Having covered fat soluble vitamins (ADEK), methylated B6 and B12, protein and magnesium, I will conclude this brief review of nutrients/supplements with a discussion of CoQ10. Fish oil, coconut oil and other fats will be discussed in an upcoming extensive series covering a new/old (depending on who you talk to) perspective on dietary fat. Before that I’ll complete the series on cooking.

Image-1 (9)Coenzyme Q10 (CoQ10) is a compound found in every cell of our bodies and concentrated in the mitochondria where it plays a crucial role in energy production. It also works as an antioxidant. Produced within the cells, it is most prevalent in heart muscle which, as you will see, has important clinical implications. It naturally declines with aging and with certain diseases such as Parkinson’s. Several medicines can reduce it including beta-blockers, antidepressants and most notably cholesterol lowering statin drugs. Good evidence shows that Coq10 can significantly lower blood pressure but it has not found its way into hypertension guidelines. It is purported to enhance athletic performance but I do not know of any credible studies.

The most beneficial use for CoQ10 supplements in my opinion is with those on statin drugs. Statins work to lower Image-1 (11)cholesterol by inhibiting an enzyme called HMG-CoA reductase. The same chemical pathway produces CoQ10 so it is also lowered by statins. It’s likely that statin induced muscle pain is caused at least in part by reduced CoQ10. More frightening is the specter of lowered CoQ10 where it is most prevalent – the heart muscle. Several years ago a patient of mine on simvastatin was diagnosed with “idiopathic cardiomyopathy” (the heart is failing and we don’t know why). Lacking other helpful options, I started him on 200mg of CoQ10 daily. His heart pump function, having been less than 40% for over a year, came up to a very healthy 60% within weeks and has remained there ever since. This doesn’t prove anything but is certainly compelling. It makes sense to place everyone taking statins Image-1 (8)on 200mg a day. At the very least, those with muscle pain or heart failure should be supplemented. Doses like that are safe and I have not seen significant side effects. The only downside is that CoQ10 can be expensive. Shop around for the best price. It should be purchased in a form called Ubiquinol which is better absorbed.

This series has covered some of the supplements I frequently or occasionally recommend. Use of these is based more on basic science and clinical judgement than on double blind placebo controlled trials. Confirm anything I’ve said with your own doctor. As mentioned we’ll follow the series on cooking with a primer on dietary fat – a subject which has been distorted, misunderstood, politicized, lied about……just about anything but discussed in rational, scientific and helpful terms.