If you want a heart that pumps well into old age, keeps a proper rhythm, and moves blood through the body smoothly, then you need a heart that is all charged up. We will discuss my top two supplements for a healthy heart: coenzyme Q10 (CoQ10) and L-carnitine. These two natural heart treatments have shown powerful results when it comes to saving lives, reducing hospital stays, improving circulation, and strengthening the heart so it can pump more blood. Clinicians, consider these important nutrients when working with your patients with heart conditions. Keep reading to find out the great safety profiles of CoQ10 and L-carnitine, even at very high doses. Patients, if you have chronic heart problems that aren’t getting better, your heart may be starving for the nutrients it needs to work properly. We will talk about the best supplements for heart health, the foods rich in them, and a urine test that can help determine if your heart muscle is thriving and if you have enough CoQ10 or L-carnitine to power it up.
We are grateful to our sponsor, Diagnostic Solutions Laboratory, for making this blog possible.
The Heart is a Battery
How is it that the heart can keep going and going and never stop? This “Energizer Bunny” effect is because the heart is chock full of mitochondria- the powerhouses of the cell. Every cell of the body requires mitochondria to make fuel or ATP (adenosine triphosphate). Without enough ATP, your cells cannot do the work they are supposed to do. “The heart is a battery,” Stephen Sinatra, MD, an integrative cardiologist often said. When cells are all charged up with fuel or ATP, the heart works well. Blood and oxygen are circulating well; you have more energy, you can meet your workout goals, you can think more clearly and focus, and much more.
The heart is the organ of the body most densely packed with mitochondria. In fact, a heart cell can have 5,000 mitochondria per cell! This number exceeds other tissues such as muscles, the brain, the liver, and kidney, which also require high amounts of energy. All of this goes to show that the highest-performance organs, the ones that do the most metabolism, are the ones that need the most ATP. When these highly metabolic organs are failing, whether it be the heart, the brain, or the liver, what they need most is a boost for their mitochondrial health.
Best Supplements for Heart Health
When it comes to building up the heart, my two favorite heart health supplements are CoQ10 and L-carnitine. I’m not alone, Stephen Sinatra included CoQ10 and L-carnitine in his “Awesome Foursome” recommendations for heart health supplements. CoQ10 and L-carnitine are critical for powering up the mitochondria in the heart. So, when a person’s heart is flagging, these are the vitamins for heart health that may be running low. There is a simple urine test that will help figure out if you need L-carnitine or CoQ10, which I will discuss more in a moment.
Dr. Stephen Sinatra’s “Awesome Foursome” for Cardiovascular Health
- CoQ10
- L-Carnitine
- D-Ribose
- Magnesium
There is a great divide between hospital medicine and nutritional medicine in the U.S. that affected my mother-in-law and it affects every patient in the United States. I hope one day cardiologists and ICU wards will have ALL of the tools at their disposal- bringing to bear the best of emergency medicine, nutritional medicine, and functional medicine for a truly integrative medical system that helps us all live longer and better lives.
CoQ10 Supplements Power Up Failing Hearts
So, what exactly is CoQ10? It’s a vitamin-like compound that your body naturally makes, and it plays a huge role in cellular energy production. Think of it as a spark plug that helps fire up the mitochondria to generate ATP. CoQ10 is also a strong antioxidant, which means it helps protect your cells from harmful free radicals, keeping them healthier for longer.
Symptoms of Low CoQ10:
- Fatigue and low energy
- Muscle weakness and pain
- Heart conditions
- Brain fog and neurological issues
- Weakened immune system
Research shows CoQ10 supplements have powerful benefits for patients with chronic heart failure.1-4 CoQ10 improves how much the heart can pump and how consistently.5 It also helped nourish the heart after heart attacks.5 People taking CoQ10 were less likely to die or be hospitalized due to heart failure.6,7 In another study, CoQ10 helped people with congestive heart failure, improving how well the heart pumped blood and preventing deaths.
CoQ10 is well tolerated by most people and considered safe, even when given at very high doses such as 1,800 mg per day.8 Many scientists agree that CoQ10 has a great safety profile, is affordable, is a natural supplement, and should be considered as an adjunctive treatment for heart failure.3
So, why don’t they use CoQ10 in hospitals in the U.S.?
Someone in good health makes enough CoQ10, but levels tend to drop with an unhealthy diet, increasing age, stress, and chronic illnesses. People who take cholesterol-lowering medications, called statins, can run out of CoQ10, because statins block the body’s ability to make CoQ10.9
Foods High in CoQ10:
- Beef heart and liver
- Fatty fish
- Pistachios and sesame seeds
- Spinach
By supporting your mitochondria with CoQ10, you’re not just helping your heart and muscles work better—you’re giving your entire body the energy it needs to function at its best.
L-Carnitine Boosts Heart Function and Saves Lives
L-Carnitine is an amino acid compound that your body naturally produces. It acts like a shuttle for fat, helping move fatty acids into the mitochondria where they can be burned for energy. L-Carnitine supercharges mitochondria, especially within the heart. Like our other superstar heart health supplement CoQ10, L-carnitine is a powerful antioxidant. It helps protect cells from oxidative stress.
Without enough L-carnitine, your body struggles to make energy from fat, and that can leave you feeling sluggish, mentally foggy, and slow to recover from exercise.
Symptoms of L-Carnitine Deficiency:
- Muscle weakness and fatigue
- Heart problems
- Brain fog and developmental issues
- Low blood sugar
- Liver and kidney dysfunction
L-Carnitine does wonders for heart function, especially for people with chronic heart failure. L-Carnitine saves lives, helps normalize the heart rhythm, and reduces chest pain after heart attacks.10 The heart pumps better, pumps more blood,7,11 and can maintain a better rhythm with L-carnitine.12 In fact, the heart seems to heal when L-carnitine is given.13
L-Carnitine supplements can help prevent heart failure and life-threatening arrhythmias. This led scientists to say, “L-Carnitine deficiency is a treatable cause of heart failure in young adults.”12 L-Carnitine protects against damage to the heart during heart attack, it can treat certain genetic cardiomyopathies (diseases that weaken the heart muscle), and it enhances circulation.14
Like CoQ10, L-carnitine is safe and doesn’t have side effects or toxicities, even with very high doses.13 Researchers say, “L-Carnitine may be safely administered at doses up to 3000 mg/day.”15 It’s a natural substance that we eat and that our bodies make every day.
So, why isn’t L-carnitine given in hospitals when treating people with heart failure?
Your body makes L-carnitine on its own, but you also get it from food—especially from red meat. Disease, getting older, eating an unhealthy diet, or certain genetic conditions can rob your body of L-carnitine.
Foods high in L-carnitine:
- Beef
- Pork
- Cod and tuna
- Dairy
Note: Recent evidence suggests that high-carnitine diets can lead to the production of TMAO by the gut microbiota, an unhealthy substance for the heart. There is more to learn about this.16
Many scientists agree that L-carnitine can be a game changer for someone with heart problems. L-Carnitine supplementation improves outcomes following heart attacks and helps keep the heart going, even after being starved of oxygen.10 That’s impressive!
Photo by National Cancer Institute on Unsplash
The Test That Measures Your Heart’s Metabolic Health: Organic Acids
Does your body have enough CoQ10 and L-carnitine? It isn’t easy to know for sure. Testing can help you figure it out. One of my favorite tests for checking on heart health- especially how well the mitochondria are working- is the Organic Acids Profile (OAp) from Diagnostic Solutions Laboratory. This is a simple urine test that takes a look at how well your cells are making energy.
The heart is pumping day in and day out, so it requires a lot of energy to do its job. When the heart does not function properly, it can be a sign that the mitochondria are struggling and cannot make energy. It means the heart (or the body’s battery) has run out of juice.
This is a simple urine test that can help determine if your heart needs extra CoQ10 and carnitine support. When specific organic acids are out of normal ranges, it can point to heart problems17,18 or cardiometabolic risks.19 When the heart muscle gets weak and can’t pump blood effectively (adult-onset dilated cardiomyopathy), some researchers recommend testing for organic acid disorders because it can reveal why the heart cannot make energy effectively and dietary treatments to fix it.18
Organic acids are byproducts that our bodies make every day as part of normal metabolism. Historically, measuring organic acids helped to figure out genetic and metabolic diseases that hurt heart function or caused other serious diseases.17 These diseases were a matter of life and death, which prompted them to begin screening for them in newborns in the United States in 1965. Leaders in integrative and functional medicine, J. Alexander Bralley, PhD and Richard Lord, PhD developed organic acid testing in the 1990s for use in chronically ill patients, not just in newborns.
Shore Up Heart Health with CoQ10 and L-Carnitine
The heart is a battery that does tremendous work pumping blood day in and day out. This battery is powered by thousands of mitochondria in every heart cell. In heart failure, both CoQ10 and L-carnitine supplements have shown remarkable results for strengthening the heart so it can function better, preventing heart deaths, cutting down on hospitalizations, promoting good circulation, and balancing blood pressure. They are safe and affordable. Yet these treatments are not available in hospitals or routinely recommended by cardiologists. Clinicians, consider CoQ10 and L-carnitine when treating patients with heart disease. Certain foods are high in these heart healthy nutrients, especially beef and fish. For developing a personalized treatment plan, organic acids urine testing can determine if the heart is making enough energy on its own, or if it needs supplemental CoQ10 and/or L-carnitine for better metabolism. Since CoQ10 and L-carnitine are essential not only for heart health, but also energy, brain function, and muscle performance, keeping levels optimal is good for overall vitality and longevity.
Boost Your Heart Health with These Natural Treatments
- Find a good integrative cardiologist who addresses root causes of heart disease with diet, blood sugar balance, exercise, stress reduction, infections, and personalized nutrition.
