To Your Health

What is the latest thinking on coenzyme Q-10 supplements?

Q. My father is beginning to show signs of mental deterioration, along with other problems that come with being 82 years old. I want him to try a coenzyme Q-10 supplement, but there seems to be a lot of controversy surrounding it, for instance what form to take and what we should expect. What is the latest thinking on coenzyme Q-10 supplements?

A. Coenzyme Q-10 (CoQ) supplements have always been controversial, in part because we are able to make our own CoQ and some people believe that we should be able to produce enough to make a supplement unnecessary. The more we learn about all the jobs CoQ performs in our bodies the more we realize how central it is to our bodies' functions. Most importantly, every cell of the body uses CoQ during the process of converting our food into energy that is usable by our bodies with the tiny structures in each cell known as mitochondria.

Of all our body organs, the brain is the heaviest consumer of energy. Although CoQ was first used to improve heart function, we are now learning about the benefit of CoQ to brain function. CoQ deficiency has been associated with the development of "neurodegenerative diseases" such as Alzheimer's disease and Parkinson's disease. CoQ supplements were part of a successful treatment program that improved cognition in such patients over a two-year period. The program also included a multivitamin, vitamin E, alpha-lipoic acid, and omega-3 fatty acid supplements in combination with diet modification, physical exercise, and prescription medications. The health care of the future is likely to take a similar tack, using a combination of several intervention techniques, rather than relying on a single "magic bullet" to solve our health problems.

The rising popularity of "statin" drugs may also promote neurodegenerative disease. There is substantial evidence that damage to mitochondria may play a key role in both Alzheimer's and Parkinson's diseases, and that CoQ supplements can reduce this damage. Statin drugs are very effective for lowering blood cholesterol level, but because CoQ and cholesterol share a common pathway as the body produces them, the statin drugs also reduce the production of CoQ. Mental problems that were previously mild enough to be unnoticeable may emerge after beginning treatment with statin drugs (see "Statin-associated neuromyotoxicity" in Drugs Today (Barc), April 2005). So if your father, like many other elderly persons, is taking a statin drug to reduce blood cholesterol, a CoQ supplement is a prudent addition to his supplement program as a preventive measure even if we are not sure about its ability to help mental problems.

CoQ is poorly absorbed under the best of circumstances, and since it can be rather expensive it is well worthwhile to maximize absorption. The most sensible way to improve absorption it to take CoQ at whatever meal of the day provides the highest fat intake. CoQ is a fat soluble substance and is absorbed the same way dietary fat is absorbed. Some brands of CoQ claim better absorption, and may in fact boost absorption slightly, but the research is clear that the biggest improvement in absorption is achieved by simply taking CoQ with food.

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