ10 , but gives an idea of its importance & variability in function.
WHY DO SOME DRUGS INTERFER WITH COQ10?
Most of the information presented here is obtained from the book Drug-Induced Nutrient Depletion Handbook
which is a good book to consult if you are taking medications. As previously mentioned we have our own Co-Q10 manufacturing process in our body and very little of the amount needed is obtained directly from food. But the precursors needed for us to make Co-Q10 are from food. When drugs interfere they are blocking
Here is a list of the prescription drugs that deplete CoQ10 levels.
HMG-CoA Reductase Inhibitors (Statins)
- Atorvastatin (Lipitor)
- Cerivastatin (Baycol, Lipobay)
- Fluvastatin (Lescol, Canef, Vastin)
- Lovastatin ((Mevacor, Altocor)
- Pravastatin (Pravachol, Selektine)
- Simvastatin (Zocor)
- Fibric Acid Derivatives
- Gemfibrozil (Lopid)
- Alpha2-Adrenergic agonists
Calcium Channel Blocking Agents
- Amlodipine besylate (Norvasc)
- Bepridil( Bepadin Vascor)
- Diltiazem (Cardizem, Cardizem SR, Cardizem CD, Dilacor XR)
- Felodipine ( Plendi)
- Funarizine ( Sibelium0
- Isradipine (DynaCirc)
- Nicardipine (Cardene)
- Nifedipine (Adalat, Procardia, Pro cardia XL)
- Nimodipine ( Nimotop)
- Verapamil (Calan, Calan SR, Isoptin, IsoptinSR)
- Acebutolol (Sectral, Prent)
- Aldomet (Methyldopa)
- Atenolol (Tenormin)
- Betaxolol (Betoptic, Betoptic S, Lokren, Kerlone)
- Bisoprolol (Zebeta)
- Carteolol (Cartrol, Ocupress, Teoptic, Arteolol, Arteoptic, Calte, Cartéabak, Carteol, Cartéol, Cartrol, Elebloc, Endak, Glauteolol, Mikelan, Poenglaucol, Singlauc)
- Celiprolol (Cardem, Selectol, Celipres, Celipro, Celol, Cordiax, Dilanorm, Selectol)
- Esmolol (Brevibioc)
- Labetalol (Normodyne, Trandate)
- Levobetaxolol (Betaxon)
- Levobunolol (Betagan)
- Metipranolol (OptiPranolol, Betanol, Disorat, Trimepranol)
- Metoprolol (Lopressor, Toprol XL)
- Nadolol (Corgard, Anabet, Solgol, Corzide, Alti-Nadolol, Apo-Nadol, Novo-Nadolol )
- Penbutolol (Levatol, Levatolol, Lobeta, Paginol, Hostabloc, Betapressin)
- Pindolol Visken, Betapindol, Blockin L, Blocklin L, Calvisken, Cardilate, Decreten, Durapindol, Glauco-Visken, Pectobloc, Pinbetol, Prindolol, Pynastin)
- Propranolol (Inderal)
- Sotalol (Betapace)
- Timolol (Timolol)
- Benzthiazide (Aquatag, Dihydrex, Diucen, Edemax, Exna, Foven)
- Chlorothiazide (Diuril)
- Diucardin (Hydroflumethiazide),
- Hydrochlorothiazide (Dyazide)
- Hydromox (Quinethazone)
- Indapamide (Lozol)
- Methyclothiazide (Aquatensen, Enduron)
- Metolazone (Mykrox, Zaroxolyn)
- Renese (Polythiazide)
- Thiazide Diuretics
- Trichlormethiazide (Achletin, Diu-Hydrin and Triflumen)
- Acetohexamide (Dymelor)
- Chlorpropamide (Diabinese)
- Glimepiride (Amaryl
- Glipizide (Glucotol)
- Glyburide (Micronase)
- Sulfonylureas (Glimepiride, Glyburide, and Tolazamide)
- Tolazamide (Tolinase),
- Amitriptyline (Elavil)
- Amoxapine (Asendin)
- Clomipramine (Anafranil)
- Desipramine (Norpramin, Pertofane)
- Doxepin (Sinequan)
- Doxorubicin (Adriamycin)
- Nortriptyline(Aventil, Pamelor)
- Trimipramine (Surmontil, Rhotrimine, Stangyl)
Psychotherapeutic Medications-Major Tranquilizers:
- Apresoline (Hydralazine)
- Phenothiazine Derivatives
- Chlorpromazine (Thorazine)
- Fluphenazine (Permitil. Prolixin)
- Haloperidol (Haldol)
- Mesoridazine (Serentil)
- Perphenazine (Trilafon)
- Prochlorperazine (Compazine, Stemzine, Buccastem, Stemetil, Phenotil)
- Promazine (Sparine)
- Thioridazine (Mellaril)Thiothixene (Navane)
- Torecan (Thiethylperazine)
- Trifluoperazine (Stelazine)
Co-Enzyme Q10 is available in 2 forms as a supplement, as ubiquinol & ubiquinone. The ubiquinol form has only been available since 2006 but is the preferred form, especially if you are at high risk for deficiency or already have a condition which could be helped by Co-Q10. The ubiquinol form is preferred because it is more bioavailable and produces 4-8 times higher blood levels than the ubiquinone, yet is only about 10% more expensive.
Co-Q10 absorbs better with fats, so needs to be taken with meals. Dosage range is from 30-50mg to 1200 mg daily depending upon the reason for taking. But keep in mind the body produces 500 mg daily at optimal age & functioning. About half of that production is lost by 60 years old, so to maintain the same level would need 200-300 mg/d.
BLOOD TESTING FOR CO-Q10
If you want to know what your Co-Q10 levels are, you can ask your Dr to order a test or you can order your own test from Life Extension
. However I generally order the 28 nutrient test from Spectra Cell Lab
because it measures cellular functions dependent upon steady states of a nutrient over time.
Co-enzyme Q10 is safe and no toxicity or adverse reactions have been reported. There are conflicting claims that it may interfere with bllod thinner (Warfarin) meds.
I have had no patients report any side effects with CoQ10 but the literature reports rare incidences of stomach upset, headache, diarrhea.