Originally Posted by fmichael

I just wanted to share something I just learned. Apparently, it is more important than most folks/internists have understood that patients with high cholesterol taking statins - like me - as well as beta blockers and apparently some other blood pressure meds be on CoQ-10 supplements, where:

Coenzyme Q10 shares a common biosynthetic pathway with cholesterol. The synthesis of an intermediary precursor of coenzyme Q10, mevalonate, is inhibited by some beta blockers, blood pressure-lowering medication,[20] and statins, a class of cholesterol-lowering drugs.[21][22] Statins can reduce serum levels of coenzyme Q10 by up to 40%.[23] Some research suggests the logical option of supplementation with coenzyme Q10 as a routine adjunct to any treatment that may reduce endogenous production of coenzyme Q10, based on a balance of likely benefit against very small risk.[24][25]

Notes
20. Kishi T, Watanabe T, Folkers K (1977). "Bioenergetics in clinical medicine XV. Inhibition of coenzyme Q10-enzymes by clinically used adrenergic blockers of beta-receptors". Res Commun Chem Pathol Pharmacol 17 (1): 157–64. PMID 17892.
21. The Synthesis of Cholesterol http://www.cholesterol-and-health.co...olesterol.html
22. Mortensen, S.A.; et al. (1997). "Dose-Related Decrease of Coenzyme Q10 During Treatment with HMG-CoA Reductase Inhibitors". Molecular Aspects of Medicine 18 Suppl.: 137–144. PMID 9266515.
23. Ghirlanda G, Oradei A, Manto A, Lippa S, Uccioli L, Caputo S, Greco A, Littarru G (1993). "Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study". J Clin Pharmacol 33 (3): 226–9. PMID 8463436.
24. Sarter B (2002). "Coenzyme Q10 and cardiovascular disease: a review". J Cardiovasc Nurs 16 (4): 9–20. doi:10.1002/cncr.11242 . . . . PMID 12597259.
25. Thibault A, Samid D, Tompkins A, Figg W, Cooper M, Hohl R, Trepel J, Liang B, Patronas N, Venzon D, Reed E, Myers C (1996). "Phase I study of lovastatin, an inhibitor of the mevalonate pathway, in patients with cancer". Clin Cancer Res 2 (3): 483–91. PMID 9816194

Coenzyme Q10, Wikipedia, the free encyclopedia (last modifoed April 16, 2010) http://en.wikipedia.org/wiki/Coenzym...armacokinetics

That said, patients on these drugs woud be well advised to their doctors before starting CoQ-10, and that is what I am planning to do, where a pharmacist recently gave me what I understood to be the opposite advice: that CoQ-10 could defeat or deminish the effectiveness of the statin.

When speaking to your physician, you may want to reference the following abstract:

Effects of CoQ10 supplementation on plasma lipoprotein lipid, CoQ10 and liver and muscle enzyme levels in hypercholesterolemic patients treated with atorvastatin: a randomized double-blind study, Mabuchi H, Nohara A, Kobayashi J, et al, Atherosclerosis 2007 Dec;195(2):e182-9. Epub 2007 Aug 6.

Abstract
The long-term efficacy and safety of HMG-CoA reductase inhibitors (statins) have been established in large multicenter trials. Inhibition of this enzyme, however, results in decreased synthesis of cholesterol and other products downstream of mevalonate, such as CoQ10 or dolichol. This was a randomized double-blind, placebo-controlled study that examined the effects of CoQ10 and placebo in hypercholesterolemic patients treated by atorvastatin. Eligible patients were given 10mg/day of atorvastatin for 16 weeks. Half of the patients (n=24) were supplemented with 100mg/day of CoQ10, while the other half (n=25) were given the placebo. Serum LDL-C levels in the CoQ10 group decreased by 43%, while in the placebo group by 49%. The HDL-C increment was more striking in the CoQ10 group than in the placebo group. All patients showed definite reductions of plasma CoQ10 levels in the placebo group, by 42%. All patients supplemented with CoQ10 showed striking increases in plasma CoQ10 by 127%. In conclusion atorvastatin definitely decreased plasma CoQ10 levels and supplementation with CoQ10 increased their levels. These changes in plasma CoQ10 levels showed no relation to the changes in serum AST, ALT and CK levels. Further studies are needed, however, for the evaluation of CoQ10 supplementation in statin therapy.

PMID: 17681347 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/17681347

Mike