The following is an excerpt from an article recently published on NutritionalOutlook.com and written by NutraScience Labs' Senior Director of Product Innovation, Gene Bruno, MS, MHS. RH(AHG). Click here to be taken to NutritionalOutlook.com to read the full article.
Integrative medicine is defined as “an approach to medical care that combines standard medicine with CAM (complementary and alternative medicine) practices that have shown through science to be safe and effective.”[i]
One area in which integrative medicine can be particularly useful is when specific nutraceuticals are used to help compensate for certain side effects caused by some prescription drugs.
Statins and Coenzyme Q10
Physicians often use statin medications as an important therapy in reducing and maintaining serum cholesterol levels in patients with hypercholesterolemia (i.e., high cholesterol levels). However, in addition to reducing cholesterol levels, statin medications also reduce the body’s production of coenzyme Q10 (CoQ10). In turn, this can lead to a myopathy marked by muscle pain in those patients prescribed a high statin dose.[ii]
In fact, the pharmaceutical suppliers of Lipitor (Pfizer)[iii], Zocor (Merck)[iv], and Crestor (AstraZeneca)[v] all state that significant decreases in circulating CoQ10 levels in patients treated with statins have been observed and that the clinical significance of a potential long-term, statin-induced deficiency of CoQ10 has not been established. This recognition is especially evident in the fact that Merck has even gone so far as to obtain two patents to combine CoQ10 with its statin drug.[vi]
Given the potential adverse effects of statin therapy, co-administration with CoQ10 makes a great deal of medical sense. In vitro research[vii] has established that pretreatment with CoQ10 reduced the toxic effects of statins and may protect cells from statin-induced injuries and alleviate their side effects.
Likewise, animal research[viii] demonstrated that CoQ10 supplementation improved metabolic parameters, liver function, and mitochondrial respiration in rats with high doses of atorvastatin and a cholesterol-rich diet.
Evidence from a review of human studies[ix] showed a benefit in symptoms of myalgia or improvement of serum levels of CoQ10 with supplementation of 30-200 mg daily of CoQ10, with no reported risks, in patients prescribed statins. In older athletes taking statins, 200 mg of CoQ10 daily improved muscle performance as measured by time to anaerobic threshold and leg strength. Many other measures of mitochondrial function also tended to improve.[x] Other research[xi] found that 200 mg of CoQ10 supplementation daily improved endothelial dysfunction in statin-treated type 2 diabetic patients, compared to placebo, possibly by altering local vascular oxidative stress.
[For more information on this topic, read the full article on NutritionalOutlook.com.]
[ii] Ginter E. “Statins, coenzyme Q10 and diabetes type 2.” Bratislavské Lekárske Listy, vol. 115, no. 2 (2014): 112.
[iii] Product Monograph. PrLipitor® (atorvastatin calcium tablets) 10 mg, 20 mg, 40 mg and 80 mg atorvastatin. Lipid Metabolism Regulator. T.M. Pfizer Ireland Pharmaceuticals. Licensee: Pfizer Canada Inc. (Kirkland, QC, Canada). Date of Revision: May 29, 2013. Submission Control No: 163180. Page 7, Effect on Ubiquinone (CoQ10) Levels.
[iv] Product Monograph. PrZocor® simvastatin tablets, 5, 10, 20 and 40 mg. Merck Standard Lipid Metabolism Regulator. Licensee: Merck Canada Inc. (Kirkland, QC, Canada). Date of Revision: February 21, 2014. Submission Control No: 170366. Internal Filing May 6, 2014. Page 6, Endocrine and Metabolism.
[v] Product Monograph. PrCrestor® rosuvastatin calcium tablets, 5, 10, 20 and 40 mg. Lipid Metabolism Regulator. Licensee: AstraZeneca Canada Inc (Mississauga, ON, Canada). Date of Revision: April 28, 2010. Submission Control No: 130015. Page 5, Cardiovascular Co-enzyme Q10.
[vi] Patent No. US 4,929,437 and US 4,933,165. Patent date: January 18, 1989.
[vii] Eghbal MA et al. “Efficiency of hepatocyte pretreatment with coenzyme Q10 against statin toxicity.” Arhiv Za Higijenu Rada I Toksikologiju, vol. 65, no. 1 (March 2014): 101-108.
[viii] Jiménez-Santos MA et al. “Coenzyme Q10 supplementation improves metabolic parameters, liver function and mitochondrial respiration in rats with high doses of atorvastatin and a cholesterol-rich diet.” Lipids in Health and Disease. Published January 25, 2014.
[ix] Littlefield N et al. “Statins' effect on plasma levels of coenzyme Q10 and improvement in myopathy with supplementation.” Journal of the American Association of Nurse Practitioners, vol. 26, no. 2 (February 2014): 85-90.
[x] Deichmann RE et al. “Impact of coenzyme Q-10 on parameters of cardiorespiratory fitness and muscle performance in older athletes taking statins.” The Physician and Sports Medicine, vol. 40, no. 4 (November 2012): 88-95.
[xi] Hamilton SJ et al. “Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients.” Diabetes Care, vol. 32, no. 5 (May 2009): 810-812.