Statins, lack of energy and ubiquinone (Coenzyme Q10)

This post includes a summary of a study published in the British Journal of Clinical Pharmacology 2005 May; 59(5): 606–607

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Study title and author:

Statins, lack of energy and ubiquinone

Marcus M Reidenberg

Weill Medical College of Cornell University, New York, NY 10021, USA

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884835/

Reidenberg notes how the painful or tender muscle disease with elevated creatine phosphokinase levels due to statin drugs is well described. Statin muscle disease can also occur without elevated creatine phosphokinase levels or pain. More common is a feeling of lack of energy in people taking these drugs. Since statins block mevalonate synthesis, they lower levels of ubiquinone (coenzyme Q10), an essential compound for mitochondrial energy production. Thus, these people may truly lack energy.

Reidenberg reports:
(i) A randomized double-blind trial comparing 35 mg coenzyme Q10 with placebo bid was initiated for patients on statins who felt lack of pep or energy since starting the statins and who did not have muscle pain, tenderness, or elevated creatine phosphokinase.
(ii) By the time this trial started, most patients with these symptoms either stopped the statin or started coenzyme Q10 on their own, thus only three subjects were accrued in 1.5 years and the trial was stopped.
(iii) The three subjects ages were 68, 69, and 75. Their coenzyme Q10 levels prior to the coenzyme Q10 suplementation were 0.40, 0.35, and 0.36 µg ml⁻¹ (normal values are 0.69 - 1.06).
(iv) Two subjects received placebo and one received coenzyme Q10.
(v) After two weeks, subjects were asked how they felt. Both subjects taking placebo felt unchanged during the treatment period. The patient receiving coenzyme Q10 stated that several days after starting the study drug, she felt more energetic and could now walk 20 (short New York City) blocks instead of the two blocks that tired her before.
(vi)  One of the placebo patients was given coenzyme Q10 for an additional  two week period. After two weeks, he claimed that he had more energy climbing stairs and was less tired than before.
(vii) Statins lower levels of coenzyme Q10 and our subjects had levels below normal values.
(viii) Statins decrease mitochondrial activity.
(ix) Preliminary data suggests that coenzyme Q10 may reverse the age-related change in skeletal muscle fibre composition.

Reidenberg concludes: "Whether the level of fatigue and feeling of lack of energy in some people taking statins is related to skeletal muscle effects of these drugs is unknown. The results of this abbreviated randomized double-blind trial suggest it may be due to decreased ubiquinone (coenzyme Q10) levels due to effective statin inhibition of mevalonate synthesis. This would be an unintended adverse effect of the intended pharmacological action of the statin. People taking statins who describe lack of pep or energy may really lack energy because of a deficiency of ubiquinone (coenzyme Q10)".

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