CoQ10 for Ultra-Endurance Athletes: 150mg of Ubiquinone Reduce Stress & Inflammation and Stabilize Cell Membranes in 52.4 Mile Torture from 640m to 3,393m!

Image 1: Susan Kokesh, blogger and the Crazy Running Mum at the Sierra Nevada ultra-endurance run a 52.4 miles "double marathon"
  in September 2010; I probably would not even have survived this torture - respect!

As a health conscious physcial culturist, you are probably aware that the vitaminesque nutrient CoQ10, which, due to its ubiquitous presence in all living beings, is also known as ubiqinone, plays a fundamental role in cellular bioenergetics. It is a necessary cofactor in the mitochondrial electron transport chain (i.e. your cell's way of "breathing", its respiratory chain) and is therefore essential for the production of ATP, the fundamental energy unit your cells are operating on. In that, CoQ10 works as a mobile redox agent that shuttles electrons and, interestingly, also protons (those little blue and red balls from Bohr's atom model ;-) in the electron transport chain. Within the health and fitness community, it is however better known for its antioxidant value, as in its reduced form, ubiquinol, it is a potent lipophilic (which means that it does not combine with fats) antioxidant, which is able to recycle and regenerate other antioxidants, such as vitamin E and vitamin C (Ernster. 1995). Moreover, CoQ10 participates in cell signaling and gene expression and has been used as a dietary supplement (among others) for the treatment of neurodegenerative diseases and statin-induced myopathies.

In view of its pluripotent influence on mammalian metabolism (on a side note: the "-10" in CoQ10 indicates the length of the isoprenoid sidechain that is attached to the common benzoquinone ring structure; the latter is unique and can be found in humans and a few other mammals only), it should thus not surprise you that Chavier Díaz-Castro and his collegues from the University of Granada report that the intake of 150mg of the natural version of CoQ10 (2,3-dimethoxy-5-methyl-6-decaprenyl-1,4-benzoquinone; natural = has trans configuration), profoundly modulated "the undesirable effects of the evoked oxidative stress and inflammation signaling during high-intensity" (Díaz-Castro. 2011).

Illustration 1: Supplementational protocol used in the study; CoQ10 was administered as 2,3-dimethoxy-5-methyl-6-decaprenyl-1,4-benzoquinone in powder form in 30mg capsules.

As you can see in illustration 1, the 20 highly trained male amateur athletes (all had run The Sierra Nevada ultra-endurance race in the previous 2 years), who participated in the study were not given the whole dose of 150mg of CoQ10 at once, but followed what I would like to call a "loading protocol" in the two days before the event. The placebo group received an identically looking product containing beer yeast, cellulose,
acacia, silica stearic acid, magnesium stearate, cellulose gum, and maltodextrin.

The total distance of The Sierra Nevada run is >50km. It is considered one of the hardest trials worldwide, mainly because the run, in the course of which the participants "climb" from 640m to a final altitude of  3,393m is almost on a continuous incline! A 5.5 hour torture, for which the CoQ10 supplemented athletes needed on average ~25min less than the subjects in the placebo group. In this study, the exercise performance was yet of negligible importance. What the scientists were really interested were the markers of oxidative damage and inflammation and as the following data shows, those were markedly influenced by the ingestion of this rather "mediocre" (compared to what you see some "health-gurus" advocate) amount of CoQ10.

Figure 1: Effects of CoQ10 supplementation of total bilirubin, triglycerides and urinary creatinine in 20 ultra-endurance runners (data calculated based on Díaz-Castro. 2011)

As you can see in figure 1, CoQ10 induced a significant reduction in urinary creatinine even before the race started (figure 1, left column). Moreover, there were significant differences in the bilirubin (indicates heme catabolism), triglycerides and (again) creatinine (indicates net protein catabolism):

Intense physical exercise resulted in an increase in net protein catabolism and an increase in
creatinine excretion in the PG after the physical test (p < 0.001); however, the urinary levels of creatinine were lower (p < 0.05 before and p < 0.001 after the physical test) in the CoQ10 treated group. Other interesting result was that although there was an increase in urinary creatinine in the CG, it was lower than in PG (38.77 ± 10.20 vs. 88.23 ± 11.21, p < 0.05). We also observed a decrease in the bilirubin concentrations in the CG after the run (p < 0.001) with lower values compared to PG group.

