CoQ10 with statins

Researchers studying the effects of the cholesterol-lowering statin drugs over the last decade found that patients taking statins were likely to also have lowered levels of coenzyme Q10 (CoQ10), a coenzyme naturally produced in the body and important to the function of organs such as the heart. Further study has also indicated that supplementing with CoQ10 while taking statins can reverse the deficiency and limit the side effects.

A few facts and recommendations about CoQ10:

CoQ10 functions inside cells to make energy; the highest amounts of the coenzyme are found in the heart, liver, kidneys and pancreas. The muscles of the heart are especially sensitive to CoQ10 deficiency.

Statins act by inhibiting an enzyme, HMG-CoA reductase, that is responsible for synthesizing both cholesterol and CoQ10. So statins seem to simultaneously decrease cholesterol and CoQ10 levels.

A 2004 report in the American Journal of Cardiology found that 70% of people in a study group taking the statin Lipitor showed heart muscle weakness after six months. This weakness was reversed by taking CoQ10.

CoQ10 has also been studied for these statin side effects: muscle pain and weakness, fatigue, memory loss, shortness of breath and peripheral neuropathy.

A common recommendation for those taking a statin: supplement with 100 mg CoQ10 softgel twice daily, in the morning and at noon. Avoid insomnia by taking it early in the day. Be sure to consult your doctor about the possibility of CoQ10 interacting with any blood thinner you may be taking.

Reference: Marc Silver et al. Effect of atorvastatin on left ventricular diastolic function and ability of coenzyme Q10 to reverse that dysfunction. American Journal of Cardiology. Volume 94, Issue 10 , Pages 1306-1310, 15 November 2004.

See the NYBC entries for more details:

http://nybcsecure.org/product_info.php?cPath=47&products_id=317
(Jarrow 100mg CoQ10 Qsorb)

or

http://nybcsecure.org/product_info.php?cPath=47&products_id=357(Douglas Labs 200mg chewable tablet formula)

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CoQ10 for heart health

Clinical studies have shown repeatedly that CoQ10 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. In Japan, it has been widely used, and over several decades, for these types of heart health issues, and that’s one reason why its potential effectiveness and safety profile are at this point quite well characterized.

Research has also shown that as cellular levels of CoQ10 decrease, HIV disease progresses. Other studies have documented CoQ10’s immune restorative qualities, including restoration of T cell function. Many people with HIV find that CoQ10 is an important nutrient to aid in detoxification if one uses nucleoside analogs (AZT ddI, ddC, d4T, etc.), or other toxic drugs. (For example, studies have shown clear benefit when used with a heart toxic chemotherapy drug called adriamycin.)

In addition, we’ve seen widely circulated the recommendation, based on various levels of evidence, that people taking statin drugs—used to manage cholesterol—also take CoQ10. (Levels of CoQ10 in the blood are notably depleted when using this class of drugs, and there is potential for metabolic disruptions in the body as a result.)

A 2007 pilot study showed relief of muscle pain (myopathy) in people taking statins who also took 100mg/day of CoQ10. However, we have also found recommendations for higher dosages (200mg/day or more) for a variety of heart-related conditions.

For further details, see NYBC’s entry on Q-sorb Plus 100mg (Jarrow), specifically designed for enhanced absorption.

See also other forms of CoQ10, at both higher and lower dosages and in combination with other supplements, at
http://nybcsecure.org/index.php?cPath=47

GABA Hey! Blood Pressure and Sleep

NYBC carries Pressure Optimizer and GABA Soothe to help manage a range of issues. Among them, the data below suggest a benefit for managing borderline hypertension (high blood pressure). A related item in the NYBC catalog, Theanine Serene, also has a fair amount of GABA along with green tea-extract theanine; this combination was designed especially as an anti-anxiety or anti-stress formula.

The second study below looked at a combo of GABA and 5-HTP and found some benefits for helping to get a restful sleep.

