Harvard Heart Letter

Ask the doctor: What's the connection between statins and coenzyme Q10?

Ask the doctor

What's the connection between statins and coenzyme Q10?

Q. Why don't you ever tell your readers that everyone who takes a statin to lower cholesterol should be taking coenzyme Q10, too?

A. Coenzyme Q10, sometimes called CoQ10, is a vitamin-like substance present in most cells. It helps mitochondria, the powerhouses of the cell, turn sugar and other fuels into energy. Taking a statin lowers coenzyme Q10 because it is carried through the bloodstream in LDL. Lowering LDL "" the main job of a statin "" means less coenzyme Q10 in circulation. It has been hypothesized that statins' effects on coenzyme Q10 might account for the muscle aches and pains these drugs sometimes cause. However, statins don't appear to affect coenzyme Q10 inside cells or mitochondria.

Taking a supplement increases blood levels of coenzyme Q10, but the effect inside muscles is inconsistent "" one study showed an increase of coenzyme Q10 after supplementation, another a decrease. More to the point, the only two trials of coenzyme Q10 for statin-induced muscle problems contradict each other. In one, supplementation had no effect on muscle pain. The other showed a modest benefit.

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