CoQ10 and Statins: Why You Should Consider Supplementing
If you take a statin to help lower LDL cholesterol, you may have heard that statins can cause side effects like muscle aches, fatigue, or brain fog. Statins are well studied and are highly effective at reducing cardiovascular risk. At the same time, they can lower circulating Coenzyme Q10 (CoQ10), a nutrient involved in cellular energy production. For some people, optimizing CoQ10 status and tightening up key nutrition habits may be a helpful part of feeling your best while staying on a medication plan your clinician recommends.
What is CoQ10?
CoQ10, also called ubiquinone, is a naturally occurring compound found in nearly every cell. It plays an essential role in mitochondrial energy production, helping the body generate ATP, which is the main energy currency your cells use. CoQ10 also functions as an antioxidant, helping protect cells from oxidative stress. CoQ10 levels tend to decline with age, which can matter most in high energy tissues like heart and muscle.
How do statins affect CoQ10?
Statins reduce cholesterol production by inhibiting an enzyme called HMG CoA reductase. This enzyme sits in the same biochemical pathway that also contributes to the body’s production of CoQ10. Because of this shared pathway, statin therapy is associated with lower circulating CoQ10 levels. Large analyses of randomized trials have found that statins can reduce circulating CoQ10 by a meaningful amount across studies.
Important nuance: many symptoms people attribute to statins, including fatigue or cognitive changes, occur at similar rates in placebo groups in large trial analyses, suggesting a substantial portion may not be caused by the medication itself. Muscle symptoms can occur with statins, but in many cases the medication is not the primary cause. If you have symptoms, your clinician can help you sort out what is most likely and what to change.
Why CoQ10 may matter for some statin users
CoQ10 depletion is biologically plausible as one contributing factor to statin associated muscle symptoms in some individuals, because muscle cells have high energy demands and rely on mitochondria. Research on whether supplementation consistently improves symptoms is mixed overall, but several systematic reviews and meta analyses suggest CoQ10 may reduce muscle pain intensity in people experiencing statin associated myopathy or muscle symptoms.
1) May help with muscle discomfort in some people
Muscle aches are the symptom most commonly discussed with statins. While many reports are not directly caused by the medication in controlled trials, a smaller subset of people do experience true statin associated muscle symptoms. In that subset, CoQ10 supplementation has shown benefit in some meta analyses, particularly for reducing pain intensity.
2) Supports heart and vascular function through antioxidant effects
CoQ10 participates in antioxidant defenses and may support vascular function by reducing oxidative stress and supporting nitric oxide related pathways involved in healthy blood vessel function. Studies and reviews in cardiovascular populations suggest improvements in oxidative stress markers and endothelial related outcomes with supplementation, although results vary by population and study design.
3) Energy support, especially if you feel run down
Because CoQ10 is involved in ATP production, it is commonly used as a supportive supplement when people feel low energy. If fatigue is present, it is still important to look at the big picture first, including sleep quality, protein intake, hydration, iron status, thyroid function, vitamin D, B12, and total calories. CoQ10 may be one piece of a broader plan, not the only lever.
4) Brain support is possible but not definitive
CoQ10 has antioxidant roles in the nervous system and is being studied in various neurological contexts. However, large trial evidence does not support the idea that statins commonly cause cognitive symptoms, and the evidence that CoQ10 supplementation improves brain fog in statin users is not definitive. If you notice cognitive changes, it is worth reviewing medications, sleep, alcohol intake, blood sugar swings, stress load, and overall diet quality with your healthcare team.
How much CoQ10 should you take?
Common supplemental ranges are 100 to 300 mg per day, depending on goals, symptoms, and clinician guidance. Many people prefer ubiquinol, the reduced form of CoQ10, because it is often described as more bioavailable. Since CoQ10 is fat soluble, it is typically taken with a meal that includes healthy fats. Give it time, because any change can take a few weeks to assess.
- Form: Ubiquinol is commonly chosen for absorption support.
- Timing: Take with food that contains fat to support absorption.
- Track: Note changes in muscle discomfort, energy, exercise tolerance, and recovery for 3 to 6 weeks.
Are there side effects or interactions?
CoQ10 is generally well tolerated. Some people experience mild digestive upset. CoQ10 may interact with certain medications, including warfarin and other anticoagulants, so it is important to check with your prescribing clinician or pharmacist before starting, especially if you take multiple medications or have complex health conditions.
A coaching note from Wendy
If you are on statins, nutrition and lifestyle still matter a lot. I help clients improve their food quality, fiber intake, protein balance, and overall metabolic health so their labs and cardiovascular risk factors move in the right direction. With your prescribing clinician’s guidance, some clients are able to avoid starting a statin or reduce medication dependence over time, while others feel better and stay on the right medication plan for them. Either way, we focus on sustainable habits that support long term heart and brain health.
Work with Wendy
Want a simple, personalized plan to improve your cholesterol numbers through food and lifestyle, while also supporting energy, muscle health, and cognitive clarity?
If you are currently taking a statin, do not stop or change your medication without medical supervision.
Disclaimer
This content is for educational purposes only and is not medical advice, diagnosis, or treatment. Supplements can interact with medications and may not be appropriate for everyone. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication or supplement, and before making significant dietary changes. If you have symptoms you believe may be medication related, seek individualized medical guidance.
Sources
- Qu H, et al. Effects of Coenzyme Q10 on Statin Induced Myopathy. Journal of the American Heart Association. 2018.
- Nawarskas JJ. HMG CoA reductase inhibitors and coenzyme Q10. Cardiology in Review. 2005.
- Kovacic S, et al. Effects of coenzyme Q10 supplementation on myopathy in statin treated patients: systematic review and meta analysis. 2025.
- Gutierrez Mariscal FM, et al. Coenzyme Q10 supplementation for the reduction of oxidative stress: systematic review and meta analysis. 2020.
- Large trial analyses reporting that most commonly listed statin side effects occur at similar rates in placebo groups, including symptoms such as fatigue and cognitive complaints. Reported widely in early February 2026 summaries of the evidence base.