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CoEnzyme Q10

The gentleman in the front row was waving his hand energetically. He obviously had something to contribute to the discussion. I had just finished a public lecture on dietary supplements and threw the floor open for questions, anticipating the usual queries about glucosamine, calcium, vitamins and the myriad herbal concoctions that have recently flooded the market place.

The gentleman in the front row was waving his hand energetically.  He obviously had something to contribute to the discussion.  I had just finished a public lecture on dietary supplements and threw the floor open for questions, anticipating the usual queries about glucosamine, calcium, vitamins and the myriad herbal concoctions that have recently flooded the market place.  But as it turned out, the man who was looking pretty spry for his age, didn’t have a question.  He had a story to tell. 

A dietary supplement had changed his life! Until a few weeks ago, he had been in a pretty sad state.  Diabetes and a heart condition had robbed him of his vigour making him practically immobile.  Then he heard about “a pill” that could work wonders.  I was obviously interested in this scenario and asked him what this magical pill was, expecting to hear about one of the numerous multi-level marketed “natural products” that claim to be beneficial for every ailment known to mankind.  They’re not recognized by the scientific establishment, the story usually goes, because they would cut into the sales of prescription drugs.  When you are in the business of giving public lectures, you hear such accounts often.  They come complete with testimonials about miraculous recoveries and improved feelings of well-being.  Mostly these can be ascribed to the power of suggestion and people’s unfamiliarity with the nature of disease.  Many conditions resolve themselves irrespective of any intervention, but if some intervention has been made, it gets the credit. I was therefore fully prepared to hear about super blue-green algae, shark cartilage, Rubyasia from the Peruvian rain forest, “natural clay” tablets or magnetized urine capsules.  Unfortunately, though, the gentleman could not remember what miraculous substance he had taken to turn his life around, other than that it was a little yellow pill.  He did somewhat sheepishly offer to go to a nearby pharmacy and return with the information.  Frankly, I thought that would be the end of this little escapade and went on to answer the usual questions about vitamin E, ginkgo biloba and milk thistle.  And then suddenly he was back! 

He had scampered to the pharmacy with impressive speed and returned clutching a piece of paper with “coenzyme Q10” written on it.  That sure got my attention. I had long been intrigued by this substance and indeed had wondered why the medical establishment had not paid more attention to it.  This was not your usual quack supplement, it had some pretty solid research behind it.  In 1957 Dr. Frederick Crane at the University of Wisconsin became interested in how the energy needed to power the heart was produced.  Using beef heart as a model, he was successful in isolating a substance that seemed to be critical to this process.  Specifically, coenzyme Q10 was involved in the complex series of reactions by which carbon and hydrogen atoms from food combine with oxygen to form carbon dioxide and water, releasing energy.  This energy is used by the body to synthesize a marvelous molecule called ATP (adenosine triphosphate) which “stores” the energy.  When the need arises to move muscles, heat the body or power the heart, ATP undergoes a chemical reaction that liberates the required energy. Such chemical reactions involve the reorganization of the electrons that “glue” atoms together to form molecules.  This reorganization in turn involves an “electron transport system” in which the needed electrons are passed from one molecule to another until they arrive at their destination.  Coenzyme Q10 turns out to be a critical molecule in this transport system.. Without it, ATP could not be produced and energy could not be supplied.  Crane’s discovery generated a great deal of interest because a potential application was pretty obvious.  If coenzyme Q10 levels could be increased in cells, ATP synthesis would be enhanced and energy production increased. 

It took no more than a year for Karl Folkers at the University of Texas to determine the molecular structure of CoQ10, synthesize it, and to begin studying its properties. On top of its electron transport abilities, CoQ10 turned out to be a potent antioxidant, protecting cell membranes from destruction by oxygen.  This was enough for the supplement manufacturers to start putting the cart before the horse and begin to hype CoQ10 as a miracle drug.  They claimed relief from heart disease, cancer, aging, immune problems and poor exercise tolerance.  This is just the kind of activity that sours the scientific community because researchers were quite aware of the fact that studies had not corroborated these outlandish claims.  As a result, many scientists tossed CoQ10 on that great junk heap of supplements that failed to live up to promise. A handful of researchers, however, struggled on with CoQ10 studies.  They were impressed by the fact that blood levels decline with age and that the human heart has the highest concentration of CoQ10 in the body.  They organized trials with patients suffering from various heart ailments, particularly congestive heart disease.  These were always in addition to, not instead of traditional treatment!  Indeed, nine placebo-controlled trials have confirmed the effectiveness of CoQ10 in reducing shortness of breath, hypertension, palpitations and chest pain.  Echocardiographic measurements have shown improved heart function.  And perhaps most important, no study has shown any detrimental effects, even at a few hundred milligrams a day. 

Strangely, the medical community seems to be unaware of the CoQ10 research, perhaps because it is not promoted by pharmaceutical companies.  The substance cannot be patented, so there is no great push towards marketing in spite of the fact that CoQ10 may reduce insulin requirements in diabetics, help heal gum tissue in gingivitis and even improve skin condition when incorporated into creams. There is, however,the continuing question of an appropriate dose. Certainly not every CoQ10 study has shown benefit but enough have to prompt further investigation.  I’m not ready to pass off the benefits experienced by the gentleman who didn’t even remember the name of CoQ10 as being solely due to the placebo effect.  It may not help memory, but CoQ10 is worth remembering. 

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