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As noted above, there are reported cases of CoQ10 countering the action of warfarin. Thus, the physician prescribing
warfarin may need to adjust the warfarin dose if CoQ10 is to be used and therefore must be consulted.34,35
The following drugs may reduce the body’s levels of CoQ10:
1. Orlistat: reduces CoQ10 absorption.36
2. Beta blockers: decreases CoQ10 synthesis.37
3. Biguanides: decreases CoQ10 synthesis.38
4. Clondine: decreases CoQ10 synthesis.39
5. Gemfibrozil: (cholesterol-lowering drug).40
6. Haloperidol: decreases CoQ10 synthesis.41
7. HMG-CoA Reductase inhibitors: decreases CoQ10 synthesis.42
8. Hydralazine: decreases CoQ10 synthesis.37
9. Methydopa: decreases CoQ10 synthesis.39
10. Phenothiazines: decreases CoQ10 synthesis.41
11. Sulfonylureas: some of these drugs decrease CoQ10 synthesis (acetohexamide, glyburide, tolazamide).38
12. Thiazide Diuretics: decrease CoQ10 synthesis.39
13. Tricyclic Antidepressants: decrease CoQ10 synthesis.41
1. Folkers K, Yamamura Y, editors. Biomedical and clinical aspects of coenzyme Q. Vol 1. Amsterdam: Elsevier/North-Holland Biomedical
Press; 1977.
2. Yamamura Y, Folkers K and Ito Y, editors. Biomedical and clinical aspects of coenzyme Q. Vol 2. Amsterdam, Holland; Elsevier/North-
Holland Biomedical Press; 1980.
3. Folkers K, Yamamura Y, editors. Biomedical and clinical aspects of coenzyme Q. Vol 3. Amsterdam: Elsevier/North-Holland biomedical
Press; 1981.
4. Folkers K, Yamamura Y, editors. Biomedical and clinical aspects of Coenzyme Q. Vol 4. Amsterdam: Elsevier Science Publ; 1984.
5. Frei B, Kim MC, Ames BN. Ubiquinenol-10 is an effective lipid-soluble antioxidant at physiological concentrations. Proc Natl Acad Sce
1990;87:4879-83.
6. Weber C, Jakobsen TS, Mortensen SA, Paulsen G, Holmer G. Effect of dietary coenzyme Q10 as an antioxidant in human plasma. Mol Aspects Med 1994;15(Suppl):97S-102S.
7. Folkers K, et al. Increase in levels of lgG in serum of patients treated with coenzyme Q10. Res Commun Chem Pathol Pharnacol
1982;38:335.
8. Reavely N. New encyclopedia of vitamins, minerals, supplements and herbs. New York: Evans M and Company, Inc.; 1998. p. 353-61.
9. Kitamura N, Yamaguchi A, Otaki M, Sawatani O, Minoji T, Tamura H, et al. Mycocardial tissue level of coenzyme Q10 in patients with cardiac
failure. In: Folkers K, Yamamura Y, editors. Biomedical and Clinical Aspects of Coenzyme Q, Vol 4. Amsterdam, Holland: Elsvier
Science,Publ; 1984. p. 243-52.
10. Littarru GP, Ho L, Folkers K. Deficiency of coenzyme Q10 in human heart disease, Part II. Int J Vit Nutr Res 1972;42:413.
11. Folkders K, et al. Evidence for a deficiency of coenzyme Q10 in human heart disease. Int J Vit Res 1970;40:380.
12. Folkers K, Vadhanavikit S, Mortensen SA. Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with
coenzyme Q10. Proc Natl Acad Sci 1985;82:901.
13. Langsjoen H, Langsjoen P, Langsjoen P, Willis R, Folkers K. Usefulness of coenzyme Q10 in clinical cardiology: A long-term study. Mol
Aspects Med 1994;1(Suppl):165S-75S.
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Accessory Nutrients and Essential Oils
14. Tsuyusaki T, Noro C, Kikawada R. Mechanocardiography of ischemic or hypertensive heart failure. In: Yamamura Y, Folkers K, Ito Y, editors.
Biomedical and clinical aspects of coenzyme Q. Vol 2. Amsterdam, Holland; Elsevier/North-Holland Biomedical Press; 1980. p. 273-88.
15. Judy WV, Hall JT, Toth PD, Folkers K. Myocardial effects of co-enzyme Q10 in primary heart failure. In: Folkers K, Yamamura Y, editors.
Biomedical and clinical aspects of Coenzyme Q. Vol 4. Amsterdam: Elsevier Science Publ; 1984. p. 281-90.
