CoQ10: An essential nutrient for your heart health

When it comes to your heart health, lifestyle interventions can be a powerful tool to reverse the associated risks. These interventions are usually a combination of exercise, reducing stress, not smoking, eating a healthy, wholesome diet and taking supplements. Considering all of the heart healthy supplements, Coenzyme Q10 (CoQ10) could possibly be the single most important nutrient.

What makes CoQ10 so good for your heart? While most of the CoQ10 benefits to your heart come from its indispensable role in energy production in the body (including in the heart muscle cells), there is more to how it supports your cardiovascular health overall. Let’s find out.

What is CoQ10?

CoQ10 is a coenzyme that helps convert the food we eat into energy. This vitamin-like substance is naturally produced by almost every cell of the body. Although it is also found in foods like organ meats, fish, whole grains and some vegetables, the amounts you get from these foods are not enough to realize the health benefits. A host of diseases – including heart disease, diabetes, infertility, gum disease and mitochondrial dysfunction are associated with CoQ10 deficiency.

CoQ10: Your body’s spark plug

Your heart is the hardest working muscle of the body. It beats a whopping 100,000 times a day on average. You can imagine the kind of energy your heart continuously needs to do its job. This high energy requirement is what makes CoQ10 central to the health of your heart.

CoQ10 is aptly coined as ‘the spark plug of the body’. It plays a critical role in bio-chemical reactions through which your body creates energy in the mitochondria, tiny organelles present in our cells. Mitochondria are little energy producing factories that burn fat and carbohydrates and convert them into the form of energy (ATP) that can be used by cells to perform a range of functions.

This process of energy generation involves many nutrients such as magnesium, the vitamin B family, vitamin K, L-carnitine and of course CoQ10, which has a unique and indispensable role as an electron carrier. If you remove CoQ10 from the scene, the body is not able to make energy in an efficient manner. This is the reason your heart has a higher concentration of CoQ10 than any other tissue.

In context of the heart, low CoQ10 levels can spell disaster as it negatively affects how your heart makes and utilizes all the energy it needs. This could result in a weak and energy starved heart. As a result, the heart is not able to pump sufficient amounts of blood to the organs, leading to a failing heart with symptoms like shortness of breath, fatigue, general weakness and swelling in feet, legs and ankles. Inefficient production of energy in the mitochondria also causes increased production of reactive oxygen species, which cause further damage.

Heart failure is associated with reduced production of ATP in heart muscle, mitochondria dysfunction, increased production of reactive oxygen species and endothelial dysfunction. And CoQ10 is able to help as it plays a critical role in ATP production, works as an antioxidant and anti-inflammatory, and is shown to improve endothelial function. [1]

Studies show that people with advanced heart failure symptoms have low CoQ10 levels. The famous Q-SYMBIO trial found that long-term CoQ10 supplementation can help [2]:

Improve heart failure symptoms
Lower the risk of major adverse cardiovascular events such as unexpected hospitalization or urgent transplantation.
Cut down risk of death
Improve the quality of life in heart failure patients

CoQ10: Antioxidant that protects heart tissue from oxidative damage

With its antioxidant and anti-inflammatory properties, CoQ10 is known to inhibit the oxidation of low density lipoproteins (LDL) in the endothelium, a thin layer of cells that lines the interior of the blood vessels and the heart. Oxidation of LDL particles by free radicals and the chronic inflammation that follows play a key role in the development of atherosclerosis, formation of plaque in the arteries.

Plaque deposits make the arteries narrow and thicker, reducing blood flow and oxygen supply to the organs. Over time, atherosclerosis can lead to a number of health problems such as angina (chest pain), heart attack, stroke and peripheral artery disease.

CoQ10 not only protects LDL cholesterol from oxidation and prevents the development of atherosclerosis [3], the coenzyme also helps in recycling of other antioxidants such as vitamin C and vitamin E. This gives more antioxidant power to the body and makes it better positioned to fight oxidative damage caused by free radicals, that can cause heart muscle to age prematurely. CoQ10’s antioxidant benefits also extend to other health conditions such as gingivitis, infertility in both men and women and diabetes, to name a few.

CoQ10 improves endothelial functions

The health of the endothelium is important for the health of your heart. In fact, endothelial dysfunction is one of the important mechanisms that contribute to plaque formation in the arteries. Many factors such as aging, high blood sugar, cigarette smoke, high blood pressure and even chronic infections can damage endothelial functions.

