Coenzyme Q10: Implications for Health & Human Performance (And 20 Top Food Sources)

Coenzyme Q10 is a member of the ubiquinone family of compounds, named for the ubiquitous nature of these compounds in humans and all living organisms.  

Coenzyme Q10 is made naturally in the human body, therefore it’s not considered a vitamin, however it has many fundamental roles in human physiology and health.(1) 

In this article, I’ll review the roles of CoQ10 in the body, highlight its potential role in athletic performance, review CoQ10 rich food sources, and discuss considerations for special populations and supplementation. 

What Is It?

Coenzyme Q10 is a fat-soluble compound made in your body and acquired from your diet. The highest levels are found in the heart, liver, kidneys, and pancreas.

At the cellular level, the greatest concentration of CoQ10 is found in the mitochondria – the tiny powerhouses of your cells – and thus it plays a fundamental role in aerobic energy production.

To convert the carbohydrates and fats you eat into adenosine triphosphate (ATP), the primary energy currency used by your cells, it’s necessary to have CoQ10 present in the inner mitochondrial membrane.

Coenzyme Q10 also plays a key role as a fat-soluble antioxidant in your cellular membranes and lipoproteins, the latter responsible for ferrying lipids around the body. For example, oxidized low-density lipoprotein (LDL) is a biomarker associated with increased risk of heart disease, and when LDL is oxidized, the CoQ10 antioxidant is the first called into action.(2)

Coenzyme Q10 also plays an important role in recycling other antioxidants in the body, in particular, alpha-tocopherols (vitamin E) and ascorbate (vitamins C).(3)

High concentrations of CoQ10 are also found in lysosomes, the garbage collectors of your cells which clean up all the cellular debris. 

CoQ10 & Athletic Performance

If you’re an athlete, can CoQ10 help your athletic performance?

Only a few small studies have looked into whether supplementation with 100-150mg/day of CoQ10 could impact physical performance in recreational and trained athletes. To date, CoQ10 supplementation has failed to produce benefits for maximal oxygen consumption (VO2 max), time to exhaustion, aerobic power or anaerobic markers.(4,5,6,7,8)

There may be some potential benefit for muscular recovery from intense exercise, specifically with respect to oxidative stress and low-grade inflammation, however the research is limited.(9,10,11) 

CoQ10 & Human Health 

Coenzyme Q10 plays a key role in supporting cardiovascular health.

Atherosclerosis is a condition where arterial walls become inflamed and accumulate fatty substances called plaques, narrowing and stiffening arteries and increasing your risk of heart attack and stroke. 

An early sign of the development of atherosclerosis is the oxidation of in your arterial walls. A reduced form of coenzyme Q10 - the first antioxidant called into action - works together with vitamin E to quench the pro-inflammatory oxidative fires in the artery wall.  

Supplementation has been shown in multiple studies to increase the concentration of CoQ10 in LDL in humans.(12, 13) Ensuring sufficient levels of coenzyme Q10 may be a promising strategy to reduce LDL oxidation and therefore the early progression of atherosclerosis.

Some studies have shown mild benefit for blood pressure, endothelial function, and blood flow however the effect size does not appear to be large.

Fibromyalgia is another condition where coenzyme Q10 may play a supportive role in symptom management. Several small, double-blinded studies found a dose of 300mg per day reduced fatigue and tiredness, as well as pain and soreness in fibromyalgia sufferers.(13,14)

COQ10 Food Sources

What foods are richest in coenzyme Q10? 

Currently, the US National Academy of Medicine does not have a specific dietary intake recommendation for CoQ10.(15)  The estimated daily intake of CoQ10 in the general population is approximately 3-6mg per day.(16)

The dietary sources with the highest concentration of CoQ10 are animal-based foods, such as organ meats, venison, beef, chicken and fish.(16) The next best sources include nuts and oils. (See 20 Top Food Sources infographic below)

Want to learn more?    Listen to expert Dr. Cate Shanahan    talk Deep Nutrition: Why Your Genes Need Traditional Foods on the Dr. Bubbs Performance Podcast, Season 1 Episode 28.

Want to learn more? Listen to expert Dr. Cate Shanahan talk Deep Nutrition: Why Your Genes Need Traditional Foods on the Dr. Bubbs Performance Podcast, Season 1 Episode 28.

Symptoms of CoQ10 Deficiency 

Lower plasma levels of CoQ10 are found in people with diabetes (type-1 and type-2), regularly taking cholesterol lowering medications called statins, congestive heart failure (CHF), and cancer.

