~ CoQ10 and Parkinson's Disease

CoQ10 (co-enzyme Q10) has been widely used in this country for various cardiac conditions, especially congestive heart failure (CHF).

CoQ10 protects LDL cholesterol (the cholesterol that causes heart disease and stroke if it becomes oxidized) from oxidizing.

Results from a recent study conducted on CoQ10 in patients with early Parkinson's disease indicate that high doses of CoQ10 may slow the progress of Parkinson's and other neurological diseases. There is strong evidence in the medical literature indicating CoQ10 is a powerful antioxidant and may protect the neurons (brain cells) from dying.

Parkinson's disease is the second most common neurodegenerative disorder in this country (after Alzheimer's), affecting about 1% of all people over the age of 50. Parkinson's is caused by the death of brain cells that control movement. The study was a double-blinded, prospective, randomized study using doses of CoQ10 of 300mg, 600mg and 1200mg daily.

Read more about the study here.

Some studies have found that coenzyme Q10 may affect or be affected by other medications. For instance, findings suggest that coenzyme Q10 levels are depleted by various cholesterol-lowering drugs (statins) and antihypertensives (i.e. beta blockers). Those using these popular prescription drugs may need additional coenzyme Q10 because these drugs inhibit natural coenzyme Q10 synthesis in the body.

People taking certain prescription drugs may benefit from coenzyme Q10 because it reduces side effects, such as those side effects inflicted by timolol (a glaucoma medication). On the other hand, coenzyme Q10 supplementation may reduce the efficacy of certain drugs, such as warfarin (blood thinner), and increase the half-life of others, such as enalapril (an old-line anti-hypertensive). The evidence for interactions with warfarin (Coumadin) and enalapril is skimpy and is not based on any controlled study.

There are simple medical tests that can enable a physician to modulate the dosing of a drug like Coumadin or enalapril in the presence of high doses of coenzyme Q10. For instance, if an old-line anti-hypertensive drug like enalapril (Vasotec) is prescribed, it may be possible to take a lower dose of enalapril since coenzyme Q10 may prolong its effects in the body. Regular blood pressure monitoring can determine the optimal individual dose of enalapril.

Some reports indicate that coenzyme Q10 may reduce the anti-coagulant efficacy of Coumadin. In this case, all a physician has to do is continue the normally scheduled (weekly or bi-weekly) coagulation blood tests (Prothrombin and INR) and increase the dose of Coumadin if coenzyme Q10 is blunting Coumadin's anti-coagulant effect. Those who are prescribed Coumadin have these blood coagulation tests done frequently because the dose of Coumadin often has to be adjusted to reflect changes occurring in the patient's body.

An example of why frequent coagulation blood testing is so important can be seen in a scenario of a patient taking Coumadin for one medical problem while at the same time using a high dose of coenzyme Q10 for related conditions. For instance, people who undergo artificial heart valve replacement often need Coumadin to prevent a blood clot forming on the valve, which can then travel up a carotid artery to cause a stroke. Many people needing valve replacement also have weakened heart muscles (congestive heart failure) and may require supplemental coenzyme Q10 to maintain cardiac output. Coenzyme Q10 enhances the energy-producing organelles called mitochondria to more effectively produce energy within heart muscle.

So for certain heart disease patients, Coumadin is prescribed to prevent abnormal clotting (thrombosis), while coenzyme Q10 is needed to maintain heart muscle output. Coenzyme Q10 also helps prevent oxidation of LDL cholesterol, which is felt to be part of the pathogenesis of vascular disease. These patients may safely benefit from Coumadin and coenzyme Q10 as long as their physician properly evaluates the blood tests and adjusts the Coumadin dose accordingly.

It should be pointed out that tens of thousands of Life Extension Foundation members have been taking coenzyme Q10 supplements over the past 20 years. There have been no reports of problems amongst Coumadin users. A physician who regularly prescribed Coumadin and coenzyme Q10 stated that he did not have to adjust the dose of Coumadin when adding coenzyme Q10. The only reason this issue is being raised now is that Parkinson's patients may be taking 1200 mg a day of coenzyme Q10. If these Parkinson's patients are taking Coumadin or enalapril, they should alert their physician in case the dose of Coumadin has to be increased or the enalapril decreased.

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