Zymes llc. CoQ10 and Statin Therapy



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CoQ10 and Statin Therapy

Statins and Their Effect on Coenzyme Q10

Statins (e.g. ZOCOR, LIPITOR, and PRAVACHOL) are drugs used to treat people with elevated cholesterol, a major risk factor for heart disease. Statins reduce cholesterol by blocking a key enzyme (HMG CoA reductase) in the pathway that produces cholesterol.

The body uses the same pathway that produces cholesterol to produce coenzyme Q10 (CoQ10), as illustrated in the simplified diagram below. When statins block this pathway to reduce cholesterol, coenzyme Q10 production may be reduced as well. 1 Many clinical studies have shown that when blood levels of LDL-cholesterol are reduced by statins, blood levels of coenzyme Q10 are also reduced. 2-12 Other studies, however, have shown that statins may not affect blood levels of coenzyme Q10. 13 Two recent reviews of this topic suggest that more research is needed to clarify our understanding of the effect of statin therapy on coenzyme Q10. 14, 15

Cholesterol Transport in Blood

Cholesterol is a lipid and therefore cannot be dissolved in water or blood. Every cell in the body needs cholesterol to make cell membranes. Additionally, specialized cells use cholesterol to make bile for digestion of fats, or to make steroid hormones like cortisol, estrogen, and testosterone. In order for cholesterol to be transported in blood to different organs in the body, it is packaged into water soluble droplets called LDL (low density lipoprotein). LDL is often referred to as “bad cholesterol” because of the link between high LDL levels and cardiovascular disease.

When cholesterol levels are inappropriately high, LDL can transport cholesterol to the arteries where it has been associated with atherosclerosis leading to heart attacks and strokes. Cholesterol can also be carried away from cells, including those in the arteries, back to the liver for elimination from the body by HDL (high density lipoprotein). HDL is often referred to as “good cholesterol” because it has been associated with reduction in atherosclerosis, heart attacks and strokes.

Just as LDL acts as a carrier for cholesterol, LDL carries coenzyme Q10 and other water insoluble molecules throughout the blood stream. An important function of coenzyme Q10, when carried as part of LDL, is to act as an antioxidant, along with vitamin E, to help prevent oxidation of LDL. Oxidation of LDL is associated with the production of toxic free radicals and is believed to contribute to atherosclerosis and heart disease by stimulating the body’s inflammatory and immune responses. Antioxidants, such as coenzyme Q10 and vitamin E, can protect LDL from such oxidative damage.

These antioxidants exist in two forms, oxidized and reduced. The reduced form of vitamin E is converted to the oxidized form when it inactivates free radicals. Coenzyme Q10 then regenerates vitamin E from its oxidized form, back to its reduced form so that it may continue to protect against oxidative damage to LDL. Dietary supplementation with coenzyme Q10 may increase the coenzyme Q10 content of LDL, enhancing its antioxidant capacity. 16 Animal studies have shown that supplementation with Coenzyme Q10 alone, or together with vitamin E, can reduce atherosclerosis. 17, 18

In addition, some of the side effects associated with statins are fatigue and muscle weakness (also known as myopathy, or myalgia). Reduced levels of coenzyme Q10 may contribute to these side effects. Some physicians believe that dietary supplementation with coenzymeQ10 can ameliorate these effects. 19 More research is needed to prove definitively that supplementation effectively prevents these effects.

References:

  1. Folkers K, Langsjoen P, Willis R., Richardson P, Xia LJ, Ye CQ, Tamagawa H. Lovastatin decreases coenzyme Q levels in humans. PNAS. 1990;87:8931-8934.
  2. Bleske BE, Willis RA, Anthony M, Casselberry N, Datwani M, Uhley VE, Secontine SG, Shea MJ. The effect of pravastatin and atorvastatin on coenzyme Q10. Am Heart J. 2001 Aug;142(2):E2.
  3. Ghirlanda G, Oradei A, Manto A, et al. Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study. J Clin Pharmacol. 1993;33(3):226-229.
  4. Human JA, Ubbink JB, Jerling JJ, Delport R, Vermaak WJ, Vorster HH, Lagendijk J, Potgieter HC. The effect of Simvastatin on the plasma antioxidant concentrations in patients with hypercholesterolaemia. Clin Chim Acta. 1997 Jul 4;263(1):67-77.
  5. Mabuchi H, Higashikata T, Kawashiri M, Katsuda S, Mizuno M, Nohara A, Inazu, A, Koizumi J, Kobayashi J. Reduction of serum ubiquinol-10 and ubiquinone-10 levels by atorvastatin in hypercholesterolemic patients. J Atheroscler Thromb. 2005;12(2):111-9.
  6. Jula A, Marniemi J, Huupponen R, Virtanen A, Rastas M, Ronnemaa T. Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men: a randomized controlled trial. JAMA. 2002 Feb 6;287(5):598-605.
  7. Mortensen SA, Leth A, Agner E, Rohde M. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med. 1997;18 Suppl:S137-44.
  8. Palomaki A, Malminiemi K, Solakivi T, Malminiemi O. Ubiquinone supplementation during lovastatin treatment: effect on LDL oxidation ex vivo. J Lipid Res. 1998 Jul;39(7):1430-7.
  9. Passi S, Stancato A, Aleo E, Dmitrieva A, Littarru GP.Statins lower plasma and lymphocyte ubiquinol/ubiquinone without affecting other antioxidants and PUFA. Biofactors 2003;18(1-4):113-24.
  10. Rundek T, Naini A, Sacco R, Coates K, DiMauro S. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Arch Neurol. 2004 Jun;61(6):889-92.
  11. Strey CH, Young JM, Molyneux SL, George PM, Florkowski CM, Scott RS, Frampton CM. Endothelium-ameliorating effects of statin therapy and coenzyme Q10 reductions in chronic heart failure. Atherosclerosis 2005 Mar;179(1):201-6. Epub 2004 Dec 29.
  12. Watts GF, Castelluccio C, Rice-Evans C, Taub NA, Baum H, Quinn PJ. Plasma coenzyme Q (ubiquinone) concentrations in patients treated with simvastatin. J Clin Pathol. 1993 Nov;46(11):1055-7.
  13. Colquhoun DM, Jackson R, Walters M, Hicks BJ, Goldsmith J, Young P, Strakosch C, Kostner KM. Effects of simvastatin on blood lipids, vitamin E, coenzyme Q10 levels and left ventricular function in humans. Eur J Clin Invest. 2005 Apr;35(4):251-8.
  14. Hargreaves IP, Duncan AJ, Heales SJ, Land JM.The effect of HMG-CoA reductase inhibitors on coenzyme Q10: possible biochemical/clinical implications. Drug Saf. 2005;28(8):659-76.
  15. Levy HB, Kohlhaas HK. Considerations for supplementing with coenzyme Q10 during statin therapy. Ann Pharmacother. 2006 Feb;40(2):290-4. Epub 2006 Jan 31.
  16. Mohr D, Bowry VW, Stocker R. Dietary supplementation with coenzyme Q10 results in increased levels of ubiquinol-10 within circulating lipoproteins and increased resistance of human low-density lipoprotein to the initiation of lipid peroxidation. Biochim Biophys Acta. 1992;1126(3):247-254.
  17. Witting PK, Pettersson K, Letters J, Stocker R. Anti-atherogenic effect of coenzyme Q10 in apolipoprotein E gene knockout mice. Free Radic Biol Med. 2000;29(3-4):295-305.
  18. Thomas SR, Leichtweis SB, Pettersson K, et al. Dietary co-supplementation with vitamin E and coenzyme Q(10) inhibits atherosclerosis in apolipoprotein E gene knockout mice. Arterioscler Thromb Vasc Biol. 2001;21(4):585-593.
  19. Sinatra ST. The Sinatra Solution, Basic Health Publications, 2005.
Page modified: 2007-04-19 16:47:00.

Adipose - Fat tissue.

Aerobic - Without oxygen.

Adequate Intake (AI) - A recommended intake value based on observed or experimentally determined approximations or estimates of nutrient intake by a group (or groups) of healthy people, that are assumed to be adequate- used when an RDA cannot be determined.

Aldosterone - A steroid hormone, synthesized from cholesterol by the adrenal gland regulates sodium and potassium levels in the blood.

Amyloid Plaques - An abnormal accumulation of beta-amyloid proteins in the brain that are seen in patients with Alzheimer’s disease.

Amino Acids - Small molecules that are the building blocks of proteins.

Analogue - Something that is similar to something else.

