Coenzyme Q10Coenzyme Q10 : : UbiquinoneUbiquinone

By: Jennifer HuaBy: Jennifer Hua

Colleen ShipmanColleen Shipman

HistoryHistory 1957 - Coenzyme Q10 was first isolated 1957 - Coenzyme Q10 was first isolated

from beef heart mitochondria by Dr. from beef heart mitochondria by Dr. Frederick Crane Frederick Crane

1958 - The precise chemical structure of 1958 - The precise chemical structure of Coenzyme Q10 was determined by Coenzyme Q10 was determined by professor Karl Folkers and collaborators at professor Karl Folkers and collaborators at Merck, Inc.Merck, Inc.

1961 - Coenzyme Q10 was considered as a 1961 - Coenzyme Q10 was considered as a potential treatment for cancer.potential treatment for cancer.

1964 – Coenzyme Q10 demonstrated its 1964 – Coenzyme Q10 demonstrated its usefulness for the treatment of congestive usefulness for the treatment of congestive heart failure. heart failure.

1970 – Coenzyme Q10 demonstrated its 1970 – Coenzyme Q10 demonstrated its effectiveness as an anti-oxidant.effectiveness as an anti-oxidant.

Biosynthesis of Coenzyme QBiosynthesis of Coenzyme Q1. Synthesis of the benzoquinone structure from either

tyrosine or phenylalanine

3. Condensation by the HMG-CoA reductase

2. Synthesis of the isoprene side chain from acetyl-coenzyme A via the mevalonate pathway.

Coenzyme Q10: UbiquinoneCoenzyme Q10: Ubiquinone

lipophilic, water-insoluble substances lipophilic, water-insoluble substances

benzoquinone “head” and terpinoid “tail” benzoquinone “head” and terpinoid “tail”

various coenzymes Q relate to the number of isoprenoid units (5-various coenzymes Q relate to the number of isoprenoid units (5-carbon structure) in the tailcarbon structure) in the tail

Can be one to 12 isoprenoid units Can be one to 12 isoprenoid units

10 isoprenoid units are the prevalent form in humans 10 isoprenoid units are the prevalent form in humans

Solid-waxlike substanceSolid-waxlike substance

present in most tissues

§ The highest concentrations is found in the heart, the liver, the kidneys, and the pancreas.

§ The lowest concentration is found in the lungs.

Oxidation States of Coenzyme Oxidation States of Coenzyme Q10: UbiquinoneQ10: Ubiquinone

Exists in three oxidation states.Exists in three oxidation states.

Functions of Coenzyme Q10: Functions of Coenzyme Q10: Mitochondrial ATP SynthesisMitochondrial ATP Synthesis

transfer electrons from complex I or complex II complex III. initially is reduced to the semi-ubiquinone radical and then ubiquinone by transfering electrons one at a time to complex III At the same time, transfers the protons outside the inner mitochondrial membrane, generates a proton gradient across the membrane. The energy released when the protons flow back into the mitochondrial interior is used to form ATP.

Plays an integral role in supplying energy to chemical reactions in the body

Functions of Coenzyme Q10: Functions of Coenzyme Q10: AntioxidantAntioxidant

neutralize free-radical

an effective lipid-soluble antioxidant

continuously go through an oxidation-reduction state

hold electrons loosely in its reduced form

regenerate α-tocopherol from the α-tocopheroxyl radical.

interact with dihydrolipoic acid. Dihydrolipoic acid reduces ubiquinone to ubiquinol

inhibit lipid peroxidation

occurs when cell membranes and low-density lipoproteins (LDL) are oxidized ex vivoMay prevent signs of skin aging

Functions of Coenzyme Q10: Functions of Coenzyme Q10: Lysosomal FunctionLysosomal Function

transport protons across lysosomal transport protons across lysosomal membranesmembranes

help to maintain the optimal pH for help to maintain the optimal pH for cellular recyclingcellular recycling

Disease Treatment of Disease Treatment of Coenzyme Q10: UbiquinoneCoenzyme Q10: Ubiquinone

Reliable and relatively consistent scientific data showing a substantial Reliable and relatively consistent scientific data showing a substantial health benefit forhealth benefit for Angina and HypertensionAngina and Hypertension

– Singh et. al. – double-blind, placebo-controlled studySingh et. al. – double-blind, placebo-controlled study 59 men already on hypertension medications had 120mg Coenzyme Q10 daily for 8 week59 men already on hypertension medications had 120mg Coenzyme Q10 daily for 8 week Blood pressure reduced by about 9% as compared to placeboBlood pressure reduced by about 9% as compared to placebo

