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Deshu diet (Dash Diet) and Mediterranean diet (Mediterranean Diet ) has been rated as the best diet plan by (US News & World Report) for several years .

Deshu diet is the US National Heart, Lung, and Blood Institute’s (NHLBI) to develop and promote diet programs to control hypertension. Its basic purpose is simple: Eat more vegetables, fruits, and low-fat dairy products; and limit high-sugar foods and drinks, red meat, and added fat. In addition to the effect of lowering blood pressure, Deshu diet is also a balanced diet pattern designed for the general public. Many studies have found that Adhering to the Deshu diet, coupled with exercise, is good for health and weight loss.

The Mediterranean diet is a diet based on the traditional cuisine of the Mediterranean countries. Although there is no single definition of the Mediterranean diet, it is usually rich in vegetables, fruits, fish, whole grains, beans, nuts and seeds, and olive oil. The Mediterranean diet has many similarities to the Deshu diet, but it is relatively high in fat, mainly monounsaturated fats from olive oil, nuts, and seeds. (About 40% of daily energy) . Studies have found that the Mediterranean diet can reduce the risk of cardiovascular disease.

The biggest problem many people have with supplements, supplements, and even some medicines, including vitamins, is that they are often used as a substitute for a healthy lifestyle-this is the illusion that advertisers want you to form. However, people who are guaranteed to eat fruits and vegetables daily do not need vitamins; people who eat two meals of fish a week do not need fish oil; and people who exercise regularly and eat healthy diets rarely need diet meals and diet pills.

From the perspective of common sense, the oldest French lady in the world, Jenny Carmall (Jeanne Louis Calment) , live to 122 Do you really think she did it by eating health supplements?

From a scientific perspective, research after study has proven the fact: Healthy lifestyles can reduce human demand for pills and “elixir”. No solid research has shown that health supplements or supplements can improve hard indicators such as mortality.

Of course, there are many readers who leave a message saying “I”, “My mother”, “My father” … Eating XXX health products is very effective. The reality is that in many cases these can be attributed to the implied power of (placebo effect) and the general public’s unfamiliarity with the nature of the disease.

So, when I saw some fairly reliable research to support the efficacy of coenzyme Q10 in some aspects, the original response was very surprising.

On the one hand, I also hope that there is an easy way to solve the problem. Everyone is willing to cheer on the person who looks at the least likely to succeed, right?

On the other hand, more than 30 years ago, the medical community began to dispute the efficacy of coenzyme Q10. To this day, the conclusions of many studies are contradictory, and there are still no convincing data to draw conclusions about the efficacy of many scenarios.

Medical research is a developing discipline. Many theories that were previously considered correct may be overturned by new data, and some previously overthrown theories may also be supported by new data. So this article summarizes some of the latest research conclusions about coenzyme Q10.

Picture: Two common coenzyme Q10 health products (the red box is known as the health benefit).

01 What is Coenzyme Q10?

Coenzyme Q10 is found in most organisms (also known as Coenzyme Q10, CoQ10, Q10, ubiquinone, and ubidecarenone) . It is the highest in the heart, followed by the liver, kidney, and pancreas, and the lowest in the lungs. The “Q” and “10” in the name of Coenzyme Q10 refer to the quinone (quinone) chemical group and 10 isoamyl in the compound structure Dienyl subunits (isoprenyl subunits) .

Although several naturally occurring forms of coenzyme Q have been discovered, Q10 isThe most prevalent form found in humans and most mammals is also the study of its therapeutic efficacy.

Coenzyme Q10 is a lipophilic compound. In 1957, Dr. Frederick Crane of the University of Wisconsin was interested in “what substances provide energy for the heart beat”. Using bovine heart as a raw material, he successfully isolated an important biochemical substance involved in the mitochondrial energy production of cells-coenzyme Q10. . In short, coenzyme Q10 participates in a series of complex reactions that can help cells convert carbohydrates obtained in food into an important energy molecule-adenosine triphosphate (ATP ) . Remember from the high school biology class, ATP is the body’s main form of energy storage, and cells can use it to perform many key functions. When you need to move your muscles, ATP reacts chemically, releasing the energy you need. Coenzyme Q10 is critical to the process of energy production, without which ATP cannot be produced.

