CoQ10 and Statins: Can CoQ10 Help You With Statin Side Effects?

Statins are first-choice medications for lowering high cholesterol and the risk of heart-related  events like heart attacks. But statins can also 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 commonly reported 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?

Along with lowering cholesterol, statins can lower CoQ10 levels in the body by reducing levels of the chemicals needed to make the antioxidant. In animal and human studies, statins lowered CoQ10 levels in the blood and tissues.

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. In fact, some experts believe that reduced CoQ10 levels are the cause of muscle-related side effects from statins.

Good to know: Muscle pain is one of the most commonly reported statin side effects. But research has shown that muscle pain experienced while taking a statin often isn't due to the statin itself. And since statins are the go-to treatment for people who have or are at high risk of cardiovascular disease, 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 shows  CoQ10 supplementation might help with muscle pain, weakness, and fatigue.

Since there’s no definitive answer as to whether you should take a CoQ10 supplement with your statin, it’s best to talk to your healthcare provider if you have questions. They’ll help you weigh the risks versus the benefits.

Good to know: Some foods contain CoQ10. This includes fatty fish, like salmon and tuna, and whole grains. But it’s not known whether consuming more foods with CoQ10 will help you avoid statin-related muscle pain.

What should you think about before taking CoQ10 supplements?

If you’re considering a CoQ10 supplement for statin-related muscle pain, talk to your healthcare provider first. They’ll be able to help you weigh the pros and cons. Below, we’ll discuss six things you and your provider 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 the United States Pharmacopeia (USP).

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 this affects muscle levels of CoQ10 and, therefore, muscle pain.

3. CoQ10 supplements are generally well tolerated

CoQ10 supplements usually have minimal side effects. But they’re possible. CoQ10 supplements may cause nausea, vomiting, and diarrhea. They may also cause trouble sleeping. 

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, liver problems, or cancer and those who are pregnant or breastfeeding. So you should talk to your provider 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.

Give your healthcare provider and pharmacist 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 may be other ways to cope with statin-related muscle pain

If you’re experiencing muscle symptoms that you think could be related to your statin, your healthcare provider 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 provider 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 that may be contributing to your muscle pain.

• Lowering your dose: A lower statin dose may help lessen side effects. Your healthcare provider may also add a non-statin medication to your treatment regimen.

• Switching to a different statin: Your healthcare provider may have you try a different statin to see if there’s an improvement in your muscle symptoms.

Good to know: It’s not a good idea to stop taking your statin without talking to your healthcare provider 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 two to three doses per day. 

If your healthcare provider recommends CoQ10 supplements, they’ll determine the best dosage for you. 

When is the best time of day to take CoQ10?

There isn’t a best time of day to take CoQ10. What’s more important is to take the supplements with food that contains fat, since fat improves CoQ10 absorption. So taking your dose with a meal or just after a meal may be helpful. 

For some, CoQ10 supplements cause trouble sleeping, so you may want to try taking the supplements in the morning. Though if you’re taking two to three doses a day, it may be harder to avoid taking CoQ10 before bedtime. If you find the supplements are causing you to have trouble sleeping, talk to your healthcare provider and pharmacist about how best to space your doses.

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Written by:

ThienLy Neal, PharmD

ThienLy Neal, PharmD, has over 10 years experience in the pharmacy field, including in such settings as retail, hospital, compounding, and managed care. She has led various clinical programs while focusing on medication adherence programs, specialty drug initiatives, and polypharmacy safety initiatives.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

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