Should You Take CoQ10 with Statins?

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Question: Should You Take CoQ10 with Statins?

My doctor has put me on generic simvastatin to lower my cholesterol. I seem to be tolerating it OK, but I've heard that if you are taking a statin drug, you should also take CoQ10 to prevent muscle problems. Is that true? Should I be taking CoQ10?

Answer:  Unfortunately, there is no definitive answer to this question. However, the clinical evidence we have to date suggests that CoQ10 does not help much, if at all, to prevent or treat muscle problems with statins.

What Is CoQ10?

CoQ10  — also known as ubiquinone — is a coenzyme that helps muscles produce the energy they need to do their work. While some studies have suggested that statins can reduce the amount of CoQ10 in muscle tissue, other studies have not found a decrease in CoQ10 levels with statins. So even the question of whether statins affect CoQ10 levels at all is not entirely clear. In any case, many have speculated that reduced levels of CoQ10 might contribute to the myopathy (muscle injury) that can occur with statins. So, some doctors recommend CoQ10 supplementation with statin therapy.

What Is the Evidence On CoQ10 and Statins?

The medical literature is mixed on the CoQ10 question, and for two reasons.

First, as mentioned, not all studies show that statins affect CoQ10 levels in muscle tissue itself.

And second, the studies with CoQ10 in people taking statins have been very limited. Only a few, small, short-term studies have been completed, and the results of these few studies generally have been disappointing.

The clinical studies that have been conducted so far have examined the ability of CoQ10 to treat statin-induced muscle pain. The purpose of these studies was to determine whether taking CoQ10 would allow patients with statin-induced muscle pain to continue taking statins. This is an important matter, because when it comes to reducing cardiac risk due to cholesterol levels, there is as yet no good substitute for the statins.

These studies have yielded conflicting results. A randomized trial trial in 32 patients with statin-induced muscle pain showed that, after 30 days, those receiving CoQ10 had a significant reduction in muscle pain compared to those randomized to receive vitamin E. The 30-day duration of this study is viewed a problem, however, because it takes more than 30 days for CoQ10 supplementation to affect the amount of CoQ10 in the muscles themselves. Furthermore, several similar, longer-term trials with CoQ10 have shown no improvement in muscle pain on statins.

To attempt to settle the issue, a meta-analysis was performed in 2015, analyzing the available randomized trials. This analysis found no significant benefit when CoQ10 is used to treat statin-induced myopathy.  However, the quality of the available studies remains an issue, so the results of this meta-analysis cannot be considered definitive. Larger, longer-term randomized trials would be necessary to really get a handle on this question.

None of this, however, really gets to your question, which is, should a person taking statins also take CoQ10 to  prevent  statin myopathy? The reason I have only talked about using CoQ10 to treat statin-induced muscle pain is that there is at least some data available that addresses this question (as paltry as that data may be).

But when it comes to using CoQ10 as a preventive measure, the only evidence available is entirely anecdotal. There are no published randomized controlled trials that address this question.

CoQ10 and Statins - The Bottom Line

The bottom line is that no good, objective evidence from clinical trials is available to show whether CoQ10 either prevents or effectively treats statin-induced muscle pain. At the same time, the theory that CoQ10 might help remains admittedly intriguing, and the studies that have been done are quite limited in their scope and duration. Furthermore, taking CoQ10 supplements (as far as anyone knows) is harmless.

So if you are interested in trying it, and can afford it, most doctors would voice no strong objection to the idea.

If you are having muscle pain while on statins, you should talk to your doctor about trying one of the statin drugs that are are known to be unlikely to produce muscle problems, namely, Lescol (fluvastatin) or Pravachol (pravastatin).  Also, make sure your doctor checks your thyroid function and your vitamin D levels, since either hypothyroidism or low vitamin D will make statin myopathy more likely.

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  • Banach M, Serban C, Sahebkar A, et al. Effects of Coenzyme Q10 on Statin-induced Myopathy: a Meta-analysis of Randomized Controlled Trials. Mayo Clin Proc 2015; 90:24.
  • Bookstaver DA, Burkhalter NA, Hatzigeorgiou C. Effect of Coenzyme Q10 Supplementation on Statin-induced Myalgias. Am J Cardiol 2012; 110:526. 
  • Caso G, Kelly P, McNurlan MA, Lawson WE. Effect of Coenzyme q10 on Myopathic Symptoms in Patients treated with Statins. Am J Cardiol 2007; 99:1409.
  • Taylor BA, Lorson L, White CM, Thompson PD. A Randomized Trial of Coenzyme Q10 in Patients with Confirmed Statin Myopathy. Atherosclerosis 2015; 238:329.