CoQ10 – 200mg

NYBC has recently decided to stock CoQ10 in a 200mg/capsule format (Jarrow)</, since many research studies involve supplementation at that daily level or even higher. As a not-for-profit purchasing co-op, NYBC seeks low-cost options for people choosing to use supplements, so this format from the well-regarded Jarrow line seemed a good value as well.

An extract from the NYBC write-up on this supplement–

Clinical studies have shown repeatedly that coenzyme Q10 has potent abilities to assist the heart muscle, and as an adjunct treatment for angina, congestive heart failure, arrhythmia, hypertension (high blood pressure), and drug toxicity.

Research has also shown that as cellular levels of coenzyme Q10 decrease, HIV disease progresses. Other studies have documented its immune restorative qualities, including restoration of T cell function. Absorption of dietary fat soluble coenzyme Q10, due to the high inflammatory cytokine levels, is disrupted, so supplementation may help. Many PWHIV believe CoQ10 is an important nutrient to aid in detoxification if one uses nucleoside analogues (AZT ddI, ddC, d4T, etc.) or any toxic drug. Due to this impaired absorption, it’s best to take a form of CoQ10 that is mixed with lecithin or some other fat to improve its uptake. However, it may be that only very high doses will help (like 200-400 mg a day!) This will not be cheap.

CoQ10 is very helpful in conjunction with certain drugs. Studies have shown clear benefit when used with a heart toxic chemotherapy drug called adriamycin. In addition, some have suggested that it is very important to use CoQ10 when taking one of the statin drugs, used to manage high LDL cholesterol since the level of CoQ10 in the blood is depleted when using this class of drugs.


Supplement recommendations from Fred Walters / Houston Buyers’ Club

It was great to see an extended interview with our friend and colleague Fred Walters of the Houston Buyers Club in a recent posting on the website

Fred talks about his conservative Catholic background, his early vocation that took him to seminary, and his subsequent adventures as he began and nurtured the Texas-based nutritional supplements purchasing co-op for people with HIV, the Houston Buyers Club. HBC has been a beacon for so many when it comes to information about, and access to, supplements. And treatment activists that we admire a great deal, including Nelson Vergel and Lark Lands, have found a welcome forum at HBC over the years–we’re all better informed as a result.

Here’s an excerpt from the interview, in which Fred describes what he considers to be the most significant nutritional supplements for people with HIV:

I would say number one, a potent multivitamin. The top mistake people make with multivitamins is they are hypnotized by the words “one-a-day.” And there is no such thing as a potent one-a-day multivitamin for people with HIV. If you’re going to do a multivitamin you have to do several, several times a day. My favorites are Superblend by Super Nutrition and the K-Pax [KaiserPax] by Jon Kaiser [M.D., an HIV specialist in San Francisco]. Those are my two favorites. The second thing I would do is NAC, and that is a supplement that helps to increase gluthathione levels. It’s very good for the liver. The third one is fish oils, even if you don’t have high cholesterol or high triglycerides. Fish oils are real important for skin and other things in the body. They help reduce inflammation. That’s probably my biggest thing, the inflammation part. The other would be if you’re taking a high potency multivitamin you should add the selenium […]

If people are taking HIV drugs they have to take Coenzyme Q10, because what happens is that the drugs go into the body, as they’re winding their way through the cave with their guns drawn waiting to shoot at the HIV viral cells, by the time they walk up to a dead body they say, “Oh no, that wasn’t an HIV viral cell. That was a mitochondria.” And so Q10 helps to protect the mitochondria, and if you don’t protect the mitochondria in the body then you start opening yourself up to all kinds of organ and liver issues.

“Oh, how could I forget this one. […] Actually it’s getting a lot of press locally because Baylor University is studying this, but … green tea capsules. We are seeing more and more people who are doing two grams a day of green tea capsules and their T-cells are going up between 40 and 100%. Dr. Christina L. Nance is studying that at Baylor and we see that here, and today I was watching a local television show and of all days for you to call, there was a show on about food as medicine and they talked a lot about HIV, and one of the things they talked about was green tea liquid. They mentioned that it was being studied locally for HIV. So we’re not the only one on the soapbox about this. We’ve seen amazing results with that.

Read the full interview with Fred Walters at

NOTE: As far as multivitamins go, NYBC has followed its predecessor DAAIR in stocking Douglas Labs multis, which are highly bioavailable (= can be easily absorbed and used by the body):

Added Protection Without Iron (a no-iron formula is recommended especially if you have elevated liver enzymes or hepatitis)

Added Protection With Iron

Ultra Preventive Beta This is a version of Added Protection that replaces the Vitamin A with beta carotene and a good mix of carotenoids–a good idea for people with any kind of liver trouble.

