About the amounts,
I think that the Q10 Lara is taking is the ubiquinon. And this is oke. But i am not happy with the amounts!
I believe that her doctor doesn`t know what he/she is doing, doctors don`t know not much about nutritions its not a big part of their education.
CoQ10 has two basic functions, energy production and antioxidant protection. Ubiquinone is the oxidized form of CoQ10 used to create energy in the mitochondria of the cells. (We tend to think of “oxidized” as bad, yet in this case it simply means that it is in the form needed to produce ATP.) Ubiquinol is the reduced form of CoQ10 and is used to provide antioxidant protection for each cell.
The body needs both forms, and it is CoQ10’s location in the body determines the form it takes. Inside the cells, where energy is produced, Ubiquinone is in needed. Outside the cells, in the blood and on cell membranes, Ubiquinol is needed and works as an antioxidant. Together Ubiquinone and Ubiquinol form a redox pair which means each one can be easily converted to the other by the body.
Given the fact that the body can switch the two substances back and forth to meet its own requirements, the argument that Ubiquinol is the “biologically active” form of CoQ10 is not valid. Claims have been made that Ubiquinone is viewed as inferior to Ubiquinol and that adults over 40 have difficulty-reducing Ubiquinone to Ubiquinol yet a recent human study indicates otherwise and that it is not true. Also all Ubiquinol found in animal protein is converted to Ubiquinone through the process of cooking before it is eaten.
Similarly, Ubiquinol taken as a supplement is quite unstable in the stomach and is converted back to ubiquinone before absorption. This means that no matter which form of CoQ10 the consumer chooses to ingest, it’s ubiquinone that is absorbed into thebody.
Perhaps more importantly, in the four years since Ubiquinol was presented as an alternative to Ubiquinone, only one human clinical trial on the substance has been published in the peer-reviewed scientific literature. In marked contrast, there have been hundreds of clinical studies showing ubiquinone is an effective supplement for a wide variety of illnesses and conditions.
Ubiquinol does appear to have one advantage. It is more bioavailable than the dry powdered forms of ubiquinone that have been widely commercially available. In a head-to-head single-dose study, oil-based Ubiquinol was found to be 60 percent better absorbed than powdered ubiquinone, and that percentage may increase with longer-term supplementation. However, Ubiquinols’ increased absorption over ubiquinone powder is not entirely surprising, given the fact that CoQ10 is primarily lipid-soluble, so it needs to be in the presence of oil to be absorbed. To get the same absorption with Ubiquinone just take it with fat, raw nuts, coconut oil, flax oil, or avocado.
Despite its higher bioavailability than powdered ubiquinone, Ubiquinol has several drawbacks. First, it’s significantly more expensive. Second, it’s hard to work with. Manufacturers must take great care to protect Ubiquinol from exposure to air, which causes it to change back to Ubiquinone — completely defeating the purpose of using it. Third, delivery options for Ubiquinol are very limited; the only way to encapsulate it is to suspend it in oil in soft gel form.
Ubiquinone =oxidized form
Ubiquinol = reduced form
Inside the body 80% of the Co Q-10 exists in the reduced ubiquinol form. Ubiquinone, the oxidized form, when taken as a supplement, is quickly reduced into ubiquinol as it is absorbed. The fraction of reduced to oxidized Co Q-10 found in food varies considerably but in most, the majority is ubiquinone and ubiquinol makes up only about 17 to 35% of the total Co Q -10 content.
But here is the catch, Ubiquinol is better absorbed than ubiquinone. In rat experiments the ubiquinol is absorbed twice as well as ubiquinone.
My first bottom line was to figure out which products increase blood levels of Co Q-10 the most. Of course no published study cleanly compares all the various products side by side. One has to patch together information from various studies, hoping the methodologies are similar enough to yield results that are comparable. Let’s assume they are. (which is a weak assumption but it’s the best we can do at the moment)
There has been a steady progression of improvement over the years. Blood baseline levels of Co Q-10 are typically around .65 mcg/ml. The crystalline powders we first used at a dose of 100 mg/day taken for four weeks, double blood levels to about 1.35 mcg/ml. (Stogsdill 2006)
Absorption is clearly improved by mixing the crystalline ubiquinone with various fat delivery systems. The ‘softgel’ capsules from the late 1990s are advertised to increase levels to 2.56ucg/ml (at 60 mg/day for four weeks).
