A 2018 meta-analysis and systematic review has shown that Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplementation significantly ameliorates statin-induced muscle symptoms [Qu]:
- reduces muscle pain
- reduces muscle weakness
- reduces muscle cramping
- reduces muscle fatigue
The positive results of the meta-analysis suggest that Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplementation may be a complementary approach to the management of statin-induced myopathy [Qu].
Why Do You Need Coenzyme Q10 Supplements with Statin Medication?
Statin medications are drugs widely prescribed in order to lower patients’ levels of total cholesterolCholesterol is one of the major fat-soluble compounds that is found in animal plasma membranes. It is necessary for life and is found throughout the body. It is carried from the liver to the tissues where it is needed by lipoproteins of which it is a component. Much of the cholesterol is transported in Low density lipoproteins (LDL). High levels... More and the so-called “bad” ldl-cholesterol. StatinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More are used to protect against heart attack and stroke; however, they do have adverse effects.
Commonly prescribed statinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More have easily recognizable names:
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Rosuvastatin (Crestor)
- Simvastatin (Zocor)
Regardless of the statin formulation, the statin treatment duration, and the statin treatment dosage, the use of statin medications is significantly associated with reductions in the patients’ plasma Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More concentrations [Qu]. The taking of a statin medication results in the inhibition of the body’s bio-synthesis of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More [Okuyama].
Drs. Okuyama and Langsjoen fear that the use of statinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More may actually cause coronary artery calcification and mitochondrial dysfunctionMitochondrial dysfunction is the loss of efficiency in the process of ATP energy production. As such, mitochondrial dysfunction is a factor in the ageing process and in virtually all chronic diseases including cancer, cardiovascular diseases, chronic fatigue syndrome and fibromyalgia, diabetes and metabolic syndrome, and neurodegenerative diseases. Coenzyme Q10 is an essential component in the mitochondrial production of ATP energy. More through the inhibition of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More bio-synthesis and inhibition of ATPATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production. More generation [Okuyama].
Drs. Okuyama and Langsjoen warn that the pervasive use of statin medications may be aggravating the incidence of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More and atherosclerosisAtherosclerosis is the thickening of the artery walls brought about by the build-up of plaque (plaque is made up of cholesterol and other fatty substances and waste products and calcium and fibrin) and the subsequent slowing of the flow of blood through the clogged arteries. More research is needed into the role of Coenzyme Q10 in the prevention and adjunct... More through the adverse actions of the statinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More [Okuyama]:
- inhibition of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More bio-synthesis
- depletion of ‘heme A’
- inhibition of the synthesis of vitamin K
- inhibition of the biosynthesis of selenoproteins, e.g. glutathione peroxidase, which suppresses peroxidative stress
Coenzyme Q10 and Statin-Induced Muscle Symptoms
The statin-induced inhibition of the bio-synthesis of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More may also be responsible for the incidence of muscle pain, weakness, and fatigue in some patients on statin medications. Accordingly, Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplementation may be indicated to reduce the extent and severity of the muscle problems [Qu].
Coenzyme Q10 and Cardiovascular Disease
Patients on statin medications are, of course, patients at risk for cardiovascular disease.
Heart disease patients need Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplementation. Here is the evidence.
The two-year Q-Symbio studyQ-Symbio is the abbreviated name for the two-year multi-center, randomized, double-blind, placebo-controlled study of Coenzyme Q10 supplements as an adjunct treatment of chronic heart failure patients. The name reflects the focus of the study on the SYMptoms, BIomarker status (BNP), and long-term Outcomes (hospitalizations and mortality) of the supplementation. The data from the Q-Symbio study show that long-term supplementation with... More showed that daily adjunctive treatment of chronic heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients with 3 x 100 milligrams of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More significantly improved the symptoms and survival of the patients [Mortensen].
The four-year KiSel-10 studyIn the KiSel-10 study, 443 Swedish citizens aged 70 to 88 received either a combined daily supplementation of high-selenium yeast and Coenzyme Q10 or matching placebos. The elderly Swedish citizens who received the active treatment of selenium and Coenzyme Q10 had significantly reduced risk of death from heart disease, significantly better heart function as recorded on echocardiograms, and significantly lower... More showed that daily supplementation of senior citizens with 2 x 100 milligrams of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More and 200 micrograms of high-selenium yeast reduced the cardiovascular mortality, maintained heart function, and improved health-related quality of life in senior citizens [Alehagen].
