Q10 increases survival in heart failure

May 24, 2022

New review article highlights ubiquinone/Q10 as a first choice for heart failure.

Heart failure is a relatively common disorder, and often occurs as a result of a blood clot in the heart, which has left a scar in the heart muscle. This scar tissue is connective tissue that does not have the normal muscle function of the myocardium, and if a large part of the muscles of the left ventricle in particular is out of order, it is clear that the heart can no longer pump as efficiently.

The most common symptom is dyspnoea, which means that you breathe faster with physical exertion, because the oxygen concentration in the blood can not be maintained when the heart has reduced its ability to pump blood to oxygenate the lungs.

This condition is clinically classified in the so-called “NYHA” groups 1-4, which were once defined by the New York Heart Association, hence the name.

Roughly speaking, in class 1 you have no problems with normal activity, in class 2 you can not run, only walk, in class 3 only sit, and in class 4 you are largely bedridden.

All this is precisely limited by dyspnoea.

The heart failure is diagnosed and graded by ultrasound-Doppler examination and especially the “stroke volume” / EF (Ejection Fraction) of the left ventricle is measured, which is usually around 60% and satisfactory at 50%.

(The volume of the heart is a bit like with the lungs. You can not completely empty it of blood, just as you can not completely empty the lungs of air. Therefore, it is satisfying if the heart can pump out half of its contents at each heart rate.)

The heart muscle can be weakened by many things other than a blood clot, and by any of the transient conditions, such as eg. inflammation of the heart muscle (myocarditis), the pump function can also be restored afterwards.

But after a blood clot, it is difficult because the scar tissue that is formed after the blood clot will never actively pump again.
However, there is hope because the part of the heart muscle that is not damaged may well become stronger.

This is the focus of rehabilitation after a blood clot, but there is also something else that can be done. -You can optimize the energy production in the cells of the myocardium.

Treatment of heart failure
The usual treatment for heart failure was once limited to diuretics and digoxin, but has been under constant development and is today complemented with ACE inhibitors, Procoralan, SGLT-2 inhibitors and even beta-blockers, which were once contraindicated in heart failure. .

This is how the treatments develop continuously, and the idea with the treatment is primarily to relieve the heart and prevent arrhythmias or prevent that you get a blood clot again.

There are also patients with heart failure who benefit from a pacemaker, and if the situation it is completely bad, then a heart pump or a transplant.

Stop for a moment
Before we go off at a tangent maybe we should just try to get a little overview. What exactly do we want to achieve?

We want to achieve that a person with heart failure lives as well as possible for as long as possible.

So should we not try the least invasive treatment so that we avoid many of the heavy side effects following all the above treatments?

All the common treatments are intended to relieve the heart. But there are also options to make the heart stronger so that it pumps better with the remaining muscle tissue. As mentioned, exercise is one of the options, but you can also increase energy production in every single heart muscle cell.

Ubiquinon/Q10
Last week, a review article was published in Journal of Cardiovascular Development and Disease , which reviews 22 scientific articles (20 RCTs) on Q10 used against heart failure.

In the 16 articles, they found significant improvement in pump function (EF) or survival or both. In all cases, there was an inverse correlation between the blood concentration of Q10 and the worsening of the symptoms in patients with heart failure, just as the concentration of Q10 was an indicator of longevity.

In other words, those who had the lowest content of Q10 in the blood had a rapid worsening of the symptoms, just as they lived for a shorter time.
In line with this, it was similarly found that supplementation with Q10 improved the pumping function of the heart and increased the life expectancy of these patients.

The article also focuses on the inappropriate effect of statins, which not only lower cholesterol production but also the production of coenzyme Q10, as these form a common synthetic route from AcetylcoA over mevalonate to farnesyl pyrophosphate. This synthesis requires i.a. the enzyme HMG-CoA reductase and this enzyme is inhibited by statins.

Often, statins are actually prescribed to patients with heart failure, although this should be contraindicated according to the above.
It is noted very laconic that Q10 has at least as good a documentary weight as the treatment that is today considered the gold standard for treating heart failure. Exercise is extremely well documented, whereas digoxin and SGLT-2 inhibitors are poorly documented. Here we must say that Q10 is significantly better documented.

Given the solid evidence and the absence of interactions and side effects with ubiquinone/Q10, it is an obvious first-line treatment for heart failure, and should be implemented throughout the public health system.

 

Claus Hancke
Specialist in general medicine

Ref.

2022 Maj 16, Krzysztof J. Filipiak et al: Heart Failure, -Do We Need New Drugs or Have Them Already? A Case of Coenzyme Q10, J. Cardiovasc. Dev. Dis. 2022, 9, 161

Promising treatment for macular degeneration

December 22, 2007

New orthomolecular treatment named as the “first choice” for AMD, otherwise known macula degeneration.