Shimada M, Hasegawa T, Nishimura C, Kan H, Kanno T, Nakamura T, Matsubayashi T. Anti-hypertensive effect of gamma-aminobutyric acid (GABA)-rich Chlorella on high-normal blood pressure and borderline hypertension in placebo-controlled double blind study. Clin Exp Hypertens. 2009 Jun;31(4):342-354.

Abstract
The anti-hypertensive effect of GABA-rich Chlorella was studied after oral administration for 12 weeks in the subjects with high-normal blood pressure and borderline hypertension in the placebo-controlled, double-blind manner in order to investigate if GABA-rich Chlorella, a dietary supplement, is useful in control of blood pressure. Eighty subjects with Systolic blood pressure (SBP) 130-159 mmHg or diastolic blood pressure (DBP) 85-99 mmHg (40 subjects/group) took the blinded substance of GABA-rich Chlorella (20 mg as gamma-aminobutyric acid) or placebo twice daily for 12 weeks, and had follow-up observation for an additional 4 weeks. Systolic blood pressure in the subjects given GABA-rich Chlorella significantly decreased compared with placebo (p < 0.01). Diastolic blood pressure had the tendency to decrease after intake of GABA-rich Chlorella. Neither adverse events nor abnormal laboratory findings were reported throughout the study period. Reduction of SBP in the subjects with borderline hypertension was higher than those in the subjects with high-normal blood pressure. These results suggest that GABA-rich Chlorella significantly decreased high-normal blood pressure and borderline hypertension, and is a beneficial dietary supplement for prevention of the development of hypertension.

PMID: 19811362 [PubMed – indexed for MEDLINE]

***
Shell W, Bullias D, Charuvastra E, May LA, Silver DS. A randomized, placebo-controlled trial of an amino acid preparation on timing and quality of sleep. Am J Ther. 2010 Mar-Apr;17(2):133-139.

Abstract
This study was an outpatient, randomized, double-blind, placebo-controlled trial of a combination amino acid formula (Gabadone) in patients with sleep disorders. Eighteen patients with sleep disorders were randomized to either placebo or active treatment group. Sleep latency and duration of sleep were measured by daily questionnaires. Sleep quality was measured using a visual analog scale. Autonomic nervous system function was measured by heart rate variability analysis using 24-hour electrocardiographic recordings. In the active group, the baseline time to fall asleep was 32.3 minutes, which was reduced to 19.1 after Gabadone administration (P = 0.01, n = 9). In the placebo group, the baseline latency time was 34.8 minutes compared with 33.1 minutes after placebo (P = nonsignificant, n = 9). The difference was statistically significant (P = 0.02). In the active group, the baseline duration of sleep was 5.0 hours (mean), whereas after Gabadone, the duration of sleep increased to 6.83 (P = 0.01, n = 9). In the placebo group, the baseline sleep duration was 7.17 +/- 7.6 compared with 7.11 +/- 3.67 after placebo (P = nonsignificant, n = 9). The difference between the active and placebo groups was significant (P = 0.01). Ease of falling asleep, awakenings, and am grogginess improved. Objective measurement of parasympathetic function as measured by 24-hour heart rate variability improved in the active group compared with placebo. An amino acid preparation containing both GABA and 5-hydroxytryptophan reduced time to fall asleep, decreased sleep latency, increased the duration of sleep, and improved quality of sleep.

PMID: 19417589 [PubMed – indexed for MEDLINE]

Mayo Clinic’s Guide to Alternative Medicine 2011

This is an easy-to-read, magazine-style guide created by the Mayo Clinic, the world-famous healthcare facility which also happens to have a long-standing receptiveness to alternative and complementary therapies for wellness and prevention. (That’s one of the reasons why it has recently been cited as an example of best practices in American healthcare–the kind of practices that need to be more widely imitated.)

