Enzyme supplements may play role in good health

Originally published in The Ottawa Citizen July 27, 2004
Original Title: Cozy up to Co-Q

An early study released recently by the Michigan Head Pain and Neurological Institute in Ann Arbor, Michigan, showed that co-enzyme Q10 (CoQ) may be another treatment approach for migraines.

Before delving deeper into this story, a little CoQ cell biology and metabolism review will help clarify the issue.

Within our cells reside mitochondria. These tiny organelles are the cell’s power plant, using glucose and fatty acids for fuel. They produce the power by using enzymes contained within them. The purpose of an enzyme is to convert one compound into another and pass it onto another enzyme to make further changes or send the product off to its final destination.

Each enzyme has its own repetitive purpose, similar to work on an assembly line. But even the enzymes need help to function in top form.

Enter the co-enzyme.

Co-enzymes support the function of the enzyme. Indeed, without them the enzyme system would likely malfunction or be unable to produce a quality product.

CoQ or ubiquinone (from the word ubiquitous, “found everywhere”) is an antioxidant and is produced in the liver, pancreas, heart and kidneys, usually in sufficient amounts for proper physiological function. Minute quantities of CoQ are found mainly in chicken and beef. Indeed, the only way to increase the body’s supply of CoQ is through consumption of dietary supplements.

There are claims that CoQ will be helpful in treating congestive heart failure, Parkinson’s disease, heart muscle damage (cardiomyopathy), hypertension, heart attack recovery, diabetes and, now, migraines.

What is the scientific evidence to support these claims?

The migraine study hypothesis stated that a possible cause for migraine headaches could be due to the cell’s inability to produce enough energy to function properly. CoQ was given to patients to see if it would relieve their headaches. At the American Academy of Neurology’s annual meeting in April, reports suggested 300 milligrams a day halved the migraine frequency compared to placebo.

“The bottom line is that there are safe alternatives with a firm scientific basis for preventing migraine for people who don’t want to take prescription drugs, that also can be used to complement prescription drugs,” said Dr. Richard B. Lipton, a neurology professor at Albert Einstein College of Medicine in the Bronx, New York.

People suffering from congestive heart failure (CHF) have lower levels of CoQ in their heart muscle. A one-year double-blind, placebo-controlled trial of 641 people with moderate to severe CHF divided the group into halves; one group received two milligrams per kilogram body weight of CoQ daily, the other half received placebo — but both groups remained on their conventional medical therapy. The CoQ group experienced a reduction in the severity of their symptoms and had fewer readmissions to hospital for CHF exacerbations.

Other studies produced similar results, but two recent and well-designed double-blind studies did not show any benefit. More clinical trials are needed before any definitive therapeutic recommendations are made.

Three double-blind placebo-controlled hypertension studies demonstrated a nine-per-cent reduction in blood pressure in one, and similar results for the others. These studies used small patient populations (range 59 to 83 people) using doses between 60 to 100 milligrams daily.

People with hypertension can have other illnesses. It can affect young and old. The next step would be to look at specific patient populations to provide a means of comparison.

How well does it work for treating heart attack patients? In a double-blind study, 145 patients were given placebo or 120 milligrams of CoQ daily for 28 days along with their conventional medical treatment. The results showed that the CoQ group suffered fewer recurrent heart attacks, chest pain (angina pectoris) and irregular heart rhythms (arrhythmias).

One eight-week and one 12-week double-blind placebo-controlled diabetes study showed a significant reduction in blood sugar levels in people taking 100 milligrams of CoQ twice daily compared to placebo. However another study failed to note any difference.

Although there were initial positive reports about the use of CoQ in Parkinson’s disease and cardiomyopathy, the results were not statistically significant. Further trials are forthcoming.

CoQ is generally safe when taken as directed. People taking warfarin (Coumadin) should not take CoQ because it may impair the blood thinning action of the medication. Its safety has not been evaluated for children and breast-feeding or pregnant women.

Cholesterol-lowering medications like the statins, beta-blockers, tricyclic anti-depressants and phenothiazines (antipsychotic) medications can reduce CoQ levels.

It is best to take CoQ in its dry tablet or capsule form with meals because it is better absorbed with fats and oils.

Consult your physician before trying CoQ, especially if you have suffered a recent heart attack or have diabetes, heart disease, cancer or kidney failure.

For more information, check the website http://www.consumerlab.com, which provides independent analysis of many herbal products.

© Dr. Barry Dworkin 2004

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