Commercially available CoQ10 supplements are usually oil-based suspensions in soft-gel capsules, cap-tabs or powder-filled hard-shelled capsules, the former being the most common. While there have been many clinical studies using these preparations, there are very few reports, both in animal models and human subjects in the literature, comparing the absorption or the bioavailability of the CoQ10 in these products.
There are many CoQ10 supplements available commercially, but they are not equally bioavailable. As a fat-soluble compound, CoQ10 is poorly absorbed in water. It follows the same pathway as do other fats that are absorbed by the body. The breakdown of fat substances requires emulsification in the intestine (with the help of bile salts) and the formation of micelles prior to absorption. Among the other factors affecting the absorption of exogenously administered CoQ10 are its particle size, degree of solubility and the type of food that is ingested with the supplement.
Although CoQ10 is classified as a lipid-soluble substance, its degree of solubility is extremely limited. Commercially available CoQ10 capsules contain either oil-based suspensions (softgels) or dry powder blends. When tested in the laboratory, many of these products show a total lack of dissolution, indicating that their bioavailability is negligible and they will be poorly absorbed.
Which form of CoQ10 is best?
In two separate studies, we compared the relative bioavailability of CoQ10 in commercially available products, i.e., an oil suspension in softgel, powder-filled hard-shelled capsules, a tablet formula, and Q-Gel, a new solubilized CoQ10 formula in a softgel (using the new biosolv process).
These two studies, each involving 24 healthy volunteers, demonstrated that the bioavailability of CoQ10 can be greatly enhanced by using appropriate solubilization techniques.
With Q-Gel, plasma CoQ10 values showed a sharp increase, reaching a therapeutic range above 2.5 ug/ml within three to four weeks with further increases over time.
Although the optimal dose of CoQ10 is not known for every pathological situation, researchers agree that levels of 2.5 ug/ml and preferably 3.5 ug/ml'8,'9 are required to have a positive impact on severely diseased hearts. Therefore, whenever employing CoQ10 as a supplement, it is important to note not only the amount being taken, but also how it is absorbed and delivered to the body.
Product bioavailability is obviously a major concern to consumers. All CoQ10 is made in Japan and sold to various companies, but the packaging and preparations differ. New research shows that the delivery of CoQ10 in softsules, which are both water- and fat-soluble, is superior to the dry form; more CoQ10 gets into the bloodstream.
How much CoQ10 should I take?
Keeping delivery in mind, what dose of CoQ10 should one take? Whether taking capsules, cap-tabs or regular oilbased CoQ10, my recommendations are as follows:
30 to 100 mg daily as a preventive in cardiovascular or periodontal disease and for patients taking Hmg-CoA reductase inhibitors.
90 to 180 mg daily for the treatment of angina pectoris, cardiac arrhythmia, high blood pressure and moderate gingival disease.
180 to 360 mg daily for congestive heart failure and dilated cardiomyopathy.
Note: For a severely impaired immune system, as in cancer, even higher doses of CoQ10 may be required.
Once a therapeutic effect is obtained, that is, there is improved well-being, lowered blood pressure, improved shortness of breath, better gum tissues, and so on, the maintenance dose may be adjusted. Fifteen mg of Q-Gel softsule is the equivalent of approximately 50 mg of standard CoQ10.
It has been observed that for many cardiac conditions, especially CHF and cardiomyopathy, the therapeutic dose must be the maintenance dose or symptoms will return. I have noted that some patients, well-maintained on CoQ10, will have a return of symptoms if they change the brand or the dosage they are taking. Obviously, they may be getting a poorer delivery system, but if the situation is not remedied, their cardiac symptoms may return and the cause may not be recognized. Stopping or reducing CoQ10 is similar to altering intake of cardiac drugs such as beta blockers. Relapses can certainly occur.
For those using CoQ10 as adjunct therapy in treating a serious illness, it may be appropriate to ask the doctor to have a blood level obtained since blood levels are the most accurate assessment of how CoQ10 is being absorbed and delivered to tissues and organs. When CoQ10 is delivered in sufficient dosage, it will support the tissues in need.
