Case Report
 

By Dr. Bill Misner
Corresponding Author Dr. Bill Misner
American Holistic College of Nutrition , 1140 West Glass Avenue Spokane, Washington - United States of America 99205
Submitting Author Dr. Bill Misner
ALTERNATIVE MEDICINE

Coenzyme Q10, Ubiquinone, Ubiquinol, Health, Energy, Exercise, Endurance Performance,

Misner B. Coenzyme Q-10 Effects Endurance Performance - A Case Report. WebmedCentral ALTERNATIVE MEDICINE 2011;2(10):WMC002380
doi: 10.9754/journal.wmc.2011.002380
No
Click here
Click here
Submitted on: 26 Oct 2011 04:59:36 PM GMT
Published on: 27 Oct 2011 02:34:18 PM GMT

Abstract


Manufacturers of Coenzyme Q10 present differing reports marketing Ubiquinol or Ubiquinone. Each suggests their product favorable for resolving compromised health issues or poor energy metabolism associated with aging. This case study reports the running performance of a 71-year male runner while taking Ubiquinol, or Ubiquinone, each for 90-days, or taking neither supplement following a 14-day washout period. The subject best performance time on the same course while taking Ubiquinone was 2.28% faster than his time on the same course after a 14-day washout period no-supplement dose. The subject best performance time on the same course while taking Ubiquinol was –1.16% slower than his time on the same course after a 14-day washout period no-supplement dose. For these results for one subject male 71-years to be conclusive the trend should further confirmed or denied by examining dose and performances associated from a larger contingent of male and female runners over age 40.

Introduction


Coenzyme Q-10 (Ubiquinol or Ubiquinone) has been advertised to enhance health quality, improve energy production, thus benefit exercise performance. Supplement forms of CoQ10 are manufactured as Ubiquinol and Ubiquinone. Manufacturers present differing views to consumers for taking Ubiquinol or Ubiquinone:
UBIQUINOL
1. Ubiquinol is more absorbable (delivered by oil suspension) than conventional Ubiquinone in every clinical trial to date.
2. Ubiquinol conversion decreases with age or compromised health.
3. Ubiquinol is the predominant form (over 90%) of CoQ10 in healthy humans.
UBIQUINONE
1. Ubiquinone is absorbed at same rate as ubiquinol (over-double powdered ubiquinone in capsules).
2. Ubiquinone is stable exposed to air with no oxidation.
3.Ubiquinone is dispersible in water, beverages, or gels.
Ubiquinone is the oxidized form of Coenzyme Q10, while Ubiquinol is the reduced form of CoQ10. Following oral dose absorption, Ubiquinone is enzyme-converted back to Ubiquinol, and, Ubiquinol is enzyme-converted back to Ubiquinone, recycled according to the body’s cellular energy demand or to reduce oxidative cell damages. Ubiquinone and/or Ubiquinol play an important role regenerating two internal antioxidants, vitamin E and vitamin C. Within the electron transport chain, the antioxidant ratio of Ubiquinol:Ubiquinone produces ATP for energy metabolism (exercise) upon demand. Some scientists argue that Ubiquinol is best absorbed, while others argue that their proprietary form of Ubiquinone is absorbed as well as Ubiquinol. Since both forms of exogenous Coenzyme Q10 are proposed to raise serum levels higher than the other, the question this case study examined is which form produces the most energy (if any) for endurance performance? Coenzyme Q-10 is made inside the human body in the form of two alternating endogenous substances, (Ubiquinone D Ubiquinol); the amounts available may effect energy production and/or health status. Acute deficiency of Coenzyme Q-10 has been associated with fatigue and exercise intolerance, while chronic deficiency has been associated with more serious health issues such as cerebellar ataxia, obesity, cardiovascular heart disease, hypertension, Muscular Dystrophy, HIV, AIDS, Parkinson's, and Periodontal Disease (Dhanasekaran & Ren 2005, Gaby 1999). With age, the body makes less Coenzyme Q10 by the mitochondria cells significantly lowering energy metabolism and compromising health (Lenaz, G., et al.1998). Mitochondria, located inside all living cells, make Coenzyme Q-10 (Ubiquinone D Ubiquinol) for energy production and healthy cell function. Half of the body’s total Coenzyme Q10 originates in mitochondrion where it performs three vital functions (Barbiroli, B., et al 1997; Papucci, L., et al.  2003):
Ø-Assists enzymes in the mitochondria to convert dietary nutrients into adenosine triphosphate
Ø-Exerts antioxidant effects against free radicals generated during the energy-producing process
Ø-Protects the structural integrity of the mitochondrial membrane
PROBLEMS PREVENTING DEFICIENCY
Meats from livestock-fish-poultry [3.0-3.5-ounces] that contain the most Coenzyme Q10 are also higher in fat. When consumed in amounts high enough to increase Coenzyme Q10, unwanted unhealthy blood lipids may increase more than is regarded healthy:
Not-Healthy (high-fat) Foods CoQ-10 content [3.0-3.5-ounces]:
Ø      Beef                 2.60mg
Ø      Herring            2.30mg
Ø      Chicken            1.40mg
Healthy (low-fat) Foods CoQ-10 content is small [3.0-3.5-ounces]:
Ø      Spinach           1.00mg
Ø      Broccoli            0.86mg
Ø      Rice Bran          0.54mg
Ø      Sweet Potato   0.36mg
Ø      Wheat Germ     0.35mg
Ø      Soybeans         0.29mg
Ø      Garlic                0.27mg
Ø      Carrot              0.22mg
Ø      Eggplant          0.21mg