Insufficient coenzyme Q10 status may also occur as you get older, research showing  plasma concentrations declining with age.(17) Therefore, some experts believe it may play a role in supporting longevity. However, it’s not clear whether this reduction over a lifespan is indeed a sign of deficiency or a natural phenomenon.

If your intake of coenzyme Q10 is deficient or insufficient, you may experience some of the following symptoms; physical fatigue, poor memory and difficulty concentrating, poor immunity, muscle pain, and increased risk of heart disease.

It is possible to perform a blood test to assess CoQ10 status, the general population reference range is 0.36-1.59 ug/mL.

Drugs Interactions & Supplementation

If you’re taking CoQ10 supplements, be sure to check with your doctor for potential interactions with medications. 

For example, if you’re taking a blood-thinning medication like warfarin (coumadin), as well as a CoQ10 supplement, you may experience a potentially dangerous reduced anti-coagulant effect of your medication.(18)

A common side-effect of statin medications is lowered plasma levels of CoQ10.

If you’re taking a statin medication – drugs classified as HMG-CoA reductase inhibitors – you will experience a drop in your CoQ10 levels because the enzyme HMG-CoA reductaseis responsible for both cholesterol and coenzyme Q10 production. 

It’s been well-established that lipid-lowering statins like Crestor, Lipitor, etc. consistently reduce CoQ10 levels in patients.(19,20,21,22) That said, experts believe CoQ10 levels are reduced when patients take statins because overall circulating lipid levels are reduced on statins, rather than a direct inhibition of CoQ10 synthesis.  

(Talk to your doctor about supplementation if you’re currently taking a stating drug).

The best evidence for the benefit of supplementation of CoQ10 is with respect to genetic mitochondrial disorders caused by mutations in CoQ10 genes (at very high doses). CoQ10 may be somewhat effective as an adjunct therapy for congestive heart failure and coronary artery bypass surgery. And currently, there is no evidence it improves diabetes, neurodegenerative conditions or breast cancer. 

If you’re supplementing with CoQ10, be sure to consume with meals that contains some dietary fat to improve absorption. Supplement doses can range from 30-100mg per capsule.

This well above the estimated average daily intake, therefore it’s probably best to consume smaller doses more frequently throughout the day. Finally, CoQ10 production may be impacted by inadequate intake of pantothenic acid (vitamin B6).

The Bottom Line

Coenzyme Q10 is made naturally in the body and an important compound for human health, playing key roles in aerobic energy metabolism and as a fat-soluble antioxidant. 

While it has not shown the ability to directly improve athletic performance, it may be able to support recovery from intense exercise via its role in buffering oxidative stress and low-grade inflammation. 

A “Food First” approach is ideal for athletes and upgrading health, with organ meats and animal proteins the richest natural sources of CoQ10. Incorporate more foods high in coenzyme Q10 to support your best mental and physical performance.

Dr. Marc Bubbs ND, CISSN, CSCS

 

References

1)   Acosta MJ, Vazquez Fonseca L, Desbats MA, et al. Coenzyme Q biosynthesis in health and disease. Biochim Biophys Acta. 2016;1857(8):1079-1085. 

2)   Ernster L, Dallner G. Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta. 1995;1271(1):195-204.

3)   Navas P, Villalba JM, de Cabo R. The importance of plasma membrane coenzyme Q in aging and stress responses. Mitochondrion. 2007;7 Suppl:S34-40. 

4)   Laaksonen R, Fogelholm M, Himberg JJ, Laakso J, Salorinne Y. Ubiquinone supplementation and exercise capacity in trained young and older men. Eur J Appl Physiol Occup Physiol. 1995;72(1-2):95-100.  

5)   Malm C, Svensson M, Ekblom B, Sjodin B. Effects of ubiquinone-10 supplementation and high intensity training on physical performance in humans. Acta Physiol Scand. 1997;161(3):379-384.  

6)   Weston SB, Zhou S, Weatherby RP, Robson SJ. Does exogenous coenzyme Q10 affect aerobic capacity in endurance athletes? Int J Sport Nutr. 1997;7(3):197-206.  

7)   Porter DA, Costill DL, Zachwieja JJ, et al. The effect of oral coenzyme Q10 on the exercise tolerance of middle-aged, untrained men. Int J Sports Med. 1995;16(7):421-427.  

8)   Braun B, Clarkson PM, Freedson PS, Kohl RL. Effects of coenzyme Q10 supplementation on exercise performance, VO2max, and lipid peroxidation in trained cyclists. Int J Sport Nutr. 1991;1(4):353-365. 

