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FAQ (Health)

 Dr. George Jacob
Heart Infocenter


Benefits of Co Enzyme Q-10 Supplementation in Cardiovascular Health

Co Enzyme Q10 (Co Q10) is a nutritional supplement used around the world as a heart energizer. Researchers found that in most of the cases of heart problems, there was an associated deficiency of CoQ10. On the corollary, all the well functioning hearts had an adequate amount of CoQ10 in the tissue. Furthermore, when supplemental CoQ10 was administered, the ailing hearts started showing signs of new life.

Experts say that adequate levels of CoQ10 is necessary for a well functioning system. When the levels of CoQ10 drops below optimum levels, disease takes over or already had done so.

What Is Co Q10?

Coenzyme Q-10, also known as ubiquinol-10, is a strong antioxidant. Like vitamins, it is a nutrient your body must take in to feed your cells so your body can operate at an optimum level. It is present in very small amounts in food, notably seafood, and is produced by all cells of the body. Japanese scientists have synthesized CoQ-10 into a raw material that is put into supplements.

Coenzymes are vital participants in many of the ongoing chemical reactions in our bodies that are the very essence of life. These chemical reactions provide our body's cells with energy from food. These chemical reactions allow cells to grow and divide, promoting growth in children and tissue repair in adults. They also allow our bodies to quickly build up a supply of infection-fighting immune cells when necessary.

Coenzyme Q10 is an essential ingredient in the body's production of energy and in the normal metabolism of fat and energy. It participates in biochemical reactions in our bodies that provide energy. It is of extreme benefit to sufferers of angina. It prevents the accumulation of fatty acids within the heart muscle by improving the conversion of fatty acids and other compounds into energy. When a person is suffering from cardiomyopathy and other kinds of heart failure, the supplements of coenzyme Q10 are thought to help the remaining muscle cells do their jobs more efficiently.

Coenzyme Q10 is manufactured by the body and stored in your organs: liver, kidneys and heart. It is believed that, in our body, the vitamins such as niacin, vitamin B6, vitamin B12, vitamin C and folate assist our body to convert the amino acid tyrosine to coenzyme Q10.

Many of the elderly may have increased CoQ10 requirements; the decline of CoQ10 levels that occurs with age may be partly responsible for the age-related deterioration of the immune system.

CoQ10 deficiency is common among individuals with heart disease. Heart tissue biopsies in patients with various heart diseases show a CoQ10 deficiency in fifty to seventy- five percent of cases. Furthermore, cardiovascular diseases, including angina, hypertension, mitral valve prolapse, and congestive heart failure, require increased tissue levels of CoQ10.

Is Coenzyme Q10 Good for Your Heart?

A growing number of nutrition oriented doctors say that supplements of Co Q10 are absolutely essential for people with heart failure. Co Q10 was said to have several patients who used it to live longer, more active lives, has saved some people who would otherwise have died waiting for donor hearts and has even allowed some to take their names off the transplant list.

Coenzyme Q10 and CHF

More than fifty major articles have been published in reputable medical journals worldwide in the last ten years on the use of coQ-10 for heart disease, primarily congestive heart failure.

Studies at the University of Texas at Austin showed that 75 percent of heart patients have severe deficiencies of CoQ10 in heart tissue compared with healthy individuals. They have also found that taking coenzyme Q-10 significantly benefited three-fourths of a group of elderly patients with congestive heart failure.

In one of the early studies, seventeen patients with mild congestive heart failure received 30 mg of CoQ10 per day along with conventional drug therapy. All patients improved, and nine (fifty-three percent) became asymptomatic after four weeks.

In another study, twenty patients with congestive heart failure, due either to atherosclerosis or high blood pressure, were treated with CoQ10 at a dosage of 30 mg/day for one to two months. Fifty-five percent of the patients reported subjective improvement, fifty percent showed a decrease in New York Heart Association (NYHA) classification, and thirty percent showed a "remarkable" decrease in chest congestion, as seen on chest X rays. Improvements recorded in patients given Co Q10 include increased cardiac output, stroke volume, cardiac index, and ejection fraction. CoQ10 produces an increased force of heart muscle contraction. The increase in the force of contraction produced by CoQ10 is similar to, but less potent than, digitalis. (Please note that the levels of Co Q10 used are not sufficient to show a marked effect for heart disease. That may explain the lackluster performance.)

