There are two issues concerning the use of statin medications that relate to Coenzyme Q10.
The more serious issue is that several animal and human studies have shown that the administration of statin medications leads to a reduction in the plasma and muscle tissue levels of Coenzyme Q10. There is no doubt that depletion of Coenzyme Q10 is an unintended consequence of taking statin medications. Some human trials have shown the extent of the reduction to be 40 % or greater. Furthermore, ageing seems to play a role in the diminution of Coenzyme Q10 levels caused by the administration of statin medications [Deichmann]. Decreased plasma and heart muscle tissue levels of Coenzyme Q10 are associated with the increasing severity of The 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... Read more about this term [Folkers, Mortensen].
The second lesser issue is the concern that the use of statin medications may cause muscle pain and muscle weakness. The US Food and Drug Administration has warned that some drugs may interact with Statins 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.... Read more about this term in ways that can cause muscle damage [US FDA 2014]. Co-administration of a good Coenzyme Q10 supplement with the statin medication may reduce the risk of muscle damage. However, we need results from a large randomized controlled study to shed more light on the beneficial effect of a combination of statin medications and Coenzyme Q10 supplements [Littarru].
Statins block our bodies’ synthesis of Coenzyme Q10
Whenever we consider taking a statin medication, we need to be asking the cardiologist about the inhibiting effect of statin medications on our bodies’ synthesis of Coenzyme Q10.
We need to ask because cholesterol and Coenzyme Q10 are produced in the same biological pathway in the body. Basically, the body’s production of cholesterol requires mevalonate, a derivative of mevalonic acid. Statin medications work by inhibiting the production of mevalonic acid and mevalonate. But mevalonate is also necessary for the production of the isoprenoid tail of the Coenzyme Q10 molecule [Littarru].
One of the risks involved in taking a statin medication is the risk of lowering too much the concentration of Coenzyme Q10 in the blood and in the heart muscle cells. Studies have shown that statin therapy reduces plasma Coenzyme Q10 concentrations [McMurray, Molyneux].
Coenzyme Q10 and the cells’ production of energy
Why is Coenzyme Q10 so important? Coenzyme Q10 is a powerful Antioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... Read more about this term protecting DNA and lipids and proteins against oxidative damage. It is also a vital component of the cellular process of energy production [Mortensen]. The extent to which statin medication leads to the depletion of Coenzyme Q10 in the plasma has been extensively investigated [Littarru & Langsjoen].
Increasing our intake of Coenzyme Q10
The only ways to increase plasma and muscle tissue levels of Coenzyme Q10 as we age are:
- to exercise
- to absorb more Coenzyme Q10 from food and supplements
Difficult to get enough Coenzyme Q10 from our food
As we get older, past our 30s and into our 40s and middle age and old age, our bodies synthesize less and less Coenzyme Q10 even if we are not taking a statin medication. It is difficult if not impossible to make up the resulting deficit from food alone.
Good daily Coenzyme Q10 supplement necessary
In the end, the only way for middle-aged people and senior citizens to get enough Coenzyme Q10 to protect their heart muscle tissue is to take a good daily Coenzyme Q10 supplement.
Formulation of the Coenzyme Q10 supplement is all important
There is considerable variation in the quality of the Coenzyme Q10 supplements available in the United States. The big difference comes not from the raw material itself but from the processing of the raw material into a supplement that is dissolved in vegetable oils and contained in soft-gel capsules. The formulation of the Coenzyme Q10 supplement is the decisive factor.
Until now (early 2017), there is no persuasive documented evidence that it makes sense to purchase a ubiquinol supplement instead of a Coenzyme Q10 supplement using the Ubiquinone, 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.... Read more about this term form of Coenzyme Q10. The ubiquinol products are generally unstable and untested in well-designed studies.
Gold standard studies show the effect of Coenzyme Q10 supplements
In recent years, well-designed randomized controlled studies have shown beneficial heart health effects of daily supplementation with Coenzyme Q10 in the ubiquinone form.