Methods


Running performance slows down with age in years, months, and days. Loss of performance deteriorates approximately 0.6-1.0% per year. Because this case study required 180-days taking supplements and 14-days without taking supplements, the World Masters Athletics (WMA) WAVA-Age-grading calculator was selected to fairly compare all 21-timed runs of a 71-year age male subject on a the same 15K trail course. The timed performances were age-graded by percentage of the world record 15K road race by age (in years, months, and days). All timed runs were recorded on the 2010 USA National 15K Championship trail course over a period of 194-days. This subject trained 5-days per week for 90-days to attain a base level of fitness. After this 1st 90-day period was completed, the subject commenced oral dose of 400 mg Ubiquinol daily for 90-days. During this 2nd 90-day period, of twelve-timed trail runs recorded, the best time was 1:28:03. Immediately following completion of the 2nd 90-day period, this subject commenced oral dosed 400 mg Ubiquinone daily for the 3rd 90-day period. Of eight timed 15K trail runs recorded; the best was 1:23:53. After this 3rd 90-day period, the subject fasted both Ubiquinol and Ubiquinone for 14-day washout period prior to recording his final 15K timed trail run in 1:26:58. Age-grading this subject’s timed performances precisely identified which timed run during each of two 90-day periods and one 14-day washout no-supplement period were faster or slower based on percentage of the world record 15K road race by exact age (in years, months, and days).

Results


Twenty-one (21) timed 15K trail runs recorded in 194-days. The best-timed runs during each dose or no dose period occurred at age 71.20 during the Ubiquinol-dose period, at age 71.47 during the Ubiquinone-dose period, and at age 71.62 immediately following a 14-day no-supplement washout period. The best-timed run was determined based on the WMA-WAVA Age-Graded calculated percentage of the world record 15K road race for a runner the precise age in years and days. These dated timed results are listed in Table I.

Conclusions


This case reports timed 21-each 15K trail running performances of a single 71-y male subject over an extended 194-day period, 180-days taking supplements, 90-days taking Ubiquinol or 90-days taking Ubiquinone, and one 14-day washout period taking no supplements. This subject ran +2.28% faster while taking Ubiquinone, than taking no supplements [post-14-day washout]. However, while the taking Ubiquinol, this subject ran -1.16% slower than taking no supplements. One subject's enhanced performance associated with Ubiquinone is impressive but not conclusive.
This case report calls for more research examining exogenous Coenzyme Q10 dose effects upon exercise performances with large contingents male and female runners of all ages.

