Statins and Coenzyme Q10

Chances are, if you’re reading this you’re either taking a statin to lower your cholesterol, or you know someone who is.  Besides lowering cholesterol levels, statins are purported to have significant anti-inflammatory and plaque-stabilizing effects, so if you’ve had a heart event, such as a stent or an attack, your doctor has likely prescribed a statin, even if your cholesterol levels are under control.

What many don’t realize (and too often your doctor doesn’t tell you) is that statin drugs also reduce your body’s natural function of producing Coenzyme Q10, because the pathway in the body that naturally produces cholesterol is also responsible for the production of Coenzyme Q10.

Coenzyme Q10, often referred to as CoQ10, is a substance made naturally by your body, and is found in the mitochondria of every cell in our bodies and helps our bodies produce energy.  This is particularly important for heart muscle function given its extreme energy requirements.  To put it simply, Dr. Crandall says “coenzyme Q10 helps keep the heart strong.”  Additionally, CoQ10 is an important antioxidant.

Dr. Andrew Weil says “Those who are taking statins to lower cholesterol are at particular risk for deficiency, because not only do statins reduce cholesterol levels, but they also block CoQ10 synthesis in the body. Low CoQ10 levels in patients on statins can contribute to the common side effects of statin therapy such as fatigue and aching joints and muscles.”

According to the FDA, “scientific evidence confirms the existence of detrimental cardiac consequences from statin-induced CoQ10 deficiencies in man and animals”.

But here’s the good news.  Statin-induced CoQ10 deficiency can be completely reversed by supplemental CoQ10, which is safe and has no adverse effect on statin cholesterol-lowering or on statin anti-inflammatory effects.  Additionally there is evidence that CoQ10 may reduce or prevent statin side effects, though that evidence is still controversial.

Even if you’re not taking a statin, it’s important to note that our bodies ability to product CoQ10 diminishes with age.  This is important, not only for your heart, but because CoQ10 also helps lower blood pressure and strengthens the immune system.

How much?    There seems to be a broad range of recommendations online and WebMD has a chart you can find here.  However, Dr. Crandall recommends 200 to 400mg daily if you’re taking a statin.

CoQ10 comes in two forms:  ubiquinone and ubiquinol.  The first one is typically the less expensive form but it has to be metabolized by our bodies to create ubiquinol–a process that is more difficult for our bodies as we age.  If the bottle does not say which form it is, it is likely ubiquinone.  We take ubiquinol thinking the body has enough to do already.

Dr. Weil says “CoQ10 is fat-soluble, so take the supplement with a meal containing fat. Seek out the soft-gel ubiquinol form when taking CoQ10 as a standalone supplement, as this has greater antioxidant efficiency than the ubiquinone form.”  Additionally, it is widely recommended that you divide the dose and take it twice a day.

As with all supplements, be sure to check with your doctor or pharmacist for interactions that may exist with any medications you take.   Or use a reliable online source such as the interactions checker at drugs.com.

Sources:

http://www.drweil.com/drw/u/ART03367/Coenzyme-Q10-CoQ10.html