In Brazil are great experiments with Coenzyme Q10, i looked up some of these studies in brazilian magazine Rural BR. The article is in portuguese language: https://www.ruralbr.com.br/super-alimentos/vitaminas/coenzima-q10/
The article did not talk about research on my use of CoQ10, improvement of energy level while taking statins.
I used to run but then I could not run - no energy. I did not connect it with statins - I never had pain from statins. But somehow I learned that statins lower CoQ10 and since CoQ10 is necessary for mitochondria to produce energy I gave it a try, minimal 30 mg/day. I run again !
Btw, to avoid a high dose of statin, I take exetimibe ( Zetia) along with a low dose of statin. I get the anti inflammatory benefit of the statin along with the v effective LDL control with Zetia. Zetia has no known side effects, it stays in your intestine, never enters your blood stream or the rest of the body. And is now available generic, not expensive.
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I looked up some of these studies mentioned and most, if not all, used Coenzyme Q10. It is pretty well known that some people have genetic polymorphisms that do not allow Coenzyme Q10 to convert to Ubiquinol, the more active and bioavailable form that our body uses. Some of these studies also used very low doses. For example, the Parkinson's study used 200 mg of CoQ10. But a study that used 1200 mg did show positive benefits. Ubiquinol has been shown to raise blood levels far better than CoQ10 so perhaps some of the conflicting and unremarkable evidence is due to the dose and the form of the supplement. In addition, when they measure blood levels of Coenzyme Q10--that is no indication that CQ10 actually converted to its bioactive form (Because as mentioned, not everyone has that capability). In addition, more recent developments in CoQ10 utilize supplements that are even more bioavailable than ubiquinol such as MitoQ10. For example, https://www.ncbi.nlm.nih.gov/pubmed/24309493 ; https://www.ncbi.nlm.nih.gov/pubmed/19581509 and https://www.ncbi.nlm.nih.gov/pubmed/29661838 are examples that mitQ10 improves vascular function. Perhaps this book isn't yet closed.
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My internist and cardiologist believed in it but lowering my statin from 180 milligrams a day was more helpful. When I took such a large amount of statin I could not climb stairs. They reduced the statins and added another drug and my LDL went way down.
Someone in the gym asked why I took 180 milligrams of statins and I answered that my cardiologisgt want me to die of cancer.
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The reason you couldn't climb the stairs is because Statins destroy Mitochondria.
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It is disappointing that the Times' Well section author chose to rely on outdated information/references for some of the blanket negative statements, and that the Times' editors failed to do appropriate fact-checking. Medical information is not static; it proceeds incrementally and is revised as new, hopefully better, more comprehensive and newly-informed studies are conducted and published. For example, the negative statement on the effects of CoQ10 and heart failure cites a report from 2000. The following (from 2016) is more representative of current thinking: https://www.ncbi.nlm.nih.gov/pubmed/27012265/
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@A Sastre
Thank-you for your post. It is one of the greatest frustrations when reading NYT to see so many out-dated health articles which either do not rely on current information or push drugs/vaccines without telling the reader all of the facts.
Statins also inhibit biosynthesis of isoprenes, which are intermediates in the path to cholesterol. The isoprenes in turn are substrates for molecules that attach to, and regulate, cell proteins known as G proteins, a large family that are essential for cells to communicate with their environments, and with each other. Many are involved in inflammation, also a factor in heart disease. In other words, it's complicated.
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I'm prescribed a statin for familial hypercholesterolemia. However, at a full dose I suffered muscle aches and mental fogginess. After trying several different products in different combinations, my symptoms diminished greatly after my Lipidologist reduced the most tolerable statin by 1/2, which still manages to keep my lipid profile in an acceptable range.
Statins are thought to deplete body stores of CoQ10; all I know is that taking a dose daily minimizes statin side effects for me.
Check out the writings of the late Duane Graveline, MD; his personal experience with transient global amnesia after initiating statin therapy, and his subsequent research, is most interesting.
@Sunny
Personal experience or a witness’ personal account is the weakest scientific evidence and can be misleading. The size of the population studies is important, so is the design of the study. In fact, we know a large percentage of published research reports are not of adequate quality, even if they are published in respectable professionals journals. The gold standard of this kind of studies is the randomized controlled study.