The section on dietary supplements provides capsule reviews of the scientific evidence for the safety and effectiveness of several dozen popular products, from botanicals like ginseng, echinacea and St. John’s Wort, to vitamins C, D, E, B-3 (niacin), and B-9 (folate or folic acid), as well as minerals like selenium, calcium and zinc. Also discussed are fairly well-known categories of supplements, including probiotics and omega-3 fatty acids (these often obtained with fish oil supplements).

The guide rates these supplements with a green, yellow or red light symbol, depending on the strength of the evidence for their use and their safety profile. We weren’t too surprised by most of the ratings. For example, green for niacin, folic acid, Vitamin C and Vitamin D, but a yellow caution light for Vitamin E, which has shown no effectiveness in several good studies dealing with cardiovascular health and cancer, leading some researchers to wonder if the standard “alpha-tocopherol” form of the vitamin is a good format for supplementation. Also, a yellow light for St. John’s Wort, not because it isn’t effective for mild/moderate depression, but because it can interact with a lot of other medications.

Other supplements getting the green light from the Mayo Clinic editors: SAMe (for depression); saw palmetto (for enlarged prostate); green tea (for cardiovascular health, possibly for cancer prevention, and apparently–according to a large epidemiological study–for longevity); gamma linolenic acid (for peripheral neuropathy); CoQ10 (for cardiovascular health, for which it’s used by millions in Japan); glucosamine chondroitin (for osteoarthritis).

Also getting the green light, a supplement most have probably never heard of, but which is featured in the Health Concerns formula Cold Away, available from NYBC: the botanical Andrographis (a cold remedy, showing promise where many other products have disappointed).

See the NYBC entries for more details on how best to take supplements:


http://www.newyorkbuyersclub.org/

Bioperine for nutrient absorption

Bioperine, an extract of the fruit of the plant that yields black pepper, has connections to the Ayurvedic medicine tradition of India. It is frequently recommended for its ability to increase absorption of difficult-to-absorb nutrients like CoQ10, and may enhance absorption of other supplements as well. Here is a brief account of the whys and hows of its use:

Bioperine (Allergy Research Group). Each bottle, 60 vegetarian capsules. Each tablet, 25 mg black pepper fruit extract (bioperine). Suggested use it to take 1 tablet, with a multi, coQ10, etc., once or twice per day (not more than that). If possible, about an hour or so before you eat to enhance absorption.

Bioperine is the brand name for an extract from the fruit of the plant that produces black pepper (Piper nigrum). It is known generically as piperine. According to research conducted by the manufacturer, bioperine substantially increases the absorption of selenium (30%), beta carotene (60%), vitamin B6 (140-250%) as well as coenzyme Q10. These studies measure the amount found in plasma of these nutrients, comparing the amount found with or without the use of Bioperine.

One theoretical concern is that using this may increase blood levels of some drugs as well. On the good side, could this be a replacement for help reduce the dose of a ritonavir boost for example?

Sabinsa (the supplier) researchers claim it has no effect on the absorption of drugs, stating that research in India found that, Bioperine taken for enhancing nutrient absorption does not significantly affect the level of prescription drugs. Why this would be so is not clear. They also indicate that it is important that the bioperine be taken at the same time as the nutrient supplements, emphasizing that with bioperine, TIMING IS EVERYTHING.

What its mechanism of action is is not clear to us (except they call it a thermonutrient). However, it is an inexpensive addition and may permit lowering dosages of various nutrients. This also conforms with the traditional use of black pepper in many different Ayurvedic recipes. In a study in India, it was shown to be protective of the liver through antioxidant activity but not as powerful as silymarin. It may be best to err on the side of safety and NOT use this with pharmaceutical drugs; however, by contrast, it may help with protease inhibitors which do not get into the plasma well.

