The impact of CoQ10 deficiency

The human body relies on a myriad of vitamins and minerals to function properly; when we are deficient in one or more areas, dysfunction and disease are the eventual result. Of those nutrients, Coenzyme (Co) Q10 is one of the most critical. Over time, a CoQ10 deficiency can contribute to cardiovascular disease. 

Read on to discover what recent research has shown about the importance of maintaining proper levels of CoQ10. 

Coenzyme Q10 deficiency and heart health

Coenzyme Q10, CoQ10, is a powerful antioxidant that is also involved with energy (ATP) production in the cell. It is found in every cell in the body so it is needed by all cells in the body, especially cells that need a lot of energy, like those in the heart and brain. 

CoQ10 is probably the very best thing to give to anyone with heart failure. In fact, a combination of CoQ10, thiamin and magnesium is a good start for improving the health of anyone with heart failure.  

About one in 56 Americans will experience heart failure, according to the statistics of heart failure. Nearly five million Americans are currently living with congestive heart failure (CHF), with 550,000 new cases being diagnosed each year. Most CHF patients are over age 60, but 1.4 million are under age 60, with approximately one million patients between the ages of 40 and 59. More than 5% of adults between the ages of 60 and 69 have CHF.  

Prescription drugs and CoQ10 deficiency

Statin drugs deplete CoQ10, which may be a factor in why there are so many cases of heart failure.1 Statins work by inhibiting the enzyme methylglutaryl coenzyme A (HMG-CoA) reductase. They prevent the production of mevalonate from HMG-CoA. The body converts mevalonate to cholesterol and a variety of other products. One of the things that melvalonate produces is CoQ10. So, these drugs ultimately prevent the production of CoQ10. 

Patients taking these drugs commonly experience exercise intolerance, muscle aches and pains, and myoglobinuria (excessive myoglobin in their urine). Studies show these drugs have the potential to cause myopathies and rhabdomyolysis with kidney failure. Also, the FDA has warned about liver failure in conjunction with these drugs. These more serious side effects occur in about 1% of the population taking the drugs.  

The heart contains high levels of CoQ10, and these levels are found to be lower in people suffering from congestive heart failure. One article notes that the incidence of heart failure has dramatically increased in the last three or four decades¹. The prevalence of heart failure had increased by 70% between 1990 and 2000. This corresponds with the increase in the use of statins. 

How can CoQ10 help?

A literature review looked at the value of CoQ10 supplementation for patients with heart failure.² CoQ10 is involved with electron transport in the mitochondria; in other words, it is important for the production of cellular energy. It is produced by every cell and acts to protect the cell membrane as an antioxidant. Patients with congestive heart failure tend to have low levels of CoQ10, with levels decreasing as the disease gets worse.³  

There have been a number of studies showing supplementation with CoQ10 improves cardiac function. The multicenter randomized placebo-controlled Q-SYMBIO trial has assessed the impact of supplemental CoQ10 on patients with heart failure. It is the largest study on CoQ10 and heart failure in the world. Begun in 2003, the study showed that patients supplemented with CoQ10 had a 43% decrease in cardiovascular death compared to the placebo group. Only 15% of the patients in the CoQ10 group experienced serious heart events compared with 26% of the patients who received the placebo, corresponding to a 43% relative reduction, a statistically significant result.³ There was more cardiovascular mortality in the placebo group (16% vs. 9%), and overall mortality was higher in the placebo group (18% vs 10%). 

Supplementation with CoQ10 also significantly reduced the risk of death from all causes by 42% compared to the placebo group. The number of unplanned hospitalizations was lower in the CoQ10 group (8% in the supplemented group as compared to 14% in the placebo group). Also, there were significantly more of the CoQ10-treated patients who improved one or more NYHA class than there were in the group receiving a placebo (58% versus 45%). One patient in the CoQ10 group went from NYHA IV to NYHA I during his treatment.³ Also, the group receiving the CoQ10 had fewer hospital stays and scored significantly higher on the NYHA functional classification. 

The researchers concluded, “Long-term CoQ10 treatment of patients with chronic HF is safe, improves symptoms, and reduces major adverse cardiovascular events.”³ 

Other research showed that 54% of patients receiving three months of CoQ10 supplementation (between 50 and 150 milligrams per day) had improvements in at least three symptoms of heart failure. Large percentages of patients experienced improvements, with 81% having less cyanosis, 76.9% having less edema, 54% having less shortness of breath, 62% having less arrhythmia and 73% having less vertigo. Also, the severity of symptoms correlated with low CoQ10 levels.⁴  

The authors of another study concluded, “Oral CoQ (10) improves LV contractility in CHF without any side effects. This improvement is associated with an enhanced functional capacity.”⁵ That sentiment was echoed in another small study.⁶ A multicenter study, involving 2,664 patients who were given only 50-150 mg of CoQ10 per day, also had favorable results. 

The researchers found, “After three months of test treatment the proportions of patients with improvement in clinical signs and symptoms were as follows: cyanosis 78.1%, oedema 78.6%, pulmonary rales 77.8%, enlargement of liver area 49.3%, jugular reflux 71.81%, dyspnoea 52.7%, palpitations 75.4%, sweating 79.8%, subjective arrhythmia 63.4%, insomnia 662.8%, vertigo 73.1% and nocturia 53.6%. Moreover, we observed a contemporary improvement of at least three symptoms in 54% of patients; this could be interpreted as an index of improved quality of life.”⁷ 

Conclusion

Research results support supplementation of CoQ10 to help prevent heart disease, so testing of CoQ10 levels is something to consider suggesting to your patients, as is recommending a CoQ10 supplement or even carrying it in your practice.

PAUL VARNAS, DC, DACBN, is a graduate of the National College of Chiropractic and has had a functional medicine practice for 34 years. He is the author of several books and has taught nutrition at the National University of Health Sciences. For a free PDF of “Instantly Have a Functional Medicine Practice” or a patient handout on the anti-inflammatory diet, email him at paulgvarnas@gmail.com. 

References 

1. Coats AJS. Is preventive medicine responsible for the increasing prevalence of heart failure? The Lancet. 1998;352:39-41.https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(98)90018-6.pdf. Accessed Dec. 6, 2023.  
2. DiNicolantonio JJ, et. al. Coenzyme Q10 for the treatment of heart failure: a review of the literature. [Review]. BMJ Journals. Open Heart. 2015;2(1):e000326. https://openheart.bmj.com/content/2/1/e000326. Accessed Dec. 6, 2023.  
3. Mortensen SA, et. al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014;2(6):641-9. PubMed. https://pubmed.ncbi.nlm.nih.gov/25282031/. Accessed Dec. 6, 2023. 
4. Mortensen SA, et. al. Coenzyme Q10: clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chronic heart failure. International Journal of Tissue Reactions. 1990;12(3):155-162. PubMed. https://pubmed.ncbi.nlm.nih.gov/2276893/. Accessed Dec. 6, 2023. 
5. Belardinelli R, et. al. Coenzyme Q10 improves contractility of dysfunctional myocardium in chronic heart failure. Biofactors. 2006;25(1-4):137-45. PubMed. https://pubmed.ncbi.nlm.nih.gov/16873938/. Accessed Dec. 6, 2023. 
6. Munkholm H, et. al. Coenzyme Q10 treatment in serious heart failure. Biofactors. 999;9(2-4):285-289. PubMed. https://pubmed.ncbi.nlm.nih.gov/10416042/. Accessed Dec. 6, 2023. 
7. Baggio E, et. al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med. 1994;15:287-94. PubMed. https://pubmed.ncbi.nlm.nih.gov/8241700/. Accessed Dec. 6, 2023.