By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
A nutrient vital for heart function, coenzyme Q10 has for years been a mainstay for cardiovascular disease prevention and recovery among integrative cardiologists. Now, recent evidence from a study headed by Beatrice Golomb, M.D., Ph.D. at the University of California, San Diego School of Medicine demonstrates coenzyme Q10’s potential for alleviating symptoms of “Gulf War Syndrome.”
What is Gulf War Syndrome?
Gulf War Syndrome and Gulf War Veterans illnesses (GWVI) are terms commonly used to describe the “medically unexplained, chronic multi-symptom illnesses” affecting approximately one in four Gulf War Veterans (i.e. approximately 200,000 people). Thought to be caused by prolonged exposure to pesticides like DEET and permethrin, ingestion of anti-nerve agent pills (pyridostigmine bromide, or PB) and combat-related emotional stress, GWVI is characterized by symptoms like fatigue, widespread joint pain, headaches, anxiety, depression, dizziness, respiratory disorders, gastrointestinal disorders, insomnia, and memory problems. Such symptoms have become so common among Gulf War Veterans (anyone who has served in Iraq, Kuwait, Saudi Arabia, and other countries in Southwest Asia from 1990 to the present), that they’re presumed to be linked to active duty in the Gulf (making those Gulf War veterans experiencing such symptoms eligible for disability benefits and health care).
In addition to pesticide and PB exposures, the U.S. Department of Veterans Affairs acknowledges other potential contributors to the laundry list of symptoms popularly known as Gulf War Syndrome. Vaccinations (against anthrax, botulinum toxide, yellow fever, typhoid, hepatitis B, meningitis, cholera, whooping cough, tetanus, and polio), as well as chemical and biological warfare agents, burn pits, oil well fires, and depleted uranium (used in tank armor and bullets) are listed as possible exposures explaining the prevalence of GWVI.
Interestingly enough, electro-hypersensitive people tend to also report symptoms including headaches, dizziness, inability to concentrate, nervousness, pain, fatigue, nausea, problems sleeping, skin disorders, racing heartbeats, and tinnitus (ringing in the ears), when exposed to EMF (electromagnetic field) emissions from technologies such as wireless devices and electrical appliances. As military personnel routinely use radio frequency (RF) equipment like radar and other relatively high-powered radio transmitters in military operations, it’s quite possible that such occupational exposure to EMF emissions may have also contributed to GWVI symptoms.
As is usually the case with systemic issues, it’s often about the “perfect storm” of forces acting at different angles… taken all together, vaccines, pesticides, heavy metals and EMF can have a knockout effect on cells. Thankfully, the body has a remarkable ability to heal, and we are becoming more aware of natural remedies, like coenzyme Q10, for such cellular distress.
The Co Q10 and Gulf War Syndrome Study
Through a double-blind placebo-controlled study, Dr. Golomb’s team worked with 46 veterans with “syndrome defining symptoms” to test the efficacy of coenzyme Q10 against these symptoms. For a period of 3.5 months, each veteran was given daily administrations of coenzyme Q10 as either a high or low dose, or a placebo. During the following two 3.5 month periods, each veteran received the remaining respective doses so that all eventually took coenzyme Q10 during at least two periods of the study. Dr. Golomb relayed that “every single one of [the veterans] … improved,” and added that improvement was shown with all twenty GWVI symptoms. “For it to have been chance alone is under one in a million,” she said.Dr. Golomb presented her findings at a June 27 2011 Department of Veterans Affairs meeting (although her study is not yet published, we intend to provide more information about it as soon as it is).
Gulf War Syndrome, Mitochondrial Dysfunction and CoQ10
Dr. Golomb has noted that veterans with Gulf War-related illness experience the same kinds of symptoms as people with mitochondrial disorders, which arise when mitochondria do not function properly. Mitochondria are the powerhouse organelles in all our cells that produce energy, i.e. molecules of Adenosine Triphosphate, or ATP. In fact, our mitochondria recycle 90 percent of the energy we use for basic metabolism, growth and repair. Hence, when our mitochondria do not function optimally, neither do we; without a continuous supply of ATP, our cells cease to function and eventually die.