Shouldn’t we start by questioning whether it makes sense for 1/4 of Americans over 45 to be prescribed one single drug: a statin? Then, in a healthcare environment with no effective system for collecting data on adverse effects, shouldn’t we next be concerned about what percentage of people get muscle pain (or worse!), from statins?
In searching for help with my own statin-triggered disease, I’ve concluded that CoQ10 might help if taken initially with the statin, but probably won’t help if you’re one of those who’s genetically-predisposed to statin problems and in whom a statin has triggered a disease.
From the start, if you are being prescribed a statin for secondary prevention (you’ve already had a cardiovascular event), take CoQ10…unless you get specific advice not to. If you’re being prescribed a statin for primary prevention, simply don’t take it: articles in JAMA and other medical journals question if there’s any benefit at all for you.
At one point COQ10 was included by at least one drug company with their statin drug, but perhaps because this was an acknowledgement of problems (muscle pain and weakness, myopathy, neuropathy) that were simultaneously being denied as existing, this practice ended. Did it help? Who knows, because maximum profitability of statins depends upon our not even thinking about adverse effects.
NYT had an article a while back saying that statins reduced skeletal muscle function in everybody. (Dr John P. Thyfault)
StatinVictims.com
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There is a research that cautions people suffering from low levels of CoQ10 that low levels of CoQ10 could increase risk of melanoma metastasis (melanoma cancer spreads to other parts of the body).
People taking statin or older people suffering from low levels of CoQ10 had better read this research. Long-term usage of CoQ10 has been proven safe. First thing to do is to check the levels of CoQ10 in your plasma and discuss appropriate level of CoQ10 supplementation with doctors. Saying is easy though, as (1) first of all, very few doctors know this research and (2) secondly, they don'd know the appropriate level of CoQ10. Most of the doctors in your neighborhood dispense statins like candies.
https://www.jaad.org/article/S0190-9622(05)02675-7/abstract
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In Japan, not like in the U.S., alternative cancer treatment is fully accepted depending upon the needs of cancer patients. Right now, 16 workers of Fukushima nuclear plant are monitored for the prevention of cancer, using cancer risk score sheet. Recent test results of 6 out of 16 workers came out above normal level. Guess how doctors treated them? Doctors in charge of Fukushima workers, fed the 6 workers all the kind of antioxidants like vitamin C, E, etc. intervenously and orally. After 2 months of antioxidant therapy, the 6 workers' cancer risk score came out normal. This tells two things.
First, CoQ10 as an antioxidant helps cancer patients. Secondly, cancer as mitochondrial metabolic disease, a theory by Dr. Warburg and Dr. Seyfried has been gradually being accepted.
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As a retired pharma employee, I can appreciate the studies referenced here. I just know that when I told a neurologist about frequent , debilitating ,muscle cramps in my feet and legs, he rx'd
CoQ10. Tried it immediately and the cramps disappeared. If I miss a few doses, they come back. I am 73, but active running a horse farm, riding, chores, etc. I may well be a study of ONE, but for me it is effective. I have had such pain in past, I passed out as I tried to get to kitchen to ice bags, which can bring fast relief , but short in duration...
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@Gayle Hamilton
You make a fair point. Studies of one are not good for public policy, but they can raise other justifiable concerns and questions. Large numbers of patient may show clear benefits that outweigh risk (generally the case for statins), but there are exceptions--and we need to better understand some of the reasons for those.
We should not ignore the substantial benefits of statin use, but some people will not tolerate them for various reasons (and a few of those may be responsive to CoQ10). That does not make a case for the widespread use of CoQ10 as a nutritional supplement. We need better ways to identify the subpopulation(s) at risk.
The reverse can also be true, i.e. that large studies can show small statistical benefits that do not do much to justify widespread use of a treatment.
None of these circumstances are surprising. Good science involves constant questioning and modification, not dogmatic proclamations. And no doubt we would need better, more carefully controlled, preparations of CoQ10: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2170950/ .