16. Langsjoen PH, Vadhanavikit S, Folkers K. Response of patients in classes III and IV of cardiomyopathy to therapy in a blind and crossover
trial with coenzyme Q10. Proc Natl Acad Sci 1985;82:4240-4.
17. Morisco C, Trimarco B, Condorelli M. Effect of CoQ10 therapy in patients with congestive heart failure: A long-term multicenter randomized
study. Clin Invest 1993;71(Suppl):134S-6S.
18. Baggio E, Gandini R, Plancher AC, Passeri M, Carmosino G. Italian multicenter study on the safety and efficacy of coenzyme Q10 as
adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 1994;15(Suppl):287S-94S.
19. Kamikawa T, Kobayashi A, Yamashita T, Hayashi H, Yamazaki N. Effects of coenzyme Q10 on exercise tolerance in chronic stable angina
pectoris. Am J Cariol 1985;56:247-51.
20. Digiesi V, Cantini F, Brodbeck B. Coenzyme Q10 in essential hypertension. Mol Aspects Med 1994;15(Suppl):257S-63S.
21. Langsjoen P, et al. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;15:265-72.
22. Digiesi V, Cantini F, Bisi G, et al. Mechanism of action of coenzyme Q10 in essential hypertension. Curr Thes Res 1992;51:668-72.
23. Nakamura R, Littrau GP, Folkers K, Wilkinson EG. Study of Co Q10 enzymes in gingiva from patients with periodontal disease and evidence
for a deficiency of coenzyme Q10. Proc Natl Acad Sci 1974;71:1456.
24. Wilkinson EG, Arnold RM, Folkers K. Treatment of periodontal and other soft tissue diseases of the oral cavity with coenzyme Q10. In:
Folkers K, Yamamura Y, editors. Biomedical and clinical aspects of coenzyme Q. Vol 1. Amsterdam: Elsevier/North-Holland Biomedical
Press; 1977. p. 251-65.
25. Ylikoski T, Piirainen J, Hanninen O, Penttinen J. The effect of coenzyme Q10 on the exercise performance of cross-country skiers. Mol
Aspects Med 1997;18(Suppl):283S-90S.
26. Vanfraechem JHP, Folkers K. Coenzyme Q10 and physical performance. In: Folkers K, Yamamura Y, editors. Biomedical and clinical
aspects of coenzyme Q. Vol 3. Amsterdam: Elsevier/North-Holland biomedical Press; 1981. p. 235-41.
27. Murry M. Encyclopedia of Nutritional Supplements. Rocklin, CA: Prima Publishing; 1996. p. 296-308.
28. Mortensen SA, Leth A, Agner E, Rohde M. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductate
inhibitors. Mol Aspects Med 1997;18(Suppl):137S-44S.
29. Bargossi AM, Grossi G, Fiorella PL, Gaddi A, Di Giulio R, Battino M. Exogenous CoQ10 supplementation prevents plasma ubiquinone
reduction induced by HMG-CoA reductate inhibitors. Mol Aspects Med 1994;15(Suppl):187S-93S.
30. Hamada M, Kazarani Y, Ochi T, Ito T, Kokubu T. Correlatio between serum CoQ10 level and myocordiol contractility in hypertensive patients.
In: Folkers K, Yamamura Y, editors. Biomedical and clinical aspects of Coenzyme Q. Vol 4. Amsterdam: Elsevier Science Publ; 1984. p.
263-70.
31. Judy WV, Hall JH, Dugan W, Toth PD, Folkers K. Coenzyme Q10 reduction in adriamycin cardiotoxicity. In: Folkers K, Yamamura Y, editors.
Biomedical and clinical aspects of Coenzyme Q. Vol 4. Amsterdam: Elsevier Science Publ; 1984. p. 231-41.
32. Iarussi D, Auricchio U, Agretto A, Murano A, Giuliano M, Casale F, et al. Protective effect of coenzyme Q10 on anthracyclines cardiotoxicity:
Control study in children with acute lyphhoblastic leukemia and non-Hodgkin lymphoma. Mol Aspects Med, 1994;15(Suppl):207S-12S.
33. Kishi T, Makino K, Okamoto T, Kishi H, Folkers K. Inhibition of myocardial respiration by psychotherapeutic drugs and prevention by
coenzyme Q. In: Yamamura Y, Folkers K and Ito Y, editors. Biomedical and clinical aspects of coenzyme Q. Vol 2. Amsterdam, Holland;
Elsevier/North-Holland Biomedical Press; 1980. Pg. 139–54.
