Editor’s Note:
Today’s guest post is from a pharmacist who blogs under the pseudonym Avicenna, who looks at the evidence supporting the use of Coenzyme Q10 to treat statin-related muscle pain.
My pharmacy stocks plenty of natural health products (NHPs) and ensuring they can be used safely is challenging, given the limited information available on safety, quality, purity, and efficacy. Answering patient questions is always interesting and often very challenging, as they can often be non-specific. A typical question like “Is product ‘X’ good for treating condition ‘Y’?” can be difficult to answer without gathering some further information. My usual response is, “Let’s talk about this. I want to make sure I give you an answer that is right for you, given your medical conditions.”
I recently spoke with a patient taking atorvastatin (Lipitor), a cholesterol-lowering medication from the “statin” family, who was complaining about muscle pain, and asking about Coenzyme Q10 (CoQ10) for treating that pain. Treating or preventing statin-related muscle pain is a common question, given the popularity of statins and the frequency of the complaint: About 1 in 15 develop this symptom. Before diving into the efficacy of CoQ10, let’s review statins.
Statin Benefits
If you have high blood pressure, are overweight, diabetic, or sedentary, you should know your cholesterol levels: Keeping them in the normal range will lower your death risk in the short and long term.[1] If you need drug therapy to reduce your cholesterol levels, you’re probably on a statin. Statins are a class of highly effective cholesterol-lowering drugs that work to inhibit HMG-CoA [3-hydroxy-3-methyl-glutaryl-CoA] reductase. Statins work by lowering cholesterol points (e.g., low-density lipoprotein (LDL), triglycerides) and/or moderately increasing good cholesterol (i.e., high density lipoprotein (HDL)). High levels of “bad” cholesterol is a contributor to heart disease and other negative cardivascular outcomes. It clogs the arteries that feed oxygen to the heart, and is involved in the process of blood clot formation.
Statins have been extensively studied and are very effective at improving cholesterol measures, and overall cardiovascular outcomes.[2] For example, taking statins for 5 years will prevent 1 heart attack for each 28 patients treated (compared to placebo) and will prevent 1 heart-related death in 69 patients.[3] Statin therapy is even effective at preventing a first heart attack (though the effects are less impressive than in those who have already had cardiac events.[4]
In addition to the effects on cholesterol, statins also lower C-Reactive Protein (CRP), an inflammation marker, which appears to also offer additional benefits to one’s risk of heart disease.
Statin Safety
In general, statins are well tolerated. Muscle pain (myalgia) is the only common side-effect (rate of more than 1%), but surprisingly, the frequency is no different than a placebo.[5] Risk factors for muscle pain include age (65 years or older), acute or chronic renal failure, liver disease or dysfunction, hypothyroidism, genetics, the statin dose, and other medications.
Some side effects have been established as clearly linked to statins: Increased liver enzymes (aminotransferase enzymes); as well as muscle pain with elevated muscle breakdown enzyme (Creatine protein kinase, CPK).[6] [7]
Uncommon side effects reported with statin therapy include more severe forms of muscle pain, including the rare but serious rhabdomyolysis, which has been associated with kidney failure.[7] [8] The evidence that statins cause this side-effect is contradictory: randomized controlled trials show no association, but some lesser quality trials (observatory or cohort trials) have linked statins to some of these rare side-effects.[8]
The safety profile of statins results in a scenario where muscle pain complaints are frequent, but rarely serious. All require investigation, but in the vast majority of patients, discontinuing the drug is not medically necessary.
Management of Statin-Associated Muscle Pain
Statin-associated muscle pain (myopathy) typically appears as aching muscle pain, muscle weakness (but not joint pain), usually affecting both sides of the body, and more than one muscle group. Red flags for medical referral include flu-like symptoms, low back and/or proximal muscle pain, and brownish coloured urine, which could signal rhabdomyolysis.