Coenzyme Q10 is also an antioxidant. Similar to vitamin C, vitamin E, and selenium, it can prevent free radical damage to cells. Free radicals are highly reactive chemicals that usually contain oxygen atoms and can destroy important cellular components (such as DNA and lipids) .

Figure: Chemical structure of coenzyme Q10

02 How much coenzyme Q10 does the human body need?

In human bloodCoenzyme Q10 levels between 0.30 and 3.84 µg / mL are considered normal ranges ^{[3-5] .}

About 1/4 of CoQ10 in a person’s blood comes from the diet: meat, poultry and fish are the main food sources.

The remaining 3/4 is produced by the human body. For the majority of the general population, the amount of coenzyme Q10 synthesized by itself is large enough that there is no problem of coenzyme Q10 deficiency.

However, the level of coenzyme Q10 naturally produced in the body decreases with aging due to increased demand, reduced synthesis, or insufficient intake of chemical precursors required for synthesis. Some diseases (such as heart failure, hypertension, gum disease, Parkinson’s disease, blood infections, certain muscle diseases and HIV infection) Coenzyme Q10 levels may be lower than normal, but there is no evidence that Coenzyme Q10 is the cause-that is, it is not yet known that a decrease in Coenzyme Q10 levels will directly cause these diseases-but only an observed association phenomenon.

03 Efficacy of Coenzyme Q10

There are a lot of purified coenzyme Q10 on the market as health products. They are often promoted to help increase human energy, control blood pressure, prevent cardiovascular disease, Parkinson’s disease and cancer. Coenzyme Q10 is also found in many skin care products, which claims to reduce wrinkles.

Picture: Two common creams containing Coenzyme Q10

US Food and Drug Administration (FDA) Coenzyme Q10 has not been approved for the treatment of cancer or any other medical disease.

However, as an adjuvant therapy, some uses of coenzyme Q10 are often mentioned. It must be noted: Coenzyme Q10 is only an adjuvant therapy at most and cannot replace traditional treatment methods!

Cancer disease

There is no evidence that coenzyme Q10 is helpful in cancer treatment.

But there is one exception. Some cancer chemotherapy drugs-anthracyclines including doxorubicin (doxorubicin) “Remarks”> (anthracycline) -may cause heart damage. Coenzyme Q10 can reduce the risk of heart damage caused by these drugs.

Heart disease

The conjecture that additional Q10 supplementation is beneficial to the heart is mainly based on the following inferences:

1) Impaired myocardial function is the underlying cause of many cases of heart failure.

2) Energy is required for the proper functioning of myocardial cells. Coenzyme Q10 is an important biochemical substance involved in the energy production of cardiomyocytes.

3) As the condition of patients with heart failure worsens, the levels of coenzyme Q10 in patients’ myocardial cells will also decrease. sup> . Although the food (red meat, plants, and fish) contains coenzyme Q10, the amount taken from food is not sufficient to affect patients’ low levels.

Therefore, coenzyme Q10 is supplemented, so that the coenzyme Q10 in the myocardium reaches normal levels.It can increase the energy output of myocardial cells and may improve cardiac function.

Are there any data to support this inference?