With time the way the Co Q-10 crystals are blended into the oil got fancier. For example Q-absorb™ that uses a “proliposome lipid-soluble delivery system” is advertised to increase Co-Q10 levels [100 mg tid] to 3.64 ucg/ml, that’s about 3 times over baseline. (It’s also triple the daily dose as in the earlier mentioned papers) (see what I mean by this being a weak assumption)
Now there is a ‘crystal free’ COQMAX CF ™ that claims to have emulsified the Co A-10 moleules into the oil without crystal formation. This version raises blood levels to 3.43 ucg/ml after 28 days. (Xymogen) We’ve been using this at our office for a number of years.
Now along comes ubiquinol.
We have one study on absorption of ubiquinol that was sponsored by Kanek, a the company that manufactures it. (Hosoe 2006) The study looked at both safety and absorption and found no safety concerns. They report blood levels increased more with higher doses. After 28 days taking 300 mg doses per day after breakfast, ubiquinol levels increased from a baseline of 0.66 to 8.28 mcg/ml. This is something like an 11 fold increase.
This got my immediate attention.
Lower doses of ubiquinol yielded less impressive results. At 90 mg per day, ubiquinol levels increased from a baseline of 0.57 to 2.84 mcg/ml. At 150 mg per day, ubiquinol levels increased from a baseline of 0.65 to 3.84 mcg/ml. These results were only slightly higher than prior results achieved though older supplements.
Certainly if you compare this with plain old co Q-10 powder that increase levels to only 1.35 mcg/ml, these numbers look really good.
That’s the good news.
The bad news is that this is about all we know about using ubiquinol in people. Over the last 30 years there have been numerous clinical trials giving people ubiquinone. To date we have only two studies using ubiquinol in humans. The first (Hosoe et al. 2007) from which we pull this data looked at toxicity and absorption. A second in August 2007 used ubiquinol in heart failure patients. A third from that December looked at ubiquinol use in children with trisomy-21 gene.
That’s it.
While there are a multitude of studies using older forms of Co-q, there are almost none published using Ubiquinol.
Quest Labs will measure Co Q-10 levels for you. This won’t do much good as they only quantify results up to 4 ucg/ml. Higher results are simply reported as “>4” and trust me patients are not thrilled to pay the cost of the lab test (which isn’t cheap) to learn that. They like to see numbers.
Ubiquinol does increase serum C0 Q-10 above 4. I can’t confirm how much higher I’ve gotten patients.
If ubiquinol raises blood Co Q-10 levels higher than other forms of Co Q-10 do, can we assume it will have the same therapeutic action as earlier less absorbable forms, only more so?
If doubling serum Co Q-10 levels is helpful, does tripling, quadrupling or increasing it by a factor of eleven provide more and more benefit? Do the benefits of increasing blood ubiquinol levels continue to increase with dose or is there simply a threshold that needs to be crossed to get maximum benefit and above which further increases do not accrue further benefit? These are the questions.
More is not always better. Yet, sometimes it is.
At this point we don’t have the answers.
There may be subsets of the population in which ubiquinol is superior. Some people may have trouble converting ubiquinone to ubiquinol. Or perhaps, digestive problems may limit absorption of the plain or fat ubiquinone products. There may be certain conditions where we want all the Co-10 in the blood we can get and other conditions that simply doubling baseline levels will do the trick.
As much as I had hoped to arrive at a definitive answer at about this point, I’m not there and may be force to resort to the cop out of the educated and say more research is required. While we wait for that to happen, here’s what I’m doing in practice. As serum levels of ubiquinol appear dose dependent, I’m going to try patients on different doses and see if they can feel the difference symptomatically as we increase to high doses. If they don’t report further symptom improvement, I’ll keep them at the lower doses and presumably the ‘lower’ serum levels.
[This approach reminds me of a discount grocery store chain in the midwest called Hy-Vee. Their motto is, “If you can’t taste the difference, why pay the difference?” ]
Willy,
I really believe that the amounts must be the same as we advice to our dutch children. Never change a winning team.
This doctor doesn`t know whats helping Lara, the supplements she/he describe or the regular medications? So keep continue
I think that Lara should use the same protocol as the other children and the amounts she is taking right know are to high. Its just a toddler, so be carefull!
If the absorption of ubiquinon is 60% less then ubiquinol, she is still taking to much.
150 mg ubiquinon 60% is 90 mg left 60 mg.
If she is taking the ubiquinon with a little fat the absorption is higher.
greetings,
Corrij