– Burke et. al – double-blind, placebo-controlled studyBurke et. al – double-blind, placebo-controlled study 83 people with isolated systolic hypertension had 60mg Coenzyme Q10 daily for 12 week83 people with isolated systolic hypertension had 60mg Coenzyme Q10 daily for 12 week Blood pressure reduced Blood pressure reduced

Contradictory, insufficient, or preliminary studies suggesting a health Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit forbenefit or minimal health benefit for Cardiomyopathy, Cerebellar ataxia (familial), Cardiomyopathy, Cerebellar ataxia (familial), Congestive heart failure, Diabetes, Gingivitis (periodontal disease), Halitosis (if gum Congestive heart failure, Diabetes, Gingivitis (periodontal disease), Halitosis (if gum disease), Migraine headaches, Parkinson's disease, Renal (kidney) failuredisease), Migraine headaches, Parkinson's disease, Renal (kidney) failure

– Baggio et al. – open marketing studyBaggio et al. – open marketing study 2500 Class II or III patients had 100mg Coenzyme Q10 for 3 months with2500 Class II or III patients had 100mg Coenzyme Q10 for 3 months with Signs of heart failure were reduced: 77% in edema, 54% in dyspnea, 82% in jugular venous pressure.Signs of heart failure were reduced: 77% in edema, 54% in dyspnea, 82% in jugular venous pressure.

– Khatta et al. – double-blind, placebo-controlled studyKhatta et al. – double-blind, placebo-controlled study 85 CHF patients had Coenzyme Q10 treatment 85 CHF patients had Coenzyme Q10 treatment Failed to find any evidence of benefit the patients with coenzyme Q treatment.Failed to find any evidence of benefit the patients with coenzyme Q treatment.

For an herb, supported by traditional use but minimal or no scientific For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health evidence. For a supplement, little scientific support and/or minimal health benefit forbenefit for Alzheimer’s disease, Athletic performance, Breast cancer, Chronic Alzheimer’s disease, Athletic performance, Breast cancer, Chronic obstructive pulmonary disease (COPD), HIV support, Infertility (male), Insulin obstructive pulmonary disease (COPD), HIV support, Infertility (male), Insulin resistance syndrome (Syndrome X), Lung cancer, Muscular dystrophy, Prostate cancerresistance syndrome (Syndrome X), Lung cancer, Muscular dystrophy, Prostate cancer

Efficacy DataEfficacy Data A lot of studies in the literature (70+)A lot of studies in the literature (70+)

– Laboratory/Animal/Preclinical studiesLaboratory/Animal/Preclinical studies Laboratory – Coenzyme’ structures and function in cell respirationLaboratory – Coenzyme’ structures and function in cell respiration Animal – pretreatment Animal – pretreatment

– Human/Clinical studiesHuman/Clinical studies Disease treatmentDisease treatment

For Heart disease:For Heart disease:– Some large trials (up to 360 patients)Some large trials (up to 360 patients)– Some long term (up to 30 months)Some long term (up to 30 months)– Double-blind placebo-controlled trial, or meta-analysisDouble-blind placebo-controlled trial, or meta-analysis

Others:Others:– Small trials (usually less than 100 people)Small trials (usually less than 100 people)– Short term (up to 12 week)Short term (up to 12 week)– Most are double-blind randomized placebo-controlled trialMost are double-blind randomized placebo-controlled trial– Few are non-double blind, or non-randomizedFew are non-double blind, or non-randomized

Coenzyme Q10: UbiquinoneCoenzyme Q10: Ubiquinone By definition not a vitaminBy definition not a vitamin

Produced endogenously in all tissues (~0.5g/day Produced endogenously in all tissues (~0.5g/day regenerated, with a body pool of ~2g) regenerated, with a body pool of ~2g)

Naturally present in small amounts in a wide varied of foodsNaturally present in small amounts in a wide varied of foods

Rich sources can be found in organ meats such as heart, Rich sources can be found in organ meats such as heart, liver and kidney, as well as beef, soy oil, sardines, mackerel liver and kidney, as well as beef, soy oil, sardines, mackerel and peanutsand peanuts

1 pound of sardines1 pound of sardines = 30 mg = 30 mg 2 pounds of beef = 30 mg2 pounds of beef = 30 mg2.5 pounds of peanuts = 30 mg2.5 pounds of peanuts = 30 mg