34. Heck AM, Deweitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm
2000;57(13):1221-30.
35. Landbo C, Almdal TP. Interaction between warfarin and coenzyme Q10. Ugeskr Laeger. 1998;160(22):3226-7.
36. Xenical (orlistat), Product Prescribing Information. Nutley, NJ: Roche Laboratories, Inc., Sept 2000.
37. Kishi T, Watanabe T, Folkers K. Bioenergetics in clinical medicine XV. Inhibition of coenzyme Q10-enzymes by clinically used adrenergic
blockers of beta-receptors. Res Commun Chem Pathol Pharmacol. 1977;17(1):157-64.
38. Kishi T, Kishi H, Watanabe T, Folkers K. Bioenergetics in clinical medicine XI. Studies on coenzyme Q and Diabetes Mellitus. J Med
1976;7(3):307-21.
39. Kishi H, Kishi T, Folkers K. Bioenergetics in clinical medicine. III. Inhibition of coenzyme Q10-enzymes by clinically used anti-hypertensive
drugs. Res Commun Chem Pathol Pharmacol 1975;12(3):533-40.
40. Aberg F, Appelkvist EL, Bröijersén A, Eriksson M, Angelin B, Hjemdahl P, et al. Gemfibrozil-induced decrease in serum Ubiquinone and alpha- and gamma-tocopherol levels in men with combined hyperlipidaemia. Eur J Clin Invest 1998;28(3):235-42.
41. Kishi T, Makino K, Okamoto T, Kishi H, Folkers K. Inhibition of myocardial respiration by psychotherapeutic drugs and prevention by
coenzyme Q10. In: Biomedical and clinical aspects of coenzyme Q10. Yamamura Y, Folkers K, Ito Y, editors. Vol 2. Amsterdam:
Elsevier/North-Holland Biomedical Press; 1980. p. 139-54.
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Accessory Nutrients and Essential Oils
42. Ghirlanda G, Oradei A, Manto A, Lippa S, Uccioli L, Caputo S, et al. Evidence of plasma Co10- lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study. J Clin Pharmacol 1993;33(3):226-9.
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Meschino Health Comprehensive Guide to Accessory Nutrients and Essential Oils
Accessory Nutrients and Essential Oils
Creatine
General Features
It is now widely accepted that Creatine supplementation can increase muscle strength and mass.1,2,3,4 Creatine is an
amino acid that is stored in muscle in the form of Creatine phosphate. During explosive or intensive exercise, Creatine
phosphate is broken down by a specific enzyme to yield Creatine, plus phosphate, plus free energy. The free energy
released from the breakdown of Creatine phosphate is used to regenerate ATP, which is the fuel that powers muscle
contraction.2
The normal daily requirement for Creatine is about 2 grams for a person weighing 70 kg. Animal protein (especially
meats) normally provides at least half that amount, with approximately one gram per day synthesized by the liver. A
half-pound of raw meat contains about 1 gram of Creatine, but fish is also a good source.
A number of recent studies have demonstrated that short-term Creatine supplementation increases Creatine
phosphate stores in skeletal muscle by 10% to 40%.3 This in turn leads to an increase in muscle mass, which is
thought to occur from increased protein synthesis, as the muscle lays down an increased number of contractile
myofilaments (protein bands that contract and generate force). Increased muscular fluid retention may also participate
in muscle volume gains with Creatine use.5,6,7 Creatine has also been shown to provide antioxidant properties. This
may be of some significance as free radicals generated from exercise can af ect muscle fatigue and protein turnover.24
It also appears that Creatine supplementation may allow athletes to train harder (due to increased available energy for
muscle concentration), which promotes strength gains, and increases muscle size due to hypertrophy (larger muscle
fiber size).2,3
The established protocol for Creatine supplementation used by athletes involves a loading dosage of 20 to 25 grams
per day for the first 5 to 7 days. Typically an athlete will mix a heaping teaspoon of Creatine monohydrate crystals into
a glass of juice to obtain about 5 grams of Creatine. During the loading phase the athlete does this on 4 or 5 occasions
throughout the day to attain an intake of 20-25 grams. After the loading phase is completed, the maintenance daily
dosage is usually 5 to 10 grams per day. Recent reports suggest that taking Creatine with glucose (a simple
carbohydrate) may increase the amount of Creatine absorbed by the muscles. As such, some manufacturers combine
Creatine with carbohydrates in a premix product to help improve Creatine delivery to muscles.25
Clinical Application and Mechanism of Action