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Commonly used statin drugs for lowering cholesterol also inhibit production of Co-Q10, thus causing mitochondrial dysfunction and muscle pain. Supplementation with Co-Q10 has shown beneficial in ameliorating symptoms. For example, Dr Deichmann studied treatment with CoQ10 (200 mg daily) in older athletes taking statins, and found CoQ10 did improve muscle performance and leg strength (quadriceps muscle reps). Animal studies (using mice) show that CoQ10 ameliorates mitochondrial dysfunction induced by statins. For more see: https://jeffreydachmd.com/2018/08/cardiomyopathy-reversible-with-coq10-a...
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@Jeffrey Dach MD
There have been no reputable peer-reviewed published studies that suggest any of the things that you claim - as summarized completely and accurately by the article.
Studies on mice show almost zero reproducibility in humans. In fact they only predict 43% drug toxicity - certainly a very basic question.
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@SteveRR
A Search in Google Scholar for Co
Q10 and Mitochondrial Dysfunction yields 18,800 articles all of which are peer reviewed. I would venture a guess that many of them are even "reputable". So it is quite obvious that Statin drugs are mitochondrial toxins and Co-Q10 may serve as antidote.
I would not be so quick to dismiss mouse studies. Using the mouse to model human disease has been the suject of considerable debate. see: Justice, Monica J., and Paraminder Dhillon. "Using the mouse to model human disease: increasing validity and reproducibility." (2016): 101-103.
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You see how dogmatic some of these NYT readers are?!
Is there any evidence as to CoQ10 being administered as an antiinflammatory?
Because coenzyme Q10 is not regulated, one has no way of knowing what the levels and - more importantly - bioavailability - are for the different products. Remember that the CoQ needs to not only be absorbed through the gut, but must make its way through the circulation, into muscle cells, and then into their mitochondria. Its likely that one would need high levels of CoQ to have any impact; along with these high levels will come side effects and complications.
For many people with high cholesterol, dietary changes and exercise can reduce the dose of statin required, and thus reduce any potential statin-associated muscle issues. If lifestyle changes don't work, then trying different statins might work. Ultimately, its a balance between finding a level of statin that keeps cholesterol in a good range while minimizing side effects.
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How about just not taking the statin? The evidence does not in fact indicate that high LDL cholesterol causes heart disease, and cholesterol levels tell us nothing at all about the degree of calcification of the coronary arteries. The NNT for statins is ridiculously high, and even then statins seem to increase life by a few days. Check your insulin levels instead. High insulin is definitely linked with all the criteria used to diagnose metabolic syndrome - high triglycerides plus low HDL, abdominal adiposity, high BP, high blood sugar - and all of those are linked with diabetes, which is a massive risk factor for CHD.
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Mimi, yes, about LDL not being able to predict heart disease. There are two causes of high LDL. High fat diets cause large, buoyant LDL, the kind that floats through and doesn’t ‘catch’ onto the sides of blood vessels. High carb diets produce small, dense LDL, which DO catch onto the blood vessel linings and build up. The LDL count from a typical blood test does not distinguish between large, buoyant and small, dense LDL.
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As a component of the electron transport chain, CoQ10 participates in aerobic cellular respiration, which generates energy in the form of ATP. Therefore, those organs with the highest energy requirements—such as the heart, liver, and kidney—have the highest CoQ10 concentrations. In this sense, I sometimes wonder why we have to take statin for lowering cholesterol level because statin sabotages production of both cholesterol and CoQ10. One ACCP statin study shows as much as 40% reduction of CoQ10 in comparison with placebo group.
I take CoQ10 as supplement, for heart health as long-term CoQ10 treatment of patients with chronic heart failure is safe, improves symptoms, and reduces major adverse cardiovascular events. http://heartfailure.onlinejacc.org/content/2/6/641. Also Coenzyme Q10 promotes osteoblast (bone making) proliferation and differentiation and protects against ovariectomy-induced osteoporosis. https://www.ncbi.nlm.nih.gov/pubmed/29115467\
In addition, CoQ10 supplementation might also be useful in preventing consecutive cataract formation.
https://www.ncbi.nlm.nih.gov/pubmed/20374575
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Can't you just experiment on yourself? If you have muscle problems on statins, take some Coq10. You either feel better or you don't. Question answered.
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That is not how science works. Apart from that CoQ10 may have side effects as well. Why take the risk in absence of a scientific risk/benefit analysis?
