In this week’s edition of the American Heart Association journal Circulation, new guidelines for the lowering of cholesterol were announced. Prior to this, cardiologists were of the opinion that for very high risk heart patients, LDL cholesterol, otherwise known as “bad” cholesterol, should be 100 or lower. The new guidelines now lower the bar to 70. What this means is that there may literally be an explosion of new patients taking statin drugs. It is estimated that there are currently 13 million people in the United States taking various statin cholesterol-lowering drugs. However, it is estimated that 36 million people in the United States could benefit by taking these cholesterol-lowering drugs.
Although the current thinking is that these statin drugs will literally save hundreds of thousands of lives, I am not sure that the final story is in. My concern is that as more people take these drugs for longer periods of time, we may start to see increases in long-term adverse effects — some of which are already known and some not yet known. There has been some data published in the last several years indicating that the statin drugs can inhibit the synthesis, or natural production, of a critically important nutrient in our cells called ubiquinone, otherwise known as coenzyme Q10 (CoQ10).
CoQ10 is an essential element of the respiratory chain in our mitochondria, producing the necessary energy to power our cells. These cells include heart, brain, nerve and muscle cells, to name just a few. There is scientific evidence to support the belief that dysfunction and death of mitochondria can lead to heart failure, Parkinson’s, Alzheimer’s and many other chronic diseases of aging. In fact, some doctors believe the statin drugs may be one of the causes for the dramatic increase in heart failure we are experiencing in this country.
In the June 2004 edition of the journal Archives of Neurology, a study was published regarding the use of atorvastatin (Lipitor®) and its effect on CoQ10. In the study, 34 individuals over the age of 45 with elevated LDL cholesterol were studied. Serum CoQ10 levels were drawn at baseline. Next, all 34 individuals were treated with Lipitor 80 mg daily. Fourteen days after starting treatment, 32 of the subjects had a decrease in their plasma CoQ10 levels by 49%. By 30 days, the CoQ10 levels had dropped even further.
The data was highly statistically significant. In this very short study, the patients generally did not report any severe adverse effects, although one subject experienced weakness and tingling in the legs, which disappeared two days after the dose of Lipitor was cut in half. It should be noted that for that individual, their CoQ10 level had dropped approximately 60% below the baseline level.
This study was conducted by the Department of Neurology at Columbia University, one of the most prestigious neurological institutions in the world. The authors concluded that even brief exposure to atorvastatin causes a marked decrease in blood CoQ10 concentration. The authors further indicate that widespread inhibition of CoQ10 synthesis could explain the most commonly reported adverse effects of statins, especially exercise intolerance, myalgias (muscle pain) and myoglobinuria (muscle protein in the urine). It should be noted that another drug called cerivastatin (Baycol) was so effective at inhibiting CoQ10 synthesis that it was actually removed from the market because of its many adverse effects, including numerous deaths.
CoQ10 is an amazing nutrient. As I noted above, it is an essential element in the production of energy in our cells. Without adequate levels of CoQ10, our cells would basically not function and would die. The typical multi-vitamin has ZERO CoQ10, while the average diet only provides about 1 mg per day of CoQ10, woefully inadequate for optimal health. CoQ10 has many wonderful benefits, the most important being that of promoting and even improving cardiovascular function. There have been multiple studies in the literature over the last decade or so showing that CoQ10 supplementation decreased the incidence of angina, improved cardiac output in congestive heart failure, and even reduced the risk of adverse cardiovascular events and death. CoQ10 also appears to have beneficial effects in regard to improving immune function, fertility and kidney function. In one study, patients with end stage kidney failure had dramatic benefits with CoQ10 supplementation. It also has beneficial effects in regard to the central nervous system. CoQ10 has been the only nutrient or drug that has actually been shown to slow the progression of Parkinson’s disease in a well-done published study. I even recently reported on a published study regarding the beneficial effects of CoQ10 as a supplement for migraine headache patients.
If you are currently taking a statin drug or your doctor has talked about starting you on one, I would strongly recommend that you speak to your physician about adding CoQ10. It is my recommendation that you take 200 to 400 mg a day of CoQ10 if you are on a statin drug. For those of you who have a heart condition or other medical concerns as mentioned above, you should also consider the possible benefits of CoQ10. I recommend to my Parkinson’s patients to take up to 1,200 mg per day, as this was the most effective dosage in the published study.