Q-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... Read more about this term (Mortensen 2014):
Adjuvant treatment with Coenzyme Q10 – i.e. Coenzyme Q10 in addition to conventional medication – of chronic heart failure patients for a two-year period yielded these results. Taking 300 milligrams of Coenzyme Q10 every day — 100 milligrams three times daily with a meal — was:
- beneficial to The 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... Read more about this term symptoms and survival
- associated with reduced incidence of major adverse cardiovascular events (hospitalizations, surgeries, etc.)
The KiSel-10 study was a four-year randomized, double-blind, placebo-controlled study of 443 Swedish citizens aged 70 to 88 who 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... Read more about this term (Alehagen 2013, 2015):
Four-year supplementation of elderly citizens aged 70 – 88 years with a combination of high selenium yeast and Coenzyme Q10 reduced the risk of death from heart disease. Positive effects of the supplementation were seen in improved heart function on echocardiograms and in reduced levels of a bio-marker for heart disease.
Follow-up studies have shown that the beneficial effects have persisted to the ten-year point following the commencement of the four-year supplementation. The daily dosage was 200 micrograms of high selenium yeast and 200 milligrams of Coenzyme Q10, taken separately as 2 times 100 milligrams each day, with meals.
Statin medications are every effective at what they do: reduce the risk of heart attack. But they may be implicated in the increasing prevalence of chronic heart failure through their inhibition of the body’s synthesis of Coenzyme Q10 [Okuyama &Langsjoen].
Dr. Judy believes that it is the elderly — and perhaps the overly obese — who are at most risk from the unintended consequences of statin medications. One problem with the research results that are available to us at present is that they are from heterogeneous study samples that have mixed younger and older participants. The age range in the studies has been too large. We need for researchers to do studies exclusively in the more receptive older population.
Coenzyme Q10 capsules are safe, effective, and affordable. If you have to take a statin medication, it makes sense to talk to a cardiologist about taking a good Coenzyme Q10 supplement too.
Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized A 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.... Read more about this term placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866.
Alehagen, U., Aaseth, J., & Johansson, P. (2015). Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens. Plos One, 10(12), e0141641.
Deichmann, R., Lavie, C., & Andrews, S. (2010). Coenzyme q10 and statin-induced Mitochondrial 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.... Read more about this term. The Ochsner Journal, 10(1), 16-21.
Folkers, K., Vadhanavikit, S., & Mortensen, S. A. (1985). Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with coenzyme Q10. Proceedings of The National Academy of Sciences of The United States of America, 82(3), 901-904.
Littarru, G. P., & Tiano, L. (2010). Clinical aspects of coenzyme Q10: An update. Nutrition, 26(3), 250-254.
Littarru, G. P., & Langsjoen, P. (2007). Coenzyme Q10 and statins: biochemical and clinical implications. Mitochondrion, 7 SupplS168-S174.
McMurray, J.J.V, Dunselman, P., Wedel, H., et al. (2010). Coenzyme Q10, rosuvastatin, and clinical outcomes in heart failure: a pre-specified sub-study of CORONA (Controlled Rosuvastatin Multinational Study in Heart Failure),” Journal of the American College of Cardiology, 56, 15, 1196–1204.
Molyneux, S.L., Florkowski, C.M., Lever, M. & George, P.M. (2005). Biological variation of Coenzyme Q10. Clinical Chemistry, 51, 2, 455–457.
Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & Littarru, G. P. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC. Heart Failure, 2(6), 641-649.
Mortensen, S. A. (2011). Low coenzyme Q₁₀ levels and the outcome of statin treatment in heart failure. Journal of The American College of Cardiology, 57(14), 1569; author reply 1569.
Mortensen, S. A. (2003). Overview on coenzyme Q10 as adjunctive therapy in chronic heart failure. Rationale, design and end-points of “Q-Symbio”–a multinational trial. Biofactors (Oxford, England), 18(1-4), 79-89.
Okuyama, H., Langsjoen, P. H., Hamazaki, T., Ogushi, Y., Hama, R., Kobayashi, T., & Uchino, H. (2015). Statins stimulate Atherosclerosis 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... Read more about this term and heart failure: pharmacological mechanisms. Expert Review of Clinical Pharmacology, 8(2), 189-199.
US Food and Drug Administration. 92014, Jan. 31). FDA expands advice on statin risks. Consumer Updates. Retrieved from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm293330.htm.
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