What To Know About CoQ10 and Statins

If you’re taking statins to lower your cholesterol, you might’ve heard that taking a CoQ10 supplement can help lessen your chances of experiencing the muscle aches that can be a side effect of statins. So … does that mean you should add these supplements to your daily routine?

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“Some studies show that replacing CoQ10 with a supplement could reduce the risk of muscle damage when you’re on a statin,” says interventional cardiologist Leslie Cho, MD, “but most studies have shown that is not the case.”

Dr. Cho explains why some people think CoQ10 supplements can help with muscle pain and how much to take, if you do want to try it.

Can CoQ10 help with muscle pain?

Coenzyme Q10, more often known as CoQ10 or ubiquinone, is an antioxidant your body produces naturally to help protect your heart, brain and muscles. It’s also found in certain foods, like oily fish, eggs and nuts.

As you age, your body makes less CoQ10 — and the thinking had been that taking statins lowered your CoQ10 levels, too. That’s why some people on statins turn to CoQ10 supplements — to help replenish lost CoQ10.

But what does this have to do with muscle pain? One of the symptoms of a CoQ10 deficiency is myopathy, diseases that affect your muscles. So, if it were true that statins lowered CoQ10 levels, and low CoQ10 levels caused muscle pain, taking CoQ10 supplements along with statins could help treat or prevent muscle pain.

But that’s the thing: It’s not actually true.

“The thought was that taking statins depletes ubiquinone, but it turns out that there’s no change in the ratios,” Dr. Cho explains. “Initially, people thought that depleted CoQ10 levels caused myopathy in people taking statins, but when you look at the basic science data, that’s just not the case.”

Should statins and CoQ10 be taken together?

There’s just not enough scientific evidence to show that taking CoQ10 can benefit people who are taking statins.

In very small clinical trials, CoQ10 supplements were shown to help treat or prevent muscle pain (myalgia). But large meta-analyses showed no benefit to taking CoQ10 pills.

That said, if you take CoQ10 supplements and want to continue doing so, Dr. Cho says it’s probably OK to continue to take them.

“People should know that the data around CoQ10 and statins is quite poor,” she advises, “but if you want to take CoQ10 supplements because you feel like they help you, that’s fine.”

If you do want to take CoQ10 supplements, she advises taking 200 milligrams per day. Just be sure to tell your healthcare provider about them (and any other vitamins or supplements you’re talking) so they can flag any safety concerns.

What to do about muscle aches from statins

If you’re experiencing muscle aches while taking statins, the most important thing to do is to talk to your healthcare provider about your options. But it’s important to know that most people who take statins don’t experience muscle pain as a side effect.

“Cholesterol-lowering medications have been studied in more than a billion people, and in clinical trials, the rate of the side effect of muscle aches was quite low,” Dr. Cho shares. “Muscle pain is thought to affect 5% to 10% of people taking statins.”

You’re mostly likely to experience this side effect if you:

Are female
Are over age 65
Have obesity or overweight
Have underweight
Have other significant health issues
Regularly drink alcohol
Take other medications that can increase myalgia on statins, like antibiotics, diltiazem and amiodarone

If you fall within the percentage of people taking who do have muscle pain, you may feel desperate for relief. One study found that nearly 30% of people with this side effect stopped taking their medication as a result.

But dropping your statin significantly raises your risk for heart attack and stroke. So, instead, talk to your healthcare provider about switching to a different kind.

“There are two different types of statins — lipophilic statins and hydrophilic statins,” Dr. Cho says. “Hydrophilic statins tend to be gentler on the muscles, so if people can’t tolerate lipophilic statins, we start looking into those instead.”

Your provider may also start you on a low dose of statins and slowly increase the amount you take. This can help your body more easily adjust to the medication, which can ward off muscle aches.

“Studies show that even people who couldn’t tolerate statins before are often able to tolerate them this way,” she adds. “So, just because you couldn’t take statins before doesn’t mean you can’t take them now.”

The bottom line on statins and CoQ10

Most people who take statins don’t experience muscle aches, but if you do, it’s important to know that you have options — and that there’s no conclusive evidence to show that taking CoQ10 supplements will help.

But if you still want to take CoQ10 supplements, stick to 200 mg per day, and be sure to tell your healthcare provider that you’re taking them.

“If you want to take them, that’s fine,” Dr. Cho reiterates, “but if you don’t, it’s also fine to stop taking them, or never start them to begin with. What’s most important is that you talk to your healthcare provider about any concerns you have about your statins.”