Details of the Coenzyme Q10 and Statin-Induced Myopathy Study
The researchers evaluated the results of nine studies enrolling 433 patients (222 in the CoQ10 supplementation groups and 211 in the placebo groups).
All of the studies enrolled more than 30 patients reporting muscle symptoms. The Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More treatment in the studies lasted from 30 days to three months and consisted of 100 to 300 milligrams of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More daily.
Compared to the patients in the placebo group, the patients in the Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More treatment group had statistically significantly lower levels of muscle pain, muscle weakness, muscle cramping, and muscle fatigue [Qu].
Summary: Coenzyme Q10 and Statin Medications
- The use of statinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More reduces the levels of circulating Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More by 16% to 54% [Qu].
- SignificantThe outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant. More benefit to heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients requires plasma CoQ10 levels be raised above 2.5 mcg per milliliter [Langsjoen].
- Beyond inhibiting the bio-synthesis of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More in all patients and causing muscle inflammationInflammation is an immune system response to an injury to cells or tissues. It is the body’s attempt to defend against invaders such as bacteria andviruses and to mend the damage done by invaders. Typically, inflammation manifests itself in the form of fever and swelling, in the swarming of white blood cells and the release of cytokines to fight against... More in some patients, statin medications are known to have the following other adverse effects [US Food and Drug Administration; Qu]:
- intestinal problems
- liver damage (although rarely)
- high blood sugar and increased risk of type 2 diabetes
- StatinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More may interfere with other medications [Qu].
Sources
Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined seleniumSelenium (symbol Se, atomic number 34) is a trace element that is an essential nutrient and an essential component of some of the most important antioxidants in the body, in particular the selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Selenium is involved in the optimal functioning of the immune system. Professor Alehagen has pointed out that there exists a... More and Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More supplementation: a 5-year prospective randomized double-blindA double-blind study is a study in which neither the investigators nor the study participants know which participants are receiving the active treatment and which participants are receiving the control treatment until the study has been completed and the seal on the code has been broken. More placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.
Langsjoen, PH & Langsjoen, AM. (2013). Comparison study of plasma Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More levels in healthy subjects supplemented with Ubiquinol versus UbiquinoneUbiquinone, the oxidized form of Coenzyme Q10, expressed as Q10 or CoQ10, is absolutely essential for the mitochondrial ATP energy production process. Ubiquinone is the form of Coenzyme Q10 that the body synthesizes, and ubiquinone is the form of Coenzyme Q10 that has been extensively tested for safety, absorption, and efficacy in clinical trials. More. Clinical Pharmacology in Drug Development, 3(1) 13–17.
Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & Littarru, G. P. (2014). The effect of coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More on morbidity and mortality in chronic heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More: results from Q-SYMBIO: a randomized double-blindA double-blind study is a study in which neither the investigators nor the study participants know which participants are receiving the active treatment and which participants are receiving the control treatment until the study has been completed and the seal on the code has been broken. More trial. JACC. Heart FailureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More, 2(6), 641-649.
Okuyama, H., Langsjoen, P. H., Hamazaki, T., Ogushi, Y., Hama, R., Kobayashi, T., & Uchino, H. (2015). StatinsStatins are a class of medications that effectively block the body’s synthesis of cholesterol. In so doing, statins also block the body’s synthesis of Coenzyme Q10. More stimulate atherosclerosisAtherosclerosis is the thickening of the artery walls brought about by the build-up of plaque (plaque is made up of cholesterol and other fatty substances and waste products and calcium and fibrin) and the subsequent slowing of the flow of blood through the clogged arteries. More research is needed into the role of Coenzyme Q10 in the prevention and adjunct... More and heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More: pharmacological mechanisms. Expert Review of Clinical Pharmacology, 8(2), 189-199.
Qu, H., Guo, M., Chai, H., Wang, WT, Gao, ZY & Shi DZ. (2018). Effects of Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled TrialsRandomized controlled trials are studies in which patients or healthy volunteers are assigned at random (purely by chance) to receive one or more clinical interventions. One or more of the interventions is the active treatment being tested. Another of the interventions is the control against which the active treatment is being tested. The control is, typically, the standard practice or... More. J Am Heart Assoc, 7(19): e009835.
U. S. Food and Drug Administration. (2012). FDA Drug Safety Communication: Important safety label changes to cholesterol-lowering statin drugs. FDA Drug Safety Communication. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-important-safety-label-changes-cholesterol-lowering-statin-drugs
The information presented in this review article is not intended as medical advice and should not be construed as such.
17 September 2019
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