For further information, please see the NYBC entry:

Bioperine

SUPPLEMENTS AND OTHER SMART STRATEGIES FOR LONGER LIVING – A panel discussion on traditional, complementary and alternative treatments for HIV

We reprint below our report on this June 2009 forum, which brought together a range of views on managing HIV:

SUPPLEMENTS AND OTHER SMART STRATEGIES FOR LONGER LIVING was the title of a panel discussion on traditional, complementary and alternative therapies for HIV presented on June 25, 2009 by the New York Buyers’ Club in celebration of its fifth anniversary. The event brought together experts whose knowledge spans East and West, and whose experience ranges from community organizing and scientific writing, to clinical research and the practice of medicine, whether as an M.D. or as a licensed acupuncturist and specialist in Chinese herbalism.

NYBC was especially proud to host our Guest of Honor, Sunil Pant, the first openly gay Member of Parliament in Nepal, and Founder/Director of the HIV-support organization the Blue Diamond Society, which was recognized by the International Gay and Lesbian Human Rights Commission in 2007 as “one of the most effective human rights groups in the world.” At the start of the panel discussion, our Guest of Honor gave a moving account of the work he and his organization have done over the last decade in securing rights for sexual minorities in Nepal, and in fighting for decent treatment of Nepalis with HIV/AIDS. Sunil also took a moment to recall the many years he has known and worked with our own George Carter, who has directed NYBC efforts to provide supplements and other aid to BDS.

We also felt privileged to hear from our other panelists: Dr. Paul Bellman, a NYC physician who has been treating people with HIV/AIDS since the start of the epidemic; Tim Horn, President and Editor of AIDSmeds.com; Alex Brameier, a licensed acupuncturist and herbalist; and George Carter, Director of the Foundation for Integrative AIDS Research. It’s true that the first two of these panelists are in the mainstream of AIDS treatment practice, by which we only mean to say that their main area of expertise is antiretroviral pharmaceuticals. Yet Dr. Bellman also spoke of the usefulness of several supplements that NYBC and its predecessor DAAIR have long recommended: alpha lipoic acid, carnitine, and CoQ10. Tim Horn, whose website focuses largely on pharmaceutical treatments, nevertheless also acknowledged that the “holistic” approach to long-term health for people with HIV makes a lot of sense. And he went on to say that he recognizes that a whole range of “therapies” (including even diet and exercise) may be needed to address worrisome trends in heart and lung disease among people with HIV who are taking ARVs.

Alex Brameier, the Lic. Ac. on our panel, engaged our audience with an impromptu survey on how people view their acupuncture treatments. She then discussed some of the conditions that lend themselves to acupuncture, based on clinical experience: pain relief, stress reduction, neurological and musculoskeletal disorders, to name a few. Very useful as well was the contrast she drew between acupuncture as practiced in China and Japan (where treatment may be daily or every other day), and the West, where time and financial constraints often dictate otherwise. Her tips on how to get the best out of acupuncture and how acupuncture and herbs can work together were also very valuable.

Last but not least among our contributors was George Carter, who’s had two decades of experience with supplements, from clinical research to acting as NYBC Treatment Director. George, as all who know him can attest, is nothing if not thorough, and for this event he prepared a “Short Primer on Side Effects,” a compact but comprehensive review of HIV medication side effects, ranging from malabsorption/diarrhea//nausea, to lipid abnormalities (of concern for cardiovascular health), to fatigue and insomnia, to insulin resistance/diabetes, to liver damage, to bone issues, to peripheral neuropathy. We hope to produce this super-useful handout as a handy pocket guide in the near future, so stay tuned.

An inspirational, lively, and (if we do say so ourselves) immensely informative event. If you were there, thanks for coming! And if not–we certainly hope to see you at the next one.

Reprinted from the SUMMER 2009 SUPPLEMENT: Newsletter of the New York Buyers’ Club, which can be read in its entirety at

http://newyorkbuyersclub.org/supplement/index.html

In addition to the piece above, this issue contains a report on how research on diet and nutrition has led to new knowledge about supplements (“Are You Ready to Join the Food Revolution?”), and a short review on HIV and cognitive impairment.

Note: Email subscriptions to THE SUPPLEMENT are free to NYBC members.

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.