Coenzyme Q10 Deficiency – How much coenzyme Q10 is needed to see benefits?
Here’s another question and answer from my February interview with Dr. Cynthia Shelby-Lane regarding the need for coenzyme Q10 to prevent heart disease.
Lisa Nelson RD: How much coenzyme Q10, if any, should individuals with heart disease supplement to see benefits?
Dr. Shelby-Lane: CoenzymeQ10-H2, also known as ubiquinol, is the reduced form of coenzymeQ10 (CoQ10) that is over five times more bioavailable than ordinary (standard) CoQ10. CoQ10 plays an essential role in providing energy to the body through the mitochondria, the energy-producing organelles found in all cells. There are between 100 and 300 mitochondria inside every cell, and they are responsible for over 90% of the body’s energy production. Mitochondria can truly be described as the cell’s ‘blast furnaces,’ and CoQ10 plays a critical role in the utilization of oxygen inside these mitochondria. CoQ10 also acts as an antioxidant to protect the mitochondria against the massive free radical production that occurs during the cell’s energy-producing respiratory cycle.
CoQ10 is produced naturally in all cells, but there is an age-related decline in CoQ10 production that has been linked to a wide variety of disorders in humans. Heart cells were the first cells discovered that suffered major declines in CoQ10 with age, but we now know that CoQ10 levels decline with age in almost all cells. It is vital for our health to supply dietary CoQ10 to offset the inevitable age-related decline in CoQ10 levels that occurs throughout the human body.
CoQ10 supplementation has been strongly linked to improved cardiovascular health in a wide variety of studies. It decreases peripheral blood flow resistance, especially in the microcirculation, which accounts for up to 90% of blood flow resistance. Numerous studies have also shown that CoQ10 can improve cardiac function, support healthy blood pressure, protect brain cells, slow aging markers, and shorten recovery times in power lifting and body building.
With CoenzymeQ10-H2 you can get the therapeutic benefits of higher dose coenzyme Q10 at much lower dosage levels.
Recommended Dosage: 50 mg to 300 mg standard CoQ10 per day with meals. Most manufacturers will not specify, so standard Coenzyme Q10 is still the most used. It may be difficult for the consumer to get the more concentrated so, so this value (50 -300 mg) is for standard CoQ10. Testing is the best way to know if you are getting adequate supplementation.
To be effective, you need to take enough CoQ10 to significantly raise its level in the blood to see any beneficial effect. The amount needed to do that varies among individuals, and also depends on the potency or “bioavailability” of the CoQ10 used. Some people get a good rise with 100 milligrams, whereas others need two or three times that much to attain the same blood level. Taking too little of this supplement won’t help you.
A typical dose for heart disease is 50 to 150 milligrams a day. However when heart failure is severe, up to 360 milligrams a day taken in doses of no more than 180 milligrams at a time may be needed. Experts say that “the sicker the cardiac patient, the weaker the heart, the higher the CoQ10 dose needs to be.”
Some researchers recommend 2 milligrams of CoQ10 for each kilogram of body weight (0.9 milligrams for each pound of body weight).
CoQ10 is fat soluble. To be effective, it must be taken with some fat for absorption. Take it with a little peanut butter or olive oil. If possible, take CoQ10 in the form of soft gel capsules. They are better than dry capsules or tablets.
Dosage is determined by measuring blood levels of coenzyme Q10.
Generally, people who have heart failure begin to see an improvement in symptoms in about four weeks, although some people may take as long as three months. Maximum improvement occurs after six months, which is longer than ordinary drugs take to exhibit an effect. Once started, you must take CoQ10 continually to maintain its heart-strengthening benefits.
Safety
CoQ10 is very safe. In a large Italian study, 22 out of 2,664 patients reported mild side effects. This comes out to be less than 1 percent. The typical side effect reported is mild transient nausea. No toxicity has been found, even at high doses, in animals or humans.
Important Caution
CoQ10 is not a substitute for conventional drugs. It is usually used along with conventional therapy for best results. You should do this only under the supervision of your doctor. Heart failure is a serious condition that should not be self-diagnosed or self-medicated. If you have serious heart disease, always consult a doctor for the proper course of treatment.
All the best,
Lisa Nelson RD
Coenzyme Q10 Deficiency
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Lower Cholesterol – If HDL is high do you worry about an elevated LDL level?
Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.
Lisa Nelson RD: If you have a patient with a high HDL level, let’s say an HDL greater than 80; are you concerned if their LDL level is elevated??
Dr. Shelby-Lane: New research has revealed that LDL or “bad” cholesterol inhibits the breakdown of fat in adipocytes, or fat cells, thus suggesting that it is a regulator of fat stores.
This new knowledge gives you three important areas to work on to not only boost your HDL number but to also boost your HDL quality. It is interesting indeed that HDL-building nutrients like niacin and pantethine also help lower triglycerides and improve cardiovascular health, giving more proof to this new field of emerging HDL science.
Key nutrients that support HDL are:
- Niacin: Niacin has been shown to directly boost your levels of apoA-I while lowering triglycerides. I recommend non-flushing inositol hexanicotinate.
- Pantethine: Pantethine provides the energy to help form HDL, while also providing energy to assist triglyceride and LDL cholesterol metabolism.
- Phosphatidyl Serine: This nutrient contains a mix of the key phospholipids that are often lacking in the diet and are needed to construct the healthy cell membrane of HDL.
Along with HDL-building nutrients it is vital to take anti-inflammatory nutrients to calm down immune cells that are inducing free radical damage to the apoA-I protein. The basis of this approach is a diet rich in fruits and vegetables. Many nutrients may be of assistance. Some top choices include grape seed extract, resveratrol, tocotrienols (vitamin E), vitamin C, DHA, pomegranate, and blueberries. Stress management and getting adequate sleep are essential.
