CoQ10 Blood Levels in Heart Failure Patients
Peter Langsjoen, MD, is considered the world’s foremost expert in the use
of CoQ10 to treat cardiac disease. He conducts his research and clinical
practice in Tyler, Texas.
Peter Langsjoen, MD
When the ubiquinol form of CoQ10 was introduced last year, Dr. Langsjoen
and his associates were curious to investigate whether it could reverse the
course of advanced congestive heart failure. Along with his pioneering
father, Dr. Langsjoen had observed that patients with advanced heart failure
often failed to achieve adequate blood (plasma) levels, even when high doses
of conventional CoQ10 were used.7
Dr. Langsjoen found that in response to the administration of 900 mg of
conventional ubiquinone CoQ10, advanced heart failure patients only
increased their total CoQ10 levels to less than 2 mcg/mL of blood.
Congestive heart failure patients with CoQ10 blood levels as low as this
respond poorly, with very little improvement in ejection fraction (a test
that measures the heart’s pumping capacity).8
In healthy people, the ingestion of 900 mg of conventional (ubiquinone)
CoQ10 is expected to raise total blood levels to around 3 mcg/mL. Dr.
Langsjoen postulated that the reason ubiquinone fails to significantly
increase CoQ10 blood levels in critically ill patients is the impaired
absorption caused from the intestinal and liver edema they so often suffer.
Comparing CoQ10 Blood Levels
In order to ascertain the effects of ubiquinol, Dr. Langsjoen identified
patients with advanced congestive heart failure who had been taking 450 mg/day
of ubiquinone, but whose mean total plasma CoQ10 blood level was only 1.4
mcg/mL. All of these patients were then changed to 450 mg/day of ubiquinol.
The results showed that ubiquinol increased mean plasma CoQ10 levels up
to 4.1 mcg/mL (or 2.92-fold greater than ubiquinone).8
A review of previous studies indicates that significant clinical benefit in
heart failure patients requires a plasma CoQ10 level of around 4 mcg/mL.9-11
In severe heart failure patients, the only way these higher levels can be
obtained appears to be with ubiquinol—not conventional ubiquinone CoQ10
Comparing Improvements in Cardiac Function
The ejection fraction test assesses the heart’s pumping capacity by
measuring how much blood is pumped after each beat compared with the amount
of blood remaining in the heart. Healthy people have an ejection fraction of
50-75%, while those with congestive heart failure often have values below
In the study conducted by Dr. Langsjoen, the ejection fraction improved
from 24% up to 45% in ubiquinol-treated patients who had follow-up
echocardiograms. This represented a recovery of up to 88% in this critical
measurement of cardiac output. The higher blood levels of CoQ10 and the
improved ejection fractions were accompanied by a remarkable clinical
improvement in these heart failure patients.8
Based on the findings from this study, Dr. Langsjoen’s group concluded:
“It is our preliminary observation that ubiquinol has
dramatically improved absorption in patients with severe heart failure and
that the improvement in plasma CoQ10 levels is strongly correlated with both
clinical improvement and improvement in measurement of left ventricular
Why Congestive Heart Failure Deaths are Increasing
Congestive heart failure currently strikes five million Americans.13
Most victims are over 65, an age when cardiac muscle CoQ10 levels are
sharply depleted (by as much as 72%) compared with youth.14
Each year, about one million Americans are hospitalized because of
congestive heart failure and nearly 53,000 die directly from it.15
A predicted increase in heart failure mortality can be attributed to several
factors, including obesity-diabetes, more people surviving heart attacks (with
heart muscle damage), and an aging population. As one can see from the chart
on the next page, normal aging causes a severe depletion of CoQ10 in tissues
throughout the body,14,16,17 which
helps explain why older people suffer more congestive heart failure.
An even more insidious reason why more cardiac patients are dying from
congestive heart failure is the prescribing of statin drugs without
sufficient CoQ10 intake. Since statin drugs deplete CoQ1018 synthesis in the
body, one can easily see why congestive heart failure deaths are
skyrocketing in those being aggressively treated by mainstream
Those at high risk for heart disease (such as diabetics) and those who
have survived a heart attack often need to be prescribed a statin drug to
reduce additional coronary artery occlusion. These statin drug users also
need to supplement with an adequate amount of CoQ10 to protect against the
cardiac cell energy depletion that is the underlying cause of congestive
Multiple Advantages of Ubiquinol Over Ubiquinone
Last year, we provided what we thought was irrefutable evidence of the
multiple advantages of the ubiquinol form of CoQ10. Compared with
conventional ubiquinone CoQ10, ubiquinol was shown to absorb into the
bloodstream up to eight times better,20-22
reduce fatigue 90% more effectively,28
and slow aging in middle-aged mice 40% better.19
Some commercial supplement companies, however, told their customers that
all they had to do was take more ubiquinone to obtain the same benefits of
ubiquinol. Commercial companies had a self-serving reason for sticking with
ubiquinone—their profit margins on it were significantly higher.
We at the Life Extension Foundation take a different view. Keeping our
members in a youthful state of longevity is the most efficient way of
maintaining the revenue stream we need to fund our scientific research
projects. We had no problem reducing our margins to provide members with the
clearly superior ubiquinol form of CoQ10.
