Since the original seminal paper, Introduction to Coenzyme Q10, Dr. Langsjoen and his wife have co-authored dozens of papers dealing with the consequences of lack of sufficient bioavailability of Coenzyme Q10. Out of this abundance of papers I have chosen the following few, best depicting the efforts of the Langsjoens to communicate their views and research findings to the medical community.



1.) Supplemental Ubiquinol in Patients with Advanced Congestive Heart Failure

Peter H. Langsjoen - East Texas Medical Center and Trinity Mother Francis Hospital, TX, USA

Alena M. Langsjoen - Coenzyme Q10 Laboratory, Inc., Tyler, TX, USA

Abstract:

Patients with moderately advanced (New York Heart Association class IV) congestive heart failure (CHF), often fail to achieve adequate plasma CoQ10 levels on supplemental ubiquinone at dosages up to 900 mg/day.

These patients often have plasma total CoQ10 levels of less than 2.5 μg/ml and have limited clinical improvement. It is postulated that the intestinal edema in these critically ill patients may impair CoQ10 absorption.

We identified seven patients with advanced CHF (mean ejection fraction (EF) of 22%) with sub-therapeutic plasma CoQ10 levels with mean level of 1.6 μg/ml on an average dose of 450 mg of ubiquinone daily (150-600 mg/day).

All seven of these patients were changed to an average of 580 mg/day of ubiquinol (450-900 mg/day) with follow-up plasma CoQ10 levels, clinical status, and EF measurements by echocardiography.

Mean plasma CoQ10 levels increased from 1.6 μg/ml (0.9-2.0 μg/ml) up to 6.5 μg/ml (2.6-9.3 μg/ml).

Mean EF improved from 22% (10-35%) up to 39% (10-60%) and clinical improvement has been remarkable with NYHA class improving from a mean of IV to a mean of II (I to III).

Ubiquinol has dramatically improved absorption in patients with severe heart failure and the improvement in plasma CoQ10 levels is correlated with both clinical improvement and improvement in measurement of left ventricular function.

2.) Statin Induced Cardiomyopathy

By Peter H. Langsjoen , M.D., F.A.C.C.

In this paper Peter Langsjoen directed his primary attention to the effect of statins on cardiac muscle performance. In the final paragraph of this report he states, "Statin-induced CoQ10 depletion is the topic of a recent petition to the FDA requesting that this drug / nutrient interaction be identified in a black box warning as part of statin package insert information. A comprehensive review of animal and human trials addressing this issue has been submitted to the FDA as a supporting document. We, of course, do not expect any response from the FDA, but 10 years from now when the full extent of statin toxicity becomes painfully evident, at least we can, in good conscience, know that we tried and who knows, sometimes small sparks may spread in dry grass."

3.) Statins Contraindicated in Heart Failure

By Peter H. Langsjoen , M.D., F.A.C.C.

In this paper Langsjoen makes one of the strongest early warnings of the relationship between statins and congestive cardiac failure. With researchers Eddie Voss, MEng and Luca Mascitelli, MD of THINCS ( The International Network of Cholesterol Skeptics) the aggravation and even causation of congestive heart failure by statin drugs was brought to light and introduced to the medical community.

In this report they drew attention to the fact that statins lowered serum LDL cholesterol and CoQ10 both by 51% in one study and emphasized that without CoQ10, mitochondria cannot produce adenosine triphosphate, which provides the energy for muscle heart contraction. They concluded by saying, "Based on the foregoing, we conclude that statins are contraindicated in patients with borderline and full-blown heart failure."



4.) Treatment of Heart Disease with Coenzyme Q10

By Peter H. Langsjoen , M.D., F.A.C.C.

In the text of this early paper, Langsjoen describes his clinical research. "CoQ10 was added to standard treatments for heart failure such as fluid pills (diuretics), digitalis preparations (Lanoxin), and ACE inhibitors. Several trials involved the comparison between supplemental CoQ10 and placebo on heart function as measured by echocardiography. CoQ10 was given orally in divided doses as a dry tablet chewed with a fat containing food or an oil based gel cap swallowed at mealtime. Heart function, as indicated by the fraction of blood pumped out of the heart with each beat (the ejection fraction), showed a gradual and sustained improvement in tempo with a gradual and sustained improvement in patients' symptoms of fatigue, dyspnea, chest pain, and palpitations. The degree of improvement was occasionally dramatic with some patients developing a normal heart size and function on CoQ10 alone."