Up to 20 percent of people who take statin drugs to lower cholesterol suffer from muscle aches, particularly when they try to exercise. A systematic review found eight studies that showed that Co-enzyme Q10 (CoQ10) does not reduce statin-induced muscle pain, compared to placebo (Atherosclerosis, April 2020;299:1-8). Furthermore, taking CoQ10 did not improve the proportion of patients remaining on the statin treatment.

A previous article in the New York Times (Oct. 9, 2018) explains the history of efforts to use CoQ10 to reduce statin-induced muscle pain. In 1957, COQ10 was discovered to be a molecule that helps muscles convert food to energy (Biochim Biophys Acta, 1957 Jul;25(1):220-1), and in 1978, studies showed that statins lower both cholesterol and CoQ10 because they are both made through the same biochemical pathway (Arch Biochem Biophys, 1979 Jan;192(1):86-99). Researchers studied whether raising CoQ10 would stop the muscle aches, but in 2015, a review of six studies found that it did not (Mayo Clin Proc,2015 Jan;90(1):24-34).. Other studies showed the same results (Atherosclerosis, 2015 Feb;238(2):329-35), but CoQ10 promoters still make claims of this benefit.

What Is Co-Enzyme Q10?
Reactions in your body produce chemicals called oxidants that damage cells and shorten life. To protect your cells from oxidant damage, your body produces antioxidants such as superoxide dismutase and CoQ10. Since tissue levels of CoQ10 drop with aging, it is tempting to think that reduced levels of this coenzyme cause aging. However, research shows that lowered levels are the result, rather than the cause, of aging because CoQ10 is found in the mitochondria, the energy sources of cells. With aging, the number of mitochondria and size of cells become smaller, so everything in the mitochondria is reduced. CoQ10 has been found to be ineffective in treating diseases affecting the mitochondria (Neurology, May 1993;43(5):884-890).

Since CoQ10 is a source of energy, researchers thought that perhaps CoQ10 supplements would increase endurance, but studies have failed to show this (Int J of Sprts Med, Oct 1995;16(7):421-427). Many years ago, researchers at the University of Texas showed that people who have arteriosclerotic heart disease have lower blood levels of CoQ10 than people who have normal hearts, but people with damaged hearts have less functioning heart muscle, so they should be expected to have lower levels of CoQ10.

For CoQ10 to improve health and energy, it would need to get into the cells, particularly the mitochondria, where it functions. Studies show that CoQ10 pills get into the bloodstream, but cannot be recovered in the cells (Int J of Sport Nutr, 1999;9(2):166-180). Therefore, CoQ10 from pills cannot get into heart muscle and kidneys (J Nutr, Mar 1995;125(3):446-453), and they have not been shown to effectively treat heart failure (Ann Intern Med, 2000 Apr 18;132(8):636-40). CoQ10 is sold as a dietary supplement, so by a law passed by congress in 1994, it cannot be regulated by the U.S. Food and Drug Administration. It can cause stomach upset and insomnia, and can interact with drugs. Check with your doctor or pharmacist if you decide to take this supplement.