50 times more antioxidant power than Vitamin E 50 times more antioxidant power than Vitamin E

Found to sustain vitamin E’s antioxidant effectsFound to sustain vitamin E’s antioxidant effects

Coenzyme Q10: UbiquinoneCoenzyme Q10: Ubiquinone Endogenous synthesis decreases after age 20Endogenous synthesis decreases after age 20

Believed to fall off rapidly in middle age, Believed to fall off rapidly in middle age, accelerating the aging processaccelerating the aging process

Exercise increases catabolism of and need for Exercise increases catabolism of and need for CoQ10CoQ10

Disease or other stress impairs intake and Disease or other stress impairs intake and absorption of the substrateabsorption of the substrate

Drug Action of Coenzyme Q10: Drug Action of Coenzyme Q10: UbiquinoneUbiquinone

AbsorptionAbsorption Absorbed in the small intestines directly into the lymphatic Absorbed in the small intestines directly into the lymphatic

system, followed by absorption into the blood streamsystem, followed by absorption into the blood stream

Absorption tends to be poor (lipophilicity)Absorption tends to be poor (lipophilicity)

~60% or more of oral dosage forms are excreted in the feces~60% or more of oral dosage forms are excreted in the feces

Can be highly variable, depending upon dosage form and on Can be highly variable, depending upon dosage form and on food intake at time of CoQ ingestionfood intake at time of CoQ ingestion

Absorption is lower if taken on an empty stomach and higher Absorption is lower if taken on an empty stomach and higher if taken with foods, especially those with a high lipid contentif taken with foods, especially those with a high lipid content

Drug Action of Coenzyme Q10: Drug Action of Coenzyme Q10: UbiquinoneUbiquinone

Distribution/MetabolismDistribution/Metabolism In the blood, CoQ10 is partitioned into various lipoproteins: In the blood, CoQ10 is partitioned into various lipoproteins:

VLDL, LDL and HDL, with peak blood levels occurring in 5 to VLDL, LDL and HDL, with peak blood levels occurring in 5 to 10 hours10 hours

It is found in all cells of the body and is distributed to the It is found in all cells of the body and is distributed to the various tissues of the body (important to know that is able various tissues of the body (important to know that is able to enter the brain)to enter the brain)

Takes roughly 3 weeks of daily dosing to reach the Takes roughly 3 weeks of daily dosing to reach the maximum serum concentrationsmaximum serum concentrations

ExcretionExcretion

Of what is absorbed elimination occurs through the bodies Of what is absorbed elimination occurs through the bodies bilebile

Low plasma clearanceLow plasma clearance

Elimination half-life of 34 hoursElimination half-life of 34 hours

Dosage Forms of Coenzyme Dosage Forms of Coenzyme Q10: UbiquinoneQ10: Ubiquinone

Capsules (10 mg, 30 mg, 75 mg, 100 mg, 150 mg)Capsules (10 mg, 30 mg, 75 mg, 100 mg, 150 mg)

Chewable Tablets (100 mg, 200 mg)Chewable Tablets (100 mg, 200 mg)

Liquid softgel (30 mg/5 ml)Liquid softgel (30 mg/5 ml)

Tablets (25 mg, 50 mg, 60 mg, 200 mg)Tablets (25 mg, 50 mg, 60 mg, 200 mg)

Wafers (60 mg, 200 mg)Wafers (60 mg, 200 mg)

Vcaps (bio-grown CoQ10; 22mg)Vcaps (bio-grown CoQ10; 22mg)

Can also be found in a number of skin products on Can also be found in a number of skin products on

the marketthe market

Dosage Forms of Coenzyme Dosage Forms of Coenzyme Q10: UbiquinoneQ10: Ubiquinone

CoEnzyme Q10, 300mg (60 caps): CoEnzyme Q10, 300mg (60 caps): $84.96$84.96 WholeHealth.com WholeHealth.com Pure Encapsulated CoQ10 60mg (250caps): Pure Encapsulated CoQ10 60mg (250caps): $132.00$132.00; 30mg ; 30mg

(250caps): (250caps): $76.80$76.80 Graceful Graceful Earth.comEarth.com Coenzyme Q-10 30 mg (60 chewable tabs): Coenzyme Q-10 30 mg (60 chewable tabs): $9.09$9.09 CoEnzyme Q10, 50 mg (200 Softgels): CoEnzyme Q10, 50 mg (200 Softgels): $44.18$44.18 Co-Q-10-Plus, 50 mg (60 tabs): Co-Q-10-Plus, 50 mg (60 tabs): $41.50$41.50 Cybervitamins.com Cybervitamins.com CoQ10 Vitaline, Enzymatic Therapy, 100 mg (30 Chocolate CoQ10 Vitaline, Enzymatic Therapy, 100 mg (30 Chocolate

