CoQ 10, gum disease and cardiovascular health

Yes, your dentist is right: brushing with a good toothpaste (such as one with baking soda), flossing, and regular checkups can keep your smile bright–and also, very importantly, can help prevent gum disease. But did you know that the supplement CoQ 10 has also been found effective in fighting gum disease?

First, a few words about gum disease: the most widespread form, afflicting up to 30% of adults, is gingivitis, an inflammation and bleeding around the teeth that accompanies plaque buildup. If left unchecked, gingivitis can progress to periodontitis, which is characterized by more severe infection and abscesses around the teeth, and tooth loss.

As early as the 1970s it was recognized that CoQ10 could counteract gum disease, and quite quickly. Research found that CoQ10 doses of 50 mg – 75 mg a day halted deterioration of the gums and promoted healing, often within days of beginning therapy. In a carefully controlled trial, 50 mg per day of CoQ10 was notably more effective than placebo in reducing symptoms of gingivitis after three weeks of treatment (Wilkinson EG et al, 1976).

And there’s more: research from the just past few years has highlighted a surprising connection between gum disease and cardiovascular disease. One study found that 91% percent of patients with cardiovascular disease also suffered from moderate to severe gum disease (Geerts SO et al 2004). Researchers now believe that the inflammation associated with gum disease triggers the release of pro-inflammatory chemicals into the bloodstream, which provokes a systemic inflammatory response. It’s also very suggestive that many of the same factors that increase the risk for heart disease also increase the risk for periodontal disease, including C-reactive protein (CRP), fibrinogen, and cholesterol (Wu T et al 2000).

So here’s your bonus: CoQ 10 has a good track record of helping fight gingivitis and preventing the progression of gum disease. But, by fighting off gum disease with this supplement and all the other means mentioned above, you may also be reducing your cardiovascular risk. Isn’t that something to smile about?

NYBC stocks CoQ10 in several formats. See the entry below, which also provides detailed recommendations for use of this supplement:

COQ 10


Recommendations for Cardiovascular Health: from “Supplement Your Prescription,” by Hyla Cass, M.D.

We return to this excellent guide published in 2007 by Hyla Cass, a practicing physician and expert on integrative medicine.

In Chapter 4 of the book, Dr. Cass reviews recent findings that call into question the idea that dietary cholesterol causes cardiovascular disease. In line with the current scientific thinking on this subject, she suggests looking at underlying inflammation as essential to any understanding of risks to heart and circulatory system health. As a consequence, she says, people who want to reduce risk of cardiovascular disease should consider dietary changes that are anti-inflammatory (that is, a diet high in antioxidants, anti-inflammatory herbs, and antioxidant-rich foods–that’s colorful fruits and vegetables, curry, turmeric, rosemary, ginger, green tea, dark chocolate, low-toxin fish like salmon or sardines).

Statin drugs, though they come with some side effects, have proven of benefit to certain groups of people with cardiovascular complications, including diabetics, those who have had a heart attack, and those diagnosed with cardiovascular disease. Like many others, Dr. Cass recommends supplementing with CoQ 10 if you’re taking statins. She also supports use of omega-3 fatty acids (from fish oil), niacin (though not recommended for diabetics), plant sterols, tocotrienols (a form of the antioxidant vitamin E), and D-ribose for controlling cholesterol and otherwise countering cardiovascular disease. In addition, the B vitamins are recommended to help lower homocysteine, high levels of which are associated with artery damage and increased risk of heart disease.

Citation: Hyla Cass, M.D., Supplement Your Prescription: What Your Doctor Doesn’t Know About Nutrition (Basic Health Publications, 2007).

Book Review: “Supplement Your Prescription — What Your Doctor Doesn’t Know About Nutrition,” by Hyla Cass, M.D.

This is an excellent guide to managing the side effects of prescription drugs through better nutrition and nutritional supplements. Published in 2007 by Basic Health Publications, it synthesizes much recent research on how the most frequently prescribed drugs for Type 2 diabetes, cardiovascular disease, osteoarthritis, and depression often cause nutrient deficiencies that can lead to additional health problems. Dr. Cass, who is a practicing physician and a specialist in integrative medicine, provides clear analyses of these damaging side effects and offers recommendations on how to address them.

The first condition discussed by the book is Type 2 Diabetes/insulin resistance/metabolic syndrome. For those who are taking the most commonly prescribed drug for Type 2 Diabetes, metformin, Dr. Cass stresses the importance of supplementing with Vitamin B12 (200-1000mg/day) folic acid (400-800mg/day) and CoQ 10 (30-200mg/day) to make up for the nutrient-depleting effects of the medication. Vitamin B12 and folic acid, together with Vitamin B6, are crucial for keeping levels of an amino acid called homocysteine in check in the body. Since elevated levels of homocysteine are associated with heart disease, stroke, hypertension, neuropathy, and Alzheimer’s, it’s a top priority to keep the body supplied with the B vitamins that can control it.

Dr. Cass also provides a “Diabetes Supplement Program” especially directed to pre-diabetics who may be able to address their condition with diet, exercise, and supplements (the B vitamins and CoQ 10 mentioned above, plus alpha lipoic acid, antioxidants, and the trace minerals chromium and vanadium, which are needed in blood sugar processing).

Much more to discuss in this very useful book, so we will come back to it again!

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.

Coenzyme Q 10 reverses diastolic dysfunction related to taking statins

Here’s a report from 2004 on CoQ10 and how it may benefit people taking statins:

NEW YORK (Reuters Health) – Findings from a small study suggest that statin therapy can impair left ventricular diastolic function, but that coenzyme Q10 supplementation can reverse this dysfunction. “For more than a decade, there has been a suggestion of impairment of diastolic function after the administration of statins, and our findings suggest that this may be a common event and potentially a precursor to symptoms associated with ventricular dysfunction,” lead author Dr. Marc Silver, from Advocate Christ Medical Center in Oak Lawn, Illinois, and colleagues note. As such, routine coenzyme Q10 use may be beneficial, they add.The findings, which appear in the American Journal of Cardiology for November 15th, are based on a study of 14 asymptomatic patients who were treated with atorvastatin at a dose of 20 mg/day for 3 to 6 months.Doppler echocardiography was used to assess left ventricular diastolic function before and after atorvastatin therapy. Patients who showed worsening of diastolic function were offered treatment with coenzyme Q10 while continuing atorvastatin therapy.

During follow-up, 10 of the patients showed worsening of at least one marker of diastolic function, the authors note. Nine of these patients elected to take coenzyme Q10 capsules and eight showed reversal of at least one diastolic abnormality.

Although statins are thought to reduce coenzyme Q10 levels, not all of the patients in the current study showed significant reductions. Moreover, there was no evidence that baseline levels predicted diastolic dysfunction. Therefore, the authors support the routine administration of coenzyme Q10 capsules when statins are given.

The study was supported, in part, by Kaneka Corporation, Osaka, Japan, which markets coenzyme Q10 under the name KanekaQ10.

Am J Cardiol 2004;94:1306-1309.

For additional CoQ 10 information, see the NYBC Supplement Fact Sheets.

NYBC Product Info Sheets:

CoQ 10 – 100mg strength

CoQ 10 – 30mg strength