Probably not, and at best the answer is uncertain. Trials of CoQ10 for muscle aches on statins contradict each other, and the most carefully designed one found no benefit.
The idea is reasonable on paper, which is why it has lasted. But the studies are small, their results conflict, and a larger body of research suggests that most muscle symptoms people notice on a statin are not caused by the statin in the first place.
Key takeaways
- Statins reduce CoQ10 levels in the blood, which is where the theory comes from.
- One pooled analysis found that CoQ10 eased muscle symptoms, and a later one found no benefit.
- A trial that first confirmed true statin muscle pain with blinded testing found CoQ10 did not help.
- In large blinded trials, muscle symptoms were almost as common on placebo as on a statin.
- If a statin seems to cause aches, the step with the best support is talking to your prescriber about the statin itself.
Why the theory sounds plausible
CoQ10 is a compound your cells use to produce energy. The body makes it through the same chemical pathway that statins block to lower cholesterol.
The first link in the chain holds up. A meta-analysis of 12 randomized trials with 1,776 participants found that statin treatment lowered circulating CoQ10 compared with placebo.1
The next links are where it gets shaky. A lower blood level does not prove that muscle is short of CoQ10, or that the shortfall causes aching, or that taking capsules fixes it. Only trials in people with symptoms can answer that.
What the trials found
| Study | Design | Finding |
|---|---|---|
| 2015 randomized trial | Statin muscle pain confirmed first by blinded testing against placebo, then CoQ10 or placebo for 8 weeks | No reduction in muscle pain |
| 2018 meta-analysis | 12 trials, 575 patients | Less muscle pain, weakness, cramping and tiredness with CoQ10 |
| 2020 meta-analysis | 7 trials, 321 patients | No benefit for muscle pain, and no effect on staying on the statin |
The case for CoQ10
A 2018 meta-analysis pooled 12 randomized trials with 575 patients and reported that CoQ10 improved muscle pain, weakness, cramps and tiredness compared with placebo.2 A blood marker of muscle injury, creatine kinase, did not change.
This is the result most often quoted in favor of CoQ10. It deserves to be taken seriously, and it also deserves context: the trials were small, and they used different products, amounts and ways of scoring symptoms.
The case against
A 2020 systematic review found that only two of the eight trials it examined showed CoQ10 relieving muscle pain, and its pooled analysis of 321 patients showed no benefit over placebo.3 It also checked something practical: CoQ10 did not increase the share of people who managed to stay on their statin.
One trial took an extra step that the others did not. It first tested 120 people with a history of statin muscle pain using a blinded crossover of a statin and placebo. Only 41 of them developed pain on the statin but not on placebo. Those 41, whose pain was confirmed as statin-related, were then given the statin with either CoQ10 or placebo.
In that trial, CoQ10 raised blood CoQ10 levels but did not reduce muscle pain, and pain was reported by 14 of 20 people taking CoQ10 compared with 7 of 18 taking placebo.4
Why most statin aches are not from the statin
That screening result points to the larger issue. Aches and pains are common in adults whether or not they take a statin, and when you start a new tablet it is natural to connect the two.
Blinded trials show how often that connection is wrong. In an analysis of 19 placebo-controlled trials with 123,940 participants, muscle pain or weakness was reported by 27.1% of people taking a statin and 26.6% of people taking placebo.5 The authors estimated that more than 90% of muscle symptoms reported on a statin were not due to the statin.
This matters for judging any remedy. If most symptoms come and go for other reasons, almost anything taken for them will seem to work some of the time. Our guide to statin side effects covers this evidence, including the minority of people whose symptoms are real drug effects.
What has better support than a supplement
Muscle symptoms should not be ignored, and they should not be self-treated. A National Lipid Association statement advises clinicians to try several strategies to find a regimen a patient can tolerate, such as a different statin, a different dose or a different dosing schedule.6 If that fails, non-statin medications with outcome evidence are available, as described in our article on statin alternatives.
Those are decisions for you and your prescriber. Do not start, stop or change a medication without your prescriber, and do not stop a statin on your own because of aches. Report the symptoms, including when they started and what else changed around that time.
If you take CoQ10 or any other supplement, tell your prescriber so they can read your symptoms and lab results with the full picture.
Next step: check whether your treatment is doing its job
If you are on a statin and unsure whether it is worth the trouble, numbers help. Both Cardio Res-Q assessments, the Comprehensive Assessment ($775) and the Enhanced Assessment ($999), include ApoB, which shows how well your current treatment is controlling the particles that drive plaque. The personalized plan may include supplement recommendations, and it is fair to ask what evidence supports them.
Read Already on a Statin? to see what an assessment can and cannot tell you, then visit the Cardio Res-Q program page. Medication changes always go through your prescriber.
Are You a Candidate for Cardio Res-Q?
Three quick questions about the risk factors we screen for. Your answers stay between you and the clinic.
Frequently asked questions
Should I take CoQ10 with my statin?
Trials have not shown a reliable benefit. Some pooled analyses found less muscle pain with CoQ10 and others found none, and the trial with the strictest design found no effect. Whether to take it is a question for your prescriber, who should know about every supplement you use.
Do statins deplete CoQ10?
Statins lower the amount of CoQ10 measured in the blood. What has not been shown is that this drop causes muscle symptoms or that replacing CoQ10 relieves them.
My muscles ache on a statin. What should I do?
Tell your prescriber and keep taking the medication unless they advise otherwise. They can check for other causes and may suggest a different statin, dose or schedule. Severe or unexplained muscle pain or weakness should be reported promptly.
Does CoQ10 lower cholesterol or heart risk?
The trials discussed here tested CoQ10 only for muscle symptoms in people taking statins. They were not designed to show any effect on cholesterol or on heart attacks, so they cannot support that claim.
Related reading
This article is for general education and is not medical advice. Decisions about testing and medication should be made with your clinician. If you have chest pain or other symptoms of a heart attack, call 911.
