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CoQ10 - Muscle Pain and Statin Medications
CoQ10 is vital for energy production and as an antioxidant. It has been shown that people who take medications for high cholesterol, more specifically statin medications, have a tendency to develop fatigue and muscle pain. This study talks about the relationship of CoQ10 and associated muscle pain while taking statin medications. The red highlighted section below gives you a summary of the results.
Caso G, Kelly P, McNurlan MA, et al. Effect of Coenzyme Q10 on Myopathic Symptoms in Patients Treated with Statins. Am J Cardiol. 2007;99:1409-1412.The statin class of cholesterol lowering agents is well known for causing muscle symptoms of varying degrees. The inhibition of 3-hydroxy 3 methyl glutaryl coenzyme A (HMG-CoA) by statins is the same pathway shared by coenzyme Q10. Coenzyme Q10 is important for mitochondrial electron transport and decreased levels may affect oxidative phosphorylation and mitochondrial adenosine triphosphate production (ATP). Statin therapy may reduce coenzyme Q10 levels and impair muscle energy metabolism resulting in myopathy or other muscle symptoms associated with these agents. This pilot study was conducted to determine if supplementation with coenzyme Q10 would improve muscle symptoms in statin treated patients. This was a double-blind study involving 32 patients on statin therapy. Patients were enrolled if they had myopathic symptoms that had no other identifiable cause. Patients were randomly assigned to either 100 mg of coenzyme Q10 or 400 international units of vitamin E for 30 days. Myopathic symptoms and their interference with daily activities were evaluated prior to and after the intervention using the Brief Pain Inventory Questionnaire. Pain intensity was evaluated using the Pain Severity Score (PSS). There was no significant difference in the doses of statins used between the two treatment groups but the doses did very. Patients treated with simvastatin received anywhere from 10 to 80 mg, atorvastatin 10 to 20 mg, pravastatin 10-40 mg, and lovastatin 40 mg. The results showed a significant decrease in pain intensity in the coenzyme Q10 treated patients. Pain intensity decreased by 40 ± 11% (p<0.001). Patients taking vitamin E showed no difference in pain intensity. In addition, the interference of pain with daily activities also significantly improved in the coenzyme Q10 treatment group 30 ± 14% (p<0.02) while there was no effect on daily pain in patients treated with vitamin E. However, there was no correlation between pain scores and the creatine kinase (CK) concentrations. These results indicate that supplementation with coenzyme Q10 may decrease pain and improve patient's ability to perform daily activities without the need for an alteration in drug therapy or drug discontinuation. Of note, some of the limitations of this study were the lack of a placebo control arm and a lack of standardization of statin dose. Additional studies are warranted to more effectively assess the efficacy of coenzyme Q10 on statin associated muscle symptoms. Furthermore, the evaluation of the optimal dose and duration of coenzyme Q10 supplementation warrants evaluation as these parameters have varied greatly in studies conducted to date and remain unanswered.