Muscle symptoms typically appear after a few weeks to months of treatment, though they can appear anytime after the first week.[8] Symptoms typically disappear within days to weeks of discontinuing treatment.
When statin muscle pain develops (without evidence of more serious complications) options for management can include: decreasing the dose, stopping therapy for a few weeks, switching to other statins (some data suggests pravastatin and fluvastatin may be better tolerated [8]), alternate day treatment, or completely stopping statin therapy and switching to another type of cholesterol-lowering drug. Given the demonstrated benefits of statin therapy, this is usually the least-desirable option.
Here’s where Coenzyme Q10 comes in.
It’s been proposed that statins may reduce the amount of Coenzyme Q10 in the body, since it shares a metabolic pathway with cholesterol. Give the supplement, reduce the pain, goes the hypothesis. So, let’s look at the evidence.
Developing a Focused Clinical Question
Before I could answer my patient’s question, I needed to focus it enough to be answerable. Using the PICO format, I developed a question that could be answered in a science-based way:
P – Patient (or Population) – What are the characteristics of the patient? In this case, a 67-year-old male with familial hypercholesterolemia, on atorvastatin, and no other medications. Let’s look at the data for any statin, as in general, the drugs are therapeutically alike.
I – Intervention – What intervention or treatment were we interested in? For this case, we’re interested in giving CoQ10 orally, adding it to existing drug therapy.
C – Comparison – CoQ10 compared to what? In this case, compared to no treatment (watchful waiting) or placebo.
O – Outcome – What is the intervention supposed to do? We want to know if it reduces patient-reported complaints of muscle pain.
So my focused clinical question was the following: In a 67 year old patient with familial hypercholesterolemia, on a statin, is CoQ10 superior to a placebo for the reduction of muscle pain symptoms?
What is CoQ10?
Also named ubiquinone, Coenzyme Q10 is an oil-soluble, vitamin-like substance that is obtained through food (meats, seafood) and also produced in the body.[9] It is present in most cells of our body, but mostly in mitochondria (energy producing part of cells) of heart and liver cells[10] Coenzyme Q10 levels are highest in the first 20 years of life. It declines with age to the point that at 80 years of age, the levels are lower than at birth. It has many functions in the body, ranging from antioxidant to biochemical cofactor.
CoQ10 is, in Canadian regulatory terminology, a “natural health product”. It’s available without a prescription and is sold in pharmacies and health food stores. Taking CoQ10 supplements does lead to increased blood levels. In the blood, it’s transported in cholesterol particles (mostly in LDL). Dosage usually ranges from 50 to 250 mg divided in two or three daily doses.
Purported uses for CoQ10 include hypertension, angina, congestive heart failure, Huntington’s disease, migraines, muscular dystrophy, breast cancer, infertility and many, many other conditions. Most of these uses have little to no evidence to support their use, and little research exists to demonstrate the natural product is factor in any of these conditions.[11] The only FDA approved condition is for the rare genetic disorder of mitochondrial encephalomyopathy.[9] The relevance of CoQ10 to statin myopathy is thought to come from its involvement in cell energy production, where preliminary data emerged to suggest that muscle mitochondrial dysfunction due to low levels of CoQ10 in the body might explain the muscle pain and/or weakness.[12] [13]
Limited data means it’s not clear that low levels of CoQ10 cause myalgia, or if myalgia can occur without low levels of CoQ10. In fact, at least four other equally valid hypotheses for statin-induced mylagia exist.[14] Consequently, the measurement of CoQ10 levels is not clinically relevant.
Safety and Interactions
CoQ10 is well tolerated. Reported side effects seem to be minor and include nausea, vomiting, diarrhoea, appetite suppression, heartburn, stomach discomfort in less than 1% of patients. Allergic reactions have also been reported.[9] CoQ10 oral supplements at recommended doses in most adults seems safe in studies lasting up to 30 months. There is little data in children, pregnancy and in breastfeeding women.[9] However, it is generally very well tolerated in most people.
