Key takeaways:
Statins can lower the amount of coenzyme Q10 (CoQ10) in the body. Some researchers think this contributes to muscle pain, a commonly reported statin side effect.
Whether CoQ10 supplements help with muscle pain from statins is unclear. Some studies show they help, while other research hasn’t found them to be effective.
If you’re interested in taking CoQ10 supplements to try and relieve muscle pain from statins, your healthcare team can help you weigh the risks versus benefits.
Save on related medications
Statins are first-choice medications for lowering high cholesterol and the risk of heart-related events like heart attacks. They’re very effective, but they have a bad rap for muscle pain, even though it’s rare.
Why do some people who take statins have muscle pain? It’s not exactly clear why this is, but one theory is that statins can decrease how much coenzyme Q10 (CoQ10) your body makes.
CoQ10 is a naturally occurring antioxidant that serves several key functions in the body. Some experts think there’s a link between reduced CoQ10 levels and muscle pain, a possible statin side effect.
So, if you’re taking a statin, should you take CoQ10 supplements? Here, we’ll cover what you need to know about CoQ10 and statins.
How do statins affect CoQ10 levels?
Statins can lower CoQ10 levels in the blood by reducing levels of the chemicals needed to make the antioxidant. But statins haven’t been shown to lower CoQ10 levels in the muscles.
Your cells — especially your mitochondria, a critical part of each cell — need CoQ10 to make energy. So decreased CoQ10 levels in the body could mean your muscles have less energy to work with. This may lead to muscle aches and pains.
Experts have multiple theories about why this is, but the research is ongoing. Statins are the go-to treatment for people who have or are at high risk of cardiovascular disease. Because of this, the benefits of statins often outweigh the risk of muscle-related problems.
Should you take a CoQ10 supplement if you take a statin?
The data on CoQ10 supplements and statins is conflicting. Some research shows that CoQ10 supplements won’t help you avoid statin-related muscle pain. But other research suggests taking CoQ10 supplements might help with muscle pain and fatigue. The American Heart Association doesn’t recommend taking CoQ10 supplements with statins.
There’s not a definitive answer as to whether you should take a CoQ10 supplement with your statin, so it’s best to talk to your healthcare team if you have questions. They’ll help you weigh the risks versus the benefits. It might make sense to try it for a few weeks, if you don’t have any other options (more below).
What should you think about before taking CoQ10 supplements?
CoQ10 supplements for statin-related muscle pain may not be right for everyone. Here are six things you may want to consider.
1. CoQ10 supplements aren’t regulated by the FDA
CoQ10 dietary supplements are available over the counter (OTC). Like other OTC supplements, they aren’t regulated by the FDA for safety or effectiveness. So what’s written on the label of CoQ10 products may not accurately reflect what’s inside.
If you decide to take a CoQ10 supplement, look for a high-quality product that has a seal of approval from a third-party testing organization.
2. It’s unclear whether CoQ10 supplements increase muscle levels of CoQ10
We know that CoQ10 supplements increase blood levels of CoQ10. But we don’t know how much — if at all — this affects muscle levels of CoQ10. It’s also not clear whether CoQ10 makes a difference in muscle pain.
3. CoQ10 supplements are well tolerated
CoQ10 supplements usually have minimal side effects. But they’re possible. CoQ10 supplements may cause nausea, vomiting, and diarrhea.
CoQ10 can also lower systolic blood pressure in people with high blood pressure. So it’s a good idea to keep an eye on your numbers if you’re taking blood pressure medication.
Since toxicity from CoQ10 supplements isn’t likely, it might not hurt to try CoQ10 for muscle pain (even if it doesn’t end up working). But CoQ10 supplements haven’t been widely studied — especially in people who:
Have kidney problems
Have liver problems
Have cancer
Are pregnant or breastfeeding
For all of these reasons, you should talk to a healthcare professional before trying CoQ10 supplements.
4. CoQ10 supplements may interact with other medications you take
CoQ10 may reduce the effectiveness of warfarin (Coumadin, Jantoven). It can also lower your blood sugar, which may be a problem if you take diabetes medication that also lowers blood sugar, such as insulin or metformin.
