Statins
The most prescribed drugs. Statins lower LDL cholesterol by blocking HMG-CoA reductase. But this same pathway makes CoQ10, leading to muscle pain and fatigue. Whether statins help most people—especially for primary prevention—is debated. Informed consent matters.
How Statins Work
Block HMG-CoA Reductase
Rate-limiting enzyme in cholesterol synthesis. Liver makes less cholesterol.
Lower LDL
Primary effect. Reduces LDL particles. 30-50% reduction typical.
Same Pathway as CoQ10
Mevalonate pathway makes both cholesterol AND CoQ10. Both reduced.
Anti-Inflammatory
Some benefit may be from reducing inflammation, not just cholesterol.
Common Side Effects
Muscle Pain
Most common complaint. Myalgia affects up to 30%. CoQ10 depletion factor.
Fatigue
Energy drop. Mitochondria need CoQ10. Common but underreported.
Cognitive Issues
Brain fog, memory issues. Brain needs cholesterol. FDA warning added.
Diabetes Risk
Increases diabetes risk 9-27%. Dose-dependent. Significant concern.
Liver Enzymes
Liver stress possible. Monitoring recommended. Usually reversible.
Hormone Impact
Cholesterol is hormone precursor. Testosterone, estrogen, cortisol affected.
If You Take Statins
Supplement CoQ10
100-300mg ubiquinol daily. Replace what statins deplete. Reduces side effects.
Monitor Symptoms
Track muscle pain, energy, cognition. Don't assume symptoms are aging.
Check Blood Sugar
Monitor HbA1c. Watch for diabetes development. Especially if prediabetic.
Vitamin D
Made from cholesterol. May need more when on statins. Check levels.
Consider Alternatives
Discuss diet, exercise, other interventions. Statins not only option.
Lowest Effective Dose
Side effects dose-dependent. Discuss with doctor about minimal dosing.