Flavored Chewable Wafers): Flavored Chewable Wafers): $25.88$25.88 iherb.com iherb.com New Chapter Organics Bio-Grown CoQ10, 22mg (30 Vcaps): New Chapter Organics Bio-Grown CoQ10, 22mg (30 Vcaps):

$23.24$23.24 drugstore.com drugstore.com Nivea Visage Q10 Advanced Wrinkle Reducer Lotion SPF 15: Nivea Visage Q10 Advanced Wrinkle Reducer Lotion SPF 15:

$10.99$10.99 drugstore.com drugstore.com Nivea Visage Q10 Advanced Wrinkle Reducer Night Crème: Nivea Visage Q10 Advanced Wrinkle Reducer Night Crème:

$10.99$10.99 drugstore.com drugstore.com Nivea Visage Q10 Advanced Wrinkle Reducer Plus Eye Creme Nivea Visage Q10 Advanced Wrinkle Reducer Plus Eye Creme

SPF 4 0.5 oz (14 g): SPF 4 0.5 oz (14 g): $10.99$10.99 drugstore.com drugstore.com

Recommended Dosage Recommended Dosage Amounts for Coenzyme Q: Amounts for Coenzyme Q:

UbiquinoneUbiquinone No known toxic doseNo known toxic dose For Hypertension: 30 mg, 2 times a dayFor Hypertension: 30 mg, 2 times a day For Angina: 50 mg, 3 times a dayFor Angina: 50 mg, 3 times a day For Congestive Heart Failure For Congestive Heart Failure

Mild: 30 mg a dayMild: 30 mg a day

Severe: 30 mg, 3 times a daySevere: 30 mg, 3 times a day For Cardiomyopathy: 50 mg, 2 times a dayFor Cardiomyopathy: 50 mg, 2 times a day As an Antioxidant: 30 mg to 60 mg a dayAs an Antioxidant: 30 mg to 60 mg a day Mitral Valve Prolapse in Children: 2 Mitral Valve Prolapse in Children: 2

mg/kg/daymg/kg/day

Dietary Supplement Health and Dietary Supplement Health and Education Act of 1994Education Act of 1994

The term "dietary supplement“ under The term "dietary supplement“ under Section 201 (21 U.S.C. 321)Section 201 (21 U.S.C. 321)

(1) means a product (other than tobacco) intended to supplement the (1) means a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary diet that bears or contains one or more of the following dietary ingredients: ingredients: (A) a vitamin; (A) a vitamin; (B) a mineral; (B) a mineral; (C) an herb or other botanical; (C) an herb or other botanical; (D) an amino acid; (D) an amino acid; (E) a dietary substance for use by man to supplement the diet by increasing (E) a dietary substance for use by man to supplement the diet by increasing

the total dietary intake; or the total dietary intake; or (F) a concentrate, metabolite, constituent, extract, or combination of any (F) a concentrate, metabolite, constituent, extract, or combination of any

ingredient described in clause (A), (B), (C), (D), or (E); ingredient described in clause (A), (B), (C), (D), or (E);

(2) means a product that (2) means a product that (A)(i) is intended for ingestion in a form described in section 411(c)(1)(B)(i); (A)(i) is intended for ingestion in a form described in section 411(c)(1)(B)(i); oror (ii) complies with section 411(c)(1)(B)(ii); (ii) complies with section 411(c)(1)(B)(ii); (B) is not represented for use as a conventional food or as a sole item of a (B) is not represented for use as a conventional food or as a sole item of a

meal or the diet; and meal or the diet; and (C) is labeled as a dietary supplement; and (C) is labeled as a dietary supplement; and

FDA: Laws and regulationsFDA: Laws and regulations No determined state regulations on this productNo determined state regulations on this product

Violations of the Violations of the Dietary Supplement Health and Dietary Supplement Health and Education Act of 1994Education Act of 1994 (amendment to the (amendment to the Federal Food, Federal Food,

Drug, and Cosmetic ActDrug, and Cosmetic Act)) occur when claims are made that occur when claims are made that a supplement are intended for the use in the diagnosis, cure, a supplement are intended for the use in the diagnosis, cure, mitigation, treatment or prevention of diseasemitigation, treatment or prevention of disease

Why is this important? Why is this important?