The existing data is:

01: Existing data 1

For the preventive effect of Coenzyme Q10: Only a few studies have explored whether Coenzyme Q10 can help prevent heart disease, and the results are inconclusive. ^{[ 3,4,11] .}

02: Existing data 2

Adjuvant therapy for coenzyme Q10: A study called Q-SYMBIO published in 2014 is worth noting ^{[12] .}

Researchers from Europe randomly divided 420 patients with moderate to severe heart failure into two groups. In addition to standard therapy, one group took 100 mg of Coenzyme Q10 3 times a day, and the other group received a placebo. After 16 weeks, some functional indicators were measured; the trial was terminated after two years. The clinical endpoint is any major adverse cardiovascular event (MACE) , including unplanned hospitalization due to heart failure, cardiovascular disease Death, organ transplant needs, etc. Researchers also compared total mortality.

The results for Coenzyme Q10 are surprisingly good. Although the short-term (16 weeks) took no significant difference, two years later, the incidence of MACE in the coenzyme Q10 group was 15%, and The placebo group was 26%. This difference reached statistical significance (p = 0.003) . All-cause mortality also improved, with 10% all-cause mortality in the coenzyme Q10 group and 18% in placebo (p = 0.08) . In addition, patients taking coenzyme Q10 died from cardiovascular events.Mortality has also been significantly reduced, with fewer other adverse events ^{[12, 13] .}

However, this experiment also has some major methodological flaws:

• The biggest problem is that the number of patients participating in the study is still not enough, and there are many clinical trial centers located in different countries participating in this trial. This also means that in a specific clinical center, diseases that can be randomly assigned Very few people. Because the incidence of adverse events (MACE) is relatively low in general, random events may be observed. In other words, the significant effect observed in the experiment may be just because it happened …

• Second, the number of deaths from patients with moderate to severe heart failure in this trial in two years was much lower than usually observed. It is not clear what caused this. But given the small number of patients participating in the trial and the small number of deaths, the trial’s estimate of the risk of reducing mortality was statistically inaccurate. Such inaccurate estimates are often difficult to repeat in the last large trials.

• This trial began before 2003 and is expected to end in 2008. Why wasn’t it announced until 2013, and this uncomplicated, two-year trial was published in 2014?

• Finally, this trial was conducted by two companies producing coenzyme Q10 supplements (Kaneka Nutrient and Pharma Nord) and the International Coenzyme Q10 Association Contributed. Lead author Mortensen is one of the founders of the International Coenzyme Q10 Association. This will inevitably bring some “bias” (bias) into the process of experiment design and data analysis. Prove the effectiveness of Q10.

Therefore, there is no conclusion about the role of coenzyme Q10 in the adjuvant treatment of heart failure. . We need more rigorous design studies, including more diverse populations ^{(American College of Cardiology Foundation / American Heart Association Task Force) Coenzyme Q10 is recommended for patients with heart failure. (warfarin) , maybe you should not take Coenzyme Q10. Mayo Clinic (Mayo Clinic) points out that there may be a drug interaction between coenzyme Q10 and warfarin (https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/in-depth/warfarin-side-effects/art-20047592?pg=2) . Although many compounds were initially thought to have drug interactions with warfarin, and later overturned by pharmacokinetic studies, caution was advised before thorough research.}

Relieves muscle pain caused by statins

Coenzyme Q10 to reduce side effects of muscle pain caused by statinsThis idea is similar to that of patients with heart failure, but also originated from a coincidence discovery:

1) Statins can reduce low-density cholesterol lipoprotein (LDL) , which is harmful to health, but also take statins Will reduce the level of Coenzyme Q10 ^{[18] .}

2) Muscle soreness is a common side effect of statins, and coenzyme Q10 is important for muscle function.

So, can muscle soreness be relieved by increasing the concentration of coenzyme Q10 in the blood?

Although the results of various studies are not very consistent ^{[19] , in general, the existing science Evidence does not support that coenzyme Q10 can reduce the muscle pain caused by statin cholesterol-lowering drugs with the lowest [20, 21] .}

However, because Coenzyme Q10 has few side effects, some doctors will recommend trying to supplement Coenzyme Q10 for one to two months. (Doses range from 100 ml to 200 mg per day ) to see if it really relieves muscle cramps, pain, or weakness caused by statins.

