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Coenzyme Q10: Flexing different muscles against statins

Coenzyme Q10 (CoQ10) is a veteran player on the dietary supplement market, having enjoyed two decades of activity as a heart health supplement. CoQ10 fits into the small niche of dietary supplements that are characterized by being (1) manufactured by the body, (2) available from foods, and (3) can be reduced by drugs or disease. CoQ10 has an integral role in cell energy production and also serves as a fat-soluble antioxidant.

Your CoQ10 supply can be threatened by a group of drugs called statins, which have risen to global prominence. Statins are embraced as the drug of choice for producing favorable changes in blood cholesterol profiles and reducing the risk of heart disease. However, the way in which they exert their lipid-lowering effects happens to intersect with the same biochemical pathway that regulates the body's CoQ10 synthesis capacity. Thus, statins have the potential of reducing CoQ10 concentrations in the body.

One study published in the Journal of the American Medical Association found that use of the statin drug simvastatin (Zocor) produced notable drops in blood CoQ10 concentrations. In one of the only studies that has peered into muscle "under the influence" of statins, European researchers found that 8 weeks of either simvastatin or atorvastatin (Lipitor; another statin drug) induced similar reductions of blood CoQ10 in men with elevated blood lipids. Only high dose simvastatin produced a sharp drop in skeletal muscle CoQ10 content.

Two of the more common adverse side effects associated with statin therapy are elevation of liver enzymes (chemical hepatitis) and myopathy, a condition characterized by skeletal muscle weakness, pain, and reductions in the integrity of muscle cells. Indeed, reports of liver failure and over 100 deaths associated with the use of cerivastatin (Baycol) ultimately led to its removal from the market in 2002. Because of skeletal muscle's high energy demands, energy production and muscle cell integrity are vital aspects of well functioning tissue. Because CoQ10 content can vary between muscle types, and blood concentrations may show seasonal and racial differences, a certain minority of individuals may be at higher risk of statin-associated adverse effects that are suggestive of CoQ10 depletion in tissues. Indeed, 1-5% of those using statins manifest muscle weakness and pain.

It's prudent to inform your medical professional about your use of CoQ10 supplements if you are on statin therapy.

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