In the November 28, 2006 edition of the Vitality Council Newsletter we reported on a study which indicated that eating eggs, which contain the antioxidants lutein and zeaxanthine, has positive effects on AMD.

Almost two years ago we described a maybe even more important study undertaken at the University of Rome. It showed that normal recommended doses of simple dietary supplements prevents the most common form of blindness, the age related degeneration of the retina otherwise known as “retinal calcification.” This is what medical professionals call AMD. About one in eight people over the age of 85 have AMD severe enough to cause vision loss.

This study has recently been published again, giving us grounds to discuss AMD in more detail.

One does not become completely blind due to AMD. Peripheral vision is still maintained, enabling one to orient themselves in a room or go for a walk. Even so, AMD does cause handicap. Central vision is lost, which means that the ability to see shapely is lost. Therefore reading is impossible, seeing the TV, cooking, using tools, working on the computer, and recognising friends and family is difficult. A grey dot in the middle of the field of vision replaces everyone’s faces.

Central sight is governed by a yellow spot on the eye’s retina where the highest concentration of colour registering cones is found. This is why one of the first things lost in AMD is colour vision.

The changes in AMD can be directly observed on the retina when one looks into the eye. In the early stages it is characterized by small or larger deposits of yellowish waste products in the eye. Every one of these deposits represents a hole in the field of vision. This is unnoticeable so long as these hoses are small. Almost everyone over the age of 50 has at least one of these deposits, but if there are many deposits of greater size, the risk for blindness is great.

Severe cases of AMD can be characterised by an accumulation of larger deposits alone. This is called dry AMD. Another, and more dangerous, form is the so called wet AMD. In this form “leaky” blood vessels grow in under the retina, possibly as the body’s effort to bring more energy to the retina. The result is that liquid seeps out of these vessels causing total destruction of central vision. This can occur very quickly, but with quick intervention of an ophthalmologist (eye doctor) the new blood vessels can be blocked with laser treatment and vision can be saved in many cases.

The deposits and new blood vessels lead to the creation of dents in the retina. In severe cases scars form and pull on the retina. This leads to vision where straight lines seem bent. Often, but not always, one can discover the beginnings of AMD by holding a piece of graph paper at a normal reading distance and looking at it one eye at a time. If the lines are curved, an eye doctor should be consulted immediately.

New methodology
The republished study mentioned earlier is a double blinded study that showed with statistical certainty an improvement in the sight of patients with early stage AMD after they received a combination of n-3 fatty acids, Q10, and L-carnitine. The improvement in sight, which was slight, was first present after 3-6 months, after which sight remained stable until the end of the study one year later. This effect lasted even longer in a following study. It was also observed that the number of deposits decreased! This is important and very promising. Improvement occurred primarily for those with mild cases, but also for some with more severe AMD. Early diagnosis is paramount.

The theory behind these finds is that AMD is a disease of the mitochondria, which means that it is a disease which affects energy production in the cells. This is supported by the fact that cells from AMD affected retinas have more damaged mitochondria than normal cells when viewed under and electron microscope. The logic behind the treatment used in the study is therefore the following:

The vitamin-like substance carnitine is necessary for mitochondrial fat uptake and metabolism.

The fat is added as n-3 fatty acids, like those found in fish oil. N-3 fats compose no less than 30% of the structure of the retina!

Q10 can be understood as the motor’s sparkplug. It optimises metabolism so that energy production can start. The body’s own Q10 production falls with age and because of this, and carnitine deficiency, there becomes less energy available. It is hardly coincidental that patients with wet AMD have less Q10 in their blood than normal.

This important study powerfully indicates that quick action can stop newly diagnosed AMD. The authors strongly believe that their treatment should be the treatment of choice for newly diagnosed AMD.

By: Vitality Council

References:
1. Feher et al. Metabolic therapy for early treatment of age-related macula degeneration. Orv Hetil 2007;148:2259-68.
2. Feher et al. Improvement of visual functions and fundus alterations in early age-related macular degeneration treated with a combination of acetyl-L-carnitine and coenzyme Q10. Ophtalmologica 2005;219:154-66
3. Feher et al. Mitotropic compounds for the treatment of age-related macular degeneration. The metabolic approach and a pilot study. Ophtalmologica 2003;217:351-7
4. Blasi et al. Does coenzyme Q10 play a role in opposing oxidative stress in patients with age-related macular degeneration? Ophtalmologica 2001;215:51-54.
5. Feher J et al. Mitochondrial alterations of retinal pigment epithelium in age-related macular degeneration. Neurobiol Aging 2005;June 22: 15979212.