Life Extension Update
CoQ10 treatment improves statin-induced myopathy
Statin drugs are used effectively by a large number of individuals with elevated cholesterol levels to help reduce the risk of cardiovascular disease; however, a not uncommon side effect is muscle pain which could be related in part to the drugs’ inhibition of the body’s synthesis of coenzyme Q10 (coQ10), a cofactor for the production of energy in the cells’ mitochondria.
In a double-blind trial reported in the May 15, 2007 issue of The American Journal of Cardiology, Giuseppe Caso, MD, MSc, PhD and colleagues at Stony Brook University in New York administered 100 milligrams coenzyme Q10 per day to 18 men and women with myopathic symptoms resulting from current statin use, and 400 international units vitamin E to another 14 patients with the condition. The groups were similar in age, weight, body mass index, cholesterol levels, and statin drug use. Myopathic pain was evaluated by completion of the Brief Pain Inventory Questionnaire by participants at the beginning of the study and after 30 days of treatment.
At the trial’s conclusion, subjects who received coenzyme Q10 had a 40 percent decrease in pain severity and a 38 percent decrease in interference by pain in their daily activities. The group that received vitamin E did not experience improvements. Sixteen of the eighteen participants who received coQ10 reported less pain compared to 3 subjects in the control group.
Statin drugs reduce a precursor of cholesterol and coenzyme Q10, which could affect oxidative phosphorylation and mitochondrial ATP production, resulting in mitochondrial energy deficit. Decreased plasma coQ10 during treatment with statin drugs is associated with a higher blood lactate to pyruvate ratio, indicating mitochondrial respiratory system dysfunction. This may result in a reduction of the aerobic capacity of muscle accompanied by increased muscle fatigue.
“It can be hypothesized that some of the myopathic symptoms in patients treated with statins may result from partial inability of the mitochondria to supply the ATP needed for muscle contraction because of decreased coenzyme Q10 levels,” the authors write. “Results of the present study showing improvement in myopathic symptoms using coenzyme Q10 supplements supports this hypothesis, suggesting a possible etiologic role of coenzyme Q10 depletion in the pathogenesis of myopathic symptoms in statin-treated subjects.”
Elevated cholesterol is associated with a greater-than-normal risk of atherosclerosis and cardiovascular disease. While antioxidants can inhibit cholesterol from oxidizing onto the linings of the arteries, knowing and controlling your cholesterol levels is still an important step in preventing cardiovascular disease.
Drugs that inhibit the enzyme HMG-CoA reductase are referred to as "statins." These drugs lower cholesterol by slowing down the production of cholesterol and by increasing the liver's ability to remove the LDL cholesterol already in the blood.
Some people with high cholesterol are able to reduce to safe levels by using combinations of dietary supplements that have been shown to lower serum cholesterol, protect against LDL cholesterol oxidation, and reduce the risk of an abnormal arterial blood clot formation.
The effectiveness of any cholesterol-reduction therapy varies considerably between individuals. The nutrients we recommend have not only been shown to lower cholesterol, but also protect against cardiovascular disease by other mechanisms such as inhibition of cholesterol-oxidizing free radicals and abnormal blood clots inside arteries (thrombosis).
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