There were also significant differences in the inflammatory response, with (statistically significant, p<0.05) lower values of interleukin 6 (IL-6; -32%) and TNF-alpha (-23%) before the start of the race, and -22% lower TNF-alpha values after the "torture". Moreover, the basal hydroper-oxide content in the erythrocyte membranes, the scientists measured as an indicator of the degree of oxidative stress were lower before and after the exercise test, as the scientists call it.

Taken together, these results suggest that the addition of a small dose of CoQ10 to your supplemental regimen could induce unexpectedly profound cell-stabilizing benefits, of which it would yet be interesting to see how those translate into performance benefits, health and longevity, in the long run.

300mg CoQ10 Boost Peak Power Increases in Young Elite Athletes. Plus: 140ml of Beet Root Juice, That's all it Takes to Minimize the Oxygen Demands During a Workout

Athletes from various sports train at the Olympic Camp, where the CoQ10 study was conducted.

As unfortunate as it may sound, the number of "next big things" in the area of performance enhancing (legal) substances - at least in large parts - a line-up of supplemental non-starters. Against that background it is all the more surprising that today' SuppVersity article features not one, but two already available supplements that could in fact make a valuable contribution to your workout regimen. And while we are going to take a brief look at the latest research on the ergogenic effects of beet root juice later, we will start out with a study the results of which did actually surprise me - in a positive sense, that is.

• Reduced CoQ10 (ubiquinol) increases peak power in trained athletes (Alf. 2013) -- While previous studies on the efficiacy of CoQ10 demonstrated at best inconclusive and statistically, but mostly practically insignificant benefits, the latest study from the Olympiastützpunkt Rhein-Ruhr in Essen, Germany, reports a whopping +11% increase in peak power per kg body mass in the 53 males and 47 females young German athletes (average age 19.2 years, height 181 cm, weight 78 kg) who consumed 5x 60mg ubiquinol, the completely reduced form of CoQ10, which comes in three redox states, i.e. fully oxidized (ubiquinone), semiquinone (ubisemiquinone), and fully reduced (ubiquinol), on a daily basis day as a supplemental adjunct to their 6-week training regimen.
  

  

  Figure 1: Progress of absolute peak power in the placebo and 5x60mg ubiquinol group (Alf. 2013)

  While it is not possible to tell, whether it was the comparatively long study period (CoQ10 needs week to build up in the tissue; cf. Cooke 2008), the high dose of ubqiuinol (previous studies with 150mg did not yield comparable results, cf. Svensson. 1999) or a combination of both thats responsible for the ergogenic effects you see in figure 1 cannot be said for sure. What is however certain and actually pretty remarkable, if you take into account that these young athletes were all training regularly at the Olympic Training Camp Rhein-Ruhr in Essen and that many of them have been competing at the Olympic Games 2012 in London., is that the supplemented athletes did make 2.5% more out of  their 6 weeks at the camp.
  Addendum: In view of the fact, that Rick just asked about potential side effects on facebook and I assume that, smart as you are, you will immediately spot the 2009 study by Sumien et al. talking about detrimental effects on cognitive function, I want to point out that the human equivalent of 2.6mg/g chow the high dose group received would exceed an ubiquinol intake of >6g even for the lightweights of you. With 1/4 of the dosage not producing any long-term negative sides in the same rodent study, you are thus probably on the save side w/ 300mg/day. This hypothesis is by the way backed by a 2008 review by Hidaka who report a no-observed-adverse-effect level (NOAEL) of 1200 mg/kg/day derived from a 52-week chronic toxicity study in rats that would translate to 720 mg/day for a person weighing 60 kg (Hidaka. 2008)
  Moreover, the way in which the gap between the supplement and placebo group widens only in the last weeks of the intervention seem to support the previously mentioned "pre-loading hypothesisand raises the hope that the ergogenic effects will persist for more than just 6 weeks.
  