Looking back at the symptoms associated with GWVI, it’s very possible that lack of energy due to mitochondrial dysfunction is at the heart of such illness. Since our hearts, brains and skeletal muscle require the most energy, mitochondrial dysfunction may manifest first as neurological or musculoskeletal, if not cardiac symptoms. On a tangential side note, autism, which has also been linked to vaccinations, has been recently associated with mitochondrial dysfunction (Guilivi, et al.2010).
While some mitochondrial diseases are inherited, other causes of mitochondrial dysfunction include free radical damage to mitochondrial structures (including DNA), especially due to environmental toxins. In consideration of all the hazardous substances Gulf War Veterans came into contact with, it’s no wonder that they’re suffering the consequences of energy shortage which has resulted from severely compromised mitochondria.1 In addition, deficient mitochondrial metabolism may have actually catalyzed more oxidative stress, and further compounded the problem.
Nutrient deficiency can also lead to mitochondrial dysfunction. Coenzyme Q10 and L-carnitine, for example, are absolutely necessary for ATP production. As our bodies begin to stop producing these nutrients after age 40 or so, we need to obtain them through dietary sources2 or take them in supplement form to prevent illnesses linked to debilitated mitochondria. It makes perfect sense, then, that regular ingestion of coenzyme Q10 was shown to alleviate symptoms of GWVI, as Co Q10 enhances mitochondrial function, both as an antioxidant and coenzyme.As an antioxidant, coenzyme Q10 helps prevent mitochondrial damage caused by pesticides and other free radical catalysts like heavy metals, cigarette smoke and even emotional stress. As a coenzyme, Q10 is also involved in the reactions of at least three mitochondrial enzymes, making it essential for mitochondrial health. Without Q10, our bodies can’t make the energy needed to repair and mitigate free radical damage.
Gulf War Syndrome and Statins
Another reason mitochondria might cease to function properly is use of cholesterol-lowering drugs such as statins. Statins are a double edged sword. They do inhibit cholesterol production by blocking an enzyme required to produce it; however, this same enzyme is also needed to produce coenzyme Q10. Hence, while statin use can help reduce the risk of cardiac events in high risk coronary patients, it could also lead to heart failure due to energy starvation resulting from coenzyme Q10 deficiency.
This is why it’s so important that people taking statins also supplement with coenzyme Q10. More importantly, people should avoid taking statins unless it is absolutely necessary for their health. Unfortunately, “absolute necessity” is a subjective concept. Statin drugs are widely overprescribed, partially due to consumer demand created through television and magazine advertisements (think about how many times have you seen a statin drug commercial which urges you to “Ask your doctor about [brand name of drug]”).Lack of physician awareness of the adverse health effects associated with statins also contributes to inadequate risk-benefit analyses when prescribing statin drugs; most physician knowledge of particular drugs comes from pharmaceutical reps.
Pharmaceutical companies put a lot of money into product promotion and advertisements to tell physicians and patients alike why people should take statins; statin drugs generate billions of dollars in annual sales. Statins are not necessarily the best treatment option in many situations, and physicians and patients need to start asking themselves why shouldn’t people take statins? At the end of the day, co Q10 depletion can lead to mitochondrial dysfunction, which is linked to heart disease, diabetes, and neurodegenerative disorders like Parkinson’s and Alzheimer’s diseases. The most commonly reported side effect of statin use – muscle soreness, tiredness and weakness – indicates compromised mitochondria; patients also tend to experience cognitive and digestive problems, liver damage, and impotence.
While statins can be life-savers for high risk people, taking statins unnecessarily is like putting your body at war with itself, as far as mitochondrial dysfunction is concerned. This is not to suggest that the toxic exposures Gulf War Veterans have faced are, by any means, equatable to statin use (it just happens that Dr. Golomb studies both statins and GWVI). Rather, we recognize that the health problems suffered by Gulf War Veterans have taught us even more about the importance of mitochondrial integrity. We can honor their brave and dedicated service by gaining wisdom from their sacrifices.
