Miracle? No, but Q10 has promise

By Chris Woolston, Special to The Times
November 12, 2007
http://www.latimes.com/features/heal...tory?track=rss

The product: Coenzyme Q10 -- it sounds like an obscure, man-made chemical, perhaps the final ingredient in a snack food, right behind yellow No. 5.

Strange name aside, coenzyme Q10 is in fact a vital nutrient for every cell in your body, not to mention every cell in your dog and your office ficus tree. All plant and animal cells are powered by mitochondria, tiny structures that pump out energy for the cells. Mitochondria, in turn, need a steady supply of the vitamin-like antioxidant Q10 to keep the power generators running smoothly.

"It's the quarterback of mitochondria," says Dr. Robert Bonakdar, director of pain management at the Scripps Center for Integrative Medicine in La Jolla. "Levels of coenzyme Q10 determine whether energy is being made efficiently or sluggishly."

Your body makes its own Q10, and you get a little more from lots of different foods. But some people have unusually meager supplies of this must-have nutrient. Bonakdar says that he often finds low levels in patients with migraine headaches, fibromyalgia and chronic fatigue syndrome when he does Q10 blood tests.

Studies have found consistently low levels of the nutrient in people who have congestive heart failure or take statin drugs (such as Lipitor or Crestor) to lower cholesterol.

Anybody interested in taking Q10 won't have to look far. Most drug stores and health food stores sell a variety of Q10 pills and powders. Depending on brand and dosage, the supplements can cost anywhere from $50 to $200 a month.

The claims: Not surprisingly, this crucial nutrient has spawned some big claims. Various websites assert that Q10 supplements can speed weight loss, boost energy and treat an astonishing number of illnesses, including AIDS, Parkinson's, cancer and heart disease. One website selling the supplements states that "people across the world use coenzyme Q10 with phenomenal results." Another site claims that most people don't have nearly enough of this "miracle antioxidant."

The bottom line: For now, the promise of coenzyme Q10 supplements is still built largely on hope, assumptions and just a smattering of science, says Dr. Brent Bauer, director of complementary and integrative medicine at the Mayo Clinic in Rochester, Minn.

Yet Bauer believes there is promise, saying that Q10 supplements seem extremely safe and the few studies so far have been encouraging.

"We can be fairly confident that there's something to it," he says. " I don't recommend it for my patients, but for people who are interested in trying it, using it for hypertension, heart failure and for statin treatment makes the most sense."

A few small, brief studies suggest that coenzyme Q10 supplements can relieve some cases of hypertension. As reported earlier this year in the Journal of Human Hypertension, three randomized, placebo-controlled studies involving a total of 120 patients have found that Q10 can reduce high blood pressure by an average of 17/8.

A 2004 placebo-controlled Israeli study of patients with advanced heart failure found that Q10 supplements improved quality of life but didn't enhance the pumping power of the heart. "Even if the heart function doesn't improve, a lot of people feel better," Bauer says. "They have more energy."

The widespread popularity of statins has spurred new interest in Q10 supplements, Bauer says. "Boatloads of patients are very excited about taking it along with their statins," he says. Some experts suspect that dwindling levels of Q10 might cause muscle pain, and a 2007 study found that combining Q10 with statins cut pain by 40% within one month.

Even if Q10 doesn't really prevent side effects, Bauer says, it has done its job if it encourages more people to stick with their life-saving medications.

Bonakdar says that Q10 supplements have helped many of his patients with migraines, fibromyalgia and chronic fatigue syndrome. Many -- but not all. "Some people respond really well to small doses, while others don't respond to even high doses," he says.

The supplements seem to have a strong effect only in patients who have low levels of Q10, Bonakdar says. But because few physicians ever test Q10 levels, most patients who try the supplement are taking a shot in the dark. Still, "if someone is at wit's end, it's not a bad idea to give it a try," he says.

As for healthy people, there's no reason to believe that the supplement does anything -- and that includes speeding weight loss and boosting energy, Bonakdar says. "A lot of advertising is geared toward people who don't need it," he says.

Coenzyme Q10 is very fragile, and only a small percentage survives the trip from supplement to bloodstream. Products labeled "crystal free" are good choices because crystals can block absorption, he says. He also recommends patience. "You have to give it three to four months to see any effect," he says.

Nobody knows which dose works best, and the effects on any particular patient are completely unpredictable, says Dr. Domenic Sica, professor of medicine and pharmacology at Virginia Commonwealth University and a board member of the American Society of Hypertension.

"It's probably going to reduce blood pressure in some people, but for the life of me nobody knows why," he says. "There are a lot of unknowns, too many to recommend it with regularity. It definitely can't be a substitute for seeing a doctor or taking medications."

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