We have been discussing the functions and health benefits of Coenzyme Q10 with long-time Coenzyme Q10 researcher, Dr. William Judy. In Part 1, we discussed the actions and benefits of Coenzyme Q10. In Part 2, we discussed the absorption of the two forms of Coenzyme Q10, ubiquinone and ubiquinol. Now, let’s look at some important recent studies of its health benefits.

William V. Judy, Ph.D. earned a Ph.D. in physiology and bio-physics from West Virginia University in 1971. Dr. Judy taught physiology for many years in the Indiana University College of Medicine, and he has been doing research on the absorption and effects of Coenzyme Q10 for 46 years. His initial work was in collaboration with Dr. Karl Folkers, University of Texas, whom he collaborated with for more than 27 years. He was one of the first researchers to run long-term clinical trials, spanning 30 years or longer, on hundreds of cardiac patients, many of whom had been “left to die” by the medical establishment.

Dr. Judy is the co-author of six medical textbooks (Physiology and Biophysics). His latest book on Coenzyme Q10, “The Substance that Powers Life: Coenzyme Q10, An Insider’s Guide,” was published near the end of 2018. Dr. Judy’s research findings have been presented in six scientific reviews on Coenzyme Q10. His research group has done over 80 single-dose Coenzyme Q10 absorption and bioavailability studies in the past 40 years.

Dr. Judy has been an expert witness on six lawsuits relative to CoQ10. The last lawsuit was between a USA and a Swiss company.

Dr. Judy is currently the chairman of the Southeastern Institute for Biomedical Research (SIBR), Inc., a clinical research support center for the pharmaceutical and natural products industries. SIBR Inc. is a contract research center that conducts clinical trials on natural products for the international community. Dr. Judy has traveled the world, lecturing to physicians, health care professionals and scientists about the benefits of Coenzyme Q10 in health maintenance and disease prevention.

Passwater: Dr. Judy, aside from the absorption/bioavailability information in the studies, what were the clinical results of the Q-Symbio Study and the KiSel-10 Study you mentioned? They both used the ubiquinone form of CoQ10, isn’t that right? Ubiquinone seems to have been the choice of nearly every scientist and clinical trial ever run. I’m still laughing at the ads years ago saying that ubiquinone was obsolete now that ubiquinol was available. Scientists don’t seem too impressed with ubiquinol.

Judy: Right. Both studies used the same ubiquinone Coenzyme Q10 supplement that gave the superior absorption in the Spanish study. Okay, what to tell you?

Dr. Svend Aage Mortensen was a personal friend of mine. He was a cardiologist at the Copenhagen University hospital, and he designed and led the research in the Q-Symbio Study. That study showed that daily Coenzyme Q10 supplementation with 100 mg three times a day—taken with meals—is an effective adjuvant heart failure medication that actually improves heart muscle cell function. Instead of blocking or inhibiting one or another heart muscle cell function, the Coenzyme Q10 supplementation helps revive the ATP energy production in the energy-starved heart.

Q-Symbio was a two-year randomized, double-blind, placebo-controlled study. The results were published in the Journal of the American College of Cardiology: Heart Failure journal (17). The supplementation with Coenzyme Q10 as compared with placebo supplementation improved the patients’ symptoms and survival rates, improved their quality of life, reduced their need for hospitalization. (Please see Table 2.) Q-Symbio is the best clinical study we have in the Coenzyme Q10 research field.

Table 2.

The reasons for the differences shown in Table 2 are:
  1. A more homogenous population in the European group.
  2. Higher plasma CoQ10 levels in the European group.
  3. Better compliance.
  4. Differences in diet.
  5. Genetic differences.
Passwater: Don’t you think as highly of the KiSel-10 study (18)? It’s one of my favorites.

Judy: Ah, yes, I really admire the work that Professor Alehagen is doing. He is a cardiologist, a professor in the medical faculty at a university in Sweden. He was also one of the co-researchers on the Q-Symbio Study.

