Saturday, November 6, 2010

Coenzyme Q10 and Parkinson's

In yesterday's post, I discussed some of the evidence that Parkinson's disease is possibly caused by defects in the energy efficiency of the mitochondria of susceptible (and poisoned) individuals.  I don't mean to do a whole Parkinson's series or anything, but the post did bring up some interesting questions. 

We already know that a ketogenic metabolism seems to increase energy efficiency in the brain.  But what else might do the same?  Well, researchers are already looking into some trials of a few compounds of interest - Coenzyme Q10 (also known as ubiquinone) and creatine.  There are a few published animal studies, a few small clinical trials of CoQ10, and human trials are ongoing for both CoQ10 and creatine. 

CoQ10 is an interesting vitamin/molecule.  Yesterday I compared mitochondria (our cells' energy factories) to a ski resort.  There are proton pumping complexes in the mitochondria that pump against a gradient, rather like the ski lift carrying skiers up the hill.  Eventually the energy is used to transport electrons across membranes in the "electron transport chain" and ATP is created (skiers set free to fly down the hill).  To beat the analogy to death, CoQ10 is a bit like the attendants at the top of the ski lift, making sure everyone gets off the lift okay, and guiding skiers between lifts.  While small doses of CoQ10 didn't seem to help symptoms of Parkinson's large doses (1200mg) seemed mildly helpful, and even larger doses are being tried now.  

Creatine is a compound made from amino acids, and basically helps the body make ATP more easily.  According to the Wikipedia article, we make a lot of creatine from dietary amino acids, but about half of our creatine is taken directly from eating skeletal muscle, and the muscles of vegetarians are lower in creatine.  In animal studies, supplementation with creatine (combined with CoQ10) was helpful for Parkinson's symptoms.

Anyone who reads "statin skeptic" literature knows that statins lower CoQ10 levels.  A pubmed search reveals a lot of papers on the subject - questions arise as to whether statins cause heart failure due to CoQ10 depletion - the heart, like the brain, is energy-hungry, and CoQ10 depletion over time might damage the heart (the study I linked showed lower CoQ10 in statin users and worse heart failure in people with low CoQ10, but no link between statin use and worsening of heart failure...)  There are also questions if the CoQ10 depletion causes ALS (Lou Gerhig's disease) and whether the CoQ10 depletion causes the known (rare) statin side effect, diabetes.  

So the obvious question is - would statins cause Parkinsons?  This small study found that there didn't seem to be a link between Parkinson's progression and statin use, and this brief editorial notes that in population studies, higher LDL cholesterol levels are associated with lower risk of Parkinson's disease, but in the Rotterdam study, statin use seemed to have no correlation with Parkinson's disease risk, and other small studies showed the use of cholesterol-lowering drugs was associated with a decreased risk of Parkinson's.  Turns out that serum cholesterol levels (and triglycerides) are the strongest determinant of serum CoQ10 levels - the reason being that CoQ10 rides along with the lipoprotein complexes in the body.  Moderate alcohol use also seems to be associated with CoQ10 increases.  And the best dietary sources of CoQ10?  Meat, eggs, and certain vegetables such as broccoli.  Dietary intake wasn't correlated that much with serum levels, though that could be because serum levels had more to do with how much cholesterol was floating around.

What can I make of this confusing mess?  CoQ10 is a powerful antioxidant, one of whose jobs is likely to protect cholesterol and triglycerides as they are transported through the scary circulatory system.   People with lots of inflammation will have high triglycerides, high cholesterol, and high CoQ10.  The high CoQ10 is probably protective against Parkinson's disease (and perhaps a robust amount of cholesterol is too).  Statins are also antioxidant and antiinflammatory, so it is possible that those attributes make up for obliterating the cholesterol making machinery and depleting the body's CoQ10, at least in the case of Parkinson's disease.  The jury, though, is still out.


  1. hmmm this isnt very related really but i have a question... cholesterol is made in to pregneglone(sp?) which goes to DHEA the hormones... how does one determine how DHEA is used and transported and which hormones it is made into? from reading, inflammation plays a role in how they are chosen, as well as the sex organs relation to the brain... anyway, might CoQ10 assist cholesterols transport to DHEA?

    im still learning/reading so i could have a lot of this off but am curious!

  2. i'm a huge fan of mitochondria boosters, as these are the components/supplements that helped me the most in the past with my CFS/FM symptoms, especially with regard to fatigue, brain fog and physical performance (before i found out that most of that was caused by gluten and food intolerances, and nutritional deficiencies as a result. at least that's what i believe so far). interestingly tho, CoQ10, and even the "activated" QH never had any noticeable effect on me, in contrast to say, NADH or Ribose (two VERY cool supplements!). would be cool if you maybe could do a post on other aspects or substances which directly influence mitochondria performance or m. stress tolerance.

  3. Doc Emily, really appreciate your fresh blogging, I have been following paleo blogs for about two years now and incorporate many tricks and tips into my lifestyle. You bring a fresh alternative as other bloggers have been really helpful and provide excellent perspective, however, most have seemed to have run out of steam and becoming just another ******* Betty Crocker cookbook.
    Thank you for drilling down to the nuts and bolts of evolutional psychology and providing fresh insight to evolutionary medicine. If I need a cookbook the bookstores are full of them.

    Again thanks

  4. Malpaz - I don't know - I will have to look into that.

    Qualia - I knew someone with chronic fatigue who had benefit from ribose. Another thing to look into!

    Thanks Dave! I do try to keep it biological. With many scientists and doctors reading, there needs to be a certain amount of technical info, but I hope that (for the most part) I keep it simple enough for people without years and years of biology. The upside of paleo is that it gives you an entirely knew (old) intuitive framework through which to view science. The downside is that the answers are nearly always the same - terrific food, rest, fun, and sleep. The only way to keep it new is to pick apart all the paleo questions - as much to find things that don't meet the theory as to find new ways that a standard American diet might be harmful.