We have talked about the quality of health products in the past. If you decide to try, you should use products from manufacturers whose quality has been tested.

Hypertension

A small amount of existing evidence indicates that coenzyme Q10 does not significantly affect blood pressure. ^{[22] .}

Migraine

American Academy of Neurology (American Academy of Neurology) and American Headache Association (American Headache Society) guidelines point out that Coenzyme Q10 is “potentially” effective in preventing migraine ^{[23] < / span>, but the conclusion is based on very limited evidence.}

Parkinson’s disease

Some previous studies on the role of coenzyme Q10 in Parkinson’s disease have had mixed results: a phase II clinical trial showed that coenzyme Q10 can delay functional decline. ^{[24] , and another study did not find any beneficial effects (NIH) has funded a large phase III clinical trial in hopes of clarifying the facts. The latest results show that coenzyme Q10 does not improve the symptoms of early patients with Parkinson’s disease even at doses much higher than the normal standard. [26 ] . A 2017 meta-analysis combining this large study with other smaller studies also concluded that Coenzyme Q10 is not helpful for Parkinson’s disease [27] .}

Other diseases

There are also some studies on coenzyme Q10 including ALS (Hocking’s disease) , Down syndrome (Huntington’s disease) and other diseases such as male infertility. But research is limited and no conclusions can be drawn.

04 Safety of Coenzyme Q10

Taking the appropriate dose of coenzyme Q10 (30 ml to 200 mg per day for adults) is relatively safe, and no serious side effects have been reported. May have mild side effects such as insomnia or indigestion.

It is important to note that unless directed by a doctor, the National Institutes of Health (NIH) does not recommend that children take Coenzyme Q10.

Coenzyme Q10 may interact with the anticoagulant warfarin (warfarin) and insulin, making these two drugs ineffective. Warfarin’s effectiveness is affected and may increase the risk of blood clots.

Coenzyme Q10 may not be compatible with certain types of cancer therapy. If you are on cancer treatment, ask your doctor if you can take coenzyme Q10.

05 Summary

Most ordinary people do not lack coenzyme Q10. They can rely on food intake and their own synthesis to meet the needs of the body.

Elderly, some diseases (such as heart failure, hypertension, gum disease, Parkinson’s disease, blood infections, certain muscle diseases, and HIV infection) patients, or people taking statins, the level of coenzyme Q10 in the body may beIt will be low. However, for many people taking statins, although the level of coenzyme Q10 is reduced by 20-40% in the body, there is no evidence that the reduction of coenzyme Q10 will directly cause any adverse effects.

There is some evidence supporting the role of coenzyme Q10 in adjuvant treatment of certain symptoms. However, it is not yet possible to determine exactly how much to count as an “appropriate effective dose.”

Taking 90-200 mg of Coenzyme Q10 daily is safe for most adults. Some studies have used high doses of 300-600 mg per day, but it is difficult to say whether there will be long-term toxicity. Although most people tolerate CoQ10 well, it may cause some minor side effects, including upset stomach, loss of appetite, nausea, vomiting, and diarrhea. Coenzyme Q10 may also cause allergic rashes in some people.

References:

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[3] K. Overvad et al., Coenzyme Q10 in health and disease. Eur J Clin Nutr 53, 764-770 ( 1999).

[4] J. Pepping, Coenzyme Q10. American Journal of Health-System Pharmacy 56, 519-521 (1999).

[5] P. Jolliet et al., Plasma coenzyme Q10 concentrations in breast cancer: prognosis and therapeutic consequences. Int J Clin Pharmacol Ther 36, 506-509 (1998).

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[7] D. Iarussi et al., Protective effect of coenzyme Q10 on anthracyclines cardiotoxicity: control study in children with acute lymphoblastic leukemia and non-Hodgkin lymphoma. Mol Aspects Med 15 Suppl, s207-212 (1994).

