With no study showing how CoQ10 eases statin side effects, it's two steps forward, one step back for ingredient

The article, by reporter Gina Kolata, appeared in the Sunday edition​ and talked about the approval recently by FDA of a pharmaceutical alternative to statins which can cause debilitating muscle pain and weakness in a significant subset of patients. The side effects are so extreme in many cases that it causes patients to go off the medication, which is intended to lower dangerously high cholesterol levels. The new drug regimen is said to cost as much as $14,000 a year.

The benefit of certain dietary ingredients–vitamin C for example–is set in bedrock, and marketers need only mention the vitamin and consumers will fill in the blanks. Proponents of CoQ10 can only aspire to that level.  Statins have been shown to cause serious depletion of CoQ10 in muscle tissue​ and elsewhere in the body and this in one mechanism that has been postulated for the muscle pain and weakness side effects. If a dietary ingredient exists that is low cost and low risk that potentially could help patients tolerate an important medication, why does it continue to fly under the radar as far as some influencers, such as the Times​, are concerned?

Getting away from “supplements good, drugs bad” mantra​

Scott Steinford, executive director of the CoQ10 Association, said this is a rare case of a dietary supplement ingredient that can act as an adjunct to a medication, and is not seeking to supplant it. It’s not the “drugs bad, supplements good” simplistic formula that many influencers who are suspicious of supplements seem to see when they review the scientific underpinning of dietary ingredients. 

“It’s not unusual that pharmaceutical companies don’t mention supplements in relationship to their products. This is one dietary ingredient that can actually support the pharmaceutical industry,”​ Steinford told NutraIngredients-USA.

The Mayo Clinic lists a number of indications in which CoQ10 supplementation might be helpful. Among the best supported indications, according to the clinic, are heart failure and high blood pressure. The ingredient’s use in ameliorating the side effects of statin usage is judged to have only “unclear” scientific underpinning.

Specific study design needed​

But the clinic judges “deficiency” as the best-supported indication for CoQ10 supplementation, so it’s clear that certain dots remain unconnected by research. Steinford said more research needs to be done to connect CoQ10’s benefits to the specific deficiency that arises with statin usage. 

“Some of this confusion is circumstantial because there really hasn’t been any one study done to determine how CoQ10 supplementation figures in to the continual usage of statins,” ​he said. “There really hasn’t been much CoQ10 research in recent years and that is one thing we are trying to change with the CoQ10 Association. We have material committed for a new study and now we are working on the funding.”​

Steinford said the ingredient’s profile is growing, frustrations like the NYT​ snub notwithstanding. According to a recent survey commissioned by the association, as many as 70% of US cardiologists recommend their patients use CoQ10 alongside statins. And the potential opportunity is large. According to the Centers for Disease Control, the percentage of US adults over the age of 40 who are taking statin drugs had risen to 28% by 2012.  

“This is one ingredient that is not trying to supplant pharma; it is trying to make it better with a defined mode of action,” ​Steinford said.