What is Co Enzyme Q10?
Coenzyme Q (CoQ10) is dietary supplement that is available over the counter. It ocurrs naturally in our bodies and is located in the mitochondria (the energy producer of the cell). Coenzyme Q is mainly produced by our cell, though a small proportion is produced from the diet. The cells ability to manufacture Coenzyme Q 10 decreases with age leading to lower levels. People with Parkinson’s also have lower levels of CoQ10.
What does Coenzyme Q10 do?Coenzyme Q is an antioxidant that may protect nerve cells from damage due to metabolic stress. Because of this, it is being studied as a potential treatment to protect nerve cells in diseases such as Parkinson’s. CoQ10 plays a key role in our cell’s energy production in a specific part of the cell, referred to as the electron transport chain, in our mitochondria. Portion of this electron transport chain is deficient in people with Parkinson’s; hence CoQ10 may play a role in maintaining the integrity of this process and cell health.
What is the association between Coenzyme Q10 and Parkinson’s?The potential benefit of CoQ10 in patients with early Parkinson’s was studied In a National Institute of health (NIH) sponsored research trial[i]. Patients with early Parkinson’s disease were treated with placebo (sugar pill), or CoQ10 in one of three doses- 300mg, 600mg and 1200mg/day. All subjects also received Vit E at a dosage of 1200IU/day. Vitamin E was given as it may act with CoQ10 to provide better antioxidative defense. These doses were found to be safe and well tolerated. Patients treated with CoQ10 showed a positive trend in symptom improvement when measured after 16 months of therapy. The highest dose of 1200mg/day appeared to be the most effective dosage. At the end of 16 months, the1200mg group had a 44% less decline in function with the greatest effect on measures of activity of daily living.
A more recent study showed conflicting results showing that CoQ10 had no effect yet studies varied to include lower doses (300mg) and more advanced patients[ii]. A double blind placebo controlled clinical trial was stopped in 2011 when it was noted that 1200mg or 2400mg for 16 months did not improve symtoms. It is unknown whether a longer period of time is needed to see results or if some people would respond better than othersCoQ10 is also being studies as a treatment for heart disease.
Is there a certain brand or form of CoQ10 that is recommended? The type COQ10 may be very important due to significant variability in absorption. What is important is not just how much you take but how well it is absorbed into the blood stream. Ubiquinone CoQ10 is converted through a biochemical process in the body to ubiquinol CQ10 a form that is more readily used by the body. Ubiquinol CoQ10 is now available as a supplement although these supplements were not used in the clinical research stated above. Vitaline was the brand name used in the clinical trial defined above and is ubiquinone CoQ10 packaged in a patented formula with vitamin E to aid absorption.
Are there side effects?
COQ10 is generally well tolerated. It may cause abdominal discomfort, decreased appetite, nausea and diarrhea. Occasionally some patients have reported trouble with sleep and mild liver enzyme elevation without any evidence of liver damage. Taking CoQ with meals may reduce the symptoms of nausea and abdominal discomfort. Patients who have diabetes and who are on warfarin (Coumadin) should have frequent monitoring of their glucose control and blood clotting levels, respectively. Some researchers believe that statins, a group of medicines used to treat high cholesterol can reduce levels of Coenzyme Q10.
Recent research results are disappointing and reinforce the fact that CoQ10 is not for everyone given the high cost of this supplement and the lack of definitive evidence for its benefit in Parkinson’s to date.
[i] Archives of Neurology, October 2002, Vol. 59, No. 10, pp. 1541-1550
[ii] Archives of Neurology, July 2007. Vol 64
Author: Monique Giroux, MD