[8] K. Folkers, R. Brown, W. V. Judy, M. Morita, Survival of cancer patients on therapy with coenzyme Q10. Biochem Biophys Res Commun 192, 241-245 (1993).

[9] EP Cortes, M. Gupta, C. Chou, VC Amin, K. Folkers, Adriamycin cardiotoxicity: early detection by systolic time interval and possible prevention by coenzyme Q10. Cancer Treat Rep 62, 887-891 (1978).

[10] K. Folkers, S. Vadhanavikit, SA Mortensen, Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with coenzyme Q10. Proceedings of the National Academy of Sciences of the United States of America 82, 901-904 (1985).

[11] E. Baggio, R. Gandini, AC Plancher, M. Passeri, G. Carmosino, Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. Molecular Aspects of Medicine 15, s287-s294 (1994).

[12] SA Mortensen et al., 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, 641-649 (2014).

[13] AUFRAUKJFAU Anne Louise Mortensen, Effect of coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q -SYMBIO randomized double-blind trial. Effect of coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-SYMBIO randomized double-blind trial 26, 147-156-147-156 (2019).

[14] A. Sharma, GC Fonarow, J. Butler, JA Ezekowitz, GM Felker, Coenzyme Q10 and Heart Failure: A State-of-the-Art Review. Circ Heart Fail 9, e002639 (2016).

[15] M. E. Madmani et al., Coenzyme Q10 for heart failure. Cochrane Database Syst Rev, CD008684 (2014).

[16] CW Yancy et al., 2013 ACCF / AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 62, e147-239 (2013).

[17] F. de Frutos, A. Gea, R. Hernandez-Estefania, G. Rabago, Prophylactic treatment with coenzyme Q10 in patients undergoing cardiac surgery: could an antioxidant reduce complications? A systematic review and meta-analysis. Interactive CardioVascular and Thoracic Surgery 20, 254-259 (2014).

[18] R. Deichmann, C. Lavie, S. Andrews, Coenzyme q10 and statin-induced mitochondrial dysfunction. Ochsner J 10 , 16-21 (2010).

[19] M. Banach et al., Effects of Coenzyme Q10 on Statin-Induced Myopathy: A Meta-analysis of Randomized Controlled Trials. Mayo Clinic Proceedings 90, 24-34 (2015).

[20] BA Taylor, L. Lorson, CM White, PD Thompson, A randomized trial of coenzyme Q10 in patients with confirmed Statin Myopathy. Atherosclerosis 238, 329-335 (2015).

[21] L. Marcoff, PD Thompson, The Role of Coenzyme Q10 in Statin-Associated Myopathy: A Systematic Review. Journal of the American College of Cardiology 49, 2231-2237 (2007).

[22] MJ Ho, ECK Li, JM Wright, Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. The Cochrane database of systematic reviews 3, CD007435-CD007435 (2016).

[23] E. Estemalik, S. Tepper, Preventive treatment in migraine and the new US guidelines. Neuropsychiatr Dis Treat 9, 709-720 (2013).

[24] CW Shults et al., Effects of Coenzyme Q10 in Early Parkinson Disease: Evidence of Slowing of the Functional Decline. JAMA Neurology 59, 1541-1550 (2002).

[25] BJ Snow et al., A double-blind, placebo-controlled study to assess the mitochondria-targeted antioxidant MitoQ as a disease-modifying therapy in Parkinson’s disease. Movement Disorders 25, 1670-1674 (2010).

[26] TPSGQ Investigators, A Randomized Clinical Trial of High-Dosage Coenzyme Q10 in Early Parkinson Disease: No Evidence of Benefit. JAMA Neurology 71, 543-552 (2014).

[27] Z.-G. Zhu et al., The efficacy and safety of coenzyme Q10 inParkinson ’s disease: a meta-analysis of randomized controlled trials. Neurological Sciences 38, 215-224 (2017).

This article is from WeChat public account: return to Park (ID: fanpu2019) , author: history Jun