Vitamin cofactor proves well-tolerated with minimal side effects
By Jackie Sharp, CNP
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Pulmonary arterial hypertension (PAH) is a disease that affects the blood vessels of the lungs, causing high pressure that leads to heart failure. Abnormalities of the intracellular organelle, the mitochondria, are present in the blood vessels of patients with PAH. The mitochondria are the cell’s powerhouse, producing energy, but also are required for producing the heme that is used in hemoglobin in red blood cells. Coenzyme Q (CoQ10) is a vitamin cofactor that is essential for mitochondrial functions.
Recently, CoQ10 has been shown to improve cardiac function in heart failure patients through its effects on the mitochondria, so we hypothesized that CoQ10 might improve mitochondrial functions in energy and heme production and thus benefit PAH patients.
We conducted a prospective study in which eight PAH patients and seven healthy controls were supplemented with oral CoQ10 (100 mg, three times a day) for 12 weeks. CoQ10 levels were similar among PAH and control individuals at baseline. However, PAH patients had higher CoQ10 levels than controls after taking CoQ10.
Many studies have identified abnormalities in iron metabolism and red blood cells in pulmonary hypertension patients. In our work, we found similar abnormalities in patients at baseline, but also found that CoQ10 improved the hemoglobin content of red blood cells that increased in the PAH patients. These changes were not seen in healthy subjects. In fact, hemoglobin decreased slightly in healthy controls. CoQ10 improved right heart function in PAH subjects, but exercise and other markers of heart failure, such as serum brain natriuretic peptide levels, did not improve over the course of the three-month study.
Equally important, CoQ10 was well-tolerated in this study, confirming the minimal side effects of supplementation. The decrease in immature red blood cells, improvements in heart function by echocardiogram and increased red cell hemoglobin at 12 weeks suggest that trials of longer duration and/or higher doses of CoQ10, may demonstrate benefit for patients with PAH.
Jackie Sharp is a certified nurse practitioner in the Pathology Department of Cleveland Clinic’s Lerner Research Institute.
Note: These results are preliminary, and we do not recommend at this time that patients take CoQ10 for the prevention or treatment of pulmonary hypertension unless advised to do so by their physician.
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