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Should You Take CoQ10 with Statins?

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Updated July 08, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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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 generally agreed-upon answer to this question.

CoQ10 - also known as ubiquinone - is a coenzyme that helps muscles produce the energy they need to do their work. Some studies suggest that statins can reduce the amount of CoQ10 in muscle tissue, and it has been speculated that reduced levels of CoQ10 might contribute to the muscle injury that can be associated with statins. So, some doctors recommend CoQ10 supplementation with statin therapy.

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

First, not all studies show that statins affect CoQ10 levels. And second, studies with CoQ10 in patients taking statins have been very limited. Only a few, small studies have been completed, and the results of these few studies are mixed.

Here is what UpToDate, an electronic reference for doctors and patients, has to say about these studies:

  • "A small thirty-day randomized trial that compared CoQ10 100 mg daily with vitamin E 400 IU daily in 32 patients with myopathic pain while receiving statins found a significant reduction in pain in patients treated with CoQ10, but not in patients treated with vitamin E; neither treatment affected plasma CK levels [128]. Short-term administration of CoQ10 would not be expected to substantially increase tissue levels of ubiquinone, and the findings from this trial need confirmation in a larger trial with a longer duration of CoQ10 therapy."
  • "In a preliminary report, a small randomized trial compared twelve weeks of CoQ10 200 mg daily with placebo in 44 patients with statin-induced myalgia [129]. Patients were off lipid-lowering therapy for two weeks prior to randomization and were then treated with escalating doses of simvastatin (10 to 40 mg daily as tolerated). CoQ10 supplementation increased plasma CoQ10 levels but reportedly did not increase the proportion of patients who tolerated simvastatin or decrease myalgia scores."
In summary, the few, small studies that have been completed have yielded conflicting results. Some appear to show some benefit from CoQ10, while others appear to show none. The bottom line is that there is not enough evidence at this point to recommend CoQ10 supplementation as a general policy in people taking statin drugs.

However, if you are having muscle pain while on statins, you should talk to your doctor about first switching to one of the statin drugs that are especially unlikely to produce muscle problems, namely, Lescol (fluvastatin) or Pravachol (pravastatin). If that is not an option, or if muscle pain persists, then taking a trial of CoQ10 would make sense.

Want to learn more? See UpToDate's topic, "High Cholesterol Treatment Options," for additional in-depth medical information.

Sources:

Rosenson RS, Baker SK. Muscle injury associated with lipid lowering drugs. UpToDate. Accessed: August 1, 2011

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