Q10 and why it maybe useful for Heart Failure patients
If you have a look at our previous posts on Q10 we have advocated a look at this interesting supplement. Of course as usual if you are tempted to use it make sure you speak to your clinician and please note that it does have a procoagulant effect therefore if you are on warfarin then consult your warfarin nurse.
Researchers claim that patients who took the supplement, known as Coenzyme Q10, alongside their normal medication during a two-year study had lower levels of mortality than those who did not.
They say that doctors should now consider including the supplement, which costs around 25p per tablet, as part of the treatment of people who have a heart condition.
The supplement known as CoQ10, occurs naturally in the body and plays a role in turning sugar into energy for the cells.
Heart muscle contains large amounts of CoQ10, but previous research has shown that it decreases in patients who have suffered heart failure.
The new study, which involved 420 patients who had suffered heart failure, showed that those who took three 10mg tablets of CoQ10 a day had lower levels of heart failure two years later.
Fewer of the patients who had taken the supplement had died at the end of the study.
Professor Svend Mortensen, from the Heart Centre at Copenhagen University Hospital, who led the study, said: “The CoQ10 treated patients had reduced hospital admission rates for worsening heart failure and lower cardiovascular death, both of which may reflect a significant improvement in cardiac function.
“CoQ10 should be considered as a part of the maintenance therapy of patients with chronic heart failure.”
The results were presented at Heart Failure 2013 – the main annual meeting of the Heart Failure Association of the European Society of Cardiology – in Lisbon, Portugal.
It is also found in foods such as red meat and fish, but at very low levels that deemed to be insufficient to impact on heart failure.
The molecule is known to play an essential role in the mitochondria, the tiny power stations found inside almost every cell of the body that convert sugar into energy.
The new study, known as the Q-SYMBIO trial, followed patients in Denmark, Sweden, Austria, Slovakia, Poland, Hungary, India, Malaysia and Australia.
After two years, 14% of patients taking CoQ10 had suffered problems with their heart compared to 25% of those who had been taking a placebo.
Just 9% of the patients taking CoQ10 had died compared to 17% taking the placebo.
CoQ10 is currently sold over the counter at pharmacists, including Boots, as an energy booster.
Statins, one of the drugs taken by heart failure patients to control cholesterol, is also known to block the synthesis of CoQ10 in the body, causing levels to drop.
It is unclear how many of the patients in the study were taking statins and the CoQ10 could have been compensating for this effect in the study.
But Professor Mortensen said he hoped to conduct a trial to see how taking CoQ10 with statins could improve heart patient mortality rates compared to just taking statins alone.
He added: “Statins reduce CoQ10, and circulating CoQ10 prevents the oxidation of LDL effectively, so I think ischemic patients should supplement statin therapy with CoQ10.
Helen Williams, a consultant pharmacist for cardiovascular disease at NHS Southwark Clinical Commissioning Group and a member of the Royal Pharmaceutical Society, said: “this is a relatively small study for a cardiovascular trial.
“We have often been misled before by small studies that fail to show benefits when extended to larger numbers of patients, so I would great these results with cautious optimism.”
We believe that any positive trial is worth exploring and should not be dismissed in public before a larger clinical trial can take place.
CoQ10 and your Heart
We are having a lot of questions asked at the moment surrounding Q10 so we thought it would be a good idea to put more information on the website so that people could reference it against the other pieces of information we have on what seems to be an ever popular topic for discussion. It has always been a popular topic with us so we are pleased it is being referenced more by patients.Coenzyme Q10 (Ubiquinone / Ubiquinol which is synthesised from Ubiquinone and is highly absorbent and more potent than Ubiquinone) is a mitochondrial coenzyme that is essential for the production of adenosine triphosphate (ATP), the body’s form of chemical energy. The human body has approximately 100 trillion cells, and each one must produce its own energy to carry out its biological functions. The cells produce this energy by burning (oxidizing) carbohydrates, fats and proteins. This controlled burning or oxidation process (catabolic reactions) occurs as a result of oxygen combining with foodstuffs to produce energy, carbon dioxide and water. More than 95 percent of the oxygen we inhale is used solely for the purpose of making energy through this process. The result of these chemical reactions is converted into chemical energy in the form of ATP molecules. These ATP molecules supply the energy needed for the various cellular chemical and biological reactions necessary for life to occur (termed: bioenergetics). ATP is the fuel used to provide cellular energy, making life possible.CoQ10 was discovered by Frederick L. Crane, Ph.D., in the late 1950s, during his research on the biochemistry of the mitochondrial electron transport chain. The substance was sent to Karl Folkers, Ph.D., for identification and identity of its structure. It was designated “coenzyme Q10″ because of its quinone structure and the 10 isoprene unit side chain. During this time, another group of scientists led by R. A. Morton, Ph.D., isolated the same substance from mitochondria and designated it ubiquinone (from ubiquitous, meaning everywhere) because of its widespread occurrence in nature. The role of CoQ10 in the electron transport chain was first described by Peter Mitchell, Ph.D., who was awarded the Nobel Prize for that work.