Dr. Langsjoen’s remarkable findings that high-dose ubiquinone was
ineffective for advanced heart failure patients, whereas ubiquinol reversed
the course of the disease, provide the most conclusive evidence to date of
the superiority of ubiquinol CoQ10.
Fascinating History of CoQ10
In this issue of Life Extension magazine, we publish an insider’s look at
the 50-year history of CoQ10 that describes the initial skepticism and the
subsequent discoveries made by scientists who fastidiously persevered
against the conventional dogma of the day (see page 57). You’ll be amazed as
to how much painstaking cardiovascular research went into providing us with
the wealth of CoQ10 data we now have today.
We also publish in this issue, an update on new studies showing the
combination of CoQ10 (and other nutrients) with conventional therapies
improves treatment outcomes in advanced breast cancer and melanoma cases
(see page 44). Based on the research that exists to date, you may be as
startled as I am that oncologists are failing to tell certain cancer
patients to take high-dose CoQ10.
Help Combat Today’s Leading Cause of Death
It is so regrettable that the major cause of death in the Western world
is medical ignorance. There are five million Americans suffering from
congestive heart failure today, and most of them don’t take any CoQ10. Those
that do mostly take the antiquated ubiquinone form that provides very little
benefit in advanced cases.
The Life Extension Foundation compiles and publishes avant-garde
scientific information and first disseminates it to members. We then provide
it to the world (via the Internet) at no charge. If more cardiologists paid
attention to what we published last year about ubiquinol, a significant
percentage of those who died from congestive heart failure in 2007 could
still be alive.
Every time you purchase a product from us, you contribute directly to
aggressive life-extension research that could save enormous numbers of human
For 20 consecutive years, members have taken advantage of the annual
Super Sale to stock up on a large supply of advanced natural products at
reduced prices. During this annual winter event, every Life Extension
product is discounted to enable members to enjoy huge savings on our top-of-the-line
This year’s Super Sale ends on January 31, 2008. I encourage members to
check their personal supplies and stock up during this one-time-a-year price
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7. Langsjoen H, Langsjoen P, Langsjoen P, Willis R, Folkers K. Usefulness
of coenzyme Q10 in clinical cardiology: a long-term study.
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8. Langsjoen P. 5th Annual International CoQ10 Symposium. Kobe, Japan:
November 9-12, 2007.
9. Langsjoen PH, Langsjoen AM. Overview of the use of CoQ10 in
cardiovascular disease. Biofactors. 1999;9(2-4):273-84.
10. Langsjoen PH, Littarru GP, Silver MA. Role of concomitant coenzyme
Q10 with statins for patients with hyperlipidemia.
Curr Topics Nutr Res.2005;3(3):149–58.
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with emphasis on heart failure and myocardial ischaemia.
Asia Pacific Heart J. 1998;7(3):160-8.
12. Available at: http://www.hearthelp.com/diseases/ejection-fraction.html.
Accessed November 7, 2007.
13. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1486.
Accessed November 7, 2007.
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tolerance of the senescent myocardium to aerobic and ischemic stress:
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Accessed November 7, 2007.
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antioxidant and energizer. Biofactors. 1999;9(2-4):371-8.
17. Kalén A, Appelkvist EL, Dallner G. Age-related changes in the lipid
compositions of rat and human tissues. Lipids. 1989 Jul;24(7):579-84.
18. Folkers K, Langsjoen P, Willis R, et al. Lovastatin decreases
coenzyme Q levels in humans. Proc Natl Acad Sci USA. 1990 Nov;87(22):8931-4.
19. Yan J, Fujii K, Yao J, et al. Reduced coenzyme Q10 supplementation
decelerates senescence in SAMP1 mice. Exp Gerontol. 2006 Feb;41(2):130-40.
20. Hosoe K, Kitano M, Kishida H, et al. Study on safety and
bioavailability of ubiquinol (Kaneka QH) after single and 4-week multiple
oral administration to healthy volunteers. Regul Toxicol Pharmacol. 2007
21. Shults CW, Oakes D, Kieburtz K, et al. Effects of coenzyme Q10 in
early Parkinson disease: evidence of slowing of the functional decline. Arch
Neurol. 2002 Oct;59(10):1541-50.
22. Shults CW, Flint BM, Song D, Fontaine D. Pilot trial of high dosages
of coenzyme Q10 in patients with Parkinson’s disease. Exp Neurol. 2004 Aug;188(2):491-4.
23. Young AJ, Johnson S, Steffens DC, Doraiswamy PM. Coenzyme Q10: a
review of its promise as a neuroprotectant. CNS Spectr. 2007 Jan;12(1):62-8.
24. Sharma SK, El Refaey H, Ebadi M. Complex-1 activity and 18F-DOPA
uptake in genetically engineered mouse model of Parkinson’s disease and the
neuroprotective role of coenzyme Q10. Brain Res Bull. 2006 Jun
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of high-dose coenzyme Q10 formulations in Huntington’s disease mice. Biochim
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26. Beal MF. Mitochondrial dysfunction and oxidative damage in
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28. Anti-fatigue effect in rats. Unpublished data, Kaneka Corp.