Antioxidant - A chemical compound or substance like a vitamin that inhibits the oxidation of other molecules.

Arteries - Blood vessels that carry oxygenated blood away from the heart, whereas veins carry deoxygenated blood to the heart.

Atherosclerosis - A disease of the arteries resulting from the formation of an atherosclerosis plaque, historically known as “hardening of the arteries”. The plaque consists of excess cholesterol and other lipids, inflammatory cells such as macrophages, with excess of proteins and calcium. The plaque eventually ruptures and causes narrowing of the artery leading to an insufficient blood supply to the organ it feeds.

ATP - Adenosine triphosphate. The cells of the body cannot use food directly for energy. The energy (calories) in food must be broken down into a form of energy small enough for the cells to use. That smallest form of energy is ATP.

Bias - To influence in an unfair way.

Beta Blocker - A medicine used to treat high blood pressure and some other heart conditions.

Bile Acids - Specific compounds produced by the liver and excreted in the bile to help in the digestion of fats.

Bioavailability - A term used by pharmacologists and pharmacists to describe the amount of a medication that reaches the blood stream.

Biological Membranes - All cells are surrounded by a cell membrane, sometimes called a plasma membrane or plasmalemma. It is a thin double layer of phospholipid and proteins that envelopes the cell, separating the cell’s interior from its surroundings and controlling what moves in and out.

Biosynthesis - A process where chemical compounds are made in the body from simpler compounds or smaller molecules, an important part of metabolism.

Blinded - Most clinical studies are “blinded” to assure accurate results. Double-blinded means that neither the patient nor the investigator know which group the patient is assigned to. Single-blinded means the investigator knows which group the patient is assigned to, but the patient does not.

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Carbohydrates - Commonly known as sugars (monosaccharides and disaccharides) and starches (polysaccharides), their most important function is energy storage.

Cardiac Asthma - An asthmatic attack caused by heart disease.

Cell Membrane - Also called a plasma membrane or plasmalemma. It is the outermost layer of a cell composed of primarily phospholipids and proteins. It serves to separate and protect the cell interior from its surroundings and regulate the movement of molecules into and out of cell.

Centers for Disease Control (CDC) - A government agency that studies infectious diseases.

Chemical Bonds - The holding together of molecules by attraction of atoms to each other, commonly through sharing of electrons.

Chylomicrons - Small fat globule composed of protein and lipid (fat) created by the cells of the small intestine used to transport fat from the intestine to the liver and to fat tissue. After a fatty meal, the blood is so full of chylomicrons that it looks milky.

Cognition - The ability to think, reason, and remember.

Confidence Intervals - Describes the range within which the real effect is likely to occur. As with the 5% chance described for the p value, the confidence interval usually provided is the 95% confidence interval. For example if a new cholesterol drug lowered cholesterol by a mean of 20 mg/dL with a 95% CI of 4 to 35, there is a 95% probability that the true effect of the drug lies within this range. If the CI does not overlap 1.0, the result is said to be significant at p<0.05. In our example the CI (4, 35) does not overlap 1.0, therefore the treatment effect is considered to be statistically significant.

Cortisol - A steroid hormone, synthesized from cholesterol by the adrenal gland that is involved in the response to stress. Also used as a drug, synthetic cortisol also known as hydrocortisone, is used to teat allergic and inflammatory diseases.

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Dementia - A progressive decline in mental functioning, over and above what’s expected from normal aging, due to damage or disease in the brain.

Double Blind - In clinical studies, double blind means that neither the patient nor the investigator know which treatment group the patient is assigned to.

Dietary Reference Intakes - Includes four measurements; Recommended Daily Allowance (RDA), Allowable Intake (AI), Tolerable Upper Intake Level (UL) and Estimated Average Requirement (EAR). DRI is generally used by nutrition professionals instead of RDAs.


Efficacy - The ability of a drug to produce an acceptable amount of the desired effect. In precise terms ‘efficacy’ refers to the effect of a drug in the controlled setting of a clinical trial. This is different from ‘effectiveness’ which refers to the effect of a drug in real world setting.

Electron - A negatively charged particle that orbits the nucleus of an atom. The flow of electrons produces electricity.

Electron Transport Chain - The energy currency of the body, ATP, is made in the mitochondria, from the food we eat, through a series of chemical reactions called the electron transport chain. Electrons are transported through a series of compounds in what is known as the electron transport chain. Each time electrons are transferred from one compound to another, the energy generates a proton gradient that provides the energy to produce ATP.

