August, 2005
by Chris Masterjohn
Statins Inhibit Coenzyme Q10 SynthesisSince coenzyme Q10 (CoQ10) and cholesterol are both synthesized from the same substance, mevalonate, statin drugs (Lipitor, Zocor, etc) also inhibit the body's synthesis of coenzyme Q10. This is not a "side effect," of statins, but a direct, inherent function of the drugs.
In fact, the use of statins can decrease the body's synthesis of coenzyme Q10 by as much as 40%!1
Functions of Coenzyme Q10Coenzyme Q10 is a fat-soluble antioxidant that is found in virtually all cell membranes, hence its alternative name "ubiquinone." The antioxidant activity of vitamin E requires the CoQ10 to be available, to which vitamin E will pass on the unpaired electron (free radical) that it has scavenged. CoQ10 also acts as an anti-oxidant independently, protecting against DNA damage and other forms of oxidative damage caused by the consumption of excess polyunsaturated fatty acids.
Coenzyme Q10 is also an essential component of the mitochondria (the "power-house" of the cell), playing a critical role in the formation of ATP, the body's fundamental energy unit, from carbohydrate and fatty acid metabolism.
It appears that Coenzyme Q10 might be involved in maintaining the proper pH of lysosomes, which are a digestive component of cells, as well.2
Coenzyme Q10 and the HeartIn his book, The Doctor's Heart Cure, Dr. Al Sears, MD, director of the south Florida Center for Health and Wellness, devotes an entire chapter to the importance of CoQ10 to the heart.
According to Dr. Sears, coenzyme Q10 prevents arteriosclerosis by reducing the accumulation of oxidized fats in blood vessels, eases high blood pressure, regulates the rhythm of the heart, and improves chest pain and exercise toleration in angina patients.
He describes one woman who came to his Center on statins and two additional blood pressure medications, also suffering from memory loss. A blood test revealed her CoQ10 levels were in the lowest 95% of the population. Supplementing with 200 mg of coenzyme Q10 allowed her to stop both blood pressure medications. She felt "energized," and her memory recovered. Her cardiologist, upon hearing the good news, reacted angrily and threw her bottle of CoQ10 in the trash.3
According to the Linus Pauling Institute's review of coenzyme Q10, controlled intervention studies have shown improvement of congestive heart failure with the administration of coenzyme Q10, although there is conflicting evidence. Animal evidence suggests a significant role for coenzyme Q10 in reducing myocardial damage due to heart attack or open-heart surgery, and collective evidence shows a promising role in reducing high blood pressure.2
Coenzyme Q10 and the BrainBrain levels of coenzyme Q10 begin declining at the age of 20, and are lowest in the victims of stroke and neurodegenerative diseases.3 Animals with with a Huntington's gene experience fewer brain lesions with CoQ10, but motor improvement and survival benefit is not significant. Evidence is, however, promising for CoQ10 in therapy for Parkinson's.2
Perhaps, if both cholesterol and CoQ10 are important to the function of the brain, coenzyme Q10 deficiency as well as cholesterol depletion might play a role in the side effects sometimes seen from statins associated with memory loss, such as transient global amnesia (TGA).
Coenzyme Q10 in FoodCoenzyme Q10 is found in the highest amounts in red meat products. It is especially high in organ meats such as liver and heart, from which it was first isolated.3 Thus, the combination of cholesterol-lowering statin drugs and a so-called "heart-healthy" regimen free of red meat could dramatically compromise coenzyme Q10 status.
Coenzyme Q10 is also destroyed by heat, so meat should not be overcooked to obtain maximum CoQ10 benefit. Boiling has been found to have negligible effect on the survival of CoQ10, while frying substantially reduces CoQ10, from 14 to 32 percent.4
According to The Doctor's Heart Cure, the organs of wild, grass-fed animals have up to ten times more CoQ10 than the organs of grain-fed animals. "Unless you regularly consume wild game or eat internal organs of grass-fed animals," Dr. Sears writes, "it is difficult to maintain good blood levels of CoQ10 from dietary sources alone."3
If you are interested in finding a source of grass-fed animal products local to you, you can do so by clicking on your state at EatWild.com.
The table below shows the distribution of CoQ10 in 98 different foods. Certain oils, such as soybean, rapeseed, and sesame, have substantial amounts of CoQ10, but samples were taken from Japanese and Finnish retail stores, and it's possible that the oils currently available in the U.S. may be processed in ways that are more injurious to the CoQ10 content. Pending further information, oils shouldn't be considered a reliable source of coenzyme Q10.
Reindeer muscle meat was found to have dramatically higher coenzyme Q10 levels than beef or pork, rivaling those found in the hearts of other animals. The studies from which the data were drawn did not give information on feed, so perhaps this is attributble to the feed of the animal, as Dr. Sears claims.
The table below draws from two different studies. It will be updated soon when I am able to obtain more information.
Supplementing with Coenzyme Q10Since coenzyme Q10 synthesis declines with age, it becomes more important to obtain it from the diet. For the Standard American Diet (SAD), this essentially means from supplements. Dr. Sears has measured the CoQ10 status of hudreds of patients at the Center for Health and Wellness and reached the following conclusions:
"If you are in one of these categories, as hundreds of patients discovered, CoQ10 supplements can make a dramatic difference in your energy level and cardiovascular health."