CoQ10 interferes with some drug therapy. It can magnify the effects of blood pressure medications. Tt can also interfere with warfarin (Coumadin) therapy, possibly increasing the risk of clotting. CoQ10 may also interfere with cancer chemotherapy, reducing its effectiveness.[9]
The Evidence
A 2007 systematic review by Marcoff looked at laboratory and clinical evidence for CoQ10 and its potential role in statin myopathy.[14] It found that statins do not conclusively decrease blood levels of CoEQ10; low dose statins do not decrease CoQ10 levels in muscles, (but this may be drug and dose dependant); and no consistent mechanism of cellular damage or effects can explain myopathy.
The review identified two relevant trials and found contradictory results. In the first trial, 44 patients with high cholesterol and a history of statin-induced muscle pain who were off statins for at least 2 weeks, re-treatment with statin therapy (escalating doses of simvastatin 10 – 40mg daily), while taking CoQ10 supplements for 3 months did not affect pain scores or how patients could tolerate therapy.[15] This suggests that CoQ10 does not seem to prevent muscle pain in people who have had a history of statin-induced muscle pain.
The only positive evidence mentioned in the systematic review comes from another small study done by Case et al.[16] This second trial evaluated if CoQ10 supplements could treat or improve muscle pain in patients currently taking statins. They enrolled 32 patients (15 women, 17 men) who had myopathy symptoms defined as pain alone or accompanied by other symptoms, such as weakness and fatigue. Authors measured pain at the start of the trial and after 30 days using the subjective Brief Pain Inventory questionnaire (BPI) and Pain Interference Score (PIS), the latter being a test of how pain affects their daily living and well-being. Eighteen patients were randomized to receive either 100 mg of CoEQ10 per day, while the remaining (N=14) received 400 IU of vitamin E. Patients and investigators were blinded to which treatment was given.
Results were encouraging. The investigators found a significant decrease in pain scores by about 40% -+11% (Pain severity score, PSS=2.97-+0.48, p0.001) and a reduced interference of pain on daily living of about 38% -+14% (PIS 2.82 -+0.61, p0.02) in the Coenzyme Q10 group compared to placebo group (vitamin E). Sixteen of the 18 patients taking CoQ10 improved while only 3 of the 14 improved with vitamin E. This suggest that CoQ10 may provide moderate, short-term relief of statin-induced muscle pain.
Limitations to the trial included its small size, randomization process (not detailed), and little evidence the two groups were matched with respect to other medical conditions or other medications. Importantly, the use of other prescription or non-prescription medications was not detailed. The short trial duration (30 days) limits the relevance of the findings: Statin pain tends to last much longer than 30 days. Also, it is questionable if 30 days of CoQ10 could even have affected muscle levels at all. Longer studies with tissue sample would be required to demonstrate this.[8] Finally, the control group used (vitamin E) may not be a true placebo group (sugar pill), only one dose of CoQ10 was used, and the trial did not have the size to evaluate if patients on high doses of statins had better relief of pain.
Conclusion
Muscle pain during statin treatment is a common problem encountered by patients, and a frequent question posted to pharmacists. The documented benefits of statins on morbidity and mortality suggest that all evidence-based efforts should be made to keep patients on therapy.
Consider this: in moderate to high risk heart patients, for every 1 million patients treated with a statin, 15 cases of the severe adverse effect rhabdomyolysis might occur. However, 30,000 cardiovascular deaths or non-fatal myocardial infarctions would be avoided. That is one case of rhabdomyolysis for every 2000 severe cardiovascular events avoided.[17] In light of this risk- benefit relationship, it’s critical that muscle pain be evaluated by a physicians before statin therapy is discontinued, because the benefits outweigh the risks of treatment.
