Statin drugs and Coenzyme Q10

I am continually impressed at how few of my colleagues take advantage of a wonderful nutritional supplement, Coenzyme Q10 (CoQ10).

Despite some of the recent backlash against statin agents, I do believe that they serve a role. I take issue with the pharmaceutical industry's endless advertising and force-feeding of drugs to the public and to physicians. Nonetheless, statin agents do serve a purpose.

If you go to your doctor with a fever of 103 degrees, coughing up thick yellow sputum, and you are struggling to breathe, would you refuse an antibiotic for pneumonia? Probably not. But an antibiotic for a sore throat may be a different matter.

So it goes with the statin drugs, too. An otherwise healthy 50-year-old woman with an LDL cholesterol of 140 mg/dl probably does not need a statin drug. A 35-year-old man with heterozygous hypercholesterolemia with an LDL cholesterol of 280 mg/dl, who will develop his first heart attack within the next 2 or 3 years, does need these drugs. The rub, of course, is deciding who in between also needs them.

Let's just accept that some people do indeed need a statin drug for one reason or another. How common are the muscle aches?



In my experience, muscle aches are inevitable. The longer you take a statin drug, the more likely you will develop them. The higher the dose, the more likely.

Thankfully, for most people muscle aches are more of a nuisance than a real danger. Usually, a reduced dose of the drug, periodic breaks from the drug (we often advise one or two weeks off every three months), or a change to another agent helps.

However, in my view, coenzyme Q10 provides a virtual antidote to most of the muscle aches and weakness. A recent review was published in the Journal of the American College of Cardiologist that concluded that there was insufficient evidence to support the use of CoQ10 for this purpose. Obviously, the authors do not use CoQ10 in everyday practice. If they did, they would have no doubt whatsoever that CoQ10 provides the majority of people with complete relief of the muscle complaints.

Time and time again, I have witnessed complete relief from muscle aches and muscle weakness from statin drugs using CoQ10. However, in our experience, a dose of at least 100 mg per day needs to be maintained. Occasionally, a higher dose will be necessary, e.g., 300 mg per day. The preparation also must--MUST--be an oil-based gelcap to work (just like vitamin D). The capsules that contain powder are so poorly absorbed that they usually fail to yield the needed effects.

Pictured is the Sam's Club (Members' Mark brand) that has served us well, providing reliable effects at a reasonable price. (CoQ10 is expensive, no matter where you buy it. That's the only drawback I'm aware of.) GNC has a great preparation, as does Life Extension. Just be sure it is a gelcap, not a capsule filled with powder.

There's more to CoQ10 than relief of statin muscle aches. More about that in future.

Comments (10) -

  • DietKing2

    9/17/2007 2:49:00 PM |

    Thanks for this post! I've been waiting for this one!
    So I'm not off base for ingesting my CoQ-10 twice daily! Yay!
    Talk about peace of mind, right?
    The market must be clamoring for this stuff because Life Extension led the way with a newer, more bioavailable version of CoQ10 (ubiquinol vs. ubiquinone) recently and now less expensive versions are popping up all over the internet--affordable protection, man!
    Thanks for the post!
    AdamWink

  • Terri in Texas

    9/17/2007 4:26:00 PM |

    I can appreciate that Co Q-10 probably works for _most_ people, and I wish I was one of them. But... there are those of us who are probably either so sensitive to statins, or perhaps even genetically predisposed to react horribly to statins, that even 200 mgs. daily of the LE quality formulation won't stave off debilitating statin side effects.  So therefore, no statins for me.

    Is there any credible evidence that Co Q-10, say 100 mgs. daily, might still be a good thing?  I currently am taking slo-niacin and a tiny bit of a beta blocker for MVP.

    Thanks!  Keep up the great blogging!

    Terri

  • Nancy M.

    9/17/2007 6:54:00 PM |

    I'm curious if you've seen this article by Gary Taubes.  I really like this guy, he's wonderfully skeptical of "common knowledge".

    http://www.nytimes.com/2007/09/16/magazine/16epidemiology-t.html?_r=1&oref=slogin&ref=magazine&pagewanted=print

  • Dr. Davis

    9/21/2007 12:41:00 PM |

    Terri--

    Outside of the statin issue, I use CoQ10 for 1) blood pressure reduction, 2) enhancement of left ventricular function if it is impaired by heart attack or other conditions, and 3) increasing energy, though an inconsistent effect.

  • Dr. Davis

    9/21/2007 12:42:00 PM |

    I've not read Gary Taubes book, but I think that he makes many excellent points on the mislaid conventional wisdom on diet.

    Over the past few years, we've learned some very important lessons in the Track Your Plaque experience, as well, that has caused us to change out dietary approach rather dramatically.

