I started taking a statin a few weeks ago and have been experiencing more musculoskeletal pain than usual. Could it be from the medication, and, if so, might CoQ10 supplements help as I’ve heard?
Muscle symptoms can occur with the use of statin drugs, so it’s possible this is the cause of your increased pain. Estimates vary widely, with anywhere from 1 to 5 to even 20 percent of statin users experiencing muscle side effects manifesting as weakness, tenderness, or pain, typically in large muscle groups—legs, upper arms, shoulders, lower back, or chest. In most cases, these side effects are relatively mild. Rarely, statins can cause a more serious muscle condition called rhabdomyolysis, which can also damage the kidneys.
Statin-related muscle effects are more likely to occur in people taking higher statin doses and in those over 75, women, and people of East Asian descent. A family history of statin intolerance, certain medical conditions (including impairments in kidney, liver, or thyroid function), and some medications (including some HIV drugs) also increase the risk of side effects.
But often, people taking statins attribute their musculoskeletal symptoms to the drug when something else is to blame. After all, such pain is common in middle-aged and older people due to many other factors. And some clinical trials have found that nearly as many people taking a placebo report muscle problems as do those taking statins.
That said, the timing of your symptoms suggests there could be a connection, so you should speak with your doctor, who may discontinue the statin, lower the dose, or switch you to another type of statin or another medication. If the statin is to blame, your symptoms should resolve within days or weeks. Your doctor may also take a blood sample to check for an elevated level of creatine kinase, a marker of muscle damage.
CoQ10 to the rescue? Statins work by inhibiting an enzyme in the liver that’s integral to cholesterol production. This enzyme is also involved in the body’s production of coenzyme Q10 (CoQ10), a vitamin-like antioxidant substance needed for energy production—so taking a statin also reduces blood levels of CoQ10. Thus, some statin users take CoQ10 supplements to replenish supplies in hopes of preventing or treating muscle problems.
But studies on the effectiveness of CoQ10 supplements have been mixed. For instance, in a randomized controlled trial of 50 statin users with mild-to-moderate muscle symptoms, published in Medical Science Monitor in 2014, those who took CoQ10 (50 milligrams twice daily) for 30 days reported less pain and less “pain interference” (how much the pain affected daily activities), while those taking a placebo had no change in symptoms. And a 2019 study in Drug Design, Development and Therapy found that of 60 patients who had previously not tolerated statins because of statin-related muscle symptoms, those who took CoQ10 (100 milligrams a day) for three months had improvements in physical weakness, muscle aches, or pain.
On the other hand, a systematic review and meta-analysis of clinical trials, published in Atherosclerosis in 2020, found that CoQ10 did not relieve muscle symptoms better than a placebo and did not increase the percentage of people who were able to stay on their medication.
According to the National Center for Complementary and Integrative Health (NCCIH, a part of the National Institutes of Health), “Although results of individual studies have varied, the overall scientific evidence does not support the idea that CoQ10 can reduce muscle pain caused by the cholesterol-lowering drugs known as statins.”
If you decide to try CoQ10 anyway, it is considered to be generally safe when taken as directed, with studies showing low toxicity and few adverse effects. The NCCIH notes only mild side effects, such as digestive upset and insomnia. But be aware that CoQ10 supplements may interact with some medications, such as the blood thinner warfarin, and they may interfere with some cancer treatments.
