Coenzyme Q:The Ubiquitous Quinone
Part II

This article first appeared in the
October, 1993
issues of VRP's newsletter

Coenzyme Q: The Ubiquitous Quinone Part I

Coenzyme Q: The Ubiquitous Quinone Part II

Coenzyme Q: The Ubiquitous Quinone Part III


by A.S. Gissen
In part 1 of our review on Coenzyme Q10, we examined the broad range of clinical and experimental evidence of CoQ10's vital role in the process of cardiac bioenergetics. Since its introduction into clinical research in the mid 1960's, most CoQ research has centered on its vital role in cardiac health. During the past thirty years, however, a large body of evidence has accumulated suggesting that the implications of CoQ deficiency go far beyond its well researched role in cardiac health. In this, part 2 of our examination of CoQ, we will discuss the far reaching implications of CoQ deficiency in conditions as varied as cancer, muscular dystrophies, physical performance and athletics, diabetes, and periodontal disease.

CoQ and Cancer
Recently, a review of 15 years of experience with the administration of CoQ10 to cancer patients was published.(31) This paper examined eight new case histories, in addition to two earlier reported cases. The results of these cases supports the earlier findings that therapy of cancer patients with CoQ10, which has no significant side effect, allowed survival of these patients on an exploratory basis for periods of 5-15 years. All of these patients were receiving CoQ10 supplementation for heart failure, and CoQ10's anti-tumor effect was discovered by accident. These patients had cancers of the lung, pancreas, larynx, breast, and prostate. Unfortunately, interest in the use of CoQ10, either alone or as adjunct therapy in the treatment of cancer, has been lacking. This is surprising since many of the patients in these preliminary studies were considered to be terminal before beginning CoQ10 therapy. Indeed, the authors of this latest review called for systematic protocols to begin based on these extremely encouraging results.

CoQ and Muscular Dystrophies
At present, several hypothesis suggest that muscular dystrophy results from some type of metabolic deficiency. This defect is manifested by an abnormality in muscle structure that gives rise to the death of the muscle fibers and to the abnormal muscle regeneration that is a characteristic of muscular dystrophy. As early as 1966 it was shown that in mice with genetic muscular dystrophy, CoQ administration would produce improvement.(28)

An interesting observation in humans was that virtually every form of muscular dystrophy is associated with cardiac disease.(29) This, coupled with early success using CoQ in animal models of muscular dystrophy, led to experimentation with CoQ10 administration in human forms of muscular dystrophy and neurogenic atrophies.

Muscular dystrophy is not a single disease, but rather, a group of closely related syndromes. The use of CoQ10 supplementation has been tried in a large number of these syndromes including the Duchenne, Becker, and limb-girdle dystrophies, myotonic dystrophy, Charcot-Marie Tooth disease, and Welander disease.(29) In these patients, improvements in physical well-being was commonly observed. Additionally, a direct relationship between muscle and cardiac impairment was found, as both of these improved on CoQ10 therapy. A later study, that also included some additional forms of muscular dystrophies (fascioscapulohumeral muscular diseases and hypotonia congenitale), also showed improvements in cardiac function for almost all patients, as well as improved physical performance and quality of life for many patients.(30) The authors concluded that therapy with CoQ10 is without any side effect, and may be given for the lifetime of the patients with muscular dystrophy. They also noted that there is presently no therapy for such patients which provides the improvement in quality of life as does CoQ10.

CoQ, Physical Performance, and Athletics
With its central role in the production of energy, it is not surprising that the relationship between CoQ levels and physical performance has received considerable attention. The results of this research have shown that athletes, as opposed to sedentary individuals, have lower levels of serum CoQ10 and higher levels of muscle CoQ10.(32) Sedentary individuals showed the opposite pattern, with serum levels of CoQ10 being higher than muscle levels. Studies assessing the changes in CoQ10 levels with increasing physical activity have clearly shown that with an increase in exercise levels, CoQ10 levels increase substantially in both the heart and muscles.(33) This exercise-induced increase in CoQ10 levels has even been shown to prevent or reverse the age-related decline in muscle mitochondrial CoQ10.(34) Due to this relationship between muscle energy-output and CoQ10 levels, the administration of CoQ10 has been examined both in highly trained athletes, and sedentary individuals, for any positive effect on energy output and athletic performance.