Ensure your fasting blood sugar never gets above 90. If it is, use “anti-glycating” nutrients that help protect your HDL from sugar-induced damage. Top choices include R-alpha lipoic acid, grape seed extracts, and resveratrol.
HDL cholesterol is a pivotal molecule that protects your circulation and directly manages its health. It is no longer adequate to simply have an HDL score above 40. You need high quality HDL – HDL that is energized and ready for duty.
Lisa Nelson RD: So, if you have an individual with an HDL of 88, do you take action if their LDL level is elevated at 145? Or are you less concerned, due to the protective effects of the high HDL level?
Dr. Shelby-Lane: This requires further testing with an expanded lipid profile to determine risk and treatment options. (See my answer to question number 7 to learn more about the expanded lipid profile test.)
February is American Heart Month. In recognition of American Heart Month you can access Heart Health Made Easy at a 25% savings. Learn more about this take action guide to lower cholesterol and blood pressure at http://www.hearthealthmadeeasy.com.
All the best,
Lisa Nelson RD
How to Lower Cholesterol in 8 Simple Steps
Lower Cholesterol – Do you need to treat a low HDL level?
Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.
Lisa Nelson RD: Should individuals with low HDL levels receive treatment even if all other levels are normal?
Dr. Shelby-Lane: According to ScienceDaily (May 29, 2005) — High circulating levels of the “good cholesterol” HDL are associated with decreased risk of cardiovascular disease. HDL helps the liver excrete extra cholesterol by binding to a receptor in the liver called scavenger receptor-BI (SR-BI). However, the signaling events between HDL and SR-BI that afforded heart healthy benefits were not known.
In a study appearing online on March 24, 2005, in advance of the April 1, 2005 print edition of the Journal of Clinical Investigation, Philip Shaul and colleagues from the University of Texas Southwestern Medical Center examine the following pathway:
The authors show that HDL activates an enzyme called eNOS and sets off a cellular signal that depends on cholesterol efflux and two intact domains of SR-BI — the transmembrane domain and its cytoplasmic tail. These regions of SR-BI may serve as “cholesterol sensors” which set into motion cellular events to activate eNOS. This may be the mechanism responsible for the ability of HDL to reduce cardiovascular disease risk.
Lisa Nelson RD: Again, let’s clarify. If an individual has low HDL levels they should seek treatment even if all other cholesterol levels are normal. Correct? Correct?
Dr. Shelby-Lane: Again, a low HDL is an isolated risk factor and should be included in the overall health picture, and can be modified with diet, nutrition, and some newer drugs.
February is American Heart Month. In recognition of American Heart Month you can access Heart Health Made Easy at a 25% savings. Learn more about this take action guide to lower cholesterol and blood pressure at http://www.hearthealthmadeeasy.com.
All the best,
Lisa Nelson RD
How to Lower Cholesterol in 8 Simple Steps
Lower Cholesterol – Is grapefruit juice safe with medications, such as Lipitor?
Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.
Lisa Nelson RD: Is it safe for individuals taking medication for heart disease, such as Lipitor, to eat grapefruit or drink grapefruit juice?
Dr. Shelby-Lane: I am including information that may help answer your question about grapefruit and a variety of nutritionals that affect statin drugs for the lowering of cholesterol.
Zocor (Simvastatin), for example, is a Statin drug, used to lower high cholesterol levels, and also known as HMG-CoA reductase inhibitor. Zocor may affect the absorption or utilization of vitamins E and coenzyme Q10. Tests showed the average concentration of coenzyme Q10 in blood plasma decreased by approximately 50% after statins were used for 30 days. Supplementation is considered beneficial.
Grapefruit and grapefruit juice may increase the effects of HMG-CoA reductase inhibitors and should not be consumed at the same time. It is suggested that these medications be taken with water. Grapefruit contains substances that may inhibit the body’s ability to break down statin drugs increasing the toxicity of the drug. Muscle pain, tenderness, or muscle weakness may be a result. If you begin to notice these symptoms, contact your doctor.
Niacin is the form of vitamin B3 used to lower cholesterol. Large amounts of niacin taken with a statin drug may cause serious muscle disorders (myopathy). Reasonable levels of niacin combined with statin drugs have been shown to enhance the cholesterol lowering effect. For proper dosage, consult your physician before taking niacin.
Pomegranate juice has been shown to inhibit the same enzyme inhibited by grapefruit juice. This may cause reactions similar to grapefruit juice when it is used with statin drug treatments.
A study of 37 people with high cholesterol treated with diet and statin drugs found vitamin A increased in the blood over two years of therapy. People taking statin drugs and vitamin A supplements should have blood levels of vitamin A monitored.
Magnesium and aluminum containing antacids were reported to interfere with statin drug absorption. To avoid this interaction, take statin drugs two hours before or after any aluminum/magnesium containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.
It should be noted that doctors often recommend supplementing with 100 mg of coenzyme Q10 per day for maintaining healthy levels. However, those on statin drugs may have a greater need for a higher dose. It further should be noted that the symptoms associated with the combination of grapefruit juice and statin drugs (muscle weakness and discomfort) are commonly reported as symptoms associated with CoQ10 depletions. Supplementation with coenzyme Q10 is strongly recommended.
The herbs Artichoke plant, Garlic and Plantain may decrease blood cholesterol levels, and therefore enhance the effects of Zocor. Consult with your pharmacist or physician before taking them.
All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight
