QUESTION: Patient began receiving CoQ10 Injections and as received 8 -20mg Injections and 6- 40mg Injections. COQ 10 Level was 1.01 in two months ago and is now at 0.3. Have you encountered an incident like this before?
ANSWER: You see this with fat soluble things (like Vit D) and parenteral application. There are a few potential reasons for a single test to show a similar or lower level of the analyte on follow up testing.
- The metabolism of Q10 is mostly intracellular and so IM has to go to the plasma then obviously to the cell to be metabolized.
- One thing with fat solubles is that IM admin should not be re-checked for 6-8 weeks after an IM series due to local (to the IM) fat and muscle depot and slow equilibration to the plasma.
- Another is that the intracellular nature of the Q10 makes plasma sampling tricky to equate to cell levels.
- And finally, the accurate assay of CoQ10 is very difficult in any lab. The sampling and prep for transport is very critical so false negatives and positives are common – therefore I almost never test for it, and if I do I have the patient run serial samples (with exquisite care in processing) and average three samples to get a trend.