Unfortunately, there’s little high-quality, persuasive evidence to support the use of CoQ10. This initial data is promising, but larger, better trials are required before using this supplement can be considered to be supported by good science. In light of the risk-benefit ratio, however, in cases where discontinuation of statin therapy is being contemplated, a trial of CoQ10 may be reasonable.
For Additional Information
For pharmacists or other health professionals, this practice tool provides a good summary and management algorithm for statin myopathy.[17]
References
[1] Hulten E et al. The Effect of Early, Intensive Statin Therapy on Acute Coronary Syndrome A Meta-analysis of Randomized Controlled Trials. Arch Intern Med. 2006;166, 1814-1821.
[2] Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005. 366(9493): 1267–78.
[3] Larosa et al. Effect of Statins on Risk of Coronary Disease: A Meta-analysis of Randomized Controlled Trials J American Medical Association. 1999 Dec 22-29;282(24):2340-6.
[4] Thavendiranathan P et al. Primary Prevention of Cardiovascular Diseases with Statins:A Meta-analysis of Randomized Controlled Trials,Arch Intern Med. 2006;166:2307-2313.
[5] MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002: 360(9326): 7–22.
[6] Kashani A, Phillips CO et al. Risks associated with statin therapy: a systematic overview of randomized clinical trials. Circulation. 2006 Dec 19;114(25):2788-97.
[7] Josan K, Majumdar SR et al. The efficacy and safety of intensive statin therapy: a meta-analysis of randomized trials. Can Med Assoc Journal. February 26, 2008; 178 (5).
[8] Miller ML, et al., Muscle injury associated with lipid lowering drugs. In: UpToDate, Basow, DS (Ed), UpToDate,
Waltham, MA, 2009. Accessed 03-01-10.
[9] Natural Medicines Comprehensive Database [Internet Database]. Stockton, CA. Therapeutic Research Facility. (Updated periodically). Accessed 20-12-09.
[10] Wikipedia: Coenzyme Q10. Cited 20-02-10.
[11] Mayo Clinic. Cited 20-02-10.
[12] P.D. Thompson, P. Clarkson and R.H. Karas, Statin-associated myopathy, JAMA 289 (2003), pp. 1681–1690.
[13] P.S. Phillips, R.H. Haas and S. Bannykh et al., Statin-associated myopathy with normal creatine kinase levels, Ann Intern Med 137 (2002), pp. 581–585.
[14] MARCOFF, L., & THOMPSON, P. (2007). The Role of Coenzyme Q10 in Statin-Associated MyopathyA Systematic Review Journal of the American College of Cardiology, 49 (23), 2231-2237 DOI: 10.1016/j.jacc.2007.02.049
[15] Young JM et al., CoEnzyme Q10 does not improve simvastatin tolerability in dyslipidemic patients with prior statin-induced myalgia, AHA 2006 (abstract). Circulation 2007;114:II41.
[16] CASO, G., KELLY, P., MCNURLAN, M., & LAWSON, W. (2007). Effect of Coenzyme Q10 on Myopathic Symptoms in Patients Treated With Statins The American Journal of Cardiology, 99 (10), 1409-1412 DOI: 10.1016/j.amjcard.2006.12.063
[17] Tsuyuki RT et al., Assessment of muscle pain associated with statins — A tool for pharmacists, Canadian Pharmacists Journal, Volume 142, Issue 6 (November-December 2009), pp. 280–283.
Science-Based Pharmacy 
Believe it or not, it has worked for me, 100mg a day and never a muscle spasm at night even at 80mg Zocor daily. I did experiment and found that 30mg was too little to avoid spasms.
Muscle Spasms is not a side-effect linked to statins. Remember that statin-induced muscle pain is a chronic, aching pain or weakness, in both sides of the body and in muscle groups.
It is not a pain that is similar in to muscle spams, where this type of pain is a sharp, sudden painful involuntary contraction of a muscle.
However, Its good that you haven’t stopped taking Zocor because of the spams, since they might not caused by the drug.