In highly trained athletes, the administration of CoQ10 has been shown to increase both total energy output and time to exhaustion.(35) Of the parameters examined before and after exercise, several seemed to be affected by the administration of CoQ10. As in other studies, it was found that highly trained athletes had lower levels of serum CoQ10, and this level was significantly raised by CoQ10 administration. A comparison of serum markers of muscle damage showed a significant drop after supplementation of CoQ10, indicating that the use of CoQ10 resulted in a large decrease in the amount of muscle damage caused by exercise. In the case of sedentary individuals, CoQ has proven to be effective in increasing work output in normal, sedentary individuals,(36) as well as have a beneficial effect on impaired aerobic function in people complaining of fatigue with no medical origin.(37)

Other studies have shown that while short term CoQ10 supplementation has little effect on aerobic function in trained athletes, it does have significant effects on anaerobic function. This increase in anaerobic function led to increases in exercise duration, maximum oxygen consumption, maximum heart rate, and performance.(38) Interestingly, this study showed not only increases in cardiovascular and muscular efficiency, but also an increased tolerance to blood lactic acid levels. Based on the evidence that trained athletes have lower serum CoQ10 levels, it seems that supplementation may be necessary to ensure adequate levels of CoQ10 in the muscles, blood, and other organs.

CoQ and Diabetes
Although the investigation of CoQ10 levels in diabetics is relatively new, initial results have shown that deficiencies of Q10 may play a role in the pathogenesis of diabetic complications. The pancreas is an organ that contains large amounts of CoQ10,(39) and a deficiency of CoQ10 would be expected to impair the ability of the pancreas to produce adequate amounts of insulin. The activity of CoQ10- dependent mitochondrial enzymes in diabetic patients has been found to be significantly lower than that of controls.(40) It was concluded that this deficiency of CoQ10 may contribute to the development of diabetic complications, including cardiovascular disease and neuropathy. The blood levels of vitamin E were also found to be depressed in some of these patients, indicating that both bioenergetics and antioxidant capacity may be defective in diabetics. Three patients from the group with the most organ complications died from heart failure within a few months of CoQ10 measurement, and all of these patients had very low serum-CoQ10 levels, among the lowest in the study group, as well as low levels of serum vitamin E. In a supplementation study, the administration of CoQ10 to diabetic patients gave a reduction in fasting blood sugar levels in 36 percent of the cases, and a reduction in blood ketone bodies in more than half the cases.(41) These results in both insulin and non-insulin dependent diabetics, although preliminary, are certainly encouraging. Due to the serious nature of diabetic organ-complications, the rationale for the use of CoQ10 is certainly strong. In fact, the combined use of CoQ10 and vitamin E, based on these findings, may represent a useful combination for the control and/or prevention of diabetic complications.

CoQ and Periodontal Disease
Periodontitis is a very common disease in all parts of the world. The main cause of the disease is deposition of plaque on the teeth and the inhabitation of bacteria ' in the area between the gingiva and the teeth. Both oral hygiene and nutritional status have been shown to affect the condition of periodontal tissue.(42) However, periodontal disease often affects persons without any obvious reason, especially with advancing age. Early research examining healthy and diseased gingiva showed a significant deficiency of CoQ10 in diseased gingiva, but not in healthy gingiva.(43) In light of this apparent deficiency of CoQ10, trials were conducted to determine the effects of CoQ10 supplementation on the progression of periodontal disease.

The oral administration of CoQ10 to patients with periodontal disease was effective in reducing gingival inflammation, as well as periodontal pocket-depth and tooth mobility.(43) Not only did these improvements not occur in the placebo group, but the researchers correctly assigned what patients received CoQ10 or placebo in every case. Because periodontal disease is often resistant to treatment with improved hygiene or surgical intervention, CoQ10 supplementation may represent an important step in improving periodontal health.

References: Part 2
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