- Eat CoQ10-rich foods like beef organ meats, fatty fish (salmon, mackerel), nuts, and spinach.
- Eat carnitine-rich foods such as beef, pork, cod, tuna, and dairy.
- Test mitochondrial health, CoQ10, and L-carnitine with a urine OAp Organic Acids Profile from Diagnostic Solutions Laboratory.
- Measure serum CoQ10 levels.
- CoQ10 supplements, to be taken as directed with a fatty meal: 100 mg – 300 mg per day, with up to 1800 mg/day reported as safe. Both ubiquinone and ubiquinol forms are suitable, but the ubiquinol form is believed to be more absorbable.
- L-Carnitine supplements, to be taken as directed: 250 – 500 mg three times a day, with up to 3,000 mg/day reported as safe.
Diagnostic Solutions Laboratory bridges the gap between healthcare providers and the clinical laboratory by offering cutting-edge laboratory tests such as GI-MAP, OMX (Organic Metabolomics), IgG Food Explorer, IgE Allergy Explorer, CytoDX, and GenomicInsight. Designed to identify underlying root causes of symptoms and disease, our test results give practitioners the tools needed to formulate personalized treatment protocols for optimized patient outcomes. Our commitment to education and service ensures both practitioners and their patients will benefit from the latest research.
References
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8. Yeung CK, Billings FTt, Claessens AJ, et al. Coenzyme Q10 dose-escalation study in hemodialysis patients: safety, tolerability, and effect on oxidative stress. BMC Nephrol. Nov 3 2015;16:183. doi:10.1186/s12882-015-0178-2
9. Ahmad K, Manongi NJ, Rajapandian R, et al. Effectiveness of Coenzyme Q10 Supplementation in Statin-Induced Myopathy: A Systematic Review. Cureus. Aug 2024;16(8):e68316. doi:10.7759/cureus.68316
10. DiNicolantonio JJ, Lavie CJ, Fares H, Menezes AR, O’Keefe JH. L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis. Mayo Clinic proceedings. Jun 2013;88(6):544-51. doi:10.1016/j.mayocp.2013.02.007
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12. Kayikcioglu M, Ozbay B, Yagmur B, et al. Primary Carnitine Deficiency as a Treatable Cause of Heart Failure in Young Patients. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. Oct 2022;50(7):535-539. doi:10.5543/tkda.2022.21319
13. Song X, Qu H, Yang Z, Rong J, Cai W, Zhou H. Efficacy and Safety of L-Carnitine Treatment for Chronic Heart Failure: A Meta-Analysis of Randomized Controlled Trials. BioMed research international. 2017;2017:6274854. doi:10.1155/2017/6274854
14. Lango R, Smolenski RT, Narkiewicz M, Suchorzewska J, Lysiak-Szydlowska W. Influence of L-carnitine and its derivatives on myocardial metabolism and function in ischemic heart disease and during cardiopulmonary bypass. Cardiovascular research. Jul 2001;51(1):21-9. doi:10.1016/s0008-6363(01)00313-3
15. Cruciani RA, Dvorkin E, Homel P, et al. Safety, tolerability and symptom outcomes associated with L-carnitine supplementation in patients with cancer, fatigue, and carnitine deficiency: a phase I/II study. J Pain Symptom Manage. Dec 2006;32(6):551-9. doi:10.1016/j.jpainsymman.2006.09.001
16. Demarquoy J. Revisiting the Role of Carnitine in Heart Disease Through the Lens of the Gut Microbiota. Nutrients. Dec 9 2024;16(23)doi:10.3390/nu16234244
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19. Oliveira LC, Azinheira Nobrega Cruz N, Passadore M, et al. Abstract P420: Amino acid and organic acid signature in urine of prepubescents with higher cardiometabolic risk evaluated by waist-to-height ratio. Hypertension. 2024;81(Suppl_1):AP420-AP420. doi:doi:10.1161/hyp.81.suppl_1.P420
Cass Nelson-Dooley, MS, is a researcher, author, educator, and laboratory consultant. She studied medicinal plants in the rain forests of Panama as a Fulbright Scholar and then launched a career in science and natural medicine. Early on, she studied ethnobotany, ethnopharmacology, and drug discovery at the University of Georgia and AptoTec, Inc. She joined innovators at Metametrix Clinical Laboratory as a medical education consultant helping clinicians use integrative and functional laboratory results in clinical practice. She owns Health First Consulting, LLC, a medical communications company with the mission to improve human health using the written word. Ms. Nelson-Dooley is an oral microbiome expert and author of Heal Your Oral Microbiome. She was a contributing author in Laboratory Evaluations for Integrative and Functional Medicine and Case Studies in Integrative and Functional Medicine. She has published case studies, book chapters, and journal articles about the oral microbiome, natural medicine, nutrition, laboratory testing, obesity, and osteoporosis.