I realise now that ”muscle spasm” can be another way to described statin-induced myalgia. So, If your symptoms are similar to what I described and your physician has rules out other causes, you probably have statin myalgia.
The evidence for CoQ10 to PREVENT spasms tells us that it is not useful for this use. However, one small trial showed that it might offer moderate pain relief for those who are currently taking statins. The science cannot tell us if the pain relief will last longer than 30 days, or how much CoQ10 to take.
I originally tried 30mg CoQ10, but that was not enough, the spasms subsided to a point that it happened occasionally, say 2 or 3 times a week, instead of every night. I selected 100mg only because it was the next available dosage at my PHARMACY. I have not had a spasm since taking this dosage.
What about switching to Niaspan?
It would depend on the reason one is on a statin, and other medical conditions. Niacin is a very effective agent, and a trial on Niaspan may be appropriate. It has its own set of side effects, though.
Niacin is not as good in lowering LDL than statins, but it is slightly better at decreasing TGs and increasing HDL (good cholesterol). In most people, it’s the LDL that needs to be lowered.
There are some concerns with liver toxicity with niacin products, but the limiting side effect is flushing and itch that happens very commonly. To the point were few people can tolerate niacin. Basically, it’s a good 2nd or 3rd choice after statins.
i like your post but i have an opinion if you donot mind.most pepole taking statin are high in age and they think that musle pain accompaning statin therapy is due to aging and it’s complication so they use NSAIDS to avoid this pain
Please understand, I was 37 years old when put on statins, and this is the discovery I made, have had bouts where I stopped the CoQ10, and the spasms returned, and this was a test I initiated over the years as doctors tried Zocor, Lipitor and Crestor. I am an engineer, very analytical, I am certain that the CoQ10 is the reason for the spasms ceasing, but it was definitely dosage dependent, I take the Q-gel formulation at 100mg, 30mg was not good enough, they say this Q-gel type is more potent, don’t know.
I have been battling statin side effects for months. When I stop the zocor, I get better so I’m going to take CO-Q10 for several months and see what happens. What harm could it do? I am tired of my poor quality of living using these sometimes dangerous meds.
Other than minor gastro-intestinal side-effects, potential harms of coQ10 include decrease in blood pressure and interaction with blood thinners. Always ask your physician beforr trying any natural product, just to be on the safe side.
Good luck, Ronald, keep in mind that 30mg helped somewhat, 100mg was the best for me, and I relaize everyone is different. It will be interesting to hear of your results, please let us know. BTW, I have not heard of any negative feedback on Co-Q10, it is heart loving.
Any update on Ronald??
I have been on various statins for about 10 years and never experience muscle soreness unless I workout hard. I am an avid cross country skier, runner and biker and since I have been on statins, my muscles would stay sore longer than I would like after tough and/or long workouts. I started taking a CoQ10-containing supplement 6 weeks ago. I can say I have never felt better and the nagging soreness is gone, even with an increase in my training load (skied 25 miles on Saturday and 7 yesterday). I don’t feel this is psychosomatic – it is very noticeable to me.
My friend had to go off statins completely almost a year ago – due to severe burning pain in her arms and forearms. The pain comes and goes unpredictably even after all this time. The only way she can get to sleep is to keep moving a large cold pack around on her arms until the arm is so cold that it numbs the burning, and she can fall asleep. Her heart doctor said, after trying an alternative statin last year, “if you can’t tolerate cholesterol meds then I can’t help you.”
Doctors who write about this condition obviously have never EXPERIENCED the symptoms themselves, or they wouldn’t be so cavalier about the condition! Like the ones who say that it’s people who have started exercising after beginning to use statins who are confusing that pain with symptoms of statin use! Of course; they’ve never used their muscles before so they can’t distinguish the pain!
Are Statins so good?