1. Researchers have noted that Gulf War Veterans with symptoms of fatigue, memory problems and pain are also prone to excessive blood clotting, as demonstrated through blood tests showing chronically activated coagulation systems. Thick, sticky blood hinders the circulatory delivery of vital oxygen and nutrients to cells and tissues throughout the body, hence it may also contribute to mitochondrial dysfunction.
2. Dietary sources of coenzyme Q10 include oily fish like salmon and sardines; L-carnitine is found in red meat, lamb and pork.
References and Resources:
- U.C. San Diego Health. Coenzyme Q10 Helps Veterans Battle Gulf War Illness Symtoms. November 3, 2014.
- Kennedy, Kelly. “Anti-oxidants ease Gulf War Syndrome, study finds,” USAToday.com, June 26, 2011.
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- Sinatra ST. The Sinatra Solution: Metabolic Cardiology (Basic Health, 2008).
- Press Release. “UC San Diego Studies on Gulf War Veterans Continue.” Gulfwarcouncil.com, July 18, 2008.
- “Q10 for Gulf War Veterans.”Clinical Trials.gov, Dec. 7, 2009.
- U.S. Dept. of Veterans Affairs. “Gulf War Veterans’ Illnesses: Medically Unexplained Chronic Multisymptom Illnesses.” Publichealth.va.gov, accessed June 29, 2011.
- U.S. Dept. of Veterans Affairs. “Gulf War Veterans’ Illnesses: Exposures during the Gulf War.” Publichealth.va.gov, accessed July 1, 2011.
- U.S. Dept. of Veterans Affairs. “Gulf War Veterans’ Illnesses: Vaccinations (including Anthrax and Botulinum Toxoid).” Publichealth.va.gov, accessed July 1, 2011.
- Public Abstract: “Biomarkers of Gulf War Veterans Illnesses’: Tissue Factor, Chronic Coagulopathy, and Inflammation.” Va.gov, April 11, 2088.
- Sinatra ST. Metabolic Cardiology: An Integrative Strategy in the Treatment of Congestive Heart Failure. Altern Ther Health Med. 2009 May/Jun;15(3):44-52.
- Sinatra ST. Metabolic Cardiology: The Missing Link in Cardiovascular Disease. Altern Ther Health Med. 2009 Mar/Apr;15(2):48-50.
- Sinatra ST. Coenzyme Q10 and congestive heart failure. Ann Intern Med. 2000 Nov 7;133(9):745-6.
- Golomb BA, Evans MA. Statin Adverse Effects: A Review of the Literature and Evidence for Mitochondrial Mechanism. Am J Cardiovasc Drugs, 2008; 8(6): 373-418.
- Parker-Pope, Tara. “Great Drug, but does it prolong life?” NYTimes.com, Feb. 9, 2008.
- Project Summary Statement: Memory and Mood Enhancing Therapies for Gulf War Ilness.” VA.gov, accessed June 29, 2011. Available at http://www.va.gov/RAC-GWVI/docs/Recently_Funded_Research/VA_BLRD_Shetty_2010.pdf
- U.S. Federal Communications Commission. “Radio Frequency Safety: Frequently asked questions about the safety of radiofrequency (RF) and microwave emissions from transmitters and facilities regulated by the FCC.” Fcc.gov, accessed July 1, 2011. http://transition.fcc.gov/oet/rfsafety/rf-faqs.html
- Giulivi C, Zhang Y-F, et al. Mitochondrial Dysfunction in Autism. JAMA. 2010;304(21):2389-2396.
- Schon EA, Manfredi G. Neuronal Degeneration and Mitochondrial Dysfunction. J Clin Invest. 2003;111(3):303–312. Available at http://www.jci.org/articles/view/17741
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