You may have seen the news coverage revealing that the NHS is considering prescribing statins to all over 50s in the UK. What is less widely known is that as well as their efficacy at lowering cholesterol, statins also deplete the body of an essential nutrient, Co Enzyme Q10. We asked the world expert on the subject for the facts...
Do statin drugs deplete you of co enzyme Q10?
Unfortunately, the answer is an emphatic “yes”. The wildly popular cholesterol-lowering drugs block all our cells’ ability to make both cholesterol and the nutrient
co enzyme Q10 (CoQ10). Statins block the production of the molecule ‘mevalonate’, which is the essential precursor to both cholesterol and CoQ10 production.
Why do I need CoQ10?
CoQ10 was discovered by Fred Crane, Ph.D. in 1957 and is now known to be a powerful antioxidant. CoQ10 is not strictly speaking a vitamin because our bodies can make its own, as well as obtain it from food. Peak CoQ10 production occurs at the same time as our peak athletic performance, which is in our mid 20s and thereafter we become more dependent on dietary sources.
CoQ10 is most highly concentrated in organ meats such as heart, liver, and kidney, which are not commonly consumed in our modern society. The combination of statin drug-induced blockage of CoQ10 production and low dietary intake leads to severe depletion of this essential nutrient. If you lower cholesterol by 40% with statin drug therapy, you will lower CoQ10 levels by 40% too.
CoQ10 is the cofactor, or coenzyme, necessary for the production of about 90% of our cellular energy and it follows that almost all patients taking statin drugs experience some degree of fatigue and muscle weakness. Often this fatigue and weakness is so severe that the statin drug must be stopped.
Are statins really that bad?
Despite pharmaceutical reassurances that statin adverse effects are either rare or mild, it is becoming increasingly clear that they are neither.
Statin drugs have been on the market now since 1987 and are some of the most widely prescribed drugs in medical history, with annual worldwide sales topping £60 billion!
Many readers of this article will likely have personal experience with statin side effects or will know a close friend or relative who has. Statin drug side effects include, but are not limited to, varying degrees of fatigue, muscle weakness and/or muscle pain, shortness of breath with exertion, impairment in short-term memory, peripheral neuropathy with numbness and tingling in the feet, liver damage, and concern over an increase in both diabetes and cancer.
In a remarkable 2002 Canadian paper published in the Journal of the American Medical Association, a striking 75% of over 85,000 patients who were prescribed statin drugtherapy were no longer having their prescriptions refilled after just two years.
In 2004, a study published in the American Journal of Cardiology documented evidence of early heart muscle weakness in 70% of patients taking statin drug therapy for a period of six months. Interestingly, this early heart muscle weakness reversed back to normal by adding supplemental CoQ10 at 100mg three times daily (total of 300mg/day).
More recently, other studies have shown reversal of skeletal muscle pain and weakness by adding supplemental CoQ10 to statin drug therapy.
Should I take statins and CoQ10 together?
Drug-nutrient interactions are not a new phenomenon in medicine and all physicians are very familiar with the necessity to add vitamin B6 to patients undergoing treatment of tuberculosis with the drug isoniazid, as well as the requirement to supplement with folic acid in patients treated with the immunosuppressant drug methotrexate.
Although the statin-CoQ10 drug-nutrient interaction is not widely publicised, it certainly has been very well studied and is well-known in medical and pharmaceutical research literature as far back as 1990 when Merck & Co., Inc. (the manufacturer of two statin drugs, lovastatin and simvastatin) obtained two patents to combine CoQ10 with the statin drug in the same tablet to prevent liver and muscle damage. Although these patents have not been acted upon, the basic science behind them is sound and taking supplemental CoQ10 with a statin drug makes perfect sense. Importantly, taking a CoQ10 supplement does not affect the cholesterol-lowering action of the statin drugs.
What does the future hold for statins?
After 24 years of practicing cardiology, I have developed a humble respect for how little we know of the common and devastating problem of atherosclerosis, or hardening of the arteries, with its associated clinical events of heart attack, stroke, and sudden death. Yes, I am confident that we know of some factors that clearly accelerate or worsen atherosclerosis such as stress, smoking, air pollution, hypertension, diabetes, high vegetable omega 6 fat intake compared to low omega 3 fish oil intake, the potential harm from hydrogenated vegetable oils (also known as trans fats) and I am open to the possibility that atherosclerosis may turn out to be an infectious disease, as atherosclerotic plaques are teaming with microorganisms identical to those we carry in our mouths. This last possibility would be similar to the revolutionary finding that the vast majority of peptic ulcers are caused by the bacteria helicobacter pylori.
The prevailing wisdom in my profession still clings to the vilification of cholesterol and cholesterol-lowering drug therapy. Whether I like it or not, statin drug therapy remains a common aspect of my cardiac practice, as most new patients have already been started on cholesterol-lowering therapy by their primary care physician. I try to prevent statin side effects in the first place by adding supplemental CoQ10 to all patients on statin drug therapy. All CoQ10 supplements are better absorbed when taken with a meal.
In conclusion, all statin drugs cause a deficiency of the vitamin-like nutrient, CoQ10 which can be alleviated through supplementation, bringing about a lessening of drug side effects and a significant improvement in overall quality of life. The dose of CoQ10 can be 200mg per day with a low dose statin or up to 400mg per day in patients on a high dose statin.
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