Eliminate - After drugs are metabolized, they are removes from the body by two main routes: in the urine through the kidneys and in the feces through the gastrointestinal tract.

Enterocyte - An intestinal cell that helps to break up food molecules and transports them into the tissues of the body.

Estimated Average Requirement (EAR) - A daily nutrient intake value that is estimated to meet the requirement of half of the healthy individuals in a life stage and gender group - used to assess dietary adequacy and as the basis for RDA.

Estrogen - A steroid hormone, synthesized from cholesterol that is the primary hormone involved in the development of female sex characteristics. Estrogen is also present at a significantly lower level in men.

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Fermentation - A process that occurs in the absence of oxygen such as making alcohol (wine) from grapes with yeast.

Fibrate - A class of drugs used to lower cholesterol that work differently than the statins.

Folic Acid - One of the B vitamins.

Free Radicals - Atoms or molecules with highly reactive unpaired electrons that are generally pro-oxidants. Also referred to as reactive oxygen species such as superoxide, hydrogen peroxide, and hydroxyl radical and are associated with cell damage. Free radicals are neutralized in the body by anti-oxidants.

Free Radical Scavenger - Found in every living cell of the body and are potent antioxidants.

Gamma Rays - Electromagnetic radiation of high energy that is released by radioactive decay.

Genetic Material - Deoxyribonucleic acid (DNA), used to store the genetic information of an organism.

Glucose Toxicity - High blood glucose can lead to damage of organs and the complications of diabetes.

Gram - The standard measure of mass in the metric system indicated by the symbol g. 1 gram (g) = 1000 milligrams (mg). 1 gram = 1/1000 of a kilogram (kg). 1 ounce = 28.3 grams, 1 gram is about the mass of a paper clip.

GRAS - Generally Regarded As Safe is recognition by the FDA (Food and Drug Administration of the Department of Health and Human Services) of the safety of a substance that is added to food.

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Heavy Metals - Common metals that are “heavy” include gold, cobalt, copper, manganese, molybdenum, vanadium, strontium, zinc, mercury, lead, and cadmium. Some like cobalt, copper, manganese, molybdenum, vanadium, strontium, zinc, are required in the diet in trace amounts, but high levels can be detrimental. Others such as mercury, lead, and cadmium are not essential to bodily functions and accumulation is associated with illness.

Hemoglobin A1C (HbA1C) - A measure of blood sugar control over 2 to 3 months.

High Energy Phosphates - Compounds like adenosine triphosphate (ATP) and adenosine diphosphate (ADP) that contain high energy phosphate bonds that when broken release energy for the body to use.

HMG-CoA Reductase - The rate-limiting enzyme, 3 - hydroxy - 3 - methyl - glutaryl - CoA reductase or HMGR, of the pathway that synthesizes cholesterol and other molecules. Drugs that inhibit HMG-CoA reductase are commonly called statins because of the commonality of the generic drug names: atorvastatin, pravastatin, and simvastatin. Statins are used to lower blood levels of LDL cholesterol, a risk factor for cardiovascular disease.

Hormone - From the Greek horman - “to set in motion”. A chemical substance that is secreted into body fluids and transported to another cell or organ, where it produces a specific effect.

Hypothesis - The explanation for certain facts or observations that can be tested through experimentation.

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Ionizing Radiation - Produced by radioactive decay, nuclear reactions, and by extremely hot objects like the sun. X-rays are a use of ionizing radiation as is radiation to kill cancerous cells. However, overuse of ionizing radiation can be hazardous.

In Vitro - Refers to experiments performed in test tubes or cell cultures.

In Vivo - Refers to experiments performed in live animals.

Jugular Reflux - An elevation of venous pressure that can be seen in bulging jugular veins and in the veins of the arm and can be produced by congestive heart failure.

LDL - Low density lipoprotein, a fatty droplet composed of protein and cholesterol used to carry cholesterol throughout the body. Referred to as the “bad” cholesterol because it may accumulate on the walls of the arteries leading to atherosclerosis.

Left Ventricle - The largest lower chamber of the heart, it that receives oxygenated blood from the left atrium and pumps it out to the body through the aorta to the body.

