Key Takeaways
- Statins lower cholesterol but can cause muscle pain, and some people take CoQ10 to help.
- There’s not enough evidence to prove CoQ10 helps with muscle pain from statins.
- Always talk to your healthcare provider if you have side effects from statins.
Statins are a class of medicines commonly prescribed to lower cholesterol and help prevent heart attacks and strokes.
While they have lots of benefits, statins are also associated with muscular side effects, ranging from muscle pain to breakdown.
Statins deplete your muscles’ coenzyme Q10 (coQ10), which may lead to muscle damage. Some people who take statins also supplement with coQ10 to minimize muscular side effects.
Here’s what you need to know about coQ10 supplementation for people on statin therapy, including possible benefits and precautions.
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Statins
Statins, also known as HMG-CoA reductase inhibitors, are the primary medications used to lower low-density lipoprotein cholesterol (often referred to as “bad” LDL cholesterol).
Statins can generally reduce LDL cholesterol levels by 20% to 50% and lower triglycerides (fats) by 10% to 20%. These changes can help protect the heart. Research shows that taking a statin for five years can reduce the risk of major heart problems by about 10%.
About 25% of Americans over 39 take a statin medication. This class of drugs includes commonly-prescribed medications like:
Statins can cause significant side effects that primarily affect the muscles. These may include:
Research shows that 10% to 25% of people who take statins report muscular side effects, which may lead to discontinuing treatment. It is important to notify your healthcare provider of any adverse effects and decide how adverse effects should be addressed.
Other side effects of statin therapy include:
Uses of CoQ10
Supplement use should be individualized and vetted by a healthcare professional, such as aregistered dietitian nutritionist (RD or RDN), pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
CoQ10, also known as ubiquinone, is an important energy source for every cell in the body. It has antioxidant and anti-inflammatory properties.
Many disease states are associated with low levels of coQ10. Some of these include:
CoQ10 is one of the most commonly used dietary supplements in the U.S. It’s been studied for conditions such as:
Keep in mind that so far, there’s not enough evidence to routinely recommend coQ10 for all of these uses.
CoQ10 is made in the body by the same pathway blocked by statins. CoQ10 levels can be depleted in people who take these medicines. It’s theorized that lower levels of coQ10 are responsible for the muscular side effects of statin medications.
But overall, the data is mixed and doesn’t fully support taking coQ10 to counter all statin side effects.
A small study compared the effects of 400 milligrams (mg) of coQ10 daily to a placebo (sugar pill) in 37 adults who also took simvastatin. Researchers concluded that eight weeks of coQ10 supplementation had no significant effect on levels of coQ10 in the muscles. CoQ10 supplements did not improve symptoms of muscle pain, even in those who did see an increase in coQ10 levels in the muscles.
However, another clinical trial showed a coenzyme Q10 supplementation (50 mg twice daily) reduced statin-related muscle symptoms.
Researchers completed an analysis of eight clinical trials that examined coQ10’s role in people taking statins. The effects of coQ10 supplementation were mixed or didn’t support use in muscle pain any more than a placebo. It also didn’t significantly increase creatine kinase activity, which may be a marker for muscle pain.
Nutrition
CoQ10 is made in the body. It can also be obtained through some foods or in supplement form.
In general, the body needs about 500 milligrams (mg) of coQ10 daily, but only about 5 mg of this comes from food sources. Standard doses of coQ10 supplements are 300 mg.
Foods rich in coQ10 include the following:
- Organ meats
- Fish, like salmon and tuna
- Nuts
- Oils
- Whole grains
- Soy
- Spinach
Special Considerations
Precautions
Discuss the use of coQ10 with your healthcare provider prior to using it if you are in one of these categories to optimize safety:
- Avoid coQ10 if you’re allergic to it or its components (parts).
- Seek immediate medical attention if you have a severe allergic reaction (itching, hives, shortness of breath).
- Some people should take extra precautions while taking this supplement. These include children and those who are pregnant or nursing.
Side Effects
As with all supplements, coQ10 may cause side effects. These side effects may be common or severe.
Mild side effects of coQ10 include:
Interactions
CoQ10 may interact with the following prescription medications:
- Statins. As detailed above, statins reduce levels of coQ10 in the body.
- Jantoven (warfarin). CoQ10 is structurally similar to vitamin K and may decrease levels of Jantoven in the body.
- Theophylline. Animal studies show an interaction between theophylline, an asthma medication, and coQ10.
- Insulin and other diabetes medications. CoQ10 decreases fasting blood sugar levels slightly, so it could cause low blood sugar (hypoglycemia) if taken with other diabetes medicines. Signs of hypoglycemia include fast heart rate, shakiness, or headache.
Carefully reading a supplement’s ingredients list and nutrition facts panel to know which ingredients and how much of each ingredient is included is essential. Please review the supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says.
When choosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
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