So how does this fit into a heart failure patients profile?
Cells that require the most energy contain a higher number of mitochondria. The more work required, the more energy needed. The cells of the brain, the skeletal muscle, the heart and the eye contain the highest number of mitochondria (as many as 10,000 per cell), while the skin cells, which do not require much energy, contain only a few hundred mitochondria. Cardiac cells are muscle cells whose function is to contract repeatedly, pumping blood continuously around the body. This means these cells need a large and continuous supply of energy to in order to function efficiently, so no surprise they have a large number of mitochondria within them. CoQ10 (being at the center of the creation of cellular energy) assumes significant importance in cells with high energy requirements, such as the cardiac cells.
Much of the research in support of CoQ10 supplementation has been focused on CHF. These patients’ hearts have been shown to have increased oxidative stress, as well as decreased concentrations of CoQ10.1,2 We already know heart muscle cells have a remarkably high-energy requirement. Consistent correlation between the level of CoQ10 and the severity of CHF appears to be a well-documented. Low levels of CoQ10 have been linked to decreased heart muscle function (poor myocardial function).3,4 The more severe the heart failure, the more the deficient the CoQ10 level is. Recently, it has been found that CoQ10 levels can be used as a predictor of mortality in CHF.
CoQ10 has a potential role for the prevention and treatment of heart ailments by improving cellular bioenergetics. Supplementation can help correct energy depletion and oxidative stress, which are inherent in these cardiac conditions; this can result in helping to restore the energy and efficiency of the heart. Significant improvement has been observed in exercise tolerance in patients given adjunctive CoQ10.7
Supplementation has been shown to cause sustained clinical improvement in the heart muscle contraction (improved ejection fraction, heart wall motion and heart size), and progress in improving other related symptoms (fatigue, chest pain, shortness of breath, exercise ability and palpitations).8 Some studies have showed significant development with NYHA class improving from a mean of IV to a mean of II.9 CoQ10 supplementation can also protect against ischemia and reperfusion injury.10 The improvement in some patients can be rather significant, with the heart size and heart function returning to near normal.
As we all know every patient is different and CoQ10 supplementation should be used as a parallel therapy, supporting traditional medical treatment and not in place of it. As with all supplements it is vital that you speak to your doctor or nurse before starting on a self prescribed course. CoQ10 reacts with warfarin therefore may affect your INR levels.
Complimentary Supplements and Heart Health
I would never suggest you don’t use your prescribed drugs from your Doctors and Nurses but I am getting very interested in all these complimentary supplements.
Before I had Heart Failure which was caused by a viral attack I was a great exponent of the following supplements –
High Potency Vitamin C
High Potency Vitamin D
Very good quality Fish Oil – High EPA and DHA levels – more expensive than the average but better for you
Plant Stereol supplement
These were taken every morning without fail. Now you may say well you got heart failure so they can’t be that good – well you are wrong. The results of my MRI cardiac scan indicated no signs of heart disease, furred arteries or scaring of the heart. I was just unlucky that a virus, it has been suggested herpes simplex (cold sore) or an influenza style virus attacked my heart.
So as well as my beta blockers, ACE inhibitor, spironolactone, diuretic, digoxin and warfarin I have now started back on the complimentary supplement route.
I now take –
Vitamin C 2000mg per day (1000mg in the morning and 1000mg at approx 6pm)
Vitamin D high potency (1 capsule in the morning)
Fish oil capsule once in the morning (EPA/DHA level is 950mg out of total 1360mg)
I have just bought some 6 hour bovine colostrum which from what I can gather may promote increased density of stem cell production and more, this is a very interesting product. I am just awaiting delivery from the USA.
I am looking to get myself associated with Q10 again, however Q10 is a pro-agulant and this will effect my INR warfarin level. I have researched Q10 for a while now and I came across a site that the kills two birds with one stone. Very good quality fish oil with added Ubiquibnol from Kaneka in Japan. Highly absorbent Q10 with highly refined fish oil as well.
In fact the whole site is excellent and seems to be a quality business. I will buy some and post the results.
Interesting little post about Coenzyme Q10 and its effects on Warfarin
Coenzyme Q10 can be used in the management of mitochondrial disease, heart failure, hypertension, angina and arrhythmias. It is thought to work by being a free-radical scavenger, antioxidant, and membrane stabilizer. Coenzyme Q10 is structurally related to Vitamin K (menaquinone); therefore, it possesses procoagulant properties which will effect your INR if you are taking Warfarin.
If you take Q10 without your clinician knowing and you are prescribed Warfarin talk to them.