Confusion Over CoQ10 effectiveness

Question
QUESTION: I read much about the benefits of CoQ10, especially for the heart health. There are claims that CoQ10 inhibits blood clot formation. However, these claims contradict other claims that CoQ10 has properties similar to K2, in that it can be a coagulant. How can CoQ10 be a blood clot inhibitor and a coagulant at the same time? If Coq10 diminishes the effectiveness of a blood thinner drug (coumadin, for example), one can deduct that Coq10 is, indeed, a coagulant? Therefore, if coq10 is a coagulant (causes blood clots), how can it be beneficial to the cardiovascular system? Can you please clarify the confusion or these contradicting claims?

ANSWER: Hi Dominic,
CoQ10 is similar in structure to Vitamin K, and may possibly initiate the clotting cascade, causing clots to form more easily, and thus blocking the effects of coumadin (anti-coagulants).   "Blood thinner" is really a misnomer;  coumadin doesn't make your blood runnier or thinner, but just inhibits the formation of clotting by blocking the clotting cascade.

So yes, if you are on coumadin, you probably shouldn't use CoQ10!
As far as CoQ10 claims for inhibiting blood clot formation, I haven't any evidence for this;  if you can provide a website with that information, I would appreciate this.

However, the "claimed" cardiovascular benefits of CoQ10 are that it helps to lower blood pressure, and may be good for certain types of cardiac disease, such as heart failure.  However, the research in this area is sketchy at best;  no cause or effect has been proven to date.  For example, it has been found that people with high blood pressure have low levels of naturally occurring CoQ10, but this doesn't prove that increasing CoQ10 will lower blood pressure definitively.   

I hope this clears up your confusion about CoQ10, Dominic.
Crystal





---------- FOLLOW-UP ----------

QUESTION: Hello Crystal,

Thanks for the response.

The following website suggests that CoQ10 inhibits blood clot formation:

http://www.umm.edu/altmed/articles/coenzyme-q10-000295.htm

How can anyone make such contradictory claims!

This is scary, as I was planning on taking CoQ10 for my high level of cholesterol as well as for my heart health. But if CoQ10 is prone to causing clots more easily, how can one recommend it to someone with heart-related issues? Blood clots can lead to deadly strokes - so, CoQ10 is not safe, even if blood thinners are not taken simultaneously?
I would have preferred CoQ10 over cholestorol lowering drugs, such as Lipotor, but CoQ10's propensity to promote or to cause blood clots makes me wonder - if CoQ10 causes clots, what's the use of having someone, such as a diabetic, with a weak heart take it?

Thanks,
Dominic

ANSWER: Hi Dominic,
Hopefully my answer will clear your confusion.  I went to the website to see what you were referring to.  Yes indeed, it does say Q (I'm just going to abbreviate CoQ10 as "Q" so I don't have to keep typing it) inhibits blood clot formation.  I need more info to see which mechanism of action is involved to answer this seemingly paradoxical question.

I will confirm that YES indeed, Q does effectively inhibit blood clot formation via it's anti-platelet effects.  This means that it will reduce the amount of sticky platelets that like to collect and stack up around any kind of cell injury or fatty streaks in our blood vessels (especially for someone like you who has high blood cholesterol, which means you have atherosclerosis, and at higher risk of heart attack, stroke, deep vein thrombosis, etc.)  The fatty thrombus (clot formed from cholesterol stuck to the inside of your blood vessels) sometimes comes loose from the vessel wall, causing vessel wall injury.  In response to this injury, platelets immediately rush to the area and cover the thrombus, just making it more likely to block your vessels, thus causing a heart attack, stroke, (depends on where the clot is).   That's where Q comes in....it prevents the platelets from gathering at the cholesterol plaque and reduces your risk of making that clot and occluding a major blood vessel.