See: http://archinte.ama-assn.org/cgi/content/abstract/170/12/1024
This big studie says: “Conclusion: This literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.”
Helge,
that study did fail to find mortality benefit, finding only a trend towards benefit (fixed-effect RR: 0.93 (0.86-1.00)). However, a recent Cochrane review DID find benefit in primary prevention. It would be interesting to try to see why these two analyses reached different conclusions. Mortality certainly is the most important outcome, but it isn’t the only important one: heart attacks and strokes are also important. The article you mention does not look at these, so we have to at look other trials (such as the Cochrane review I cited) to get a more complete look on overall benefit of statins in primary prevention.
As my article says, statins are very good in people who’ve had a vascular event (secondary prevention). In people who haven’t, the evidence seems mixed in terms or all-cause mortality, but looks positive in terms of preventing heart attacks and stroke.
Here’s the Cochrane review:
http://www2.cochrane.org/reviews/en/ab004816.html
See also this link :
http://www.thincs.org/index.htm
I very much appreciate this article and all the comments. The article is clearly written and layed out. Clearly, the benefit of CoQ10 is not well proven via research, and I hope that more and extensive research will occur. In the meantime, I would like to try using CoQ10 for my own muscle ache (arms, and very difficult at nighttime sleep. but also periods of the day.) It doesn’t seem to conflict with my other medications. Thank you very much!
I have suffered severe consequences of taking statins. Noticing muscle weakness in my legs as well as terrible joint pain, it was decided I needed knee replacement. I opted to have both done at the same time. Three weeks later after some therapy both knees tore loose tearing ligaments, tendons and left my kneecaps on the sides of my lower legs. The sutures had pulled through the weakened muscles. Much of the quadriceps in both legs was so damaged that it had to be removed. This left the surgeon with a difficult job of reattatching the patellas and securing what was left of my muscles in an attempt to enable me to walk though with much disablity.
Synopsis – People who make their living from prescribing drugs (drug companies, doctors, pharmacists – will all say statins are great and CoQ10 is unproven – but the people with first-hand experience know better.
Rather than ad hominems, I invite you to look at the evidence. Besides, by your logic, pharmacists should love CoQ10 – they sell it too.
Your logic is–well, actually is ISN’T.
Doctors, et al, make their livings helping people to avoid early death from heart disease and stroke by prescribing drugs (after advising lifestyle changes that most patients largely ignore or claim that they cannot achieve).
I started taking statins when I was 30 or so. Couldn’t tell anything at first, but last 5 years have been horrible. I am almost 42 now. When I stopped taking Zocor, I saw some improvement but my cholesterol shot back up. About 5-6 months ago, I switched to Crestor which seemed to work better at first but then my legs started hurting again! They hurt all day everyday but particularly the calves and hamstrings.
My 63-year-old husband had taken Crestor for quite some time with NO ill effects at all. However, his insurance stopped paying any portion of the Crestor cost, so his physician switched him to Lipitor. Left rib area pain ensued shortly thereafter and following a chest CT and chest X-ray, bothwith negative results, the pain has remained. My husband has stopped the Lipitor, now for nearly two weeks and he feels 80% better. Upon questioning, his physician absolutely denied the possibility that the Lipitor could be the cause of this left rib area pain. Hmmmm……….my husband disagrees. We shall see.
Excellent post. Although I suspect muscle pain is actually under-reported/recorded with long-term treatment.
Have just started taking Pravastatin for the last 6 weeks to lower my cholesterol levels. Have noticed burning , aching pain behind my left knee, as well as on the inner side of my left knee. Making walking difficult because of pain. Pain is less when I am off my feet, but still hurts. Nothing seems to alleviate it, such as motrin and bengay or aspercreme. I am a teacher by profession. These stories scare me, as well as other stories I have read about the horrors of statins. Question: I plan to start taking CoQ10 immediately. Will CoQ10 interfere/interact with atenolol and the diuretic I am also taking for high blood pressure?
