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Mistaken Beliefs About Coenzyme Q10 Supplements




ResearcherThere are many mistaken assumptions about the essential bio-nutrient Coenzyme Q10.  For the most part, these assumptions have been allowed to pass unquestioned and be accepted as fact.

  • The mistaken belief that ubiquinol is always better absorbed than ubiquinone
  • The mistaken belief that older people (over the age of 40) always need ubiquinol supplements
  • The mistaken belief that ubiquinol is the “active form” of Coenzyme Q10
  • The mistaken belief that ubiquinol is synthesized in the body
  • The mistaken belief that people need to take ubiquinol to get ubiquinol into the blood
  • The mistaken belief that ubiquinol is absorbed as ubiquinol

Let's take these assumptions in turn and see what we can make of them.

Assertion: Ubiquinol is always better absorbed than ubiquinone

Actually, it turns out that the formulation of the Coenzyme Q10 supplement and the solubilization of the Q10 crystals in the supplement are more important for the absorption of Coenzyme Q10 than the form (ubiquinone or ubiquinol) is.

This point was clearly shown in a double-blind cross-over comparative study conducted by Professor Guillermo Lopez-Lluch, Professor Placido Navas, and a team of researchers at the Pablo de Olavide University in Sevilla, Spain.  In their study, a patented ubiquinone CoQ10 supplement gave significantly better bioavailability than a patented ubiquinol supplement [Lopez-Lluch].

Both the patented ubiquinone Q10 supplement and the patented ubiquinol supplement gave significantly better bio-availability than any of five other ubiquinone Q10 formulations [Lopez-Lluch].

Dr. Judy explains that this misconception may have gotten started as the result of an unscientific comparison of ubiquinol absorption results in a Japanese study with the results from a much earlier Parkinson's disease study in which a dry powdered crystalline form of ubiquinone was used.  The dry powder ubiquinone is poorly absorbed but was the only formulation available back then. This comparison was not good science. 

  • It was not a head-to-head comparative study.
  • It did not test more recent formulations of ubiquinone against the ubiquinol supplement.
  • It drew on results from investigators, study participants, study protocols, supplement formulations, laboratories, and analytical methods that were all different from one another. 

Assertion: Older people (over the age of 40) always need ubiquinol supplements

This assertion is to be found all over the Web without any scientific documentation.  Surprisingly, one medical doctor writes in his Web blog, without any references to scientific studies, that “if you're older (than 25), your body becomes more and more challenged to convert the oxidized Q10 to ubiquinol.”  Where does that statement come from?

Actually, a recently published study shows that supplementation with both ubiquinone CoQ10 and ubiquinol will raise the plasma levels of ubiquinol in older men (average age: 63 years) significantly and that the difference in the increases is not statistically significant [Zhang].

Assertion: Ubiquinol is the active form of Coenzyme Q10 

 As Dr. Judy explains, both redox forms of Coenzyme Q10 are important. The oxidized form, which is called ubiquinone, is essential for the cellular process of ATP energy production. The reduced form, which is known as  ubiquinol, is an important fat-soluble antioxidant protecting against free radical damage to cells and lipids and proteins and DNA.

Assertion: Ubiquinol is synthesized in the body 

Dr. Judy explains that ubiquinone is synthesized (manufactured from other compounds) within the body. Ubiquinol is not. The cells convert (do not manufacture) ubiquinone into ubiquinol as needed. 

Assertion: People need to take ubiquinol to get ubiquinol into the blood

This statement is not factual.  An often-cited study done by Drs. Mohr, Bowry, and Stocker has shown that we do not need to take a ubiquinol supplement in order to get enough ubiquinol in the blood plasma and in the lipoproteins in the blood. Long-term supplementation on the order of three times 100 mg ubiquinone Q10 per day resulted in four-fold enrichment of ubiquinol in plasma and in LDL-lipoproteins [Mohr].

Furthermore, the Zhang study referred to above showed that older men achieved significantly increased plasma ubiquinol concentrations from both ubiquinone and ubiquinol supplements.  The difference in the increases from the two different supplements was not statistically significant [Zhang]

Assertion: Ubiquinol is absorbed as ubiquinol   

As Dr. Passwater points out, a reduced compound such as ubiquinol will oxidize in an oxidative environment such as gastric fluid.  Dr. Judy's lab studies and dog studies have shown that the ubiquinol in ubiquinol supplements is converted to ubiquinone prior to its absorption in the small intestines.  Then, once it has passed into the lymph, it is converted back to ubiquinol, and it passes into the blood circulation as ubiquinol.  

In the blood, the body's Coenzyme Q10 is approximately 96% in the form of ubiquinol.  This makes sense as there is little need for the bio-energetic form (ubiquinone) of Q10 in the blood and much need for the antioxidant form (ubiquinol). When, then, the Q10 passes from the blood into the cells and into the tissues, it is converted back to its bio-energetic form, ubiquinone.

The ubiquinol form of Q10 is very unstable and, consequently, much more expensive for the Q10 capsule manufacturer to work with.  Dr. Judy has found ubiquinol is very unstable in air, in water, and in gastric juice. His studies have shown that the ubiquinol inside some ubiquinol capsules has already oxidized to ubiquinone while still in the bottle.

Countering Mistaken Beliefs with Scientific Evidence

  • Ubiquinone and ubiquinol are nearly equally-absorbed compounds, and both forms are active important in their own ways  [Lopez-Lluch].
  • Ubiquinone and ubiquinol supplements both significantly increase plasma ubiquinol levels in older men [Zhang].
  • Ubiquinone is the active form of Q10 needed for the mitochondrial process of ATP energy production [Garrido-Maraver].
  • Ubiquinone is the form of Coenzyme Q10 that is synthesized in the body [Bentinger].
  • A good ubiquinone supplement will significantly increase the ubiquinol concentration in plasma and in lipoproteins [Mohr].
  • The ubiquinol in ubiquinol supplements will be absorbed as ubiquinone and then re-converted back to ubiquinol in the lymph [Judy].

Not all Coenzyme Q10 supplements are equally absorbed and equally effective.  The formulation of the Q10 supplement and the extent of solubilization of the Q10 crystals make a big difference in the absorption and bioavailability of Q10 supplements.

It is important to choose a Coenzyme Q10 supplement that has been tested in randomized, double-blind, placebo-controlled clinical trials such as the Q-Symbio Study [Mortensen], the KiSel-10 Study [Alehagen], and the Gulf War Illness Study [Golomb].