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Author: Michael Janson, M.D.

Coenzyme Q10 is essential for the production of energy in every cell, in the membranes of the tiny engines called mitochondria. It is especially abundant in heart muscle, and it is an excellent antioxidant, about four times more potent than vitamin E in some studies. Supplements can help angina, shortness of breath, congestive heart failure, arrhythmias, and high blood pressure. CoQ10 also increases exercise tolerance. Side benefits of taking CoQ10 are improved immunity, increased general energy levels, and protection from free-radical damage associated with aging.

Although CoQ10 is not really a vitamin because your body makes it, the amount you make declines with age and illness. The typical dose for treatment of heart disease is 100 to 400 mg daily, depending on the severity of the problem. For prevention, I think it is a good idea to take 50 to 100 mg a day, especially if you are over forty, if you have any other illness, or you have a family history of heart disease.

Another supplement that helps the heart is L-carnitine. This derivative of amino acids is essential for transport of fatty acids across the membranes of the mitochondria where they are used for energy production (this is how it works well with coenzyme Q10). When there is pain due to lack of oxygen in heart muscle (angina), the level of L-carnitine drops dramatically, and the heart muscle switches to glucose metabolism instead of fat. As a result, more lactic acid is produced, and this makes the pain worse. If there is enough L-carnitine available in advance, the pain is lessened, and the likelihood of damage to the heart is reduced. Although you normally produce L-carnitine, as with some other essential substances the production declines with age.

References:
Supplements to Treat Heart Disease
Crestanello JA, et al., Elucidation of a tripartite mechanism underlying the improvement in cardiac tolerance to ischemia by coenzyme Q10 pretreatment. J Thorac Cardiovasc Surg 1996 Feb;111(2):443-50.
Baggio E, et al., Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure (interim analysis). Clin Investig 1993:71(8 Suppl);S145-9.
Morisco C. t ao., Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. Clin Investig 1993:71(8 Suppl);S134-5.
Mortensen SA, Perspectives on therapy of cardiovascular diseases with coenzyme Q10 (ubiquinone). Clin Investig 1993:71(8 Suppl);S116-23.
Ghindini O, et al., Evaluation of the therapeutic efficacy of L-carnitine in congestive heart failure. Int J Clin Pharmacol Ther Toxicol 1988 Apr;26(4):217-20.