9)   Abdizadeh L, Jafari A, Armanfar  M. Effects of short-term coenzyme Q10 supplementation on markers of oxidative stress and inflammation after downhill running in male mountaineers. Science & Sports. 2015;30(6):328-334. 

10)Díaz-Castro J, Guisado R, Kajarabille N, et al. Coenzyme Q(10) supplementation ameliorates inflammatory signaling and oxidative stress associated with strenuous exercise. Eur J Nutr. 2012;51(7):791-799.  

11)Leelarungrayub D, Rawattikanon A, Klaphajone J, Pothong-sunan P, Bloomer RJ. Coenzyme Q10 supplementation decreases oxidative stress and improves physical performance in young swimmers Open Sports Med J 2010

12)Mohr D, Bowry VW, Stocker R. Dietary supplementation with coenzyme Q10 results in increased levels of ubiquinol-10 within circulating lipoproteins and increased resistance of human low-density lipoprotein to the initiation of lipid peroxidation. Biochim Biophys Acta. 1992;1126(3):247-254.

13)Cordero, M et al. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀effect on clinical improvement. PLoS One. 2012;7(4):e35677.

14)Cordero, M et al. Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal. 2013 Oct 20;19(12):1356-61.

15)Weber C. Dietary intake and absorption of coenzyme Q. In: Kagan VE, Quinn PJ, eds. Coenzyme Q: Molecular Mechanisms in Health and Disease. Boca Raton: CRC Press; 2001:209-215. 

16)Pravst I, Zmitek K, Zmitek J. Coenzyme Q10 contents in foods and fortification strategies. Crit Rev Food Sci Nutr. 2010;50(4):269-280. 

17)Hernandez-Camacho JD, Bernier M, Lopez-Lluch G, Navas P. Coenzyme Q10 Supplementation in Aging and Disease. Front Physiol. 2018;9:44. 

18)Natural Medicines. Coenzyme Q10. Professional handout/Drug Interactions. Available at: https://naturalmedicines-therapeuticresearch-com. Accessed 1/21/19.

19)Folkers K, Langsjoen P, Willis R, et al. Lovastatin decreases coenzyme Q levels in humans. Proc Natl Acad Sci U S A. 1990;87(22):8931-8934.  

20)Colquhoun DM, Jackson R, Walters M, et al. Effects of simvastatin on blood lipids, vitamin E, coenzyme Q10 levels and left ventricular function in humans. Eur J Clin Invest. 2005;35(4):251-258.  

21)Mabuchi H, Higashikata T, Kawashiri M, et al. Reduction of serum ubiquinol-10 and ubiquinone-10 levels by atorvastatin in hypercholesterolemic patients. J Atheroscler Thromb. 2005;12(2):111-119.  

22)Bargossi AM, Battino M, Gaddi A, et al. Exogenous CoQ10 preserves plasma ubiquinone levels in patients treated with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Int J Clin Lab Res. 1994;24(3):171-176.  

 

 

  

 

7 Evidence-Based Benefits of Intermittent Fasting

Fasting is a practice that’s been used for centuries in many diverse cultures and faiths to promote mental, physical and spiritual healing. From an evolutionary perspective, our Paleo ancestors would have gone long stretches of time without food and feasted in times of plenty. In today’s convenience society, food is everywhere and mindless eating – snacking even if you’re not actually hungry – is the norm.

You’ve likely heard many times that eating multiple small meals throughout the day is best for your health and that skipping meals is bad for you. What if skipping a meal was actually good for you? More and more research is coming out highlighting the potential benefits of intermittent fasting (IF) for not only losing weight but also for improving your overall health. It seems IF is not just a fad dietary approach, but a potential therapeutic tool to upgrade your health and support healthy weight loss.

Reducing your food intake during parts of the day has dramatic changes on key hormonal and physiological mechanisms in the body that may be catalysts for boosting your brain function, cooling inflammation, improving your heart health and slowing the aging process. It seems the wisdom from our ancestors may unlock some powerful health benefits!

Increases Fat Burning

After a full night’s sleep, you wake up with the perfect hormonal terrain for burning fat. Low insulin and high glucagon levels make delaying your first meal an effective strategy for prolonging this fat-burning period.

While the mantra “breakfast is the most important meal of the day” is deeply ingrained in our society, if your breakfast is muffins, bagels, cereal or juice then perhaps it’s time to try another strategy. Studies show better blood sugar control, cardiac markers and significant weight loss with intermittent fasting for overweight and obese individuals. (1)

Intermittent fasting not only capitalizes on your perfect fat-burning hormone balance by delaying your first meal in the morning, but provides the added weight-loss bonus of limiting food consumption in the late evening.

