The original high quality coenzyme Q10 supplement from Pharma Nord. Information for health professionals. Pharma Nord (UK) Est.1988.

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1 Information for health professionals Pharma Nord (UK) Est.1988 Make the right choice The result of 25 years of product development and research. 98% recommend it!* Documentation More than 90 clinical studies using Bio-Quinone Q10 documenting efficacy and safety. Ask us about KiSel-10 and Q-SYMBIO. 100% Active Air and moisture tight blister packing ensures optimum bio-availability. Certified Quality Documented product quality and bio-availability. Protection Dark capsules prevent light exposure and contain 100 mg Q10 dissolved in a patented oil-based formulation. The original high quality coenzyme Q10 supplement from Pharma Nord.

2 Endorsed by experts Professor Urban Alehagen, Linköping University, is one of Sweden s most experienced cardiologists and headed the KiSel-10 research team. Associated Professor Alehagen now takes Bio-Quinone Q10 himself thanks to the results of his study. Dennis Gore, Phc M.P.S M.R.S.H, a renowned community pharmacist in Manchester, has supplied Bio-Quinone Q10 to thousands of his customers and can personally attest to its effects. He has attended Q10 conferences worldwide and is considered one of the UK s best Q10 experts. Dr. Chris Steele M.B.E has been a resident GP on ITV1 s This Morning for more than 20 years and appears before two million viewers every week. Dr. Chris takes an interest in natural health products and has kept up to date with the latest Q10 research. He recommends Bio-Quinone Q10, which he takes himself. Take quality to heart Pharma Nord has spent decades perfecting Bio-Quinone Q10, in order to make a preparation that is able to document superior absorption through scientific research. 2

3 Information for health professionals History Our product Pharma Nord were the first company to introduce coenzyme Q10 (Q10) supplements to the European market, Bio-Quinone Q10 is recognised as a market leader in terms of documented quality and bioavailability. There may be cheaper brands of Q10 available, but these are a false economy. For example, a survey by Consumer Lab of Q10 brands available in the USA found some products contained no Q10 whatsoever! products are manufactured to pharmaceutical standards, a guarantee of product quality; certificates of analysis are available on request. Pharma Nord sources Q10 from world leading Q10 manufacturers. Q10 is produced by a patented process producing impurity-free Q10, in the same chemical form (all transisomeric form) as that produced naturally within the human body. Product Summary: The result of 25 years of product development and research. Efficacy and safety supported by more than 90 clinical studies. The official reference product for the International Coenzyme Q10 Association. 100% nature identical - the same form as the body produces. Blister packed to maintain maximum efficacy. 3

4 In 1978, England s Peter Mitchell won the Nobel Prize in Chemistry for having contributed to the understanding of ubiquinone Q10 s significance for energy production in body cells. Visit UKPharmaNord on You Tube and watch our video on Q10 & Quality! Why is coenzyme Q10 important? Coenzyme Q10 (also known as Q10 or ubiquinone) is a vitaminlike substance that plays a key role in the body s energy supply mechanism. Q10 acts in conjunction with enzymes which convert sugars and fat into energy, in the form of the molecule ATP. This process occurs within the mitochondria, specialised structures found in all cells. Tissues with a high energy requirement (heart, skeletal muscles and liver) are particularly dependent on this process, and an adequate supply of Q10. Q10 is also important as a lipid-soluble antioxidant, protecting cell membranes (particularly those of the mitochondrion) from the damaging effects of free radicals. Q10 is indispensible in mitochondrial bioenergetics and for human life to exist. - Langsjoen PH et al (1990) Int. J Tissue React; 12 (3):

