CoQ10 & Statins

[ConnieM]

Hi everyone,

I work with medical providers at a primary care clinic in Berkley.  The other day, I suggested to one of the nurse practitioners that I work with, that I recommend CoQ10 for patients that take statins. 

Here was her reply:
 
So, I'm looking at research done on CoQ 10 and statins... there were two very short, very small randomized trials to determine whether CoQ 10 decreased the incidence of myopathy in statin users. The longer 12 week trial didn't show any decrease in pain, and the smaller trial was only 30 days long but patients reported a decrease in pain; this trial needs to be replicated because it was too small and too short.
There's good, solid evidence that shows that 2-11% experience myopathy on statins+fibrins, while fewer than 1% experience rhabdo on a statin alone, and this is typically with a high-dose statin - 40-80mg. I don't have the numbers for mild myopathy in statin users, but I think my preceptor said it was somewhere around 3%).
For someone who is taking a low-dose statin, I wouldn't be as concerned about myopathy, and the risks of CoQ 10 would seem to outweigh the possible benefits, i.e., bleeding, electrolyte imbalance d/t vomiting, as well as interactions with oral anti-diabetic agents.

She then went on to ask if this is:

    * useful only in high-dose statin users, and if so, is there a reason to take caution in patients on coumadin and anti-diabetics?

Does anyone have any studies that I could point her towards? I looked through pubmed to no avial.

Thanks,
Connie

[fleaf]

Connie: 

Some reference links that may help you to further refine your recommendations include:

http://www.aafp.org/afp/2005/0915/p1065.html
http://www.fda.gov/ohrms/dockets/dailys/02/May02/052902/02p-0244-cp00001-02-Exhibit_A-vol1.pdf
http://www.natural-remedies-review.com/coq10-for-diabetes.html

NP's comment suggests that supplementing with CoQ10 would only be indicated after someone has developed side effects from their statin protocols.  Yet, advanced muscle breakdown is one problem we would seek to avoid - rather than reverse - when we look at medication induced depletions of key nutrients.  Is she not considering the documented depletion effects accruing over time that may lead to a number of incremental challenges in statin dosed patients? 

Being able to cite studies in support of natural protocols is a great skill.  The patchwork nature of subjects studied "officially," as well as considerable variability in study design contributes to making this a tough skill to learn. 

Fern

[jodi f.]

The book Herb, Nutrient, and Drug Interactions, by Stargrove, Treasure, and McKee (St. Louis, MO: Mosby, 2008) contains an in-depth discussion of the research involving CoQ10 and its interactions with drugs. There's way too much information for me to even read through, much less post. If you can afford it ($86.80 on Amazon), it's an unbelievable wealth of well-referenced information. Sounds like you may be in need of this type of resource!