(NYBC also stocks the SuperNutrition multivitamins.)

Last, we have to say that a major concern for NYBC members has been the cost of supplements. That’s why in 2007 the buyers’ club began offering its MAC-Pack, which is a close equivalent of the K-PAX, but at about half price. The MAC-Pack uses the Douglas Labs Added Protection multis as its base, then adds NAC, lipoic acid, B vitamins and a substantial amount of acetylcarnitine to round out the package:

MAC-Pack (See other entries on this blog for more details.)

CoQ 10 and HIV-medication related changes in lipid levels: excerpt from the Canadian AIDS Treatment Information Exchange (CATIE) info sheet

Below is an excerpt from the Canadian AIDS Treatment Information Exchange (CATIE) information sheet on the use of CoQ 10 by people with HIV/AIDS. This excerpt focuses particularly on changes in lipid profiles that may accompany HIV medications, and the strategy for addressing these potentially damaging changes:

One common side effect of highly active antiretroviral therapy (HAART) is increased levels of fatty substances or lipids in the blood. Examples of the lipid changes that can occur in HAART users include the following:
increased levels of triglycerides
increased levels of cholesterol
increased levels of LDL (bad cholesterol)
decreased levels of HDL (high-density lipoprotein – good cholesterol)

These lipid changes increase the risk of cardiovascular disease in HAART users. To decrease this risk, doctors may encourage people with HIV/AIDS (PHAs) to make changes to their diet and engage in a programme of regular aerobic exercise. If these steps don’t work, then lipid-lowering agents — commonly called statins — can be prescribed. These drugs work by lowering the levels of triglycerides and LDL while raising HDL. Thus statins can greatly reduce, but do not eliminate, the risk of developing cardiovascular disease. Examples of statins include the following:

Crestor (rosuvastatin)
Lescol (fluvastatin)
Lipitor (atorvastatin)
NK-104 (pitavastatin)
Mevacor (lovastatin)
Pravachol (pravastatin)
Zocor (simvastatin)

These drugs exert their lipid-lowering effect by reducing the body’s ability to produce cholesterol. Unfortunately, Q10 production is also affected by statins. Not surprisingly, the body’s production of Q10 can fall between 25% and 40% with the use of statins. Reduced production of Q10 means that there is less of this important antioxidant to protect cells from free radicals. It is possible that with less Q10 available, there may be an increased risk of developing certain side effects associated with use of statins, including the following:

muscle inflammation, pain and weakness
liver damage

Some PHAs who use statins also take supplements of Q10 and vitamin E.

See also NYBC’s entries on Coq10 100mg and CoQ10 30mg . The NYBC information includes reference to a 2007 study in the American Journal of Cardiology on COQ 10 and the relief of myopathic symptoms in patients treated with statins. Please also note cautions on using CoQ 10 with the blood-thinning agent coumadin.

CoQ 10: some dosing recommendations

The University of Maryland Medical Center’s Complementary Medicine website provides this guidance on dosage for CoQ 10 (Coenzyme Q 10, sometimes known as ubiquinone):

Note: these recommendations apply to Adults; also remember that CoQ10 is fat-soluble and generally best absorbed if taken when eating the fattiest meal of the day.

The general recommended dose for CoQ10 supplementation is 30 to 60 mg daily. Higher doses have been used in studies and may be recommended for the following conditions:

Congestive heart failure: 50 to 150 mg a day
High blood pressure: 50 to 150 mg a day

Heart attack: 120 mg a day for 28 days after the heart attack
Breast cancer: 400 mg per day for potential prevention and treatment

The following summaries from the UMMC website may also be useful in deciding whether CoQ 10 supplementation should be considered. Please remember that the conditions described are both serious and complex, and it is thus very important that any supplement use be discussed with your doctor.

Heart Disease

Researchers believe that the beneficial effect of CoQ10 in the prevention and treatment of heart disease is due to its ability to improve energy production in cells, inhibit blood clot formation, and act as an antioxidant. One important study, for example, found that people who received daily CoQ10 supplements within 3 days of a heart attack were significantly less likely to experience subsequent heart attacks and chest pain. In addition, these same patients were less likely to die of heart disease than those who did not receive the supplements.

Breast Cancer

Studies of women with breast cancer suggest that CoQ10 supplements (in addition to conventional treatment and a nutritional regimen including other antioxidants and essential fatty acids) may shrink tumors, reduce pain associated with the condition, and cause partial remission in some individuals. It is important to recognize that the beneficial effects these women experienced cannot be attributed to CoQ10 alone. Additional antioxidants used in these studies include vitamins C, E, and selenium

See also NYBC’s discussions of CoQ 10 – 100mg and CoQ 10 – 30mg.