It’s a good idea to give your entire healthcare team a full list of medications and supplements you’re taking. They can use this to check for interactions.
5. CoQ10 supplements are available in different forms
There are two different forms of CoQ10: ubiquinone and ubiquinol. Manufacturers of CoQ10 supplements may advertise that one is better than the other. They may also claim to use special formulations that help you better absorb CoQ10. But as mentioned above, the FDA doesn’t regulate OTC supplements.
It’s possible that some individuals may absorb one form of CoQ10 supplements better than the other. But it’s hard to know if this applies to you without trying them.
6. There are other ways to cope with statin-related muscle pain
If you have muscle symptoms that you think could be related to your statin, a healthcare professional will work with you to figure out the best course of action. Examples of next steps may include:
Waiting it out: For many people, muscle-related symptoms are temporary and get better over time. But let your healthcare team know if your symptoms persist or get worse.
Checking for statin interactions: Some medications, supplements, and foods (like grapefruit) may interact with statins and increase your risk of muscle pain. For example, blood levels of atorvastatin (Lipitor) and simvastatin (Zocor, FloLipid) may increase when taken along with certain antibiotics and antivirals. Your pharmacist can review your medication list to identify potential interactions.
Lowering your dose: A lower statin dose may help lessen side effects. Your prescriber may also add a non-statin medication to your treatment regimen.
Switching to a different statin: Your healthcare team may suggest that you try a different statin to see if there’s an improvement in your muscle symptoms.
Try again later: One study found that 90% of people who restarted a statin after stopping it were able to keep taking it long term.
Good to know: It’s not a good idea to stop taking your statin without talking to your healthcare team first. Stopping treatment may put you at higher risk of heart-related issues, like heart attack or stroke.
What’s the best CoQ10 dosage if you’re taking a statin?
In studies that found CoQ10 supplements to be effective at relieving muscle pain, the dosages ranged from 100 mg to 600 mg per day. Daily doses of CoQ10 that are greater than 100 mg are usually divided into 2 to 3 doses per day.
Frequently asked questions
Most cardiologists agree that there’s not enough evidence to recommend coenzyme Q10 (CoQ10) to everyone taking statins. The American Heart Association says the same.
CoQ10 may lower cholesterol, but there’s not enough evidence to say for sure. One review of studies found that taking CoQ10 supplements might improve total cholesterol and high-density lipoprotein (HDL), the “good” cholesterol. But it didn’t show improvement in triglycerides or low-density lipoprotein (LDL), the “bad” cholesterol.
Another study review found that CoQ10 does improve LDL and triglycerides. But there’s a lot of variability in dosing, length of studies, and medical conditions of the study participants. So more research is needed.
CoQ10 supplements don’t cause blood clots, but they can increase the risk of blood clots if you take the blood thinner warfarin. This is because CoQ10 decreases the effectiveness of warfarin.
Most cardiologists agree that there’s not enough evidence to recommend coenzyme Q10 (CoQ10) to everyone taking statins. The American Heart Association says the same.
CoQ10 may lower cholesterol, but there’s not enough evidence to say for sure. One review of studies found that taking CoQ10 supplements might improve total cholesterol and high-density lipoprotein (HDL), the “good” cholesterol. But it didn’t show improvement in triglycerides or low-density lipoprotein (LDL), the “bad” cholesterol.
Another study review found that CoQ10 does improve LDL and triglycerides. But there’s a lot of variability in dosing, length of studies, and medical conditions of the study participants. So more research is needed.
CoQ10 supplements don’t cause blood clots, but they can increase the risk of blood clots if you take the blood thinner warfarin. This is because CoQ10 decreases the effectiveness of warfarin.
The bottom line
Statins are first-choice medications for high cholesterol and lowering the risk of cardiovascular events, like heart attacks. But for some people, they may cause some bothersome side effects, like muscle pain.
Some studies suggest that taking coenzyme Q10 (CoQ10) supplements with statins can relieve muscle pain. But other research shows that CoQ10 supplements have no effect on this statin side effect. Since there’s no clear-cut answer as to whether taking CoQ10 with statins is worthwhile, talk to a healthcare professional if you’re interested in trying CoQ10 supplements. They can help you determine if it’s safe to try.
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References
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