5 Information for health professionals Why is Q10 supplementation important? Although some Q10 is obtained from the normal diet, most Q10 is manufactured within the body (e.g. by the liver). As people age, the capacity of the body to produce Q10 decreases; optimal Q10 production occurs around the mid-twenties, and decreases thereafter. Q10 levels may also be depleted by intense physical exercise, illness or lipid-lowering statin drugs. Dietary supplementation with Q10 therefore provides a mechanism to maintain adequate Q10 levels within the body. Clinical trial studies have shown significant benefit of Q10 supplementation in cardiovascular disease (e.g. congestive heart failure, hypertension), and on statin-associated adverse effects such as muscle pain. The following groups may benefit from taking : Otherwise healthy individuals from age 40 onwards Elderly patients with associated medical problems Patients with cardiovascular disease, including congestive heart failure, angina, hypertension Those receiving statin therapy Sufferers of neurological disorders (Parkinson s; atoxia) Athletes undergoing high intensity training Males with infertility problems 5

6 Many CoQ10 products claim to have superior bio-availability - Is there any documented evidence from the scientific literature to support such claims? Visit UKPharmaNord on You Tube and watch our video on Q10 & Quality! Bio-availability Bio-availability is defined as the proportion of an orally administered substance that reaches the systemic circulation. The Q10 used in Pharma Nord products is subject to a patented treatment step which modifies the crystal structure, which together with the carrier oil formulation, results in superior bio-availability (e.g. Weis et al, 1994). products are the most extensively documented in terms of effects in raising blood Q10 levels in human subjects. Data from some 14 published clinical studies (e.g. Zita et al, 2003) have shown oral supplementation with Bio-Quinone Q mg twice daily raises blood Q10 levels from approx 0.90 to 3.25mg/l. (Ref 1.) Weis M, Mortensen SA, Rassing MR, Møller-Sonnergaard J et al.: Bioavailability of Four Oral Coenzyme Q10 Formulations in Healthy Volunteers; Mol Aspects Med s, Superior absorption at body temperature One of the main reasons for the superior bio-availability of Bio- Quinone Q10 is the unique process used to dissolve the Q10 in oil. Unprocessed Q10 is in crystal form that hinders effective absorption. An inferior preparation is more like a mixture of Q10 crystals and oil, resulting in poor bio-availability of the active Q10. Bio-Quinone Q10 is prepared through a special heating process that transforms the molecular structure of Q10 from rough crystals to a snow-flake like shape. At body temperature, the snow-flake Q10 dissolves, thereby creating a homogenous solution that is more easily absorbed by the body. 6

7 Information for health professionals Did you know? Q10 is very sensitive to sunlight and oxygen. The oil used in Bio-Quinone Q10 is made oxygen free during a specially developed, patented manufacturing process. More over, the capsules are shielded against sunlight to prevent any damage to the active ingredients. One of the best documented Q10 products. Many people use coenzyme Q10 daily, but may be unaware that there can be large differences between products. The table below is a great comparison tool for you to use. Does your Q10 measure up? Bio- Quinone Q10 My current Q10 product Over 25 years of user experience in EU Yes? Scientific evidence for bio-availability Yes? Scientific data on safety Yes? Scientific evidence of effectiveness Yes? Reference product in International Q10 research Yes? Produced in Denmark under GMP control after drug standardisation Yes? Nature Identical Q10 - ie. Identical to the form of Q10 which the body naturally produces Yes? Tested and proven in more than 90 scientific studies Yes? Documentation that the product does not affect the body s own production of Q10 Yes? Used daily by thousands of consumers in more than 40 countries Yes? A unique patented oil matrix ensuring the Q10- crystals are dissolved and can be absorbed Yes? 7

8 Key Research Did you know? products have been used in over 90 clinical studies and Bio-Quinone Q10 is the reference product of the International CoQ10 Association. Improved survival in heart failure patients: The Q-Symbio Study The Q-Symbio study is a multi-national clinical trial study headed by Prof. S Mortensen of Copenhagen University Hospital, Denmark. The study was carried out in patients with chronic heart failure over 18 years of age; the effects of Q10 supplementation on symptoms and biomarker status (hence Q-Symbio) were assessed. The study found significant benefits on heart function, and a reduction in mortality of approx 50%. Study design A long term randomised double-blind placebo-controlled multicentre trial in 420 patients with chronic heart failure (New York Heart Association class III or IV). Patients were assigned 300mg coenzyme Q10 (Bio-Quinone Q10) daily, or placebo. Assessment included clinical examination, ecg and pro-bnp biochemical marker status. Results There was a reduction in mortality of 52% in the treatment group compared to placebo group (18 vs 37). In addition, cardiac function was improved, and hospital admissions reduced, in the treatment group compared to placebo. See the results opposite... 8