Discussion


The average Coenzyme Q10 turnover every 4-days in a healthy person is 500 milligrams depending upon endogenous cellular production or exogenous dietary dose (Ernster 1995).  A healthy young person (age 20) stores a range estimate of 1400-2000 milligrams inside the cells. Specific foods either supply Coenzyme Q10 or the substances that the cells convert inside for cell stores. In the absence of exogenous sources (Example: 7-day fast), Coenzyme Q10 levels may decrease by -50%. Exercise also decreases circulating Q-l0 plasma levels observed in runners immediately following exercise (Bargossi, A. M., et al. 1993). Supplemental Coenzyme Q-l0 dose increases plasma levels, reduces muscle cell oxidant damages, and increases energy metabolism rebound for future exercise-demand (Gökbel et al., 2010; Bonetti A, et al., 2000; Cooke M, et al., 2008).  Individual needs vary remarkably, from as little as 30 milligrams to as much as 500 milligrams/day, depending upon endogenous synthesis rate and exogenous dietary or supplement donors. Researchers reported endurance athletes supplementing CoQ10have higher muscle concentrations, and lower serum oxidative stress after exercise, resulting in increased exercise time to exhaustion (Cooke M, et al., 2008). When CoQ10 saturates tissues, health and energy metabolism appear to be optimal. Coenzyme Q-10 supplements prevent and resolve deficiencies immediately increase circulating plasma levels without elevating blood lipids (Quinzii et al., 2006). Exogenous Coenzyme Q-10’s half-life ranges between 33-72 hours, with blood serum concentrations peaking between 5-10 hours (6-hours average). Normal serum concentrations are 0.7-1.0 µg/mL. The therapeutic oral dose for maintaining healthy concentrations is 50-150 mg of Coenzyme Q10 per day (2 mg CoQ10 per kg of bodyweight/day). However, when a deficiency occurs, a higher oral dose is required to resolve. Aging individuals (over 70) have low Coenzyme Q-10 stores. Because aging and exercise create a deficiency state, an oral dose of 400 mg CoQ10 daily has been proposed to improve cardiovascular senescent tolerance to aerobic exercise stress (Rosenfeldt et al., 1999). This case reports a single age 71.20-71.62 male running’s performance to be 2.28% faster while taking Ubiquinone than not taking Ubiquinone. This case report therefore begs the question whether this Ubiquinone loading protocol would benefit larger populations of males and females of all ages.

References


1. Badmaev V, Majeed M, Norkus E, Piperine, an alkaloid derived from black pepper increases serum response of beta carotene during 14 days of oral beta carotene supplementation. Nutr. Res. (1999) 19(3): 381-388.
2. Badmaev V, Majeed M, Prakash L, Piperine derived from black pepper increases the plasma levels of coenzyme q10 following oral supplementation. J Nutr Biochem. 2000 Feb 1;11(2):109-113.
3. Barbiroli, B., et al.  Coenzyme Q10 improves mitochondrial respiration in patients with mitochondrial cytopathies. An in vivo study on brain and skeletal muscle by phosphorous magnetic resonance spectroscopy.  Cell Mol Biol.  43(5):741-749, 1997.
4. Bargossi, A. M., et al.  Antioxidant effects of exogenous ubiquinone (Q10) in high level endurance runners.  Free Radicals and Antioxidants in Nutrition.  1993:63-74.
5. Bonetti A, Solito F, Carmosino G, Bargossi AM, Fiorella PL. Effect of ubidecarenone oral treatment on aerobic power in middle-aged trained subjects. J Sports Med Phys Fitness. 2000 Mar;40(1):51-7.
6. Cooke M, Iosia M, Buford T, Shelmadine B, Hudson G, Kerksick C, Rasmussen C, Greenwood M, Leutholtz B, Willoughby D, Kreider R. Effects of acute and 14-day coenzyme Q10 supplementation on exercise performance in both trained and untrained individuals. J Int Soc Sports Nutr. 2008 Mar 4;5:8.
7. Cornell University Age Calculator @: http://www-users.med.cornell.edu/~spon/picu/calc/agecalc.htm
8. Dhanasekaran M, & Ren J, The Emerging Role of Coenzyme Q10 in Aging, Neurodegeneration, Cardiovascular Disease, Cancer and Diabetes Mellitus, Current Neurovascular Research, 2(5): 447- 59, December 2005.
9. Ernster L, Dallner G: Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta, 1995; 1271: 195-204.
10. Gaby, Alan R, MD, Coenzyme Q10 – Textbook of Natural Medicine, NY: Churchill Livingstone, pp 663-71, 1999.
11. Gökbel H, Gül I, Belviranl M, Okudan N. The effects of coenzyme Q10 supplementation on performance during repeated bouts of supramaximal exercise in sedentary men. J Strength Cond Res. 2010 Jan;24(1):97-102.
12. Lenaz, G., et al.  Oxidative stress, antioxidant defenses and aging.  Biofactors.  8:195-204, 1998.
13. Papucci, L., et al.  Coenzyme Q10 prevents apoptosis by inhibiting mitochondrial depolarization independently of its free radical-scavenging property.  J Biol Chem.  20
14. Quinzii CM, DiMauro S, Hirano M. Human coenzyme Q10 deficiency. Neurochem Res. 2007 Apr-May;32(4-5):723-7. Epub 2006 Nov 10. Review.
15. Rosenfeldt FL, Pepe S, Ou R, Mariani JA, Rowland MA, Nagley P, Linnane AW. Coenzyme Q10 improves the tolerance of the senescent myocardium to aerobic and ischemic stress: studies in rats and in human atrial tissue. Biofactors. 1999;9(2-4):291-9.
16. World Association of Veteran Athletes (WAVA) Age-grading calculator 2006 (updated 2010) @: http://www.howardgrubb.co.uk/athletics/wmalookup06.html

