Many people are using it to "prevent sudden death". Is it really effective to eat it after staying up late?

It has to be said that coenzyme Q10 is indeed very popular recently. In the just-concluded 2023 Taobao annual top ten product list, coenzyme Q10 not only made the list, but even topped the list . Many young people who have the habit of staying up late rely on it to "save their lives" as their own "anti-sudden death" supplement.

It started at the beginning of the year, just after the epidemic. Because coenzyme Q10 was said to have the effect of protecting the heart and preventing myocarditis , the search volume soared by 2500%, and it was once sold out online.

Not long after that, a "sudden death prevention package" was circulated on the Internet, which was said to be taken by Koreans. Koreans are famous for their lifestyle. They are notoriously sleepless and rely on iced American coffee + health products + medical beauty + fitness to "extend their lives". So what does the widely circulated "sudden death prevention package" include?

There are 2 versions online:

Version A: fish oil + vitamin B + magnesium tablets + coenzyme Q10;
Version B: Fish oil + Vitamin D3 + Lutein + Coenzyme Q10.

But both versions contain coenzyme Q10, because coenzyme Q10 has a widely circulated effect - protecting the heart . And so far, the first keyword associated with searching for coenzyme Q10 on e-commerce platforms is this. Coenzyme Q10 has two famous nicknames, " heart protector " and " cell engine ".

E-commerce platform screenshots

So the question is, what exactly is Coenzyme Q10? Is it good for ordinary people to take it after staying up late? For those who usually like to stay up late, or occasionally stay up late, or don't sleep well, is it necessary to buy a bottle to protect the heart?

Before answering this question, we need to have a basic understanding of it.

What is Coenzyme Q10?

Coenzyme Q10 (CoQ10) is a fat-soluble compound synthesized by the inner membrane of mitochondria. It plays a fundamental role in mitochondrial bioenergetics, acting as a carrier of electrons and protons (electron transfer mediator from complex I or II to complex III), promoting the production of cellular energy (ATP) and providing energy for the human body.

It is ubiquitous in almost all animals, bacteria, and all cells of the human body. It is an activator of cellular respiration and metabolism, and provides energy for many important organs such as the heart, liver, and kidneys . Although it is widely distributed in the body, it is more distributed in organs with higher energy consumption, such as the heart, liver, and kidneys, with the highest concentration in the heart.

Although coenzyme Q10 is important, it does not mean that it is recommended for ordinary people to take additional supplements on a daily basis. Why?

Why daily supplementation is not recommended

Coenzyme Q10 protects the heart?

1

Can be synthesized by the human body, usually not lacking

Coenzyme Q10 is an endogenous compound, which means it can be synthesized by the human body . It is newly synthesized in the human body at an estimated rate of about 500 mg per day. Part of it is synthesized by the human body itself, and part of it is obtained through diet. Therefore, as long as the diet is balanced and the metabolism is normal, the human body is usually not lacking in coenzyme Q10.

In terms of diet, some animal offal, beef, pork, some marine fish (such as sardines), some nuts and cooking oils (such as soybean oil, olive oil) are rich in coenzyme Q10.

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2

Exogenous supplementation is not effective

Coenzyme Q10 is synthesized from several components, including thyroxine, tyrosine, riboflavin, folic acid, vitamin B12, and vitamin C. It is transported in the plasma via low-density lipoprotein (LDL). Due to its hydrophobicity and large molecular weight, Coenzyme Q10 is poorly absorbed in the intestine. It is absorbed slowly, with peak levels in plasma occurring 5-10 hours after ingestion.

To sum up, exogenous supplementation of coenzyme Q10 is not very effective.

However, one thing is true. Although coenzyme Q10 is newly synthesized in the human body at an estimated rate of about 500 mg per day, this synthesis rate is not constant. Endogenous biosynthesis tends to decline during aging.

So a new question arises: how do I know if the coenzyme Q10 content in my body is sufficient?

Is there any way to know if I am deficient in Coenzyme Q10?

Coenzyme Q10 is essential in tissues with high energy demands, such as the heart, skeletal muscle, kidneys, liver, and brain. Second, it is the only endogenously synthesized fat-soluble antioxidant. It is present in all cell membranes, high-density and low-density lipoproteins, and mitochondria, protecting them from the toxic effects of free radicals generated during normal cellular metabolism. It also helps regenerate vitamin E into its antioxidant form.

From the description of the functional areas of Coenzyme Q10, it can be seen that Coenzyme Q10 mainly exists in cells and is extremely widely distributed and functionalized. There is currently no accurate and effective method to measure Coenzyme Q10 in the body because it is too widespread and unstable after leaving the carrier. Even after extraction, it cannot accurately reflect the actual situation in the body.

Therefore, some marketing accounts say that "frequent feelings of chest tightness and shortness of breath mean a lack of coenzyme Q10." This statement is obviously unreliable.

Since the efficiency of the human body in synthesizing coenzyme Q10 decreases with age, and there is no way to self-test whether there is enough coenzyme Q10 in the body, does it mean that as we age and have the habit of staying up late for a long time, we still need to supplement coenzyme Q10?