Lymphatic System - A network of vessels carrying lymph (a colorless fluid) to and from lymph organs (lymph nodes, spleen, and thymus) that produce and store infection-fighting cells.

Lymphoma - Any of the many often malignant tumors of the lymph nodes or in other lymphoid tissue.

Lactate/Pyruvate Ratio - Elevation in this ratio may be used to estimate mitochondrial dysfunction. If the mitochondria (makes energy through aerobic pathways) are not functioning properly, the body may turn to anerobic pathways to generate energy which increase lactate compare to pyruvate.

Lipases - Enzymes in the digestive system that break down fats.

Lipids - A class of water insoluble compounds essential for the structure and function of living cells. Lipids make up cell membranes and are used for energy storage. They also can be hormones and vitamins. Lipids are often called ‘fats’, however, fats are only one type of lipid.

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Metabolism - All of the processes of the body including those that build up (anabolism) and breakdown (catabolism) molecules in the body. Drug metabolism is the process the body uses to break down (deactivate) a drug for elimination form the body.

Mevalonic Acid - A compound used by the body to make cholesterol and other steroids.

Mitochondria - A cell structure often referred to as the “powerhouse of the cell” because that is where the food we eat is turned into energy. All cells, with the exception of red blood cells, have mitochondria. Mitochondria convert the energy found in the food we eat into a small energy rich molecule called ATP that all cells can use.

Mitochondrial Electron Transport Chain - The energy currency of the body, ATP, is made in the mitochondria, from the food we eat, through a series of chemical reactions called the electron transport chain. Electrons are transported through a series of compounds in what is known as the electron transport chain. Each time electrons are transferred from one compound to another, the energy generates a proton gradient that provides the energy to produce ATP.

Multicenter - In clinical studies, when the same study is performed in patient found in more than one study center.

Myeloma - A tumor of antibody-producing cells that are normally found in the bone marrow.

Neurodegenerative Diseases - Disease that results from the deterioration of nerve cells such as Alzheimer’s disease and Parkinson’s disease.

Neuron - The nerve cells which make up the central nervous system that communicate to each other by transmitting electrical signals to other neurons.

Neutrons - A subatomic particle found in the nucleus of every atom, except hydrogen, it has no electrical charge; it is neutral.

Nucleic Acids - Deoxyribonucleic acid (DNA) and ribonucleic acid (RNA), the molecules the body uses to store and transmit genetic information.

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Open Label - In clinical studies, when the patient knows which drug treatment they are being given.

Oxidative Phosphorylation - The process during which nutrients are broken down into ATP using the oxygen we breathe.

Oxidative Stress - A term for damage to animal or plant cells, tissues and organs caused by free radicals and other pro-oxidant molecules. It is often defined as an imbalance between too many pro-oxidants and not enough antioxidants.

Oxidized - Oxidation is the loss of an electron. Molecules that have the ability to oxidize other molecules are also known as pro-oxidants, oxidizing agents, oxidants or oxidizers. When the oxidant removes electrons from the other molecule, it becomes reduced.

Ozone - A molecule of three oxygen atoms present in low concentrations throughout the Earth’s atmosphere. In the upper atmosphere it prevents harmful ultraviolet light form reaching the Earth’s surface. At ground level ozone is associated with respiratory problems, atherosclerosis and Alzheimer’s disease.

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Pancreas - An organ located near the stomach that makes digestive enzymes that aid in digestion, and it produces several hormones, including insulin and glucagon.

Pantothenic Acid - Also called vitamin B5, is an antioxidant water-soluble vitamin needed to break down carbohydrates, proteins, and fats.

pH - A measurement of acidity or alkalinity of a solution like blood or water.

Placebo-Controlled - Refers to a clinical trial in which the effectiveness of an experimental drug is compared to that of placebo (contains no useful medicinal content) group.

Platelet - Cells involved in blood clotting.

Progesterone - a steroid hormone, synthesized from cholesterol, involved in the regulation of the processes of the female reproductive system.

Pro-Oxidant - A substance that can produce oxygen byproducts of metabolism that can cause damage to cells.

Prospective - A study that collects data after the study begins; unlike a retrospective study which analyzes data that has already been collected.

Proteins - Chains of amino acids used by the body for many things including: cell movement (muscles), structures (hair), enzymes (biological catalysts), hormones (insulin), energy storage (egg albumin), transport of oxygen (hemoglobin), and antibodies (immune system).

