The powerhouse nutrient, Coenzyme Q10 (CoQ10), is an antioxidant and multipurpose nutrient used to support cellular health. CoQ10 is fascinating because its primary role is to convert food into energy. Without energy or ATP, life does not exist. One essential organ to utilize this nutrient is the heart, where levels peak at age 20 and decline to about 50% by age 80.
The growing interest in this nutrient has become apparent in the last decade as science is revealing more and more about the benefits of CoQ10. One avenue of interest is the importance of CoQ10 testing, which assists patients and practitioners in healthcare decisions. This article provides a comprehensive view of Coenzyme Q10, its many benefits, how to test, and some scientific hurdles to be aware of.
What is CoQ10?
Coenzyme Q10, abbreviated CoQ10, or Ubiquinone, is a vitamin-like nutrient necessary for physiological processes. The functions of Coenzyme Q10 include antioxidant duties for cellular health and cellular energy production. It’s found in almost all cells due to its role in cellular respiration. Organs that utilize the most energy- the heart, brain, kidney, and liver are abundant in CoQ10, which keeps these vital organs operating. Energy production occurs in our cells' mitochondria within these organs and others. Specifically, Ubiquinone is a cofactor in the electron transport chain, which produces energy in the form of ATP. The potent antioxidant role of this nutrient is as a defense mechanism against free radicals, which protects DNA and cellular health. With this all in mind, CoQ10 is vital to human life and well-being.
What Causes CoQ10 Deficiency? What Are The Symptoms?
Adequate and even optimal levels of CoQ10 are necessary to support cellular and antioxidant activities. This nutrient is obtained through eating a balanced diet, but it is also naturally produced by the body. While adequate exogenous consumption helps maintain sufficient CoQ10 levels, other factors deplete this nutrient. Genetic factors, medications, and even age can contribute to CoQ10 deficiency.
Primary CoQ10 deficiency is genetically acquired and results from mutations in one or multiple genes that are a part of the synthesis of CoQ10. If severe, this can be detectable in infancy, while mild primary deficiency may not show up until after 60 years old. Secondary deficiencies can be due to genes not directly impacting CoQ10 synthesis pathways but affiliated genes like APTX gene that encodes for specific proteins. Pharmaceutical medications and aging also fall into secondary causes of deficiency.
Medications known to cause deficiency are anti-depressants like amitriptyline and statins such as atorvastatin. One study looked at 34 hypercholesterolemic participants whose blood concentrations of CoQ10 were measured before statin use and then again 30 days after beginning atorvastatin therapy. Levels dropped from 1.26ug/mL at baseline to 0.62 ug/mL after 30 days of statin use. According to monitoring records, a significant decline in Coenzyme Q10 was detectable as soon as 14 days post-intervention.
Like many nutrients of cellular health, CoQ 10 status declines with age. Literature states that it peaks at 25 years old. At around 65 years old, about 50% of that peak status is present. There is also a correlation to neurological function, as the brain and nervous system require about 20% of the body’s energy consumption. Therefore, a decline in Ubiquinone has been linked to a variety of neurological-based conditions. When evaluating the whole health picture, recognizing CoQ10 deficiency may be challenging since it can present similarly to a variety of conditions or pathologies.
Some key signs and symptoms that may indicate a primary deficiency or low Coenzyme Q10 status, which warrants further investigation, include:
- Muscle weakness
- Cerebellar ataxia
- Intellectual disability
- Poor muscle tone
- Involuntary muscle contractions
- Muscle stiffness
- Nystagmus (abnormal eye movements)
- Vision loss
- Hearing loss
Health Conditions Linked to CoQ10 Levels
There are various chronic diseases and health conditions affected by CoQ10. This includes diabetes, cardiovascular disease, Parkinson’s disease, Alzheimer's, cancer, migraines, medication-induced myopathy, and physical performance.
The primary role of CoQ10, as a cellular energy production component, directly impacts these conditions. With the nervous system, brain, liver, heart, and muscle tissue requiring an abundance of energy to function, it makes sense how CoQ10 plays an important role. Research has shown that oxidative stress and dysfunctional mitochondria contribute to heart disease and failure. Providing the heart with a supportive nutrient, such as CoQ10, that has antioxidant properties and supports processes in the mitochondria should be a primary intervention consideration in all heart disease patients.
A promising study out of Italy showed that Coenzyme Q10 is a beneficial adjunctive therapy in heart failure patients. In this multicenter study, patients were taking, on average, 100mg/day for 90 days, which improved at least three symptoms in 54% of the patients. Some of these symptoms include palpitations, cyanosis, pulmonary rales, and insomnia. CoQ10 in disease management can improve cholesterol levels as well, which can be a predisposing factor to the development of diabetes. In addition, providing the brain with this powerhouse nutrient has been shown to reduce migraines in chronic migraine sufferers.