9 Information for health professionals Summary of Results Bio-Quinone Q10 Bio-Quinone Q10 Reduced all-cause mortality Reduced cardiovascular mortality: MACE (Major Adverse Cardiovascular Event) Fewer hospitalisations for heart failure Significant improvement of NYHA class Reduced levels of NT-proBNP heart stress bio-marker 9

10 Key Research Did you know? SelenoPrecise by Pharma Nord is the world s most bio-available organic selenium and is approved by The European Food Safety Authority (EFSA). Cardiovascular mortality reduced by 50% in the elderly: The KiSel-10 Study The KiSel-10 study is a clinical trial conducted by Swedish researchers, headed by cardiologist Prof. Urban Alehagen. The study was carried out on the elderly population of the Kinda region of Stockholm, who were given supplemental selenium and Q10 (hence KiSel-10). The study found significant benefits on heart function, and a reduction in cardiovascular mortality risk of more than 50%. Study design A 5 year prospective randomised double-blind placebo-controlled trial in 440 individuals aged years. Participants were assigned 200 mcg selenium (SelenoPrecise) and 200 mg coenzyme Q10 (Bio-Quinone Q10) daily, or placebo. Assessment included clinical examination, echocardiography and the biochemical marker of heart tissue stress, NTproBNP (brain natriuretic peptide). Results There was a greater than 50% reduction in cardiovascular mortality in the treatment group versus placebo group (5.9% vs 12.6%). In addition, cardiac function assessed by echocardiography and NT-proBNP levels were significantly improved in the treatment group compared to placebo. Alehagen U et al (2012) Cardiovascular mortality and N-terminal probnp reduced after combined selenium and CoQ10 supplementation. Int J Cardiol: Epub ahead of print. See the results opposite... 10

11 Information for health professionals Summary of Results Reduction in cardiovascular mortality risk Improved cardiac function (via echocardiography) Decreased levels of NT-proBNP heart stress biomarker 11

12 Key Research Supplemental CoQ10 and selenium improves statin-associated myopathy In addition to inhibiting the body s production of cholesterol, statin drugs also inhibit the production of CoQ10. Adverse effects of muscle pain and muscle weakness in patients taking statins have been attributed to depletion of muscle CoQ10 levels. Study Design In addition to inhibiting the body s production of cholesterol, statin drugs also inhibit the production of CoQ10. Adverse effects of muscle pain and muscle weakness in patients taking statins have been attributed to depletion of muscle CoQ10 levels. Results Plasma levels of CoQ10 significantly increased from a mean value of 0.81 to 3.31umol/l in the treated group. Compared to the placebo group, symptoms of statin associated myopathy significantly improved following CoQ10 treatment, with 54% reduction in muscle pain, 60% reduction in muscle weakness, and 65% reduction in muscle cramps. Statin Myopathy Fedacko J et al (2013) Coenzyme Q10 and selenium in stain associated myopathy treatment Can J Physiol Pharmacol: Epub ahead of print. 12

