CoQ10 and Statins

• November 30 2017, by SANUSq Research team
• 11 min reading time

The same drugs that lower cholesterol may also lower a compound your cells rely on for energy.

Written by SANUSq Research Team | Medically reviewed by Dr Ajay Kumar, MD
Published: 15 April 2019 | Updated: 24 August 2026

First, an important note

Statins are prescribed to lower cholesterol, and for many people they are an important part of managing cardiovascular risk. Nothing in this article is a reason to stop or change a prescribed medication. If it raises a question for you, take that question to the doctor who prescribed your statin — that is the right place for it.

What is CoQ10, and why does it matter?

Coenzyme Q10 (CoQ10, also called ubiquinone) is a compound found in nearly every cell. Its central role is in the mitochondria — the tiny power plants inside cells — where it helps produce the energy that keeps muscles, including the heart, working. It also acts as an antioxidant. Levels tend to be highest in energy-hungry tissues and, like several nutrients, tend to decline with age.

It is worth knowing what CoQ10 actually does in there, because it explains why the compound draws attention in the first place. Inside mitochondria, energy production runs as a chain of electron handovers, and CoQ10 is one of the carriers in that chain: it accepts electrons at one step and passes them on at the next, cycling between two forms as it goes. Tissues that never stop working, the heart and skeletal muscle among them, hold the highest concentrations, simply because they run that chain hardest. The same electron-carrying chemistry is what allows CoQ10 to act as an antioxidant in the fatty parts of the cell, where it helps protect membranes and circulating lipids from oxidative damage.

CoQ10 and statins: the shared pathway

Here is the crux. Statins work by blocking an enzyme early in the pathway the body uses to make cholesterol. The catch is that the very same pathway is also used to make CoQ10. So when a statin turns down cholesterol production, it can turn down CoQ10 production alongside it. This is well described biochemically, and it is the reason CoQ10 comes up so often in conversations about statin side effects, particularly muscle aches.

It helps to name the pathway, because it shows this is no coincidence. Cholesterol is assembled in a long series of steps known as the mevalonate pathway, and statins act on an enzyme near the very start of it. Everything downstream of that point is turned down, not cholesterol alone. The pathway branches as it descends, and one of those branches supplies the long fat-soluble tail that the CoQ10 molecule carries. Narrow the trunk and the branches receive less as well.

That is why reduced CoQ10 production is described as biochemically expected rather than surprising. It is also where the certainty stops. Making less is one thing; what that means for the amount of CoQ10 genuinely available inside heart and muscle tissue, and whether any shortfall produces symptoms a person would actually notice, is a separate question, and the evidence has answered it far less clearly.

What the clinical evidence says

Because statins can lower CoQ10, and because some people on statins experience muscle symptoms, researchers have tested whether taking a CoQ10 supplement helps. This is where honesty matters: the results are genuinely mixed.

In other words, some people report benefit and the biological rationale is sound, but the trials do not all agree. If you are on a statin and curious about CoQ10, it is a reasonable thing to discuss with your doctor. For readers who want to explore it, SANUSq offers liposomal CoQ10 capsules.

Why the trials disagree

A mixed result is not the same as no result, and it is worth understanding what makes this particular question so hard to settle. Muscle aches are common in the general population, and commonest in exactly the age group most likely to be prescribed a statin, so telling an ache caused by the medication from an ache that would have occurred anyway is genuinely difficult. Expectation plays its part too: someone who knows they are taking a drug with a reputation for muscle symptoms is more likely to notice, and to attribute, the aches they have.

The trials also differ from one another — in how long they ran, in the form and amount of CoQ10 used, in whether participants had symptoms to begin with, and in how those symptoms were measured, which is usually by asking rather than by any objective test. Studies differing on that many axes are unlikely to converge on a tidy answer. There is a measurement problem underneath as well: blood levels are what most studies can assess, and they are not necessarily a good guide to how much CoQ10 sits inside a muscle cell.