One randomized controlled study revealed that taking coenzyme Q10 can prophylactically prevent migraines. Clinical evidence and research areas have found this nutrient to support symptoms related to these conditions robustly. Whether it is from decreasing progression, treating prophylactically, or replenishing the nutrient to prevent disease, there are many conditions CoQ10 could benefit.
The Role of CoQ10 Testing
If you’re stumped on whether or not CoQ10 deficiency is a culprit in your health condition, you can measure the levels in your blood. Testing will allow you to incorporate targeted treatment options with dietary changes or supplementation protocols. Personalized healthcare and CoQ10 investigation align with how functional medicine doctors, naturopathic doctors, and integrative practitioners evaluate health. It involves looking for the root cause, such as a nutrient deficiency manifesting as signs and symptoms. CoQ10 testing is performed by blood draw that is then sent to a lab, such as Access Medical Laboratories, to assess your status.
Vibrant America also has a Coenzyme Q10 test that will look at this antioxidant in the serum and white blood cells, revealing the nutrient status and whether it is sufficient to support immune function cellular processes.
Interpreting CoQ10 results is typically not done independently but is often part of a panel, such as the Cardiac Health Panel by Vibrant America, the Inflammation Panel by Vibrant Wellness, or the Micronutrients Panel, also by Vibrant America. Looking at the whole picture of someone's symptom and clinical presentation helps guide other tests pertinent to their case. Comprehensive testing can provide context to underlying dysfunction driving the depletion of CoQ10 and assist with therapeutic intervention decisions.
Who Should Consider CoQ10 Testing?
CoQ10 test should be considered in conditions that impact mitochondrial function, energy depletion, have a neurological basis, or if there is a concern for inadequate nutritional status. Candidates who have been on statin medications and are at an increased risk for CoQ10 deficiency should be tested.
Like high-performing athletes, individuals who expend excess energy may benefit from the antioxidative protective mechanism of CoQ10 supplementation and post-exercise recovery. There has been some suggestive information on CoQ10 as a sport-performing enhancing supplement in athletes, and therefore, CoQ10 testing for athletes may be warranted. This is especially true if the athlete plans to take 300mg or more daily of CoQ10 supplementation. Lastly, testing should be considered in those with metabolic dysfunction due to its predisposition to heart disease.
Integrating CoQ10 Status Into Lifestyle Interventions
There are three ways to obtain CoQ10 in the body. One is our innate ability to synthesize this nutrient. The second is to acquire it through nutrient-dense foods. Dietary sources of CoQ10 include eggs, nuts, chicken, whole grains, organ meats (liver, hearts, or brains), and fish (salmon, mackerel, sardines). Supplementation should be considered in the aging population, those with significant CoQ10 deficiency, and individuals with a condition where CoQ10 can be supportive. CoQ10 supplementation should not be given to those under 18 years of age unless under the supervision of a healthcare provider. In those 19 years and older, 30 to 200mg per day is the recommended range for Coenzyme Q10 supplementation.
Clinically speaking, 50-100mg per day is a standard therapeutic dose. Additional guidelines for CoQ10 supplementing include taking the dose with a meal since it is a fat-soluble nutrient, not taking it if you are on certain medications that could interact with this nutrient (such as blood thinners), and closely monitoring blood sugar in type 2 diabetes since it has the potential to lower blood sugar levels. The last thing to note is that there is some controversy over the form of supplemental CoQ10 and which form is more bioavailable, which leads to increased absorption of CoQ10 for your cells to utilize. The research is leaning towards the ubiquinol form being superior to ubiquinone supplementation.
Potential Pitfalls and Considerations in CoQ10 Testing
While blood testing is the standard method of assessing CoQ10, there is some questioning of its accuracy on bioavailable CoQ10. Some studies also reveal discrepancies between administering oral CoQ10 and seeing an increase in blood levels, suggesting absorption issues.
Evidence also suggests that this nutrient can be present and within range in the blood, but that does not always equate to how it is utilized in the tissues. This can make blood testing difficult because it may not accurately represent how therapeutic CoQ10 supplementation is for the patient.
This is why working with a nutrient-informed practitioner who can provide professional guidance for CoQ10 levels is necessary. Many integrative medicine providers will look at your health holistically and make treatment recommendations based on subjective and objective measures.
Key Takeaways: Why is Testing CoQ10 So Important For Health?
Coenzyme Q10 is valuable in optimal health and disease prevention. Understanding its significance in mitochondrial health, energy production, and anti-oxidative abilities lays a foundation for how vital it is for many organ systems. While a decline in CoQ10 is a natural progression of aging, you can do your body good by consuming foods that support this nutrient. Working with a practitioner who can assist you in the proactive management of CoQ10 for health is beneficial. They can adequately test your levels, asses all areas of your health, and make necessary recommendations for an effective supplement. In a world where supplements are widely available to be marketed, it’s always best to seek professional advice from those educated in this field.
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