In the 4-year KiSel-10 study, he enrolled more than 400 healthy senior citizens aged 70 to 88, still living at home, in a randomized, double-blind, placebo-controlled study. The researchers gave the senior citizens 200 mg/day of Coenzyme Q10 and 200 mcg/day of a high-selenium yeast preparation or matching placebos for four years. They took the Coenzyme Q10 in divided doses, 100 mg twice a day, with meals. So, it was a gold-standard design just like the Q-Symbio study design.

Compared to placebo, those receiving Coenzyme Q10 plus selenium daily had significantly fewer deaths, fewer cardiac deaths and heart attacks, maintained heart function better, had fewer cancers, fewer hospitalizations, better physical capabilities and a better quality of life.

Then, the Coenzyme Q10 plus selenium group and the control group were followed for an additional 8 years. The statistics got even better.

Passwater: What does Dr. Alehagen think was going on in the study to give that kind of health improvement in senior citizens?

Judy: You could better answer that question. I say that because Dr. Alehagen thinks there are special interactions between Coenzyme Q10 and selenium that give therapeutic benefits, and you are an expert on selenium and health.

Passwater: Dr. Alehagen is correct. There is synergy. This is what I and Dr. Karl Folkers discussed many times back in the 1970s. Dr. Folkers had noticed this particularly when working with Muscular Dystrophy patients. In this situation, the subjects were going from a low selenium state with blood levels at 67.1 mcg on average to a better selenium nourishment. The subjects switched from a nutritional triage status to a nutritional longevity status. Please see my recent interview with Professor Bruce Ames for more details on this (19).

Once the selenium reserves were full, they can stay above the triage stage for years with only modest selenium intake.

Judy: The selenium supplement was a factor, and, of course, senior citizens are bio-synthesizing less and less Coenzyme Q10, so they needed Coenzyme Q10 supplementation as well. It would be impossible for them to make up the age-related loss of endogenous Coenzyme Q10 just by eating better.

Dr. Alehagen was able to show that the senior citizens who got the Coenzyme Q10 plus selenium treatment for four years had lower bio-markers for oxidative stress, for inflammation, and for fibrosis. They also had high scores for insulin-like growth factor-1, which, of course, has implications for cell growth and metabolism.

Passwater: Four years of less oxidative stress, less inflammation, less fibrosis, and better IGF-1. Those senior citizens got a four-year advantage over the senior citizens who got the placebos. That study attracted my attention then, but now it is attracting attention throughout the nutritional world because the great results keep on coming even after the supplements were stopped.

Judy: Right. The amazing thing is the record-keeping is so complete in Sweden that Dr. Alehagen and his team of researchers have been able to follow all the study participants since the end of the study. They have found that 10 and 12 years later, although they were no longer taking the supplements, that the senior citizens formerly in the active treatment group during the time of the formal study, continued to have a significantly lower cardiovascular mortality rate.

Passwater: So, the benefits of the Coenzyme Q10 and selenium supplementation persisted?

Judy: It seems so. Either the effect persisted, or the study participants are all so smart that they have gone out and bought Coenzyme Q10 and selenium supplements for themselves since the end of the study.

Passwater: Yes, but the senior citizens in the placebo group could also run out and buy the supplements, so, there must be some sort of advantage to having gotten the active treatment for four years while the people in the placebo group did not get active treatment?

Judy: That is the way it looks. I think we all expected the Coenzyme Q10 and selenium combined supplementation to have an effect during the study itself, but who could have predicted such long-lasting effects?

Myself, I think that Coenzyme Q10 supplementation is a lifelong therapy once we reach middle age and the senior years.

Passwater: Dr. Judy, you mentioned briefly the adverse effects of statin medications. This is very important to the health of so many. Anything new here?

Judy: Absolutely. It is a shame that the continuing controversy about ubiquinol versus ubiquinone has overshadowed the discussion of the need for Coenzyme Q10 supplementation if a patient is taking a statin medication.