Acknowledgements


The author expresses appreciation to (1) Best Formulations, 938 Radecki Ct, City of Industry, CA 91748 for their generous donation of Q-Best™ proprietary Ubiquinone for this case study, and to (2) Kaneka Nutrients L.P., 6161 Underwood Rd, Pasadena, TX 77507-1033, for their generous donation of proprietary Ubiquinol, for this case study.

Source(s) of Funding


None.

Competing Interests


The author was the subject of this case study and reports no competing interests.

Disclaimer


This article has been downloaded from WebmedCentral. With our unique author driven post publication peer review, contents posted on this web portal do not undergo any prepublication peer or editorial review. It is completely the responsibility of the authors to ensure not only scientific and ethical standards of the manuscript but also its grammatical accuracy. Authors must ensure that they obtain all the necessary permissions before submitting any information that requires obtaining a consent or approval from a third party. Authors should also ensure not to submit any information which they do not have the copyright of or of which they have transferred the copyrights to a third party.
Contents on WebmedCentral are purely for biomedical researchers and scientists. They are not meant to cater to the needs of an individual patient. The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. Your use of the WebmedCentral site and its contents is entirely at your own risk. We do not take any responsibility for any harm that you may suffer or inflict on a third person by following the contents of this website.

Reviews
30 reviews posted so far

Dear Dr. Bilgin Kadri Aribas, I send my sincere enthusiastic appreciation for your review posted here. Bill Dr. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 10 Jan 2012 03:25:23 PM GMT

a well-written case study, but nothing conclusive.
Posted by Prof. Feng Feng on 07 Nov 2011 07:19:01 PM GMT

Professor Feng Feng, Thank you for your esteemed review. Today, 11-8-11, this paper was revised and as you noted, it also states without excuse that a single-subject case report is inconclusive, thoug... View more
Responded by Dr. Bill Misner on 08 Nov 2011 04:33:58 PM GMT

Dr. Constantino Ledesma-Montes, Thank you for your esteemed review and helpful comments on this article, sir. Bill Misneer... View more
Responded by Dr. Bill Misner on 08 Dec 2012 05:46:40 PM GMT

Dear Dr. Constantino Ledesma-Montes, Thank you for posting your review of this Case Report. I agree with your final comments. The gain above washout-base without consuming oral dose of 2.28% performan... View more
Responded by Dr. Bill Misner on 08 Nov 2011 04:29:18 PM GMT

revision
Posted by Mr. Santiago Perez Lloret on 31 Oct 2011 02:35:18 PM GMT

Dear Mr. Santiago Perez Lloret, Sir, thank you for this review with your comments. As you likely know, oral dose CoQ10 is poorly absorbed, and as my paper states, food sources are not high in terms of... View more
Responded by Dr. Bill Misner on 31 Oct 2011 04:27:49 PM GMT

Dear Dr. Ahmed A Khalil, Thank you for your review and well-designed suggestions. I have copied and pasted them all in my notes to use with the final rewritten version for final submission on this com... View more
Responded by Dr. Bill Misner on 31 Oct 2011 04:14:36 PM GMT

Professor Macello Iriti, Thank you for your esteemed review of this "Case Report." When the final draft is submitted, I will move the discussion section behind the conclusions section. I hope you noti... View more
Responded by Dr. Bill Misner on 31 Oct 2011 04:04:06 PM GMT

Professor Bedin, Thank you for your review of this "Case Report." Your previous scholarly comments on the former "Case Study" version of this paper definitively improved the quality significantly. I ... View more
Responded by Dr. Bill Misner on 30 Oct 2011 04:31:08 PM GMT

Dear Dr. Kulkami, Thank you for your review of my Case Report. With your science background in drug delivery, this credible review is very highly valued. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 29 Oct 2011 05:50:34 PM GMT

Dear Dr. Ekta Menghani, Thank you for a brilliant review of this paper. Your experiences observing and reporting plant-generated properties is relevant to why hydrogen-carrying properties of between U... View more
Responded by Dr. Bill Misner on 29 Oct 2011 04:38:28 PM GMT