Cools Inflammation

Inflammation is considered to be the root cause of almost every chronic disease. Weight gain is a powerful trigger for inflammation, and with two-thirds of the population classified as overweight or obese, this is a major roadblock to better health.

The Journal Obesity recently found that fasting induced a significant anti-inflammatory effect on the body, improving nervous system and immune function. (2) Cooling inflammation is critical for anyone trying to improve health or lose weight, and any dietary strategy that improves this key health marker is definitely one to consider.

Improves Brain Function

One of the most common questions I get asked by clients is how to improve their focus and concentration at work. Fatigue, brain fog, and inability to stay on task are common symptoms that people experience throughout the day. These symptoms are made worse by high blood sugars, insulin and weight gain.

Intermittent fasting may hold the answer for you. A recent study showed that IF in overweight mice led to much greater learning and memory scores. (3) They also had dramatic improvement in the structural function of their brains. Better brain function and a slimmer waistline…sounds like a nice combination!

Improves Low Mood

Low mood and depression are on the rise around the world, with the World Health Organization predicting that by 2030 it will be the leading cause of disease burden around the globe. (4) That is a powerful statistic, and, like most chronic conditions, it likely stems from a wide array of root causes.

 Low mood and depression are on the rise. Intermittent fasting can help by regulating blood sugar levels.

One root cause in particular, chronically high blood sugar and insulin, has shown a strong association with low mood and depression. With the average sugar consumption up to a whopping 160 lbs. per person per year, it’s no wonder more and more people are suffering from low mood and depression.

Supports Better Heart Health

Keeping your heart healthy is crucial for overall health, as heart disease is one of the leading causes of death worldwide. Common causes include weight gain, lack of exercise, diabetes and high blood pressure, all of which may be positively influenced by fasting.

 Delaying your first meal or going longer periods between meals can be a powerful weapon for improving your health.

Studies show that heart failure can be dramatically improved with fasting and significantly increase long-term survival. (5) If you’re overweight or out of shape, excessive carbohydrate and/or caloric intake can worsen your situation. Delaying your first meal or going longer periods between meals can be a powerful weapon for improving your health.

Slows the Aging Process

Exotic supplements and medications are available to help people look and feel younger, but food choices give you the biggest bang for your buck when it comes to anti-aging. A recent study in animals found that fasting helped to significantly reduce oxidative stress and fibrosis, two key characteristics of aging tissues. (6)

Again, these results reflect significant improvements in cellular function, something fad diets definitely don’t provide. If your cells are happy, you’ll be happy. Intermittent fasting may in fact be an effective strategy for slowing the aging process.

Easy to Follow

As a clinician, giving people a dietary plan to help them lose weight is the easy part; getting people to adhere to the protocol is the hard part. Compliance is a big piece of the puzzle. If a person can’t implement their nutrition strategy into their day-to-day life, then chances are they won’t stick to it.

Surprisingly, intermittent fasting seems to simplify things for people as studies show greater compliance with intermittent fasting compared to traditional calorie-reduced diets. (7) The best program is the one you (or your client) will stick to!

Guidelines for Intermittent Fasting

Intermittent fasting can be a great tool to use for 4-12 weeks to trigger weight loss and better health, or, for some people, a long-term lifestyle change. However, before you embark on this journey, you must make sure a few key systems are in good working order:

1. Diet – If you’re not eating clean and your diet is still made up of processed and convenience foods, then get your nutrition in line before starting

2. Sleep  If you struggle to fall asleep or don’t sleep through the night, then IF may not be the best fit for you as it may lead to increased cortisol stress levels.

3. Stress  Lack of sleep, busy workdays and intense training programs can all lead to chronic stress. If your stress levels are high, hold off on intermittent fasting until things settle down.

Most of my clients tell me they are very busy, often grabbing unhealthy breakfast options and snacks in the morning on their way to work. Intermittent fasting can not only provide a novel approach to weight loss and improved health, but also offers a potentially desirable lifestyle that frees up more time to work or spend time at home.

If you’re ready to start an intermittent fasting protocol, try it for 2-4 weeks and see for yourself how you may be able to upgrade your body, mind and energy levels with simply changing when you eat your meals!

(This article originally appeared @Paleohacks.com)

Dr. Marc Bubbs ND, CISSN, CSCS

 

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