Can coenzyme Q10 (CoQ10) help treat muscle pain from statins?

Anthony L. Komaroff, MD
Internal Medicine
Statin drugs cause muscle pain in about 3% to 10% of people who take them, so your concern about muscle pain is understandable. Statins can also cause muscle inflammation, or myositis, although only about one-half of 1% of statin users are affected.

Coenzyme Q10 -- or CoQ10, for short -- is involved in the generation of ATP, the molecule that provides energy to all cells in the body, including muscle cells. CoQ10 is also an antioxidant that protects mitochondria, the energy engines of cells, from damage by oxygen free radicals. So CoQ10 plays at least two valuable roles in preserving a cell's energy supply.

Depletion of CoQ10 might explain why statins sometimes affect the muscles. CoQ10 is carried through the bloodstream in "bad" LDL cholesterol. And because statins lower LDL levels in the blood, they also lower CoQ10 levels in the blood. However, it's not certain that statins lower CoQ10 levels inside muscle cells, where low levels would cause damage. There are a few published reports of individuals with statin-induced muscle damage who seem to have benefited from treatment with CoQ10, but no large randomized trials have proven its value either as a treatment or as a preventive measure for people starting statin therapy.

CoQ10 has side effects of its own, including abdominal pain, nausea, vomiting, or headache. CoQ10 also increases the risk of bleeding and, paradoxically, may interfere with the blood-thinning effect of warfarin (Coumadin), a medicine taken by millions of people.

Even though solid proof is lacking, I don't think it's unreasonable to try treatment with CoQ10 if you develop muscle pain while taking a statin -- presuming there are no clear reasons not to, such as a risk of bleeding. But I don't think there is any evidence that people who take statins should routinely take CoQ10 to prevent muscle damage.
The Harvard Medical School Guide to Lowering Your Cholesterol (Harvard Medical School Guides)

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The Harvard Medical School Guide to Lowering Your Cholesterol (Harvard Medical School Guides)

This title is from the experts at one of the world's most respected medical schools - your complete guide to managing cholesterol and staying healthy for life. Everybody knows that high cholesterol...

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