Natural Products Insider

MAR-APR 2019

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64 INSIDER March/April 2019 Coenzyme Q10 (CoQ10) is found in all animals and most bacteria. Primarily found in the mitochondria, CoQ10 plays a role in the generation of adenosine triphosphate (ATP). Because of the body's reliance on ATP for most of its energy, CoQ10 is found in higher concentrations in organs that require the most energy—the heart, liver and kidneys. 1 Naturally occurring in the body and found in many foods, CoQ10 is also sold as a dietary supplement and in functional foods targeted toward those who do not produce satisfactory levels themselves. It is perhaps best known for two functions: its role in the conversion of glucose and fatty acids to ATP and its role as a powerful antioxidant in cells. 2 CoQ10 can exist in three oxidation states: the fully reduced form ubiquinol, the radical semiquinone intermediate, and the fully oxidized ubiquinone. 2 While most CoQ10 products on the market are in the oxidized ubiquinone state, "it is ubiquinol that provides virtually all of benefi ts associated with CoQ10," wrote Gene Bruno, professor of nutraceutical science and Provost of Huntington College of Health Sciences. 2 When the human body is supplemented with ubiquinone, it must fi rst convert it to its fully reduced ubiquinol form. If it is not converted, the ubiquinone will remain inactive. CoQ10 supplementation is used to help address symptoms of a range of ailments, including diabetes, chronic migraines, statin-induced myopathy and cardiovascular conditions. 1 However, because of its lipophilic nature, absorption is an issue that must be cleared for effective supplementation. Diabetes Patients with diabetes exhibit signifi cantly lower levels of plasma CoQ10 compared to healthy individuals. 3 This CoQ10 defi ciency "may further impair the body's defensive mechanisms against oxidative stress induced by hyperglycemia in diabetes." A 2018 pooled analysis on the effects of CoQ10 on overweight and obese patients with type 2 diabetes showed "several studies have demonstrated that the restoration of CoQ10 levels in patients with diabetes…could potentially preserve mitochondrial function, alleviate oxidative stress and eventually lead to improvement of glycemic control." Migraines CoQ10 has also been hypothesized to be useful in migraine prevention. 4 Research suggests migraines result in defi ciencies in mitochondrial energy in the brain, and CoQ10 plays "an important role in sustaining mitochondrial energy stores," according to the researchers. Additionally, CoQ10 "counteracts endothelial dysfunction by stimulating endothelial release of nitric oxide and has anti-infl ammatory effects." 5 A 2007 study by Hershey et al. on adolescents suffering chronic migraines showed roughly one-third of subjects had CoQ10 levels below reference range. 6 The study went on to note supplementation of this subgroup with 1 to 3 mg/kg/d of CoQ10 "improved [CoQ10] level, headache frequency and disability." In a 2005 double-blind, randomized, placebo-controlled clinical trial, adult patients with migraines were treated with 100 mg/d of CoQ10 orally for three months. 7 The trial concluded supplementation "signifi cantly decreased the frequency of migraine attacks." Statin-induced Myopathy Statins are a class of lipid-reducing drugs often used to treat high cholesterol and reduce the risk of cardiovascular disease (CVD). However, it is estimated around 10 to 15 percent of people who take statins experience resultant muscle problems, often in the form of pain and/or weakness, referred to as statin- induced myopathy. A 2018 meta-analysis by Qu et al. found "[CoQ10] supplementation ameliorated statin-associated muscle symptoms, such as muscle pain, muscle weakness, muscle cramps and muscle tiredness." 8 Cardiovascular Health CoQ10 has been shown to treat various cardiovascular disorders. 4 One meta- analysis of eight controlled clinical trials concluded "treatment of [congestive heart failure with CoQ10] revealed a signifi cant improvement in several important cardiac parameters, such as ejection fraction, stroke volume, cardiac output, cardiac index and end diastolic volume index." 9 Absorption Pure CoQ10 is lipophilic, meaning it is insoluble in water, creating challenges for brands attempting to market effective doses. "This lipophilic nature makes CoQ10's absorption poor, highly variable and strongly dependent on stomach contents," said Steve Holtby, president and CEO, Soft Gel Technologies Inc. (SGTI). Despite the challenges, solutions to the absorption problem exist. SGTI's CoQsol-CF ® is one option. "It is a completely solubilized CoQ10 that does not require heat or synthetic solvents, and this mixture fully resists recrystallization at ambient temperature ranges," Holtby shared. "By improving dissolution, absorption is enhanced." Another solution comes from AQUANOVA ® and its patented NovaSOL technology. "In order to make CoQ10 water soluble, NovaSOL encapsulates the CoQ10 molecules in an ultrafi ne structure, using liquid emulsifi ers," said AQUANOVA CEO Frank Benham. "This structure is also called 'micelle.' It is derived from nature and is a vital part of human metabolism for lipophilic actives." A study in the International Journal of Food Services and Nutrition, "Comparison of the relative bioavailability of different CoQ1 0 Coenzyme Q10 (CoQ10) is best known for its role in the conversion of glucose and fatty acids to ATP and its role as a powerful antioxidant in cells. CoQ10 has been effective in treating disorders associated with di abetes, migraines, heart health and statin-induced myopathy. Poor absorption has forced supplement brands to innovate and market more bioavailable CoQ10 products. The Benefits and Challenges of Coenzyme Q10 by Alex Smolokoff INSIDER's Take

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