Monday, March 21, 2005

Common Heart Drugs May Cause Coenzyme Q10 Deficiency

By Alan R. Gaby, MD

Healthnotes Newswire (March 17, 2005)—Statin drugs, which are used by millions of Americans to lower cholesterol levels and prevent heart disease, can actually cause a worsening of heart function in some people. That adverse effect appears to be caused, at least in part, by a drug-induced deficiency of coenzyme Q10 (CoQ10) and can be reversed by supplementation, reports the American Journal of Cardiology (2004;94:1306–10).

Statin drugs such as atorvastatin (Lipitor®), pravastatin (Pravachol®), and simvastatin (Zocor®) are potent cholesterol-lowering agents that work by blocking the body’s ability to produce cholesterol. Studies have shown that people with risk factors for heart disease can reduce their chances of suffering a heart attack or dying of heart disease by 30% or more if they take a statin drug. These drugs have a potential downside, however, because they also prevent the body from manufacturing CoQ10, a compound that is needed to produce the energy on which the body runs.

Previous studies have shown that people with heart failure have subnormal concentrations of CoQ10 in their heart muscle and that supplementing with CoQ10 can improve heart function and reduce the need for hospitalizations related to heart failure. Other research has shown that blood levels of CoQ10 fall when people take statin drugs. Whether or not that decline has implications for heart health has not been clear, although some doctors suspect that CoQ10 deficiency contributes to the muscle aches that often occur as a side effect of statin therapy. Thus, while statin therapy produces an overall benefit in heart disease–related mortality, it may increase the risk of developing heart failure.

The new study evaluated 14 people without a history of heart failure who had received atorvastatin for three to six months. In 10 of these people, atorvastatin treatment was associated with a worsening of at least one of three markers of heart function, and 5 people had a worsening of all three heart-function markers. Of the 10 people with worsening heart function, 9 were treated with 100 mg of CoQ10 three times a day for three months while continuing atorvastatin. Of those 9 people, 8 had an improvement in at least one of the three markers, and 5 had an improvement in all three markers of heart function.

The heart-function abnormalities seen in this study are potential precursors to heart failure. Therefore, the results of this study suggest that supplementing with CoQ10 may reduce the risk of developing heart failure in people taking atorvastatin. Since all of the statin drugs work the same way, and because other statin drugs have also been shown to lower CoQ10 levels, it is reasonable to assume that the results of this study would apply to the other statin drugs as well.

Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Three Rivers Press, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Three Rivers Press, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.

Comment: When you look at what CoQ10 does and see that a drug that is suppose to treat heart disease can potentially cause a deficiency, it makes me wonder, WHAT ARE THEY THINKING... Here is a just a few things this wonder nutrient does...

Coenzyme Q10
The Wonder Nutrient

by Hans R. Larsen, MSc ChE

What does congestive heart failure, gum disease and obesity have in common? Very often, a deficiency of coenzyme Q10 (CoQ10). A lack of CoQ10 has also been implicated in arrhythmias, strokes, hypertension, heart attacks, atherosclerosis, muscular dystrophy and AIDS and many of these diseases can be prevented and treated successfully with CoQ10. Since its discovery and isolation 40 years ago hundreds of clinical research studies have been done on CoQ10 and it is now abundantly clear that this nutrient is absolutely vital to health(1-5).
Coenzyme Q10 (ubiquinone/ubiquinol) is a fat-soluble quinone with a structure similar to that of vitamin K. It is a powerful antioxidant both on its own and in combination with vitamin E and is vital in powering the body's energy production (ATP) cycle. CoQ10 is found throughout the body in cell membranes, especially in the mitochondrial membranes and is particularly abundant in the heart, lungs, liver, kidneys, spleen, pancreas and adrenal glands. The total body content of CoQ10 is only about 500-1500 mg and decreases with age(5).

Essential to the heart
Coenzyme Q10 has received particular attention in the prevention and treatment of various forms of cardiovascular disease. It is highly effective in preventing the oxidation of low-density lipoprotein cholesterol (LDL) that leads to atherosclerosis(2,6-8). Several studies have shown that patients with congestive heart failure and other cardiovascular diseases have significantly lower levels of CoQ10 in their heart tissue than do healthy people and supplementation with as little as 100 mg/day has been shown to markedly improve their condition. CoQ10 is now approved in Japan for the treatment of congestive heart failure(2-5,9,10).

Heart attacks and strokes produce a burst of free radicals (ischemia-reperfusion) that can result in extensive tissue damage. Patients with high CoQ10 levels suffer less damage from these events and Japanese researchers have found that CoQ10 supplementation prior to and immediately following open-heart surgery is highly beneficial in preventing reperfusion injury - a common complication in heart surgery(2,4,5,11,12). Supplementation with CoQ10 has also been found beneficial in patients with chronic stable angina, mitral valve prolapse and irregular heart beat (arrhythmias)(2-5,13-15).

Coenzyme Q10 has also proven useful in the treatment of various cardiomyopathies (diseases of the heart muscle that reduces its pumping capacity). Studies have shown that supplementation with as little as 100 mg/day for 12 months results in better pumping capacity (increased ejection fraction), increased muscle strength and improved breathing(2-4,16).

Several studies indicate that CoQ10 may be beneficial in the treatment of hypertension (high blood pressure). A study of 109 patients with long-standing, essential hypertension, who were on antihypertensive drugs, concluded that supplementation with an average of 225 mg/day of CoQ10 improved functional status, allowed about half the patients to discontinue most of their blood pressure medications and resulted in an average decrease of systolic blood pressure from 159 to 147 mm Hg and a diastolic pressure decrease from 94 to 85 mm Hg. Smaller, more recent Japanese studies have confirmed these findings(2-5,17-19).

Studies at the University of Ancona in Italy have provided evidence that CoQ10 supplementation reduces blood levels of epinephrine (adrenalin) and other catecholamines; this is believed to be partly responsible for the drop in blood pressure and may also explain why CoQ10 is effective in reducing the incidence of certain types of arrhythmias(2,20).


Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional.