Cardiologists have known for more than three decades that statin-type cholesterol-lowering drugs can lower levels of ubiquinone. Most people know ubiquinone by the name coenzyme Q10 or CoQ10.

Surprisingly, however, most doctors don’t recommend adding CoQ10 to a statin regimen. The Mayo Clinic, for example, suggests that CoQ10 supplements are usually unnecessary because people can get enough from their diet. The Cleveland Clinic maintains that “There’s not enough evidence to show that this supplement has any effect on muscle aches from cholesterol-lowering meds.”

This is not the message from the latest research. A systematic review titled “Effectiveness of Coenzyme Q10 Supplementation in Statin-Induced Myopathy” comes to a very different conclusion (Cureus, Aug. 31, 2024).

The investigators analyzed one meta-analysis and four randomized controlled trials that included 800 patients altogether. All of the randomized controlled trials compared CoQ10 to placebo for people with muscle pain while taking statins.

There were no notable side effects of CoQ10. The authors concluded: “Therefore, it can be deduced that CoQ10 supplementation significantly ameliorates statin-induced musculoskeletal symptoms.”

We wish more cardiologists would be open to this idea. One reader described the desperation that statin-induced muscle pain can cause: “My husband cannot tolerate statins. He has tried several different ones, and even at the lowest dose, he had intolerable side effects such as muscle pain and wasting. He didn’t have the symptoms before he took them, he got them while taking them, and then the symptoms resolved when he stopped taking them.

“The only reasonable deduction is that the statins were the source of the symptoms. Unfortunately, his former cardiologist would not listen to him and kept insisting he try another and another.

“A large meta-analysis found that the longevity benefit for statins averaged about two weeks. Given the long list of potential side effects, this benefit is unimpressive to say the least.

“I speak from experience when I say that a person can be suffering a great deal from muscle damage before the markers show up in a blood test. By that time, the damage could be severe and potentially irreversible.

“Statins work by suppressing an enzyme in the liver that interferes with cholesterol production, HMG Coenzyme-A reductase. It is also needed for other fundamental biological processes, including Coenzyme Q10.

That’s essential for cell energy and heart health. The cholesterol pathway dependent on HMG Coenzyme-A reductase is also linked to the production of vitamin D, adrenal hormones, and sex hormones. In addition, it makes many gene-signaling molecules required for healthy cell function and preventing cellular mutation (cancer).

“It seems to me that you don’t need a degree in molecular biology (which I do, in fact, have) to realize that this is a dangerous metabolic tack to be taking.

If my husband can’t walk and is in constant pain, it doesn’t matter what his cholesterol numbers are. Some people obviously benefit from this drug and clearly, some people can tolerate them. Many cannot, though. Just dismissing their very real concerns is not good medicine.”

CoQ10 may not reverse muscle pain for everyone on a statin. And it should not be taken by people on the anticoagulant warfarin. But this dietary supplement is considered safe and might help some people struggling with statin-related muscle pain.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com.