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@SomeoneThe risks are apparently low at least in short term since you dont hear people complaining about CoQ10 issues. I take lipitor 40mg daily and also 200 mg of CoQ10. I'm 75 and have 2 stents in my coronary arteries after angina at age 72. I'm not sure how much if any benefit I get from the CoQ (I have not noticed any) but I continue to take it to conteract possible muscle energy problems. I also exercise daily at a gym and my cardiologist says I'm doing great.
Seems to me studies about the benefits of supplements are generally inconclusive, and the reports of harm show hardly any. I think: go for it. Little risk, but maybe it’ll pan out.
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@Peter Silverman, they can take a bite out of your wallet.
"Mixed results" means what you're looking for did not happen. Statins induce muscle disfunction - there's no way around this. There are many clinical studies which show this to be true. This disfunction results in a premature "aging" of the muscles. Even if the patient has no pain or discomfort there is still a level of Muscle disfunction. Only people who have had a heart attack should ever be on this stuff.
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Many people spent $$$$ on many supplements instead of eating right and exercising daily. If one eliminates sugar, fat, etc. unless you have a genetic predisposition your cholesterol should be low. Keeping physically active (and that includes more than just walking) along with 10,000 steps daily should keep your weight low. Diet, exercise, lifestyle, (including no stress) are the key to longevity. Be proactive with your adult immunizations (pneumonia, shingles, flu) mammograms, colonoscopies, prostate tests, etc. All of this $ spent on supplements in the last 20 yrs. does not solve the problem/s.
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@Jan you might find this article in the Wapo today and consider the impact of recommending those tests. Until I retired I always laughed at the recommendation that I should "reduce stress" as I do not live in a bubble. https://www.washingtonpost.com/news/posteverything/wp/2018/10/05/feature...
Thanks for the dismissive advice, “Doc.” I inherited poor “good” cholesterol and high triglycerides from my father’s side of the family. I did all the right things (exercise and diet) with no change in my numbers (same for my dad). A low dose of statins brought my numbers down to acceptable levels. Although I fatigue more and faster than I used to, I am more fit and stronger than ever due to regular workouts. Given that my sister had a stroke at 51, I’m taking the statins.
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Due to a series of surgeries I am not exercising. I take 200 units of coQ10 daily with my 10mg of atorvastatin. I am aware of the fact that this does very little for me now. Before my surgeries I was swimming 10,000 yards a week. When I was swimming, if I missed taking coQ10 for two days, I would experience bad aches in my thighs and shoulders and it happened like clockwork. I would say that I missed the pills and got aches soon afterwards at least five or six times. On each occasion starting on the coQ10 again put an end to the pain. I am talking about pain so strong that it woke me up at night.
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I take a statin every day and eat lots of CoQ10 rich foods every day (salmon, sardines, eggs, broccoli, pork, beef) and I have no problem with muscle pain or even twitching. And, I don't waste my money on dietary supplements.....
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@Anna D Not everyone is you. Many folks cannot take statins due to muscle pain period.
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It helps to generate energy in the muscle. The heart is arguably the bodie’s most important muscle, therefore CoQ10 is good for the heart. Statin therapy blocks the produduction of CoQ10 yet is prescribed for heart health. Can someone explain why I am the only one who questions the absurdity that goes unquestioned and unanswered.
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Because you do not understand the data. That is why.
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@Luk Brown
Because it s an inconvenient truth, very inconvenient truth
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The study you link to says “No serious side effects to taking CoQ10 have been reported.”
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Good evidence does exist for the use of CoQ10 in the prevention of migraine headaches. In one study researchers measured CoQ10 levels in 1,550 migraine sufferers and fully one third were found to be deficient. Those who were deficient had a significant improvement of their migraines with CoQ10 supplementation.
One possible reason why CoQ10 supplementation was ineffective for statin-induced muscle pains is that it was given to all patients, whether they were deficient or not. Every commercial laboratory, such as Quest and Labcorp can measure CoQ10 levels and this is what we do at the New York Headache Center in most of our migraine patients. This way we do not have to recommend this fairly expensive supplement to all of our patients. Research indicates that if CoQ10 level is normal but is in the bottom quarter of normal range, migraine patients may still benefit from supplementation.
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