Do you need to take CoQ10 if you’re on a statin?
Most people take CoQ10 to help reduce statin-related muscle pain. But whether it works is up for debate. Here’s what you need to know.
If you have high cholesterol, you may be among the more than 200 million people worldwide who take a statin. It’s a type of medication that slows down the production of cholesterol in the liver. This forces your liver to pull cholesterol out of your blood to make bile, which helps you digest food in your small intestine.
Statins can be a powerful tool in lowering cholesterol — and the risk for heart attack and stroke. In fact, a large review in The Lancet found that for every 18mg/dL drop in low-density lipoprotein (LDL) cholesterol from taking statins, heart events fell by 24%.
Yet statins are not without side effects, which can include muscle pain and damage, stomach issues, liver damage, increased blood sugar and weight gain. But there’s another side effect that isn’t as obvious: lower levels of an antioxidant compound called coenzyme Q10, or CoQ10. Your body makes CoQ10 to help grow and maintain your cells.
“Statins do cause nutrient depletion of CoQ10, but it’s still often missed by many doctors who prescribe them,” says Marc Bubbs. He’s a naturopathic doctor and director of performance nutrition for Canada Basketball practicing out of Toronto and London. One reason: “It’s very difficult to ‘feel’ if you’re low in CoQ10,” he says.
Many doctors recommend CoQ10 supplements to their patients who take statin medications. They’re available over the counter. But there’s a lot of debate about their effectiveness. Here’s what we know — and don’t know — about taking CoQ10 while on statins and how to decide whether taking it makes sense for you.
The possible benefits of CoQ10 supplements
The most research on CoQ10 is around statin-related muscle pain and heart health. Let’s dive into each.
CoQ10 and muscle pain
According to the Mayo Clinic, muscle pain is one of the biggest complaints people have while taking a statin. For you, this could mean feeling weak, tired or sore. And it can range from mild to debilitating.
Why statins impact muscles isn’t well known. (And in some cases, just knowing a statin may cause muscle aches can make you feel achy. Experts call this the “nocebo” effect.) But it may have to do with a drop in CoQ10 levels.
CoQ10 plays a role in how our cells make energy. Statins interrupt the pathway that creates CoQ10. So the thinking is that if muscle cells can’t get all the energy they need, this may cause weakness and fatigue. By that logic, taking a CoQ10 supplement would help relieve muscle discomfort.
But research suggests this is up for debate. A 2018 review in the Journal of the American Heart Association found that people on a statin who took CoQ10 had far fewer muscle pain symptoms compared with those who took a placebo pill. But a more recent review in the journal Atherosclerosis found that CoQ10 made no difference in statin-related muscle symptoms.
CoQ10 and heart health
When you’re treating high cholesterol, you likely have heart health on the brain, too. Doing everything you can to prevent heart disease, heart attacks and stroke is vital. While your heart needs a lot of energy to perform at its best, the research on CoQ10’s benefits are mixed.
A 2021 review found that people with heart failure who took CoQ10 had a lower risk of dying than people who didn’t. That said, it wasn’t enough to help prevent heart attacks or strokes.
CoQ10 also acts as an antioxidant, protecting your tissues from damage. Some experts think this effect could help lower blood pressure, too. A small number of studies suggest that it could work. But most of the time, people had to take CoQ10 for up to 3 months to see their blood pressure budge.
Recommended reading: Have high cholesterol? Statins aren’t the only option.
The bottom line
CoQ10 supplements may help reduce statin-related muscle pain and support overall heart health. And they’re typically safe and free of side effects. “In general, most people tolerate doses between 30 mg and 100 mg well,” says Bubbs. If you do have side effects, they may include loss of appetite and nausea, he adds.
But CoQ10 supplements are far from a sure thing — or a substitute for your prescription medication. Always talk to your doctor before trying them.
First, they don’t mix well with some medications, such as the blood-thinner warfarin. Second, your doctor may have an even better way to help you manage statin side effects. This may include switching medications or adjusting your dosage.
You can also make little habit changes each day to lower your blood pressure and care for your heart (besides taking another pill).
Don’t forget to grab your free prescription discount card. Show it to your pharmacist each time you refill a medication to make sure you’re getting the best price.
Study on the effectiveness of statins: The Lancet (2019). “Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomized controlled trials”
Statin side effects: Mayo Clinic
Positive review on CoQ10 and statin-related muscle pain: Journal of the American Heart Association (2018). “Effects of coenzyme Q10 on statin-induced myopathy: an updated meta-analysis of randomized controlled trials”
Neutral review on CoQ10 and statin-related muscle pain: Atherosclerosis (2020). “Effect of coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis"
Impact of CoQ10 on heart failure outcomes: Cochrane Database of Systematic Reviews (2021). “Coenzyme Q10 for heart failure”
Overview of CoQ10 for blood pressure: Mount Sinai