  

  

  CoQ10 did work in previous studies, but affected mostly serum markers not performance (learn more)

  The researchers also speculate that "older athletes and “weekend warriors” might profit even more from CoQ10 supplementation than young, well-trained athletes", as both age and the lack of training are associated with a lower mitochondrial density, of which Alf et al. suspect that it may be compensated for by the provision of CoQ10. In view of it's purported beneficial effects on ATP and creatinine phosphate synthesis, this may well be the case. I would yet still refrain from buying a year-long supply of the ubiquinol before respective evidence from independent trials is available. I mean, with the current price tag on ubiquinol, even an N=1 experiment with a 6-weeks supply of 300mg of ubiquinol per day would cost you ~$60 which is not exactly cheap, but could be worth a try - assuming you have the patients to wait for the results.

• 280ml beet root concentrate have well-established ergogenic effects, more is not necessary (Wylie. 2013) -- Right from the Exeter University comes a new study on the ergogenic effects of beet root juice. While the main message of the paper is that beet root juice supplementation can effectively increase nitric oxide levels and physical performance, the real interesting part of the paper deals with the dose-response relationship.
  
  

  

  There are a couple of important confounding factors which will determine whether or not you or anyone else can benefit from nitrate supplementation. Sex is yet - as far as I know know - not one of them... ah, by the way, there may be other benefits to nitrates that are "sex-specific", but in this case the semantics are somewhat different (learn more in a previous post on beet root  juice here at the SuppVersity ;-)

  Lee J. Wylie and his colleagues found that the provision of 70, 140 or 280 ml of concentrated beet root juice (BR), with 4.2, 8.4 and 16.8 mmol NO3- on six separate occasions increased the plasma concentration of NO2- in a dose-dependent manner, with the peak changes occurring at ~2-3 h. Of the three dosing regimen,
  

  "[...] only the higher dosages (140ml and 280ml) reduced the steady-state VO₂ during moderate-intensity exercise by 1.7% (P=0.06) and 3.0% (P<0.05), whilst time to task failure was extended by 14% and 12% (both P<0.05), respectively" (Wylie. 2013)

  As the scientists point out, these results indicate that "there is no additional improvement in exercise tolerance after ingesting BR containing 16.8 compared to 8.4 mmol NO3-".
  
  The dreaded carb overload that may have popped in your head, whenever you heard about using a natural NO3- supplement should not keep you from taking advantage of nature's very own "nitric oxide supplement" ;-)

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Bottom line: In view of the fact that ubiquinol and beet root juice act via totally different pathways, a direct comparison of the two obviously doesn't make sense. A combination of both on the other hand would. I would not expect any synergistic affects, but it is relatively save to assume that the effects will add up.One thing you should keep in mind, thoug,h is that only the beets will have acute effects and provide the instant gratification everybody seems to be striving for, these days. The effects of coqu10 n the other hand will manifest only weeks after you started taking it, so that you will - for want of an independent control you will thus simply have to beleive that its working ... after all, you don't know how much progress you wouls make without it.

References:

• Alf D, Schmidt ME, Siebrecht SC. Ubiquinol supplementation enhances peak power production in trained athletes: a double-blind, placebo controlled study. J Int Soc Sports Nutr. 2013 Apr 29;10(1):24. 
• 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 anduntrained individuals. J Int Soc Sports Nutr2008, 5:8.  
• Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K. Safety assessment of coenzyme Q10 (CoQ10). Biofactors. 2008;32(1-4):199-208.
• Sumien N, Heinrich KR, Shetty RA, Sohal RS, Forster MJ. Prolonged intake of coenzyme Q10 impairs cognitive functions in mice. J Nutr. 2009 Oct;139(10):1926-32. doi: 10.3945/jn.109.110437.
• Svensson M, Malm C, Tonkonogi M, Ekblom B, Sjodin B, Sahlin K: Effect of Q10 supplementation on tissue Q10 levels and adenine nucleotide catabolism during high-intensity exercise. Int J Sport Nutr1999, 9:166–180. 
• Wylie LJ, Kelly J, Bailey SJ, Blackwell JR, Skiba PF, Winyard PG, Jeukendrup AE, Vanhatalo A, Jones AM. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol. 2013 May 2.