CoQ10 and Statins

Written by Dr Jatin Joshi, co-founder and Chief Medical and Scientific Officer of Personally, and a researcher at the University of Oxford's Centre for Evidence-Based Medicine. I have a financial stake in this company, and you should weigh what follows with that in mind.

You are on a statin, you have heard somewhere that you might need to take CoQ10 alongside it, and you would like a straight answer from someone who is not about to sell you a tub of it on the way past. Here is the honest version, and it starts with the most important thing, which is also the most reassuring: keep taking your statin.

Statins are among the best-evidenced and most beneficial medicines we have. For the people who are prescribed them, they meaningfully lower the risk of heart attacks and strokes, and that benefit is built on decades of large, careful trials. I say this first because the CoQ10 question sometimes gets used, by people who should know better, to make patients uneasy about the statin itself. It should not. Whatever you decide about CoQ10, the statin is doing the important work, and nothing in this article is a reason to stop it or skip doses.

There is a real biochemical link here, and it is worth understanding rather than fearing. Statins work by blocking an enzyme early in a chain of reactions in the body. CoQ10, a substance your cells use in producing energy, happens to be made further along that same chain. So when a statin slows the start of the chain, it can lower the amount of CoQ10 your body makes, and blood levels of CoQ10 can fall on a statin. That part is genuinely established. Statins can lower CoQ10.

The trouble is the leap that usually comes next, from "statins can lower CoQ10" to "so you must take CoQ10 or you will get muscle aches". That leap is where the evidence thins out, and this is exactly the sort of place a supplement company is tempted to look the other way.

The theory that low CoQ10 is behind the muscle aches some people get on statins is plausible, but the trials that have tested whether taking CoQ10 actually relieves those aches are mixed, and the better-designed ones have mostly not found a convincing benefit over a dummy capsule. There is also a wrinkle that matters: when statin muscle symptoms have been studied in blinded trials, where neither the patient nor the researcher knew who was on the real drug, a large share of the aches turned up just as often on the placebo. In other words, a good deal of what gets blamed on statins is real discomfort that is not actually being caused by the statin. So I cannot tell you, honestly, that CoQ10 will fix muscle symptoms, because the evidence does not support that promise.

If you are getting muscle aches on a statin, the useful move is not to quietly start a supplement and hope. It is to tell your doctor. They can check for the small number of cases where something more serious is going on, consider adjusting your dose or trying a different statin, and look at the other causes of aches that are so common in the age group most likely to be on one, from simple overexertion to a low thyroid to a dozen other things that have nothing to do with the medicine. That is a proper answer to the symptom, and it is a better one than swapping a well-evidenced drug for a supplement of your own accord.

It is worth being blunt about the stakes of that swap. Stopping a statin because of an ache the statin may not even be causing trades a small, often manageable discomfort for a return of the cardiovascular risk the drug was lowering, and that is a poor trade to make quietly and alone. CoQ10 itself is low-risk and some people choose to try it, and there is little harm in that. But go in with realistic expectations rather than a marketing promise, and do not let it become a reason to delay or avoid the conversation that actually helps.

So where does something like what we do sit in this. Honestly, near the end, and without overclaiming. A formula that knows you are on a statin can reasonably include CoQ10, at a considered dose calibrated to you and kept within the range used in studies rather than a token sprinkle or an excessive amount. I am offering that as a sensible, low-risk response to the biochemistry, not as a cure for muscle symptoms, because that is as far as the evidence takes it.

The more interesting point is the principle underneath it. Knowing your medications is exactly what lets a formula behave sensibly, and it cuts both ways. CoQ10, for instance, can affect how the blood thinner warfarin works, so if you took warfarin, a formula worth its salt should take that into account rather than cheerfully adding CoQ10 anyway. We ask what you take before we formulate. Most of the industry does not, which is the real gap here, more than any single ingredient.

If you want to see how that plays out for your own situation, the quiz is where it starts. It will ask what you take, which is the point, and it is a way to understand where nutrition fits around your medication, not a checkout.