Coenzyme Q10
- Coenzyme Q10 (ubiquinone) is a naturally occurring lipoid-soluble quinine, which by acting as an electron transporter is an essential cofactor in mitochondrial oxidative phosphorylation and generation of adenosine triphosphate.
- In its reduced form it also acts as a lipophilic antioxidant protecting cell membranes and circulating lipoproteins from oxidation. Thus, coenzyme Q 10 may protect against oxidative but its synthesis is blocked by statins.
- Statin therapy reduces Coenzyme Q10 in 2 weeks. It takes about 6 months to deplete the ubiquinone levels in muscle and it may take same amount of time to ameliorate the symptoms with coenzyme.
- Hughes K and associates have implicated low coenzyme Q10 levels as one of the factors contributing to the excess burden of heart disease in Asian Indians who are known to have lower levels than Chinese. The consistently lower values of coenzyme Q10, may also contribute to increased myalgia with statin therapy.1
- Although no significant differences were found in plasma concentrations of total cholesterol, triglycerides, and LDL between the two ethnic groups, the ratios of ubiquinol and total CoQ10 to triglycerides, total cholesterol, and LDL were significantly lower in Indian males than Chinese males.
- There are anecdotal evidence of benefits on statin myalgia with coenzyme Q10 although a systemic review failed to confirm such benefit.2 Coenzyme Q10 800 to 1400 mg has been used in patients with mitochondrial disorder by neurologists. Such therapy may be beneficial in patients who have severe myalgia with statins.
Sources
1. Hughes K, Lee BL, Feng X, Lee J, Ong CN. Coenzyme Q10 and differences in coronary heart disease risk in Asian Indians and Chinese. Free Radic Biol Med. Jan 15 2002;32(2):132-138.
2. Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy: a systematic review. J Am Coll Cardiol. Jun 12 2007;49(23):2231-2237.