Dr. Sears recommends using gel caps or chewables, and not tablets, and taking the CoQ10 with some fat or oil to increase absorption. More information can be found in his book, The Doctor's Heart Cure
Coenzyme Q10: Hero of the Heart, Victim of the "Heart-Healthy" EstablishmentThe story of coenzyme Q10 is an ironic one. Coenzyme Q10 is vitally important for the entire body, but has proven especially important to the heart. Yet the "heart-healthy" establishment guidelines hit CoQ10 with a double-whammy: statin drugs hit the body's own synthesis of CoQ10, while red meat and organ meats have both been ridiculed as unhealthy "artery-clogging" foods, yet are the primary source of dietary CoQ10.
Coenzyme Q10 deficiency is not only a "side effect" of statins, it's a side effect of obeying dietary guidelines as well.
Appendix: Food Composition Table — The Distribution of Coenzyme Q10 in Foods
Food Item |
Coenzyme Q10 (mcg/g) |
Pork heart |
126.8-203 |
Reindeer |
157.9 |
Beef heart |
113.3 |
Soybean oil |
92.3 |
Rapeseed oil |
63.5 - 73.4 |
Sardine |
64.3 |
Mackerel |
43.3 |
Pork |
24.3-41.1 |
Beef liver |
39.2 |
Beef |
31.0 - 36.5 |
Sesame oil |
32.0 |
Soybeans, roasted and ground |
30.1 |
Peanuts, roasted |
26.7 |
Cattlefish |
23.8 |
Sesame seeds, roasted |
23.0 |
Pork liver |
22.7 |
Chicken |
14.0 - 21.0 |
Yellow tail fish |
20.7 |
Horse mackerel |
20.7 |
Pistachios, roasted |
20.1 |
Pork ham |
20.0 |
Walnuts, raw |
19.0 |
Soybeans, whole, dry |
19.0 |
Cottonseed oil |
17.3 |
Azuki beans |
17.1 |
Hazelnuts, roasted |
16.7 |
Tuna fish, canned |
15.9 |
Baltic herring |
15.9 |
Pollack, frozen |
14.4 |
Sweet almond, roasted |
13.8 |
Corn oil |
13.0 |
Soybeans, boiled |
12.1 |
Eel, cultured |
11.1 |
Spinach |
10.2 |
Perilla, leaves |
10.2 |
Lard |
10.0 |
Soybeans, natto |
10.0 |
Broccoli |
8.6 |
Rainbow trout |
8.5 |
Rape |
7.4 |
Butter |
7.1 |
Chestnuts, raw |
6.3 |
Flat fish |
5.5 |
Rice bran |
4.9 |
Sanflower oil |
4.2 |
Olive oil |
4.1 |
Safflower oil |
4.0 |
Egg |
1.2 - 3.7 |
Sweet Potato |
3.6 |
Wheat germ |
3.5 |
Blackcurrant |
3.4 |
Sweet pepper |
3.3 |
Japanese radish, leaves |
3.3 |
Garlic |
2.7 |
Pea |
2.7 |
Cauliflower |
1.4 - 2.7 |
Yogurt |
2.4 |
Carrot |
1.7 - 2.2 |
Egg plant |
2.1 |
Cheese |
2.1 |
Bean |
1.8 |
Cabbage |
1.6 |
Japanese barnyard millet (whole grain) |
1.4 |
Strawberry |
1.4 |
Orange |
1.4 |
Cheese, Emmental |
1.3 |
Apple |
1.3 |
Cheese, Edam |
1.2 |
Buckwheat, whole grain |
1.1 |
Chinese cabbage |
1.0 |
Japanese radish, root |
1.0 |
Onion |
1.0 |
Potato |
0.5 -1.0 |
Lingonberry |
0.9 |
Clementine |
0.9 |
Tomato |
0.9 |
Job's tears |
0.6 |
Cow milk |
0.4 |
Orange juice |
0.3 |
Milk (1.5% fat) |
0.1 |
Lingonberry juice |
n.d. |
Crispbread, rye |
n.d. |
Bread, rye |
n.d. |
Bread wheat |
n.d. |
Brown rice |
n.d. |
White rice |
n.d. |
Whole wheat |
n.d. |
Wheat flour |
n.d. |
Barley, whole grain |
n.d. |
Oats, whole gain |
n.d. |
Lettuce |
n.d. |
Edible Burdock |
n.d. |
Garland chrysanthemum |
n.d. |
Pumpkin |
n.d. |
Cucumber |
n.d. |
Basella |
n.d. |
Rice brain oil |
n.d. |
Coconut oil |
n.d. |
Data taken from Japanese and Finnish sources.5, 6
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1. Ghirlanda, et al., "Evidence of plasma CoQ10-lowering effect of HMG-COA reductase inhibitors: a double-blind, placebo-controlled study," Journal of Clinical Pharmacology. 1993 Mar; 33(3):226-229.
2. Linus Pauling INstitute's Micronutrient InformationCenter,http://lpi.oregonstate.edu/infocenter/othernuts/coq10/index.html. Accessed August 19, 2005.
3. Sears, Al, MD, The Doctor's Heart Cure: Discover the Simple, Easy, Enjoyable and Above-All PROVEN Plan to Lose Weight and Achieve a Shock-Proof, Disease-Resistance Heart — with Delicious, Natural Foods and Just a Few Minutes of Exercise a Day, St. Paul: Dragon Door, 2004, 133-146.
4. Weber et al., "The coenzyme Q10 content of the average Danish diet," Int J Vitam Nutr Res. Vol. 67 No. 2 (1997) 123-129.
5. Kamei et al., "The distribution and content of ubiquinone in foods," Internat. J. Vit. Nutr. Res. 56 (1986) 57-63.
6. Mattila, et al., "Coenzymes Q9 and Q10: contents in foods and dietary intake," Journal of Food Composition and Analysis 14 (2001) 409-417.