If you have muscle symptoms on a statin

The most useful thing to know here is where the decision belongs. Muscle aches while taking a statin are worth reporting to the doctor who prescribed it, and they are a common enough reason for a medication review that nobody will think you are wasting their time. A doctor can check whether something else explains the symptoms, arrange a blood test if one is warranted, and weigh the options that are open to them — adjusting the dose, trying a different statin, or changing how it is taken. Those are their decisions to make with you, and stopping a statin on your own removes the cardiovascular protection it was prescribed to give.

One pattern deserves prompt rather than routine attention: severe muscle pain or weakness, particularly alongside unusually dark urine or feeling generally unwell. That combination is uncommon, but it should be reported without waiting for a scheduled appointment.

Practical points about CoQ10 itself

Most of the CoQ10 in your body is made by your body. Food contributes modestly, with organ meats, oily fish and some nuts and seeds among the better sources, and tissue levels tend to drift down gradually with age regardless of any medication. Supplements come mainly in two forms, ubiquinone and ubiquinol, which are the oxidised and reduced versions of the same molecule and convert into one another in the body. CoQ10 is fat-soluble and not easily absorbed, so it is usually taken with a meal containing some fat, and formulations differ in how well they carry the molecule across the gut wall. Whatever form you might consider, mention it to your doctor first if you take prescribed medication.

Frequently asked questions

Does the CoQ10 and cholesterol medication question apply to non-statin drugs?

Not automatically. The argument set out above is specific to statins, because of the pathway they act on. Other medicines used to lower cholesterol work in quite different ways — by reducing how much cholesterol the gut takes up, for example — and a shared-pathway argument does not carry across to a drug that does not share the pathway. If you are taking something other than a statin, or more than one lipid-lowering medicine, the person who can say what applies to your particular prescription is your doctor or pharmacist rather than an article written for the general case.

What is known about statins and CoQ10 deficiency?

What is well described is that statins reduce the body's production of CoQ10, because of that shared pathway. What is far less clear is whether the shortfall reaches a level that matters clinically, whether it explains the muscle symptoms some people report, and whether topping CoQ10 back up changes anything — the trials on that last point disagree with one another. It is best understood as an established biochemical effect with uncertain consequences, not as a diagnosed deficiency.

Does everyone on a statin get muscle symptoms?

No. Most people take statins without muscle symptoms, and muscle aches are common in people taking nothing at all, which is part of why the question has been so hard to study. If you do have symptoms, report them to your doctor rather than assuming you know the cause.

Do statins really lower CoQ10?

Statins block an enzyme in the pathway used to make cholesterol, and the body uses the same pathway to make CoQ10, so a reduction in CoQ10 production is biologically expected. This part is well described.

Will taking CoQ10 stop statin muscle aches?

The evidence is mixed. Some trials have associated CoQ10 with reduced muscle symptoms while others have found no significant benefit, so it may help some people and not others. It is worth discussing with your doctor rather than assuming either way.

Can I stop my statin if I take CoQ10?

No. CoQ10 is not a replacement for a prescribed statin. Never stop or change a prescribed medication without speaking to the doctor who prescribed it.

Can I get CoQ10 from food?

Small amounts are found in organ meats, oily fish, and some nuts and seeds, but the quantities are modest. The body also makes its own, which is the part affected by the statin pathway.

Is CoQ10 safe to take alongside a statin?

CoQ10 is generally well tolerated, and it is commonly taken alongside statins. As with any supplement, mention it to your doctor, especially if you take other medication.

References

1. Okuyama H, Langsjoen PH, Hamazaki T, et al. Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Rev Clin Pharmacol. 2015;8(2):189–99. PMID 25655639
2. Kovacic S, Habicht SD, Eckert GP. Effects of coenzyme Q10 supplementation on myopathy in statin-treated patients: a systematic review and meta-analysis. J Nutr Sci. 2025;14:e72. PMID 41158831

Read more on the blog

• Statins deplete vitamin K2
• The importance of CoQ10 for our health
• A lesson in heart health: statin drugs

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We wish you good health on your terms.
The team at SANUSq.

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Absorption & Dosage CoQ10 Energy & Fatigue Heart Health

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