  • Anonymous

    10/18/2007 1:33:00 AM |

    I have read Gary Taubes' book and there is one very important point he makes that will  get the attention of those of us who are on Statins. That point is that LDL is not relevant to heart disease or metabolic syndrome. He claims that the only credible evidence indicates that triglycerides and HDL are the important factors. What you want is high HDL and low triglycerides and if you have this, forget the LDL reading. That is precisely my situation and I plan to challenge my doctor on this at my next appointment. Can I stop taking the 20 mg of Crestor each day?
    I have been on Zocor for 20 years and recently switched to Crestor to further lower my LDL. I have never had muscle pain of any kind and my liver tests are always good. I did take CoQ10 for awhile, but I could not detect any difference. Perhaps for those of us who can tolerate statins CoQ10 is not necessary?

    Barry S

  • Anonymous

    12/13/2008 5:56:00 PM |

    I think it makes some sense to take the CoQ-10 preemptively, a month before starting any statin therapy. It's easier to prevent rather than reverse muscle pain/weakness.

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    Coenzyme Q10 (CoQ10) is produced by the human body and is necessary for the basic functioning of cells. CoQ10 levels are reported to decrease with age and to be low in patients with some chronic diseases such as heart conditions, muscular dystrophies, Parkinson's disease, cancer, diabetes, and HIV/AIDS. Some prescription drugs may also lower CoQ10 levels.

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    Pictured is the Sam's Club (Members' Mark brand) that has served us well, providing reliable effects at a reasonable price. (CoQ10 is expensive, no matter where you buy it. That's the only drawback I'm aware of.) GNC has a great preparation, as does Life Extension. Just be sure it is a gelcap, not a capsule filled with powder.

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Wheat Belly coming to bookstores!

Wheat Belly coming to bookstores!

Anyone following the conversations on these pages know that I have some very serious concerns about this thing being sold to us called "wheat"--cause it ain't wheat! It is the result of incredible genetics shenanigans inflicted on this plant, mostly in the name of increased yield per acre.



I now classify wheat as "Public Enemy #1," the prime nutritional culprit underlying obesity, heart disease, "cholesterol" abnormalities, hypertension, arthritis, psychiatric illness, and on and on. Once you read the full story, I believe that you will agree: Modern Triticum aestivum, the plant that now serves as the source for virtually all the wheat flour products now consumed--organic, whole grain, multigrain, sprouted . . . it makes no difference--does not belong in the human diet. So many people, searching for solutions for their fatigue, weight gain, leg edema, incurable rashes, joint pain, etc., will find their answers here.

Wheat Belly: Lose the wheat, lose the weight and find your path back to health will be on bookstore shelves including Barnes and Noble August 30, 2011 or is available for preorder here at Amazon. Wheat Belly will also be available as a downloadable Kindle book and as unabridged audio CDs.

You can also follow the Wheat Belly conversations on my Wheat Belly Blog. One of my recent posts discusses the herbicide-resistant semi-dwarf wheat strain, Clearfield, that is now making its way to more and more supermarket shelves.

You'll also find more conversation on the Wheat Belly Facebook pages.

Comments (18) -

  • Jana Miller

    7/31/2011 5:47:19 PM |

    Congratulations...thanks for all you do to educate and inform us about wheat!!
    all the best,
    jana

  • BJ

    7/31/2011 5:55:00 PM |

    The date of the book arrival must be incorrect?  2001?
    I am anxious to read this one!

  • Lori

    7/31/2011 6:05:42 PM |

    I've pre-ordered Wheat Belly and look forward to reading it.

    I'm enjoying my second summer free of hay fever--coincidentally, the first summer was right after I eliminated wheat from my diet. Hurray!

  • Princess Dieter

    7/31/2011 6:39:26 PM |

    Will it be a Nook book? I love my Nook! And I've got Mercola's No Grain diet, some Primal/Paleo books on there already. Would love to have yours, too. Thanks.

  • Princess Dieter

    7/31/2011 6:40:47 PM |

    OMG, I just read Lori's comment, and realize that I've been less asthmatic/allergenic this summer since ditching wheat/gluten. I've been able to scale back (stop Nasonex and cut back on inhaled steroid dosage, even) .  August-September is the worse, runny-nose-wise, so I'll get to observe and see. Hm.

  • Diana

    8/1/2011 12:34:08 AM |

    Congrats on the book! Can't wait to read it!
    Continuing on a comment above, I too have had no seasonal allergies since doing a diet which is wheat-free. Have you ever covered this topic in your blog, or could you in the future?

  • Might-o'chondri-AL

    8/1/2011 9:52:09 AM |

    7 times Sunday/Monday tried to get  just 2 sentence post about ApoE4  in previous thread and got "Server Error", so testing again in this tread ... this lousy server did this before with me.

  • Might-o'chondri-AL

    8/1/2011 10:04:44 AM |

    Anyone still checking this thread want me to continue with some ApoE4 comments here ? I went back to try previous thread and still got "server error" there. I  ask for interest because I myself don't always follow  new thread comments section  - and maybe those with ApoE4 interest are not reading here now.

  • Might-o'chondri-AL

    8/1/2011 5:39:19 PM |

    Just tried to use "reply" box of  Dr. K.'s comment on previous ApoE4 thread  to contribute and got "Server Error";
    let's see if I am still welcomed on this thread by the server....