Other studies have shown that CoQ10 significantly improves heart function in patients with CHF. In a Scandinavian double blind study of eighty CHF patients, participants were given either CoQ10 (100 mg/day) or a placebo for three months. The roles were switch. In other words, those taking CoQ10 were then given the placebo, and vice versa. The improvements noted with CoQ10 were significant; the results were more positive than those obtained from conventional drug therapy alone.

In another double-blind study, 641 CHF patients received either CoQ10 (2 mg/kg of body weight) or a placebo for one year. The number of patients who required hospitalization or who experienced serious consequences due to CHF was significantly reduced in the CoQ10 group compared to the placebo group.

In an Italian study involving a total of 2,664 patients with mild to moderate CHF, the participants 50 to 150 mg of Co Q10 orally per day for ninety days. (The majority of patients (seventy-eight percent) received 100 mg per day.) After three months of CoQ10 treatment, the percentages of patients with improvement in clinical signs and symptoms were as follows:

Sweating 79.8 percent
Edema (fluid retention) 78.6 percent
Cyanosis (purple hue of skin) 78.1 percent
Pulmonary edema 77.8 percent
Heart palpitations 75.4 percent
Vertigo 73.1 percent
Venous congestion 71.8 percent
Subjective arrhythmia 63.4 percent
Insomnia 62.8 percent
Nighttime urination 53.6 percent
Shortness of breath 52.7 percent
Enlargement of the liver area 49.3 percent

Improvement of at least three symptoms occurred in fifty-four percent of patients, showing a significantly improved quality of life with CoQ10 supplementation. The results also showed a low incidence of side effects: only thirty-six patients (1.5 percent) reported mild side effects attributed to CoQ10.

Extensive Japanese research has found that about 70 percent of patients improved on CoQ-10.

Several studies, mostly from Japan, have looked at coenzyme Q10's role in cardiovascular disease. They include two double-blind, placebo-controlled studies, which are considered the most reliable. The studies showed that coenzyme Q10 has clinical benefits for 70 percent of the patients having congestive heart failure. Coenzyme Q10 is normally concentrated in the heart muscle. Its levels drop when the heart begins to fail.

Reported research from the University of Connecticut School of Medicine showed that using CoQ10 by patients with congestive heart failure helped more than 70 percent of them. The data comes from treating thousands of patients. Researchers believe that the situations, Co Q10 hasn't helped is because of inadequate doses or using products with insufficient potency. They say that to be effective, you should take a dose of Co Q10 sufficient to substantially raise the blood levels of CoQ-10. If that happens, they believe that all heart patients would benefit from Co Q10 supplementation.

Co Q10 and Angina

Return of blood flow (reperfusion) after coronary artery bypass surgery greatly increases the risk of subsequent coronary artery disease because of oxidative damage to the vascular endothelium and myocardium. Coenzyme Q10 is believed to prevent such oxidative damage after bypass surgery or angioplasty. In one clinical study, forty patients undergoing elective surgery either served in the control group or received 150 mg of CoQ10 each day for seven days before the surgery. The concentrations of lipid peroxides and the enzyme creatine kinase, indicators of the myocardial damage, were significantly lower in patients who received CoQ10 than in the control group. The patients who received Co Q10 treatment also showed a statistically significant lower incidence of ventricular arrhythmias during the recovery period. The results clearly demonstrated that pretreatment with CoQ10 can play a protective role during routine bypass surgery by reducing oxidative damage.

In another study, twelve patients with stable angina pectoris were treated with CoQ10 (150 mg/day for four weeks). The frequency of anginal attacks was reduced by fifty-three percent compared to those receiving a placebo. In addition, there was a significant increase in treadmill exercise tolerance during CoQ10 treatment.

CoQ10 and Mitral Valve Prolapse

CoQ10 has also been shown to be quite helpful in cases of symptomatic mitral valve prolapse. In one study with 16 children, half received CoQ10 (2 mg/kg of body weight) each day for eight weeks, and the other half received a placebo. Heart function became normal in seven of the eight CoQ10-treated patients (87.5 percent), and in none (0 percent) of the placebo-treated patients. Relapse frequently occurred in patients who stopped taking the medication within twelve to seventeen months, but rarely occurred in those who took CoQ10 for eighteen months or more.)

