Hi ld123-ga, and thanks for your question. As usual, this is not a
substitute for professional medical advice, evaluation, and treatment.
I advise that you not embark on any new treatment regiment without
first directly consulting a physician.
Coenzyme Q10 (aka CoQ10) is a co-enzyme (a vitamin-like chemical) made
naturally in the body. It has been touted to be of benefit for cancer
and Parkinson's disease, as you suggest. Although not immediately
related to your question but still likely of interest, here's the
National Cancer Institute site, discussing it's use in cancer:
http://www.cancer.gov/cancertopics/pdq/cam/coenzymeQ10/patient
You can read an excellent description of CoQ10 at the University of
Washington. Although the article has some focus on it's use in heart
failure, it is still likely of interest to you:
http://faculty.washington.edu/~ely/coenzq10.html
This site also gives the history of this substance and summarizes
important milestones in it's use and development.
_________________
In the text Integrative Medicine, Rakel summarizes the current thinking on CoQ10:
"The antioxidant coenzyme Q10 (CoQ10) was first identified in 1957 and
is widely used in Japan for the treatment of cardiovascular disease.
It is synthesized by the body and found in all cells. CoQ10 is most
highly concentrated in heart muscle because of high energy needs
there. It is utilized to support the body?s bioenergetic
functions?particularly in the mitochondria, to assist in the
generation of adenosine triphosphate (ATP). After the age of 30 years,
natural levels of CoQ10 begin to diminish. Further loss is exacerbated
by stress, illness, and some medications such as the HMG-CoA reductase
inhibitors (cholesterol-lowering, ?statin? agents), certain oral
hypoglycemic agents, and beta blockers. Research suggests that CoQ10
may be of benefit in almost any disease related to the heart,
including angina, arrhythmias, congestive heart failure, lipid
disorders, hypertension, and cardiotoxicity associated with
doxorubicin (Adriamycin) chemotherapy. It has been shown to enhance
immune function in AIDS and to improve blood sugar control in
diabetes.[19] It has been used topically in the treatment of
periodontal disease.[20]"
Rakel, David. Integrative Medicine. Saunders / Elsevier Science,
2003. Chapter 96, pp. 704-705.
__________________
You can also read more about the use of CoQ10 for Parkinson's disease
in these articles:
Shults CW, Haas RH, Beal MF. A possible role of coenzyme Q10 in the
etiology and treatment of Parkinson's disease. Biofactors.
1999;9(2-4):267-72. Review.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10416040&dopt=Citation
Beal MF. Coenzyme Q10 administration and its potential for treatment
of neurodegenerative diseases.
Biofactors. 1999;9(2-4):261-6. Review.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10416039&query_hl=4
__________________
CoQ10 has been shown useful against Parkinsonian-like disease in animal models:
"Oral coenzyme Q10 has been found to be protective to
dopamine-manufacturing neurons and is neuroprotective in animal models
of Parkinson?s disease.[17] Multicenter studies are currently being
conducted by the Parkinson?s Study Group to evaluate the usefulness of
coenzyme Q10 in Parkinson?s patients."
You can read more about these animal tests, for example, in these articles:
Matthews RT, Yang L, Browne S, Baik M, Beal MF. Coenzyme Q10
administration increases brain mitochondrial concentrations and exerts
neuroprotective effects. Proc Natl Acad Sci U S A. 1998 Jul
21;95(15):8892-7.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9671775&query_hl=4
This article is available free at the link above.
_________________
There have recently been a few clinical trials testing CoQ10 for use
in treatment of Parkinson Disease:
Shults CW. Flint Beal M. Song D. Fontaine D. Pilot trial of high
dosages of coenzyme Q10 in patients with Parkinson's disease.
[Clinical Trial. Clinical Trial, Phase II. Journal Article]
Experimental Neurology. 188(2):491-4, 2004 Aug.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15246848&dopt=Citation
Shults CW. Haas R. Oakes D. Kieburtz K. Plumb S. Shoulson I. Beal MF.
Juncos J. Nutt J. Measuring the effects of therapy in Parkinson
disease.[comment]. [Comment. Letter] JAMA. 291(20):2430-1; author
reply 2431, 2004 May 26.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15161889&dopt=Citation
You can request these articles from Dr. Shults:
cshults@ucsd.edu
LeWitt PA. Clinical trials of neuroprotection for Parkinson's disease.