The confusion was when you should not take Q with coumadin because Q has a similar structure to Vitamin K.   Coumadin works differently than aspirin does in reducing clots.  They work via different clotting pathways in the body.  Coumadin blocks vitamin K where aspirin blocks platelets.  The only reason for the warning for NOT taking Q is   ONLY if you are taking coumadin, because it may render the coumadin useless.   It will NOT cause you to have a blood clot in a normal person that is not taking coumadin.   
Let's look at it this way:  vitamin K is recommended for most people because it helps the blood to clot better in case of an injury.  It does not cause a person to have a blood clot that will cause a heart attack;  it's only for injury related clotting to save your life from excessive bleeding, like when you cut your finger or get in a an accident.  You need to have good levels of Vitamin K for proper clotting (in this case, clotting is not dangerous, it is necessary for life!).     The only problem arises when people have certain conditions such as atrial fibrillation where the blood is pooling in their heart, and is more likely to start clotting;  this presents a danger, because if the clot enters the heart, it can block the lungs or cause stroke.   But in this case, the problem isn't with the person' clotting mechanism (they don't have thick blood or anything like that);  the problem is that their heart is not working correctly as a pump, and so anything that causes the blood to pool will automatically start making clots more likely.   So in this case, this patient has to be prescribed coumadin only because their blood is pooling, not because they have thick blood or a propensity to develop clots any more than the average person.  In this specific case, they have to take coumadin to prevent the pooling-induced clots, and if they take Q, it might block the life-saving effect of the coumadin.
In no way though should Q cause you to actually have a dangerous/pathological blood clot as you are referring to;  only healthy normal clotting that is necessary to keep you from bleeding to death from an injury.    So think of Q like Vitamin K....it's healthy and essential for life, and protects you from bleeding to death, but will not cause you to have an atherosclerotic plaque leading to heart attack stroke.   Q causes similar effects to aspirin (inhibits platelets).  
Although this was a lengthy discussion, it was necessary to fully explain to you the pathways of clotting, so that you understand exactly what is happening in the body.
Please let me know if this answer was satisfactory, ok Dominic?
Good luck!!!!
ps.  Lipitor and other statins are often co-prescribed with Q, so they actually work synergistically.

---------- FOLLOW-UP ----------

QUESTION: Hello Crystal,

Thank you for your time and patience with me.

I fully understood your point. However, on the following website :

http://forum.lef.org/default.aspx?f=35&m=22484

read the experience with CoQ10 from "jimmyboy" who claimed CoQ10 caused blood clots in his anal veins. Despite what others countered, he suggested to avoid CoQ10 like a PLAGUE. Further down, in response to other members' querries, he offered other websites suggesting that, depending perhaps on one's genetic structure, CoQ10 can either have blood clotting or thinning effect. His experience with CoQ10, although uniquely different from what others in the forum claimed to the contrary, appears to be confirming the truth based a personal experience. Here's the story:
A friend of mine recommended to his eldest sister, diabetic with a weak heart, take CoQ10 100mg while she was on coumadin (he probably was not aware then that his sister was taking coumadin). Two days later, she suffered a huge loss of blood requiring emergency attention. You will note, as I suspect - perhaps wrongly, that Coq10 taken with coumadin did not cause blood clotting but rather blood thinning to have caused such great loss of blood in the intestines. No blood clots were found in her cardiovascular system. Therefore, this event defies the original premise that CoQ10 taken with coumadin negates or reverses coumadin's purpose. This clearly tells me that Coq10 taken with coumadin may cause the blood to thin even more than expected. As a result of this event, the doctors removed her from the drug, coumadin. This patient continued to complain about her heart and feeling weak. Doctors could not operate on her, because of her age and diabetic condition, so her brother gave her again the same Coq10, believing it was safe as she was no longer taking coumadin or any other thinning drug. She started to feel better and stronger, but two days later she suffered a massive stroke due to blood clots in her brain, leaving her paralyzed. This seems to confirm what "jimmyboy" claimed in the forum, referred to above, that CoQ10 can cause dangerous clots, making me wonder if the benefits of CoQ10 outweigh the negatives.  Is this story revealing?

I personally take CoQ10 every now or then, especially as a pain reliever, but, now in view of these experiences and deeper research, I am beginning to wonder if I am not causing more harm to my health by continuing to take Coq10. My wife, a virtually non-bliever in alternative supplements, seems to believe in the benefits of Coq10 - perhaps, because she, like most people, hasn't read yet about the blood clotting possibilities engendered by CoQ10, taken with or without other prescription drugs.

Does this tell you anything, beyond what you have known about Coq10 so far?

Regards,
Dominic

Thanks,
Dominic


Answer
Hi Dominic,
Well, based on the history of this lady, it sounds like she was on a high dose of Coumadin, and suffered intestinal bleeding, which can be a common side effect/risk.  If her dose of Coumadin was high enough, the CoQ10 probably wasn't enough to counteract it, so I doubt that it really played any role here.
As far as her clots after the coumadin was removed, well, that's the most likely cause of her stroke.....taking her off the coumadin.   It is unlikely that the CoQ10 caused it.  

I would say that the CoQ10 was not really responsible for what you describe here, and it was all due to the presence of coumadin, and the then the subsequent removal of coumadin.

You should probably do more research about people's experiences with CoQ10 if you are concerned about the effects on your health.  Go to forums and see what people are saying about any side effects.   Remember though, that it can be hard to determine if CoQ10 is actually responsible for side effects happening, especially if they are taking multiple medications.

Crystal

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