Coenzyme Q 10: A little Known Supplement That Yields Big Results

Diabetes is a progressively increasing menace and is a consequence of the modern lifestyle. According to WHO, there are 422 million adult diabetics in the world¹. In spite of many drugs available in the market, to control diabetes and its complications, the search for newer and better treatment continues. One of the compounds which is being researched on is Coenzyme Q10. It holds much promise not only for diabetes but, also for many other diseases.

What is Coenzyme Q10?

A coenzyme is a chemical substance that helps various chemical reactions to take place in the cell. Coenzyme Q 10, which is also called Ubiquinone, is present ubiquitously (thus the name!) in all living organisms. It can be synthesized by all the animals and is fat soluble. It has an important role in carrying out various functions² in the body-

It plays a vital role in conversion of carbohydrates and fats, to ATP in the mitochondria.
It helps the lysosomes (they digest the dead organelles in the cell) to function optimally.
It acts as an antioxidant. Oxidation reactions produce free radicals which damage the cells. Coenzyme Q 10 can directly neutralize these free radicals.
It also regenerates Vitamin E and Vitamin C (which are antioxidants) to their oxidized form.

What is the damage at the microscopic level in Diabetes Mellitus?

It is known that Diabetes occurs because of lack of insulin and has various long term complications. Microscopically it has been found that there is excess of free radicals produced in diabetes. The mitochondria are the energy generators of the body and while doing so produce free radicals. These free radicals per se are not harmful to the body because they are needed for various chemical reactions. Only when they are produced in large quantity they start affecting the body adversely. In diabetes the high glucose or free fatty acids available to the mitochondria lead to production of free radicals which damage the endothelium (inner lining of the blood vessels).Nitric Oxide (NO) present in the endothelium is essential for causing the dilation (expansion) of blood vessels. This NO gets used up quickly by combining with these excess free radicals contributing to the development of hypertension in diabetes (since they can no longer expand freely)^.The free radicals have also been found to be harmful to the cells of the retina and kidney.

How coenzyme Q10 can help in Diabetes Mellitus?

There have been many studies to assess the role of coenzyme Q10 in reducing blood pressure and controlling blood sugars in diabetes mellitus. It has been found to have blood pressure lowering effect and also lowers the HbA1c in diabetic patients. Even though some studies do not confirm the positive role of Coenzyme Q10, it is a molecule important not only for energy production but also as an antioxidant. It has a direct anti oxidant action and an indirect one by virtue of converting ascorbic acid (vit C) and vit E to their active forms. All these are antioxidants. As discussed earlier there is increased production of free radicals in diabetes mellitus, Coenzyme Q10 along with Vit C and Vit E scavenge these free radicals so that the cell damage is minimum. The harmful effect of free radicals on the NO present in the endothelium is also reduced, helping in vasodilation (blood vessel expansion) in hypertensive patients.

Is Coenzyme Q10 available in nature?

Coenzyme Q 10 is abundantly available in nature and its deficiency is generally unknown.

Non-vegetarian foods containing good amount of coenzyme Q10 are-

Fish- Sardines, Mackerel, salmon, tuna, herring
Beef, Lamb, Pork- organs like heart, liver, kidneys
Eggs

Vegetarian Foods-

Spinach
Broccoli
Cauliflower
Wheat-germ
Peanuts, Pistachio, sesame seeds
Soyabean oil, Canola oil

Dosage of coenzyme Q10

Since coenzyme Q10 is freely available in the food we eat, an average person consumes 2 to 20 mg/day. Therapeutically the recommended dose is much higher, to the tune of 50 to 100 mg/day. It is a safe supplement even in very high doses. At more than 100mg/day some people may experience nausea, diarrhea and mild insomnia. It is not recommended in pregnancy and breastfeeding.

Benefits of coenzyme Q10 in diabetes mellitus

Most of the studies have not been able to establish the glucose lowering effect of coenzyme Q10 in diabetic patients but some studies have shown a reduction of HbA1c levels^5,6. Apart from the glucose lowering effect it can be recommended for its anti-oxidant property. As already discussed there is increased free radical production in diabetes. Hypertension, retinopathy, nephropathy and neuropathy are essential complications of diabetes and Coenzyme Q10 may be helpful in long term prevention of these complications⁷. Hence Coenzyme Q10 can definitely be recommended as a supplement along with other anti-diabetic medication for better control of blood sugar and more importantly reduction of complications.

References:

Global Report On Diabetes World Health Organization, Geneva, 2016

Discovery of ubiquinone (coenzyme Q) and an overview of function Frederick L. Crane Mitochondrion, volume7, supplement, June 2007

Coenzyme Q₁₀and diabetic endotheliopathy: oxidative stress and the ‘recoupling hypothesis’ G.T. Chew, G.F. Watts QJM Aug 2004, 97 (8) 537-548; DOI: 10.1093/qjmed/hch089

Mitochondrial Dysfunction in Diabetes: From Molecular Mechanisms to Functional Significance and Therapeutic Opportunities.Antioxidants & Redox Signaling. Sivitz WI, Yorek MA. 2010;12(4):537-577. doi:10.1089/ars.2009.2531

Effects of CoQ10 supplementation on Lipid Profiles and Glycemic control in Patients with Type-2 Diabetes: a randomized, double blind, placebo controlled trial Hoda Zahedi et al Journal of Diabetes & Metabolic Disorders2014 13:81 DOI: 10.1186/s40200-014-0081-6

Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes Hodgson J.M ,et al, Eur J Clin Nutr, 2002. 56(11): p. 1137-42.

Coenzyme Q10 and oxidative stress, the association with peripheral sensory neuropathy and cardiovascular disease in type 2 diabetes mellitus Forsbreq E, et al, J of diabetes complications 2015 Nov-Dec;29(8):1152-8. doi: 10.1016/j.jdiacomp.2015.08.006

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