  • Melinda

    8/1/2011 8:13:42 PM |

    Might-o'chondri-al,

    Yes, I would be interested in your replies about ApoE4.  I always read your comments around the web and like many, I wish you had your own blog so I wouldn't miss any of your output.

  • Might-o'chonri-AL

    8/2/2011 12:57:19 AM |

    Hi Melinda,
    Please copy and post this in previous thread for ApoE4 ... .
    Continuation about ApoE4:
    % of ApoE4 messes dynamic inside tissue cell so that ApoB turns to use Scavenger Receptors to try to start cascade which gets signal transducer (Specificity Protein 1) to up-regulate the cell membrane transporter protein ( ABCA1, ATP binding cassette transporter A1) that puts excess cholesterol out from that cell.   I believe this is where Doc Davis' stated ApoB irregularities  add to the problem with ApoE4 (since normal human ApoE3  works all by itself to get that signal transducer to bind to ABCA1 to work shucking cholesterol) . When cholesterol gets to build up inside the cell the large LDL can acetylate and form  excessive "droplets" in that cell's cytoplasm; while the small LDL can oxidize from CuSO4- and load up inside that cell's lysosome.

    Meanwhile % of  ApoE4 doesn't just dock with tissue cell LDL receptors and so the macrophage scavenger receptors pick up too much cholesterol laden ApoB/ApoE lipo-protein carrier molecules. Once in the macrophage the same problem of oxidized LDL piling up  in lysosome and acetylated LDL burdening cytoplasm occurs; and for that matter, in macrophages,  it is down to ApoB to get  the signal transducer going if any cholesterol is to be put out by cell membrane transporter protein ABCA1.  This is the recipe for  risky pro-atherogenic  "foam cell" formation; while the individual genetics of ApoE, ApoB, assorted receptor types, signal transducer and transport protein all make it hard to predict how ApoE4 plays out.

    Dr. Kruse broaches ApoE4 in alzheimers and this is in large part because ApoE4 causes the brain neurons to  get less than optimal cholesterol from the brain's astrocytes. It is ApoA1 working in HDL complex that controls the astrocyte cholesterol balance and when there is inflammation there is a risk of ApoA1 mis-folding to  foster amyloid aggregations.  Low intact ApoA1 and ApoE4 together increase the risk factor for cognitive problems and dementia several fold.

    Diabetics with ApoE4 have that % of ApoE4 as an  additional  limitation;  however,  irregardless of  the ApoE iso-form diabetic dementia risk arises from their glucose loads impairing kidney tubules, and thus fostering the uremic environment that stymies ApoA1 bio-synthesis. The normal role of ApoA1 is to bind to the transport protein which secures cholesterol into a safe bond with HDL; so low ApoA1 from any factor will  challenge the brain neuron over time. I suggest there are individuals whose age impaired kidneys contribute to senile dementia from impairing ApoA1 levels being made and also possibly speeding up the normal 4-6 days kidney elimination of ApoA1 ; and  so Patri's comment on limitation of high protein intake is relevant due to it's demand on aging  kidneys.

  • Dr. William Davis

    8/2/2011 1:58:16 AM |

    Oooops! Too many zeros and too few ones!
    Yes, indeed, 2011. Thanks, BJ.

  • Dr. William Davis

    8/2/2011 1:59:11 AM |

    Hi, Lori-
    I personally experienced the very same effect.
    I remember days in which my eyes were swollen shut, sinuses achingly closed, wheezing. All now a distant memory!

  • Dr. William Davis

    8/2/2011 2:00:39 AM |

    Yes, great idea, Diana. I'll cover that topic, though likely more appropriate for the Wheat Belly Blog.
    I will likely mirror this post in both blogs. It affects a LOT of people.

  • Dr. William Davis

    8/2/2011 2:02:19 AM |

    Hi, Might--
    Sorry for all the posting struggles. I'm still working with working out the kinks.
    The changes here are occuring with some back room changes in database software, etc., that is making for more than the usual headaches.
    Please don't give up in frustration. Your comments are truly valued.

  • MJ Klein

    8/2/2011 2:07:31 AM |

    is this primarily a US problem?

  • Might-o'chonri-AL

    8/2/2011 5:25:41 AM |

    Hi MJ,
    ApoE4 =  14-19% Germans & Finns and  7-12% Italians & French
    ApoE3 = +/- 60% of people
    ApoE2 = 3-4% Japanese, Finns & Nigerians and 2-4 % Mexican Americans & American Indians

  • Stella

    11/11/2011 10:55:36 AM |

    Just wondered if you were aware that for several days now (all this week, for sure) Amazon UK has been displaying the following message on the Wheat Belly page:

    "Item Under Review
    This product is not currently offered by Amazon.co.uk because a customer recently told us that the item he or she received was not as described.
    We are working to resolve this as quickly as possible. In the meantime, you may still find this product available from other sellers on this page."

    Maybe they were expecting bagel recipes? There is no explanation, and the three accompanying reader reviews are all 5*

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