PTS™ - The lead compound in the family of Ubisol-Aqua™ solubilizers.

Pulmonary Edema - Swelling and/or fluid accumulation in the lungs.

P Value - A measure of significance. A p value that is deemed significant if it is p<0.05 (read, p is less than .05). If the p value is less than 0.05, the difference between the treatment groups is considered statistically significant. It means that there is less than a 5% chance that the difference between the two treatment groups occurred by chance and that the difference between the two groups is most likely attributable to a treatment effect rather than chance. If the p value is greater than .05 (p>0.05), then it is likely that the difference between the two treatment groups occurred by chance.

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Randomized - A method of assignment in which individuals have a random chance of being assigned to one group or another.

Range- Describes the highest and lowest number in the data set.

Reactive Oxygen Species - Atoms or molecules with highly reactive unpaired electrons that are generally pro-oxidants. Also referred to as free radicals and are associated with cell damage. Free radicals are neutralized in the body by anti-oxidants.

Recommended Daily Allowance - The average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in a particular life stage and gender group. RDA is now incorporated into the DRI. For more information please refer to the International Food Information Council.

Reduced - Reduction is the gaining of an electron. Molecules that have the ability to reduce other molecules are also known as reducing agents, reductants or reducers. When the reducing agent gains electrons from the other molecule, it becomes oxidized.

Remacemide - A drug used treat Parkinson’s disease.

Reperfusion Injury - The damage to tissue that is caused when the blood supply returns to the tissue after a period of no or reduced blood flow.

Safety - Relates to the detection, evaluation, understanding, and prevention of adverse effects of drugs during short and long term use.

Statistically Significant - A mathematical measure to describe if there is a difference between groups. The difference is said to be “statistically significant” if it is greater than what might be expected to happen by chance alone.

Striatal Spiny Neurons - A type of medium sized neuron in the striatum that when destroyed, may cause problems with movement.

Standard Deviation (SD) and Standard Error (SE) - Mathematically complex calculations. What you need to know is that large SD and SE indicate a lot of variability in the data, and small SD and SE indicate that the data values are clustered closely around the mean.

Statin - A group of drugs that reduce the amount of cholesterol made by the body.

Substantia Nigra - Dark gray matter deep within the brain where cells make the neurotransmitter dopamine for movement control. Degeneration of cells in this region may lead to movement disorders such as Parkinson’s disease.

Subcutaneous - Under the skin.

Synthetic - A substance that is made a chemical process, it generally does not apply to substances created by naturally occurring biological processes.

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Testosterone - A steroid hormone, synthesized from cholesterol that is the primary hormone involved in the development of male sex characteristics. Testosterone is also present at a significantly lower level in women.

Tolerable Upper Intake Level (UL) - The highest level of daily nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in the general population. As intake increased above the UL, the potential risk of adverse effects increases.

Ultraviolet Light - Electromagnetic radiation with a wavelength shorter than that of visible light, but longer than X-rays.

United States Recommended Daily Allowances (USRDA) - Was devised by the Food and Drug Administration (FDA) for nutritional labeling of processed foods and vitamin products. The USRDA lists the percentage of each of 19 essential nutrients that are contained per serving of the labeled product. The Recommended Dietary Allowance (RDA) is the amount of nutrients and calories recommended for most healthy individuals (of any age) to consume in their daily diet to meet the requirements of the body.

Unsaturated Fats - A fat with one or more double bond in the fatty acid chain and liquid at room temperature. Unsaturated fats are commonly found in avocados, nuts, soybeans, canola oil and olive oil. Saturated fats have no double bonds in the fatty acid chain and are solid at room temperature such as butter and animal fat.

Ubiquinol - The reduced form of coenzyme Q10.

Ubiquinone - The oxidized form of coenzyme Q10.

Villus> - Hair-like protrusions into the intestine — emanating from the wall of the intestine. The purpose of the villi is to slow the passage of food, and to allow food particles to be captured in among these finger-like villi — so that the blood inside the villi can absorb the nutrients in the food.

Vitamin - A molecule required by the body in minute amounts for proper health. In general, vitamins cannot be made by the body.

X-Rays - A form of electromagnetic radiation primarily used in medicine to produce radiographic images. Is also a form of ionizing radiation which can be dangerous.

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