Monday, June 03, 2013


Co-Enzyme Q10 has been around for awhile now. Many of my patients seem to be taking it and have always asked me about it. I have always replied that after so many years of OTC sales and direct selling, I have yet to see creditable evidence of its benefit in the scientific literature. Is that all about to change.

 Co-Enzyme Q10 is a metabolic modulant and and energy enhancer for the cardiac myocardial cells working at the mitochondrial level. It is suppose to make the failing heart more energetic.
Data on Co-Q10 was first presented last Nov at the Congress of the International CoQ10 Association meeting. But the data was never published, at least not yet.
At the recently concluded Feart Failure Congress 2013, at Lisbon, Portugal, Dr Svend Aage Mortensen from the Copenhagen University Hospital, Denmark, again presented the data.  The study is called Q-SYMBIO. 202 patients in the treatment arm ( CoQ10 + conventional heart failure therapy ) against 218 patients on conventional heart failure therapy ( no CoQ10 ). The follow-up period was 2 years, but the study took almost 10 years to complete. The treatment arm received CoQ10 at 100 mg 3x a day. The patients had a mean age of 61 years, and they were all in moderate or severe heart failure. Their average LVEF was about 31%.
After 2 years of follow-up, there was a significant reduction in the major MACE, which was a composite of re-hospitalisation for CCF, CV death, need for heart transplantation, and need for LV mechanical support. There was also a reduction in all cause mortality.
That is the good news.
But this study seem to have more unanswered questions than answers? Why did it take 10 years to enroll patients in a trial where the condition ( heart failure ) was so prevalent, and the use of CoQ10  so wide spread? Why was the data from the Nov 2012 congress not published so that we can have all the details? The numbers in each arm is small despite a large population of heart failure patients and CoQ10 usage around? What was conventional heart failure treatment in each arm? To add to all this, the study was sponsored by International Co-enzyme Q10 association.
So, does Co-Enzyme Q10 really work? I really do not know. What is true, is that all the data published so far shows no harm. At worse, it is a hramless placebo.

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