Does Coenzyme Q10 Reduce Statin-Related Muscle Aches?

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Does Coenzyme Q10 Reduce Statin-Related Muscle Aches?
Studies have provided mixed results.

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CreditCreditStuart Bradford
By Richard Klasco, M.D.

Q. Does coenzyme Q10 help to reduce muscular issues and other negative side effects associated with statins? And if so, should doctors give this information to patients when statins are prescribed?
A. Coenzyme Q10, a popular dietary supplement marketed as CoQ10 “to promote heart health,” probably does not reduce statin-induced muscle problems.
In 1957, researchers at the University of Wisconsin discovered a molecule that helps muscle cells generate energy. Today, that molecule is commonly known as coenzyme Q10.
In 1978, investigators, including Dr. Michael Brown and Dr. Joseph Goldstein, who would go on to win the Nobel Prize, noted that cholesterol and coenzyme Q10 are synthesized by the same biochemical pathway. As a result, statins not only lower cholesterol levels, they also deplete the body’s stores of coenzyme Q10.
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This finding renewed interest in coenzyme Q10. Was its depletion the cause of statin-induced muscle aches? If so, could restoring coenzyme Q10 to normal levels with supplements counteract these problems? This theory attracted many proponents, including Dr. Brown, who in 1989 filed a patent on coenzyme Q10 as a treatment for statin-induced muscle problems.
In the ensuing years, coenzyme Q10 was studied extensively as a treatment for statin-induced muscle problems. But the studies yielded conflicting results.

In 2015, the Lipid and Blood Pressure Meta-analysis Collaboration Group combined data from six randomized controlled trials of coenzyme Q10 as a treatment for statin-induced muscle problems. Their meta-analysis of 302 patients concluded that coenzyme Q10 was not beneficial. A subsequent randomized controlled trial of coenzyme Q10 in 41 patients with proven statin-induced muscle problems reached the same conclusion.
Rigorous studies of coenzyme Q10 for other medical conditions — such as heart failure, Parkinson’s disease and Huntington’s disease — have also found it to be ineffective.
Some argue, with some justification, that the studies of coenzyme Q10 were not large enough, or were not long enough, or used various preparations and doses of coenzyme Q10. Still, considering the preponderance of evidence, there is no proof coenzyme Q10 helps prevent statin-induced muscle problems.


Like all dietary supplements, coenzyme Q10 is not regulated as a drug by the Food and Drug Administration, so there may be important differences between different manufacturer’s products. Side effects may also occur, including insomnia and upset stomach, and it may interact with drugs such as blood thinners, insulin and certain chemotherapies. If you do take coenzyme Q10, seek your doctor’s advice.
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Coenzyme Q10
By Mayo Clinic Staff
Overview
Coenzyme Q10 (CoQ10) is an antioxidant that your body produces naturally. Your cells use CoQ10 for growth and maintenance.
Levels of CoQ10 in your body decrease as you age. CoQ10 levels have also been found to be lower in people with certain conditions, such as heart disease.
CoQ10 is found in meat, fish and whole grains. The amount of CoQ10 found in these dietary sources, however, isn't enough to significantly increase CoQ10 levels in your body.
As a supplement, CoQ10 supplement is available as capsules, tablets and by IV. CoQ10 might help treat certain heart conditions, as well as migraines and Parkinson's disease.

Evidence
Research on CoQ10 use for specific conditions and activities shows:

• Heart conditions. CoQ10 has been shown to improve symptoms of congestive heart failure. Although findings are mixed, CoQ10 might help reduce blood pressure. Some research also suggests that when combined with other nutrients, CoQ10 might aid recovery in people who've had bypass and heart valve surgeries.
• Parkinson's disease. Early research suggests that high doses of CoQ10 might be beneficial for people in the early stages of this progressive disorder of the nervous system that affects movement.
• Statin-induced myopathy. Some research suggests that CoQ10 might help ease muscle weakness sometimes associated with taking statins.
• Migraines. Some research suggests that CoQ10 might decrease the frequency of these headaches.
• Physical performance. Because CoQ10 is involved in energy production, it's believed that this supplement might improve your physical performance. Research in this area has produced mixed results, however.

Our take
Generally safe
CoQ10 supplements might be beneficial for treating conditions such as congestive heart failure and Parkinson's disease. CoQ10 is considered safe, with few side effects. However, be sure to take this supplement under your doctor's supervision.

Safety and side effects
CoQ10 supplements appear to be safe and to produce few side effects when taken as directed.
Mild side effects might include:

• Upper abdominal pain
• Loss of appetite
• Nausea
• Diarrhea
• Headaches
• Insomnia
• Rashes
• Fatigue
• Dizziness
• Light sensitivity
• Irritability

The safety of use of CoQ10 during pregnancy and breast-feeding hasn't been established. Don't use CoQ10 if you're pregnant or breast-feeding.

Interactions
Possible interactions include:

• Anticoagulants. CoQ10 might make blood-thinning drugs, such as warfarin (Coumadin, Jantoven), less effective. This could increase the risk of a blood clot.
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