Dr. Harumi Okuyama and Dr. Peter H. Langsjoen and others published a paper in 2015 explaining the pharmacological mechanisms by which statin medications can stimulate atherosclerosis and heart failure (20). These researchers published that statin drugs can kill brain cells. It appears that some of the Coenzyme Q10 researchers have picked up on this issue.

Passwater: Aren’t they saying that the effect of the statin medication is not only to cut off the cells’ bio-synthesis of Coenzyme Q10 but also to inhibit the synthesis of important selenium-containing proteins? That sounds scary to me.

Judy: It is scary. We really need to re-consider the guidelines for the use of statin medications, and we need to investigate further the adverse effects of the statin medications.

It could be that we are reducing blood cholesterol levels and the number of heart attacks but are also giving more and more people atherosclerosis and heart failure. Heart failure is different from a heart attack. A heart attack is the sudden death of a part of the heart muscle caused by a lack of oxygen. It can be fatal. Heart failure is the medical term for the inability of the heart muscle to pump adequate quantities of blood to the body’s organs. It is sometimes called congestive heart failure. Heart failure has a poor prognosis, it gets progressively worse, and it ends in death. Heart failure has become an epidemic in this country during the same period that we have been increasing the prescription of statin medications.

Passwater: Dr. Judy, there seems to be no doubt in your mind that anyone taking a statin medication should also be taking a daily CoQ10 supplement.

Judy: That is my thought. You can improve your situation with respect to Coenzyme Q10 by taking a supplement to replace some of what the cells are no longer bio-synthesizing. But what about the inhibition of the synthesis of the selenoproteins? You cannot get around that statin-related problem simply by ingesting more selenium, can you?

Passwater: No, you can’t. Dr. Judy, let’s sum up here. Three important Coenzyme Q10 studies:

Professor Guillermo Lopez-Lluch’s comparative absorption study showing that a good ubiquinone Coenzyme Q10 product can be absorbed better than a good ubiquinol product

Professor Urban Alehagen’s KiSel-10 follow-up study showing that a combination of a Coenzyme Q10 supplement and a high-selenium yeast preparation confers persistent heart health benefits

Dr. Svend Aage Mortensen’s Q-Symbio Study showing that daily supplementation with CoQ10 in addition to conventional medications improves the symptoms and survival of chronic heart failure patients

Judy: Yes, I have been doing a lot of writing, trying to get the message out about these studies. You can find many of my thoughts on the website www.q10facts.com. Most recently, I summed up case studies in my book, “The Substance that Powers Life: Coenzyme Q10 An Insider’s Guide” and I have been writing summaries of the important discoveries we have made about Coenzyme Q10 in the past 40 or 50 years. It is an amazing substance, Coenzyme Q10—truly an essential bio-nutrient, as Dr. Karl Folkers liked to say.

Passwater: I can tell you are really excited about recent research results, Dr. Judy. Thank you for taking the time to talk with us again. And congratulations on your new Coenzyme Q10 book, “The Substance that Powers Life: Coenzyme Q10 An Insider’s Guide.” My copy is an advance copy not available in stores. However, by the time this interview is published, regular copies should be available at Amazon.com and other booksellers.
Note: The views and opinions expressed here are those of the author(s) and contributor(s) and do not necessarily reflect those of the publisher and editors of WholeFoods Magazine.References

17. Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & Littarru, G. P. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC. Heart Failure, 2(6), 641-649.

18. Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.

19. Passwater, R.A. (2019) Coenzyme Q10: Research Confirms Ubiquinone and Ubiquinol are nearly equally-absorbed compounds. The physical form and companion ingredients make the bioavailability and absorption difference in Coenzyme Q10 supplements. Part 2.

20. Okuyama, H., Langsjoen, P. H., Hamazaki, T., Ogushi, Y., Hama, R., Kobayashi, T., & Uchino, H. (2015). Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Review of Clinical Pharmacology, 8(2), 189-199. doi:10.1586/17512433.2015.1011125.