CoQ10 and Cardiomyopathy

A deficiency of CoQ10 has been found in the blood and heart tissue of most patients who have cardiomyopathy. CoQ10 supplementation can raise CoQ10 levels and produce improvements in heart function as a result of improved energy production by the heart muscle.

Several double-blind studies in patients with various cardiomyopathies have shown significant benefit with CoQ10 supplementation. In one double-blind trial, daily administration of 100 mg of CoQ10 for twelve weeks increased cardiac ejection fraction significantly, reduced shortness of breath, and increased muscle strength. These improvements lasted as long as the patients were continuously treated. However, cardiac function deteriorated when CoQ10 was discontinued, indicating that individuals with cardiomyopathy may need to be on CoQ10 indefinitely. Seventy one patients out of 80 patients treated (eighty-nine percent) improved while taking CoQ10.

CoQ-10, is now a drug of choice in many countries. It is "routinely" given to patients with congestive heart failure in Israeli hospitals. Japanese doctors have used CoQ-10 for cardiac problems for more than thirty years. It is now among the top six pharmaceutical agents used in Japan. It is prescribed for heart failure in Italy.

From Death's Door to Recovery: Story of a Co Q10 Miracle

In October 1994 Susan appeared to be dying of heart failure. She was miserable. She could barely sit up. She had difficulty breathing. She felt very tired and fatigued. She had swelling in her lungs. She was too old for heart transplant. Her doctors had basically given up. She had been treated with all the traditional medicines and she was not showing any signs of improvement. Her family didn't think she would make it to Thanksgiving (in November). She couldn't even move in a wheel chair.

Susan was suffering from high blood pressure for several years. Susan was also diagnosed with congestive heart failure . She was on a variety of drugs including ACE inhibitors and increasing doses of diuretics. She had a very active life. But, during the last six months, her condition had progressively deteriorated to the life-threatening stage.

Susan was being treated in the Manchester (Connecticut) Memorial Hospital. The diagnosis was severe congestive heart failure. According to her attending physician, she was suffering from end stage cardiac cachexia -severe weakness and weight loss. At age seventy-nine, Susan weighed a mere 77 pounds. Her heart's ejection fraction (a measure of the pumping ability of the heart) had fallen to a mere 10 to 15 percent (normal is 50 to 70 percent). This meant that very little blood and oxygen were getting to her vital organs. 

Dr. Sinatra, Susan's cardiologist, felt that Susan was a good candidate for Co Q10 supplementation. On his advice, Susan started taking 30 milligrams of coenzyme Q-10 three times a day in addition to her heart medications. 

Unfortunately, the Co Q10 supplementation does not seem to be working. Susan's condition continued to deteriorate rapidly. 

In February 1995, Susan was near death. Fluid had built up in her lungs and abdomen. She had great difficulty breathing. Her body appeared to be shutting down.

In March 1995, a miracle happened largely from a mistake. Her son, instead of picking up a bottle of 30-milligram CoQ-10 capsules at the health food store, accidentally picked up a bottle of 100-milligram CoQ-10 capsules. She was now taking 300 milligrams of CoQ-10 a day without realizing it - more than triple her recommended dose. 

In April 1995, one month after Susan started taking the higher dose of Co Q10 supplementation, she had improved so dramatically that she got up and went to her son's house for Easter dinner! Her family was dumbfounded and elated. Susan's energy was back. The swelling in her legs was going down. The fluid in her lungs was gone. The CoQ-10 was working!

Susan continued to improve. By June her heart's ejection fraction was up to 20 percent. There was also markedly less "mitral and tricuspid regurgitation" - leakage and backflow of blood into the heart's upper chambers. This made the heart's pumping more efficient and lessened fluid buildup in the tissue.

By October, Susan was out shopping. In November, she started going to church again. In December Susan traveled to visit her daughter for the first time in a year and a half. She continued to take 300 milligrams of coQ10 every day.

Excerpted from Miracle Cures by Gene Carper

Recommended Dosage

To be effective, you need to take enough Co Q10 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 coQ-10 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 Co Q- 10 dose needs to be."

Some researchers recommend 2 milligrams of CoQ-10 for each kilogram of body weight (0.9 milligrams for each pound of bodyweight).

Co Q10 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 Co Q10 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 coQ-10 continually to maintain its heart-strengthening benefits.


Co Q10 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: 

CoQ-10 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. 

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