Coenzyme Q10 is important for the heart

It does not mean that more supplements can protect the heart

Here we need to clarify a concept. It is true that coenzyme Q10 is important for our heart health, and it is also true that its content in the heart is very high, but this does not mean that supplementing with more coenzyme Q10 can protect our heart.

First of all, there is currently no evidence that coenzyme Q10 has the function of preventing myocarditis and heart disease . At the same time, in an announcement issued by the State Administration for Market Regulation and the National Health Commission in December 2020, the effects of coenzyme Q10 were summarized into two points: enhancing immunity and anti-oxidation , and its "heart-protecting" role was not recognized.

Screenshot of the State Administration for Market Regulation’s official website

As for heart failure , the research on coenzyme Q10 has become popular since the first randomized controlled trial of coenzyme Q10 in the United States in 1972. Although it has been tested for more than 50 years, neither the U.S. Food and Drug Administration (FDA) nor the American Heart Association (AHA) has yet to make coenzyme Q10 a legitimate anti-heart failure drug, so don't expect it to heal a heart that has stayed up late.

In numerous randomized double-blind trials, the evidence of its efficacy remains controversial, but many cardiologists have increasingly seen that the short-term benefits of coenzyme Q10 for elderly patients with heart failure are ineffective, but the long-term benefits may be effective. Therefore, the research is still continuing. The spirit of scientific research is to grasp the glimmer of light in the treatment of difficult problems and persevere.

However, these scientific studies are still continuing, and have become a stepping stone for many health channels. This is why coenzyme Q10 has become popular all over the world. The slogan of "one for all" has occupied people's minds, "repair your cells and increase your vitality."

But, young man, your body doesn't actually need it, and you can't absorb much. If it's advertised as having the effect of improving absorption function, then you have to look at what else is added to this small pill, but it doesn't tell you.

Coenzyme Q10 supplementation is not completely useless

The key is...

1

About the Supplementation of Medicinal Coenzyme Q10

In China, coenzyme Q10 is not only a drug approved for marketing by CFDA, but also the main or added ingredient of many health products. According to the drug instructions approved by CFDA, it can be used for patients who meet the drug indications, but it is generally used as an auxiliary treatment drug . The so-called auxiliary treatment drug means that it is based on the main treatment drugs recommended by the relevant disease guidelines. When conditions permit, the combined use of coenzyme Q10 for auxiliary treatment is considered.

Therefore, it is generally not recommended for healthy people to use pharmaceutical coenzyme Q10 for supplementation. If supplementation is necessary, it should be used under the guidance of a doctor.

2

About the supplement of Coenzyme Q10

As mentioned earlier, under normal circumstances, as long as we have a balanced diet and are not picky about food, a healthy adult can self-synthesize the coenzyme Q10 needed by his or her body. As for the age-related decline in coenzyme Q10 synthesis ability and coenzyme Q10 deficiency caused by other reasons , the "Dietary Reference Intake of Chinese Residents (2023 Edition)" proposes a specific recommended value of 100 mg/d for reducing risk factors related to cardiovascular and metabolic diseases based on the fact that coenzyme Q10 greater than 100 mg/d can significantly improve insulin resistance and lower blood pressure.

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Are there any side effects of taking Coenzyme Q10 supplements?

Coenzyme Q10 is a relatively safe supplement with no serious adverse reactions. If there are any, they generally manifest as discomfort in the digestive system . As stated in the European Society for Parenteral Nutrition's 2022 updated guidelines on nutritional supplements, "Coenzyme Q10 has little effect and there is a risk of gastrointestinal adverse reactions."

So, in general, additional supplementation of Coenzyme Q10 is not beneficial and may make you uncomfortable. For healthy young people like us, it is better not to take it.

References

[1]Mortensen SA, Rosenfeldt F, Kumar A, et al. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014;2(6):641-649. doi:10.1016/j.jchf.2014.06.008

[2]Samuel TY, Hasin T, Gotsman I, et al. Coenzyme Q10 in the Treatment of Heart Failure with Preserved Ejection Fraction: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial. Drugs R D. 2022;22(1):25-33. doi:10.1007/s40268-021-00372-1

[3]Mortensen AL, Rosenfeldt F, Filipiak KJ. Effect of coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-SYMBIO randomized double-blind trial. Cardiol J. 2019;26(2):147-156. doi:10.5603/CJ.a2019.0022

[4]An P, Wan S, Luo Y, et al. Micronutrient Supplementation to Reduce Cardiovascular Risk. J Am Coll Cardiol. 2022;80(24):2269-2285. doi:10.1016/j.jacc.2022.09.048

[5]Berger MM, Shenkin A, Schweinlin A, et al. ESPEN micronutrient guideline. Clin Nutr. 2022;41(6):1357-1424. doi:10.1016/j.clnu.2022.02.015

[6]Complementary and Alternative Medicines in the Management of Heart Failure, AHA https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/complementary-and-alternative-medicines

Planning and production

Source: Health Express

Author: Zhou Yuehang, Master of Pediatric Cardiothoracic Surgery and Cardiac Surgeon at Chongqing Medical University Zhuo Zheng Popular Science Author

Review丨Guo Xiaozhuo, Internal Medicine Ph.D., Peking Union Medical College

Editor: Yinuo