The cells of the endothelium release many important substances, including nitric oxide (NO) that work to keep endothelium healthy through various mechanisms. For example, NO performs a range of actions that keep the vascular system in a healthy, well-functioning state. It exerts anti-inflammatory effects, prevents the formation of blood clots and most importantly regulates the flexibility, permeability and integrity of the blood vessels. Reactive oxygen species and the resulting oxidative stress make NO less available, thus compromising the health of endothelium and by extension that of the heart.

Low levels of NO play a central role in the development of endothelial dysfunction, but CoQ10 improves the bioavailability of NO by reducing the oxidative damage in vascular walls.

CoQ10 supplementation can improve endothelial dysfunction in statin-treated type 2 diabetic patients, possibly by reducing vascular oxidative stress. [4] A 2011 study found that CoQ10 improved endothelial functions in patients with ischaemic left ventricular systolic dysfunction (LVSD), a condition that ups one’s risk of heart failure and even sudden death due to adverse cardiac events. The study suggested that CoQ10 improved endothelial functions by improving mitochondrial functions. [5]

Are you taking statins? Don’t forget your CoQ10 intake

Millions today are taking statins; drugs that help lower cholesterol. This has an unintended consequence that takes a heavy toll on your heart (and other areas of the body too such as the brain and muscles.) When you take statins, you not only block the synthesis of cholesterol but also other vital nutrients and CoQ10 happens to be one of these. Vitamin D, heme, selenoproteins, stress hormones, sex hormones and bile acid are some other substances whose production take a major hit when you take statins.

(The reason behind this mayhem is quite straightforward. Statins interfere with the bio-chemical pathway that makes cholesterol. It does so by blocking a particular enzyme called HMG-CoA reductase, which by the way is also responsible for various chemical reactions that produce other life, and health, sustaining molecules like the ones mentioned above).

Statins causing harm?

Ironically, long-term use of statins may set the stage for developing heart problems, a side effect attributed to the declining levels of CoQ10. We already know how CoQ10 deficiency can affect your heart health and is associated with reduced energy production in the heart muscle.

A 2015 research published in Expert Review of Clinical Pharmacology offered evidence that “statins may be causative in coronary artery calcification and can function as mitochondrial toxins that impair muscle function in the heart and blood vessels through the depletion of coenzyme Q10 and ‘heme A’, and thereby ATP generation.” [6]

Low levels of CoQ10 in the body also contribute to other side effects (such as fatigue, muscle pain and aching joints) that are often experienced by people on cholesterol-lowering drugs for a long time. And Coq10 supplementation is known to reduce muscle pain that comes with statin drugs use. [7]

You can support your heart functions and overall health by taking a high quality CoQ10 supplement, especially if you are taking statins, over 50 years of age or are at a risk of developing cardiovascular disease. Why do you need to supplement when it is produced by the body and is also present in some foods? Along with statins use, CoQ10 production declines naturally with age. Supplementation becomes necessary to reach the amounts that you need to receive maximum health benefits for your heart, which is not possible through diet alone.

CoQ10 provides powerful benefits for your cardiovascular health:

Improves symptoms in people with heart failure, reduces risk of hospitalization and death
Reduces arrhythmias
Lowers blood pressure
Improves angina symptoms, reduces the risk of angina, improve exercise performance in people with angina.
Reduces the risk of more heart attacks
Improves endothelial functions
Limits the side effects of statins on heart functions

References:

A Sharma et al. Coenzyme Q10 and Heart Failure. A State-of-the-Art Review. Circulation. Heart Failure. 2016.
Mortensen SA et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014
Ahmadvand H et al. Effects of coenzyme Q(10) on LDL oxidation in vitro. Acta Med Iran. 2013.
Hamilton et al. Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients. Diabetes Care. 2009
Dai et al. Reversal of mitochondrial dysfunction by coenzyme Q10 supplement improves endothelial function in patients with ischaemic left ventricular systolic dysfunction: a randomized controlled trial. Atherosclerosis. 2011
Okuyama et al. Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Rev Clin Pharmacol. 2015
Skarlovnik et al. Coenzyme Q10 Supplementation Decreases Statin-Related Mild-to-Moderate Muscle Symptoms: A Randomized Clinical Study. Medical Science Monitor. 2014.