Thanks!
For several years, I experienced legs and feet weakness, especially in driving a car. This was attibuted to discs problems. When my foot kept slipping off the gas and brake pedals, I knew I needed more help. I did research on the internet hoping to find “helps” to relieve these problems. Accidentally, I found out that all could be from using statins (lovastatin–for many years— and lipitor for just two weeks—). I found examples from others who had experiences similar to mine. I then realized that statins could be the cause and stoped using them. After a short time, my doctor suggested that I use coq10. When I began taking up to 600 daily, I found some relief. I would like to know if I can do more and if my muscle problems can be heale or if there is permanend damage. thanks………Barbara
Please correct errors. I use 600 mg daily of coq10 not 600. thanks………Barbara
Muscle pain under-reported (by doctors)? absolutely!!!
I developed HORRIBle cramps in my calves – enough to wake me up at night, wishing I could pass-out or die! so as to not feel the pain. It was like my muscles were trying to tear themselves apart. At some point I heard that such spasms/cramps/horror might be due to statins (which I had taken for years with no ill-efect).
I experimented for almost a year to see if there was a connection: off the statins: the cramps would subside. On the statins: the cramps returned.
Throughout all of this my doctor never really believed me, dismissed my reports of the severity of the cramps; simply stated that I really needed to keep taking the statins to keep my cholesterol down. Never even offered to try me on a different statin to see if it would be better tolerated!
Just plain did not believe the agony I was experiencing with my muscles tying themselves in knots several times a week.
Finally got some attempt to address the problem by going to a different doctor! trying a different statin now.
Took lipitor for ten days, had hurt back, doctor gave me predisone, on the third day Of predisone I had terrific pain in my right thigh. Dr never mentioned statin drug I’m on , did a Doppler to rule out blood clot. I stopped both meds it’s been 7 days off meds and I have no relief. Ice , heat, Tylenol,nothing. I can’ t walk. Does statin effect that quickly, help
I’ve tried several different statins; at some point, I always end up with horrid cramps in my feet, toes, the sides of my ankles and my calves. They’ll wake me out of a dead sleep and I have to jump up and try to force the muscle out of the cramp. It’s not excruciating, but it’s pretty awful.
I just bought a bottle of CoQ10, Nature’s Bounty, 100 mg. I’d like to start taking it without having to pay to see my doctor again, but I’m a little worried about the decrease in blood pressure. I’ve always had low blood pressure — my whole life. But lately my blood pressure is up to about 125 over 75, from its standard 100 over 70. Not sure what I’m doing differently, except taking Livalo and Sertraline.
Are the reported drops in blood pressure significant?
I have some sort of (sp??) vasovagal response that’s unexplained: I wake up sometimes in the middle of the night feeling cold but very sweaty and quite faint; in these situations, I have agonizing stomach cramps and typically either vomit or have diarrhea. It passes in about 10 to 15 minutes, but occasionally I pass out. I know that my blood pressure drops significantly during this time because of the cold, clammy sweats. I don’t want to take anything that will make that worse or happen more frequently, but I am really sick of these cramps. They’re impacting my sleep and my overall health.
Why didn’t my cardiologist(s) recommend this? I had a heart attack at the age of 42, and I was put on generic statins 3 years ago. I suffered from fleeting pains in my left rib cage, legs cramps and arm cramps. I thought they were linked to the statins. I also found they were much worse when I was de-hydrated. When the generic statin stopped working I was switched to Lipitor (80mg). I experienced sharp cramps in my calves every night and occasional sharp cramps in my forearms for years. My cardi objected but I finally stopped the Lipitor and the cramps stopped. I found that 40mg a day was about all the Lipitor I could tolerate. Then my family Dr recommend coq10. It worked immediately. I take 200mg a day. I am now able to exercise more and my LDL has come down with Lipitor at 40mg. If I stop the cq10 the cramps return within a day.