Because the above statement is the FDA’s definition of a drugBecause the above statement is the FDA’s definition of a drug

And a new drug may not be legally marketed in the United And a new drug may not be legally marketed in the United States without an approved New Drug Application (NDA) States without an approved New Drug Application (NDA)

T.J. Clark Liquid Co-Q10 Advanced Formula:T.J. Clark Liquid Co-Q10 Advanced Formula: ““[A] very beneficial supplement for individuals who [A] very beneficial supplement for individuals who

suffer from disorders of the cardiovascular system....“suffer from disorders of the cardiovascular system....“““Revive failing hearts... Lower blood pressure” Revive failing hearts... Lower blood pressure”

Monthly cost of Coenzyme Q: Monthly cost of Coenzyme Q: Ubiquinone vs. Vitamin E and Ubiquinone vs. Vitamin E and

AltaceAltaceDrugstore.com

New Chapter Organics Bio-Grown CoQ10, 22mg (30 Vcaps): New Chapter Organics Bio-Grown CoQ10, 22mg (30 Vcaps): $23.24, $23.24, 30 day supply30 day supply

Twinlab Twinsorb CoQ10, 50mg (60 Softgels):Twinlab Twinsorb CoQ10, 50mg (60 Softgels):Antioxidant, 50 mg a day: $21.60 Antioxidant, 50 mg a day: $21.60 30 day supply30 day supplyMedical conditions, 150 mg a day: $65, Medical conditions, 150 mg a day: $65, 30 day supply30 day supply

Twinlab Super E-Complex 1000 IU, (100 Softgels):Twinlab Super E-Complex 1000 IU, (100 Softgels):Medical conditions, 400mg to 600 mg a day: $9.00, Medical conditions, 400mg to 600 mg a day: $9.00, 30 day 30 day supplysupply

Altace (Ramipril): 5mg for the maintenance dose (180 Altace (Ramipril): 5mg for the maintenance dose (180 capsules): $36, capsules): $36, 30 day supply30 day supply

Monthly cost of Coenzyme Q: Monthly cost of Coenzyme Q: Ubiquinone vs. Vitamin E and Ubiquinone vs. Vitamin E and

AltaceAltaceWalgreens.com

Nature’s Bounty Q-Sorb Co Q-10 50 mg (50 Softgels): Nature’s Bounty Q-Sorb Co Q-10 50 mg (50 Softgels): Antioxidant, 50 mg a day: $12.00, Antioxidant, 50 mg a day: $12.00, 30 day supply30 day supplyMedical conditions, 150 mg a day: $36.00, Medical conditions, 150 mg a day: $36.00, 30 day supply30 day supply

Nature Made Vitamin E Premium 1000 IU USP (Softgel 100): Nature Made Vitamin E Premium 1000 IU USP (Softgel 100): Medical conditions, 400mg to 600 mg a day: $3.60, Medical conditions, 400mg to 600 mg a day: $3.60, 30 day 30 day supplysupply

Altace (Ramipril): 5mg for the maintenance dose (180 Altace (Ramipril): 5mg for the maintenance dose (180 capsules): $43.20, capsules): $43.20, 30 day supply30 day supply

ReferencesReferences Anne Keogh, Steve Fenton, Christina Leslie, et. al. Randomised Double-Blind, Placebo-Controlled Trial of Anne Keogh, Steve Fenton, Christina Leslie, et. al. Randomised Double-Blind, Placebo-Controlled Trial of

Coenzyme Q10 Therapy in Class II and III Systolic Heart Failure. Heart Lung & Circulation. 2003;12:135-Coenzyme Q10 Therapy in Class II and III Systolic Heart Failure. Heart Lung & Circulation. 2003;12:135-41.41.

Baggio E, Gandini R, Plancher A, et. al. Italian multicentre study on the safety and efficacy of Coenzyme Baggio E, Gandini R, Plancher A, et. al. Italian multicentre study on the safety and efficacy of Coenzyme Q10 as adjunctive therapy in heart failure. The Coenzyme Q10 Drug Survellance Investigators. Clin. Q10 as adjunctive therapy in heart failure. The Coenzyme Q10 Drug Survellance Investigators. Clin. Invest. 1993;71:S145-9.Invest. 1993;71:S145-9.