Dr. Abu Dzarr, Thank you for reviewing my paper and sharing your concerns. Bill Misner PhD ... View more
Responded by Dr. Bill Misner on 29 Oct 2011 04:06:58 AM GMT

Dr. Herchline, Thank you for spending your time to review this paper. I appreciate your review commentary. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 29 Oct 2011 02:32:16 AM GMT

The absence of blinding is a problem
Posted by Dr. Jacob Puliyel on 28 Oct 2011 06:26:31 PM GMT

Dr. Puliyel, Thank you for your comments and critical review. Blinding would have been performed including times listed from each 90-day period. The facts are simply that had we done blinding with sep... View more
Responded by Dr. Bill Misner on 29 Oct 2011 02:30:26 AM GMT

Professor Shenkman, Thank you for reviewing my case report. Your scholarly comments are deeply appreciated. Please include me as a scholarly reviewer of any articles you publish on WebMedCentral...As ... View more
Responded by Dr. Bill Misner on 28 Oct 2011 03:38:52 PM GMT

Dr. Nwankwo, Thank you for reviewing my case report. Your comments are deeply appreciated. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 28 Oct 2011 03:35:50 PM GMT

Dr. Hmadcha, Thank you for reviewing my case report. Your comments are deeply appreciated. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 28 Oct 2011 03:34:59 PM GMT

Dr. BK Aribas, Thank you for reviewing this case report. Your comments are deeply appreciated. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 28 Oct 2011 03:34:19 PM GMT

Dr. Karthikkumar Venkatachalam, Thank you for reviewing my case report. Your comments are deeply appreciated. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 28 Oct 2011 03:33:15 PM GMT

Dr. Singh, Thank you for your response and helpful comments. This review is most welcomed. Bill Misner PhD... View more
Responded by Dr. Bill Misner on 29 Oct 2011 02:16:26 AM GMT

Dr. Stevanovic, Thank you for your critical review and well-thought comments. Once again I completely agree with your suggested order for case reporting. I have conducted many single-case "experiments... View more
Responded by Dr. Bill Misner on 28 Oct 2011 03:30:44 PM GMT

Dr. Rao, Thank you for presenting an excellent review with comments I agree completely. I will add the following thoughts that I have been reluctant to share until now, since I conclude that your revi... View more
Responded by Dr. Bill Misner on 30 Oct 2011 04:24:22 PM GMT

Dr. Kulkami, Thank you for your review and comments. Bill Misner... View more
Responded by Dr. Bill Misner on 08 Dec 2012 05:44:50 PM GMT

Coenzyme Q-10 and Endurance Performance
Posted by Dr. Thomas Herchline on 20 Oct 2011 11:38:02 PM GMT

Review of case study
Posted by Mr. Michael Zanovec on 20 Oct 2011 06:15:48 PM GMT

Micahel Zanovec, I hope for your review of the revised version entitled, Coenzyme Q-10 Effects Endurance Performance - A Case Report Bill Misner PhD ... View more
Responded by Dr. Bill Misner on 29 Oct 2011 02:36:03 AM GMT

Comments
0 comments posted so far

Please use this functionality to flag objectionable, inappropriate, inaccurate, and offensive content to WebmedCentral Team and the authors.

 

Author Comments
3 comments posted so far

ADDENDUM FOR REVIEWERS Posted by Dr. Bill Misner on 30 Oct 2011 04:42:56 PM GMT

 

What is article Popularity?

Article popularity is calculated by considering the scores: age of the article
Popularity = (P - 1) / (T + 2)^1.5
Where
P : points is the sum of individual scores, which includes article Views, Downloads, Reviews, Comments and their weightage

Scores   Weightage
Views Points X 1
Download Points X 2
Comment Points X 5
Review Points X 10
Points= sum(Views Points + Download Points + Comment Points + Review Points)
T : time since submission in hours.
P is subtracted by 1 to negate submitter's vote.
Age factor is (time since submission in hours plus two) to the power of 1.5.factor.

How Article Quality Works?

For each article Authors/Readers, Reviewers and WMC Editors can review/rate the articles. These ratings are used to determine Feedback Scores.

In most cases, article receive ratings in the range of 0 to 10. We calculate average of all the ratings and consider it as article quality.

Quality=Average(Authors/Readers Ratings + Reviewers Ratings + WMC Editor Ratings)