[Review] [86 refs] [Journal Article. Review. Review, Tutorial]
Neurology. 63(7 Suppl 2):S23-31, 2004 Oct 12.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15477583&dopt=Citation
You can request a reprint of this article Dr. Lewitt:
palewitt@ameritech.net
______________
Regarding what CoQ10 is thought to do for Parkinson patients, the
LeWitt article above describes the rationale behind it's use:
"Beyond the concepts of neuroprotective or neurorestorative approaches
using neurotrophic substances, another trial has targeted a metabolic
abnormality detected in the PD brain as well as systemically in
mitochondria.50 A reduction in activity of the first step in the
mitochondrial chain of electron transport prompted the use of coenzyme
Q10, an antioxidant and the electron acceptor for mitochondrial
complex I. The recent clinical trial involved 80 otherwise untreated
PD subjects receiving oral coenzyme Q10 at up to 1,200 mg/day.51 Over
the 16 months of study drug administration, there was an improvement
of 6.69 points (p = 0.0416) in the adjusted mean score for total UPDRS
in the 1,200 mg/day treatment group. No improvement was seen at the
lower doses of 300 and 600 mg/day, however. Further analysis indicated
that most of the benefit from 1,200 mg/day was attributable to less
decline in activities of daily living rather than to amelioration of
clinical signs on examination. Although this study does not prove that
targeting the complex I mitochondrial defect in PD was the only
possible mechanism for the study outcome, these results have opened
the door for other ways to intervene with PD and other
neurodegenerative diseases through enhancing mitochondrial metabolism.
Currently, a trial (sponsored by the NIH and included in a 2x2
factorial design together with GPI-1485) is under way, investigating
coenzyme Q10 at a daily intake of 2,400 mg."
____________
In terms of what form to take, Rakel states:
"CoQ10 is best taken in gel capsule with oil for better absorption."
Other sources (see, e.g., the first Shults paper above) state that
taking CoQ10 with Vitamin E may decrease its efficacy, although
patients in their trial did take 1200 IU per day of Vit. E. supplied
by Vitaline / Enzymatic Therapy (see below).
Dosage:
According to Rakel: "Patient should take 200 mg daily."
The optimal dosage has not yet really been determined, however, as you
can see from the range of doses used in the clinical trials described
above. Of course, the doses in these clinical trials are quite high
and these patients need to be closely monitored for adverse side
effects.
____________
Rakel also mentions some the typical side effects of CoQ10:
"CoQ10 can cause gastritis, anorexia, nausea, and diarrhea and, if
taken in doses greater than 300 mg per day, can elevate serum levels
of aminotransferases [liver enzymes]."
In Table 96-2 in Rakel's text (pg. 736), the author describes natural
sources of CoQ10, "Oily fish, organ meats, whole grains," interactions
(may slightly decrease the effectiveness of Coumadin, a blood
thinner), and that CoQ10 may be "[d]epleted by statin drugs and some
oral hypoglycemic agents..."
____________
Regarding natural vs. synthetic forms of CoQ10, there's a lot of spin
out there. You'll see lots of terms out there like "more pure," "most
studied CoQ10," etc. The bottom the FDA doesn't regulate CoQ10, so
there's little control on quality. That being said, the natural and
synthetic forms should be equivalent. One caveat - synthetic
production or isolation of natural CoQ10 is dependent on how good any
individual process might be. If one company does an awful job of
purifying the CoQ10, then their "natural" product may be useless. If
another makes a damaged form of synthetic CoQ10, it's also bad.
So, I'd probably go with the formulations studied in at least one of
the clinical trials above, supplied by Vitaline / Enzymatic Therapy
(the two companies merged last month), which is widely available
online. Here are some sources:
http://www.dealtime.com/xPO-Enzymatic_Therapy_Vitaline_Coq10_100mg_Orange_Chewable_30_Tablets_ET05911
Drugstore.com:
http://www.drugstore.com/search/search.asp?searchtype=1&trx=28198&trxp1=60&srchtree=1&search=coenzyme+q10&Go.x=0&Go.y=0
Here's some info on this company and the merger:
http://www.nutraingredients-usa.com/news/ng.asp?id=62657-enzymatic-therapy-remifemin-black-cohosh
In Australia:
Blackmores
http://www.blackmores.com.au/products/products_detail.asp?cat=102&prod=153
Thexton
http://www.thexton.com.au/index1.php?alias=articles&artid=2149&temp=drug
In the UK:
Academy Health
http://www.academyhealth.com/coenzymeq101.html
Healthy Direct
http://shop.healthydirect.co.uk/coq10-30mg-uk.htm
Canada:
Maison Radical / ClicNature.com
http://www.maisonradical.ca/Nouveau_Dossier/Nutravite/coenzyme_q10.htm
Shoppers Drug Market:
http://www.shoppersdrugmart.ca/english/health_wellness/offers/natural/qmelt/
=======================================================
I hope this information is useful. Please feel free to request any
clarification prior to rating.
Best,
-welte-ga
================
Search strategies:
Multiple searches on medical literature databases using "Coenzyme q10"
and "parkinson disease"
Medical database searches of online medical texts describing
alternative and natural therapies using the same terms.
("coenzyme q10" OR coq10) site:.au
("coenzyme q10" OR coq10) uk
("coenzyme q10" OR coq10) site:.ca |
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