Burke BE, Neuenschwander R, Olson RD. Randomized, double-blind, placebo-controlled trial of Burke BE, Neuenschwander R, Olson RD. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med Journal. 2001;94:1112-7.coenzyme Q10 in isolated systolic hypertension. South Med Journal. 2001;94:1112-7.

Flint Beal, Clifford Shults. Effects of Coenzyme Q10 in Huntington’s disease and early Parkinson’s Flint Beal, Clifford Shults. Effects of Coenzyme Q10 in Huntington’s disease and early Parkinson’s disease. BioFactors 18. 2003;18:153-161.disease. BioFactors 18. 2003;18:153-161.

Franklin Rosenfield, Deborah Hilton, Salvatore Pepe, et. al. Systematic review of effect of coenzyme Q10 Franklin Rosenfield, Deborah Hilton, Salvatore Pepe, et. al. Systematic review of effect of coenzyme Q10 in physical exercise, hypertension and heart failure. BioFactors. 2003;18:91-100.in physical exercise, hypertension and heart failure. BioFactors. 2003;18:91-100.

Kenneth Jones, Kerry Hughs, Laurie Mischley, et. al. Coenzyme Q-10 and Cardiovascular Health. Kenneth Jones, Kerry Hughs, Laurie Mischley, et. al. Coenzyme Q-10 and Cardiovascular Health. Alternative therapies. 2004;10(1):22-30.Alternative therapies. 2004;10(1):22-30.

Langsjoen PH, Langsjoen PH, Folkers K. Langsjoen PH, Langsjoen PH, Folkers K. A six year clinical study of therapy of cardiomyopathy with coenzyme Q10. Int J Tissue React(Swtizerland), 1990;12(3):169-71.

Singh R, Niaz MA, Rastogi SS, et. al. Effect of hydrosoluble coenzyme Q10 on blood pressures and Singh R, Niaz MA, Rastogi SS, et. al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Human Hypertens. insulin resistance in hypertensive patients with coronary artery disease. J Human Hypertens. 1999:13:203-8.1999:13:203-8.

Ely, JTA and Krone, CA. A Brief Update on Ubiquinone (Coenzyme Q10). Journal of Orthomolecular Journal of Orthomolecular Medicine 2000; 15(2):63-68. Retrived from the web on May 8, 2005 at Medicine 2000; 15(2):63-68. Retrived from the web on May 8, 2005 at http://faculty.washington.edu/~ely/JOM5.htmlhttp://faculty.washington.edu/~ely/JOM5.html

Langsjoen, PH. Introduction to Coenzyme Q10. Retrieved from the web on May 8, 2005 at Langsjoen, PH. Introduction to Coenzyme Q10. Retrieved from the web on May 8, 2005 at http://faculty.washington.edu/~ely/coenzq10.html#FAQhttp://faculty.washington.edu/~ely/coenzq10.html#FAQ

Facts and Comparisons: The review of Natural Products. Aug 1997Facts and Comparisons: The review of Natural Products. Aug 1997 Physicians Desk Reference. 2005.Physicians Desk Reference. 2005. Retrieved from the web on May 6, 2005 at Retrieved from the web on May 6, 2005 at

http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/coe_0084.shtmlhttp://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/coe_0084.shtml Micromedix. 2005. OSU subscriptionMicromedix. 2005. OSU subscription National Cancer Institute (NCI) and National Center for Complementary and Alternative Medicine National Cancer Institute (NCI) and National Center for Complementary and Alternative Medicine

(NCAM). Retrieved from the web on May 8, 2005 at (NCAM). Retrieved from the web on May 8, 2005 at http://cis.nci.nih.gov/fact/9_16.htmhttp://cis.nci.nih.gov/fact/9_16.htm Dietary Supplement Health and Education Act of 1994, Public Law 103-417, 103rd Congress. Retrieved Retrieved

from the web on May 8, 2005 at from the web on May 8, 2005 at http://http://www.fda.gov/opacom/laws/dshea.htmlwww.fda.gov/opacom/laws/dshea.html Federal Food, Drug and Cosmetic Act, Title 21, Chapter 9. Retrieved from the web on May 8, 2005 at Federal Food, Drug and Cosmetic Act, Title 21, Chapter 9. Retrieved from the web on May 8, 2005 at

http://www.access.gpo.gov/uscode/title21/chapter9_.htmlhttp://www.access.gpo.gov/uscode/title21/chapter9_.html Walgreens.comWalgreens.com Drugstore.comDrugstore.com

Coenzyme Q10: UbiquinoneCoenzyme Q10: Ubiquinone