CoQ10 and Statins: Should You Take CoQ10 if You're on Statins?

Statins are among the most widely prescribed medications in the United Kingdom, taken by millions of people to help manage cholesterol and reduce the risk of cardiovascular disease [1]. But alongside their well-documented benefits, statins have a lesser-known effect on the body: they can significantly reduce levels of Coenzyme Q10 (CoQ10), a vital compound involved in cellular energy production.

In this article, we examine the relationship between statins and CoQ10, what the research says, and whether supplementing with CoQ10 is worth considering if you're on statin therapy.

What is CoQ10?

Coenzyme Q10 is a fat-soluble compound found naturally in virtually every cell of the human body. It plays a central role in the mitochondrial electron transport chain — the process by which cells generate ATP, the body's primary energy currency [2]. CoQ10 also functions as a powerful antioxidant, protecting cells from oxidative damage [3].

The body produces CoQ10 naturally, but levels decline with age — particularly after the age of 40 — and can be further reduced by certain medications, including statins [4].

How Do Statins Affect CoQ10 Levels?

Statins work by inhibiting an enzyme called HMG-CoA reductase, which is involved in the production of cholesterol in the liver. However, this same biochemical pathway is also responsible for the synthesis of CoQ10 [5]. As a result, statins reduce not only cholesterol production but also the body's natural CoQ10 synthesis.

A systematic review published in the Journal of the American College of Cardiology found that statin therapy was associated with significantly reduced plasma CoQ10 concentrations [6]. The degree of depletion varies depending on the type and dose of statin used, but reductions of 16–54% have been reported in clinical studies [7].

What Are the Consequences of CoQ10 Depletion?

One of the most commonly reported side effects of statin therapy is myopathy — muscle pain, weakness, and fatigue — affecting an estimated 5–10% of statin users [8]. Some researchers have proposed that CoQ10 depletion may contribute to statin-associated muscle symptoms (SAMS), given CoQ10's essential role in muscle cell energy production [9].

While the relationship between CoQ10 depletion and SAMS remains an active area of research, the biological plausibility is well established and has led many clinicians to consider CoQ10 supplementation as a potential adjunct to statin therapy.

What Does the Research Say About CoQ10 Supplementation with Statins?

The evidence is promising, though not yet conclusive. Several clinical trials have investigated whether CoQ10 supplementation can reduce statin-associated muscle symptoms:

• A randomised controlled trial published in Medical Science Monitor found that CoQ10 supplementation (100mg/day) significantly reduced muscle pain intensity and interference with daily activities in statin-treated patients [10].
• A meta-analysis of randomised controlled trials found that CoQ10 supplementation significantly reduced statin-induced myopathy symptoms compared to placebo [11].
• A study in the European Journal of Nutrition found that CoQ10 supplementation restored plasma CoQ10 levels in statin users and was associated with improvements in fatigue and muscle function [12].

It is important to note that not all studies show a significant benefit, and larger, well-powered trials are still needed. However, given CoQ10's excellent safety profile and the biological rationale for its use alongside statins, many healthcare practitioners consider it a reasonable option.

How Much CoQ10 Should You Take with Statins?

Most clinical studies investigating CoQ10 alongside statins have used doses ranging from 100mg to 300mg per day [10, 11]. CoQ10 is fat-soluble, so it is best absorbed when taken with a meal containing some dietary fat.

The ubiquinol form of CoQ10 (the reduced, active form) may offer superior bioavailability compared to ubiquinone, particularly in older adults [13].

Is CoQ10 Safe to Take with Statins?

CoQ10 is generally considered safe and well tolerated. It has no known serious interactions with statins and is not associated with significant adverse effects at standard supplementation doses [14]. However, as with any supplement, it is advisable to consult your GP or pharmacist before adding CoQ10 to your regimen, particularly if you are managing a cardiovascular condition.

The Bottom Line

Statins are effective and important medications for millions of people in the UK, but their impact on CoQ10 levels is well documented. While the evidence for CoQ10 supplementation in statin users is still evolving, the biological rationale is sound, the safety profile is excellent, and a growing body of clinical research supports its potential benefit — particularly for those experiencing muscle-related side effects.

If you are taking statins and are concerned about CoQ10 levels, speak to your GP and consider a high-quality, bioavailable CoQ10 supplement as part of your daily routine. You may also find our article on Best Supplements for Over 50s useful if you are managing your health as you age.

References

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4. Kalén A, Appelkvist EL, Dallner G. Age-related changes in the lipid compositions of rat and human tissues. Lipids. 1989;24(7):579-584.
5. Hargreaves IP. Coenzyme Q10 as a therapy for mitochondrial disease. International Journal of Biochemistry & Cell Biology. 2014;49:105-111.
6. Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy. Journal of the American College of Cardiology. 2007;49(23):2231-2237.
7. Rundek T, et al. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Archives of Neurology. 2004;61(6):889-892.
8. Stroes ES, et al. Statin-associated muscle symptoms: impact on statin therapy — European Atherosclerosis Society Consensus Panel Statement. European Heart Journal. 2015;36(17):1012-1022.
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11. Qu H, et al. Effects of coenzyme Q10 on statin-induced myopathy: an updated meta-analysis of randomized controlled trials. Journal of the American Heart Association. 2018;7(19):e009835.
12. Skarlovnik A, et al. Coenzyme Q10 supplementation decreases statin-related mild-to-moderate muscle symptoms: a randomized clinical study. Medical Science Monitor. 2014;20:2183-2188.
13. Langsjoen PH, Langsjoen AM. Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clinical Pharmacology in Biopharmaceutics. 2014;3(1).
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