A CASE OF FALSE CONSCIOUSNESS

Coenzyme Q10 and the Failure of Rational Thought

Why Do So Many Doctors Still Resist Giving Coenzyme Q10 to Patients on Cholesterol Lowering "Statin" Drugs?

I continue to see new patients in my practice who are on "statin" drugs like Lipitor or Crestor who have not been placed on Coenzyme Q10. 

Many doctors claim there is no definitive proof that Coenzyme Q10 should be given to people on statins.  They fall back on the familiar refrain that no large scale clinical trials have shown clear benefit.    

This is a mistake and here's why:

YOU NEED COENZYME Q10 TO RUN YOUR MUSCLES

Coenzyme Q10 is a key player in energy production in every cell in our body.  Tissues that have high energy requirements, such as the heart, require large amounts of Coenzyme Q10.

Statin drugs deplete Coenzyme Q10. They tie up an enzyme needed to make both cholesterol and coenzyme Q10.

STATINS DAMAGE MUSCLE

Statin drugs cause muscle pain.  Studies indicate 10% suffer from this problem.  But drug studies -- usually funded by drug companies -- underestimate side effects.  The number may be as high as 50%.

Muscle damage from statins, called "statin induced myopathy," exists across a spectrum of severity, ranging from mild to severe.  Approximately 30,000 people on statins suffer from life threatening damage from severer forms of statin induced myopathy.  This is a staggering number. (Current Opinions in Rheumatology  2008; 20)

The problem can occur after statins have been stopped, an unsettling fact.  It can also occur after just one dose.  The higher the dose, the greater the risk of damage. 

This is not surprising, since as many as 30 million Americans take these drugs.

30,000 is 0.1% of 30 million. The 0.1% figure is usually coupled with the word "rare".  Of course this is no consolation to any of the 30,000 people suffering from this "rare" side effect.    

By the way, statins raked in $34 billion in worldwide sales last year, a number greater than the GDP of Finland.

THE "EXPERTS" SAY MORE STUDIES NEEDED, AS USUAL

"Experts" argue that statins may lower blood levels of coenzyme Q10, but they don't seem to have much effect on levels inside the cell, where energy is produced. 

They also point out we don't know exactly what causes the muscle breakdown.

And of course, they repeat over and over are no large scale studies that definitively show coenzyme Q10 prevents or cures the problem.

WHAT THE LATEST SCIENCE SHOWS

Recent research indicates some people are genetically susceptible to muscle damage from statins.  Unless we perform genetic testing on everyone before they start statins, we can't know who's at risk.  So when it comes to muscle damage, including the so-called "rare" life threatening statin induced muscle damage, statins are a crap shoot.

As for the large scale study of the sort that definitively proves coenzyme Q10 prevents muscle damage - or can be used to treat it - who's going to fund that?

HERE'S WHY TO USE COENZYME Q10

Coenzyme Q10 is safe.  We understand its role in the body.  Although we don't have every last fact down about the causes of statin induced muscle damage, there's enough evidence to suggest that coenzyme Q10 may help prevent the problem in some people.

Common sense supports its use in people on statins.  "First do no harm", part of the Hippocratic Oath all doctors take on completion of their training, also guides us in that direction.  Yet many doctors are still waiting for that final conclusive study that will prove once and for all that it works . . . or doesn't work.  They'll be waiting for ever.

Meanwhile millions of people continue to suffer from statin induced muscle damage.  The "experts" say most cases are mild, go away on their own anyway, and certainly go away when you stop the drug.  So why all the fuss?

Why would you poison an enzyme and deprive the body a key molecule it needs to run itself and not expect bad things to happen . . .   

DO STATINS CAUSE HEART FAILURE?

We are also in the midst of an epidemic of heart failure, which is a kind of energy crisis in heart muscle cells.  Could it be that the depletion of coenzyme Q10 in the heart, our body's hardest working muscle, may have something to do with this?  This question is being hotly debated within medicine. 

Of course it's not exactly a fair fight, when the statin proponents have all those drug company billions on their side.  Nobody from mainstream medicine has proposed a large, long-term, multi-center randomized control trial to determine whether or not statins cause heart failure.

Interestingly, a recent study showed that Crestor, a newer "me-too" statins failed to prevent any deaths in over 5,000 heart failure patients, while fish oil does.  This left the study authors scratching their heads.  For some strange reason, this study was ignored by the mainstream media. (New England Journal of Medicine 11/29/07)

TAKE THE UBIQUINOL FORM OF COENZYME Q10

100 to 200 mg of coenzyme Q10 for everyone on statins is safe and prudent.

 I recommend 200mg of the Ubiquinol form.  It is the form best absorbed and it is widely available.