13 Key Research Information for health professionals Supplemental CoQ10 improves symptoms in patients with fibromyalgia Fibromyalgia is a complex disorder affecting approx 5% of the general population. Symptoms include pain, fatigue, headache and sleep disturbance. Mitochondrial dysfunction and CoQ10 deficiency have been implicated in the pathogenesis of fibromyalgia. Study Design A randomised double-blind placebo controlled trial in 20 patients aged with chronic fibromyalgia diagnosed according to American College of Rheumatology criteria. Patients were assigned 300 mg CoQ10 (Bio-Quinone) daily or placebo for 40 days. Assessment included clinical examination, and gene expression analysis for markers of inflammation and oxidative stress. Results There was a significant improvement in clinical symptoms in the CoQ10 treatment group compared to placebo. There was a 52% reduction in fibromyalgia impact questionnaire, with reductions in pain of 52% and fatigue 47%. in the CoQ10 treatment group, genetic markers of inflammation oxidative stress were downregulated, whilst those for antioxidant defence and mitochondrial biogenesis were up-regulated (compared to placebo). Fibromyalgia Cordero MD et al (2013) Can CoQ10 improve clinical and molecular parameters in fibromyalgia. Antioxid Redox Signal: Epub ahead of print. 13

14 Pharma Nord is a registered ISO:9001 firm and adheres to both Good Manufacturing Practice (GMP) and Good Distributon Practice (GDP). Safety and efficacy of The safety and efficacy of products has been extensively documented in some 90 published clinical studies. Recent examples include benefical effects of Q10 supplementation in reducing the risk of cardiovascular disease in the elderly (Alehagen et al, 2012), in reducing adverse effects of statin treatment (Fedacko et al, 2013), on the symptoms of chronic fatigue syndrome (Cordero et al, 2013), and hereditary blood disorders (Thakur et al, 2012). It should be noted that the benefits of Q10 supplementation described in such studies is proven only for products, and does not apply to Q10 supplements produced by other companies. References Alehagen U et al (2012) Cardiovascular mortality and N-terminal probnp reduced after combined selenium and CoQ10 supplementation: a 5 year prospective randomized double blind placebo controlled trial among elderly Swedish citizens. Int J Cardiol; Epub ahead of print. Cordero MD et al (2013) Can CoQ10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal; Epub ahead of print Fedacko J et al (2013) Coenzyme Q10 and selenium in statin-associated myopathy treatment. Can J Physiol Pharmacol; 91(2): Thakur AS et al (2012) Hematological parameters and RBC TBARS level of Q10 supplemented tribal sickle cell patients: a hospital based study. In J Clin Biochem; Epub ahead of print. Weis M et al (1994) Bioavailability of four oral CoQ10 formulations in healthy volunteers. Mol Aspects Med; 15: Zita C et al (2003) CoQ10 concentrations in healthy men ingesting Bio-Quinone 30mg Q10 or Bio-Quinone 100mg Q10 or placebo, daily for two months. Biofactors; 18(1-4):

15 Statistics - Consumer Survey Use Energy 52% With Statins 29% Heart 41% Gums 14% (Many respondents take it for more than one reason) Perceived Efficacy % who found effective 84% Recommendation % who would recommend 98% Participants in survey: July Blister packs beat jars! If you buy vitamins in jars, be aware that the moisture and contaminants in the atmosphere can degrade delicate nutrients. Avoid wasting money on tablets that have lost their potency and capsules that stick together. Visit UKPharmaNord on You Tube and watch our video on Blister Packing! 15

16 98% recommend it!* *Consumer survey, 2137 users, July 2013, Pharma Nord Feedback Cards Excellent product. It was recommended by my husband s heart doctor due to his intolerance of the cholesterol statins. Ever since he consumes the Q10, he has no problem with his join and muscle pain My husband and I have been taking Q10 for more than 30 years. We are now 78 years of age. My husband is still running, has an allotment and swims, attends a gym 3 times a week. P. C Whitmore B. Munt Excellent product. I m taking the 100mg Q10 as recommended by my doctor and feel better. More tolerance in everyday activities and extra protection for my heart. I started taking Pharma Nord Bio-Quinone Gold 100mg because my immune system was not good. I consider the decision to take this product to be one of the best i have made in my life. Nick K A. Baker For more information please contact customer services: Tel: +44 (0) uksales@pharmanord.co.uk Visit: Pharma Nord (UK) Ltd, Telford Court, Morpeth, Northumberland, NE61 2DB. Reg. Number