People typically refer muscle cramps or leg muscle aching while on statins due to lack of energy. Keep in mind that your heart is a muscle as well. Incidentally, the rates of congestive heart failure has spiked during the time statins have been a top seller on the market.
Coenzyme Q10 is a chemical which plays a key role in the production of energy in the body's cells. Specifically, this substance participates in the processes within tiny powerhouses in cells known as 'mitochondria' (my-toe-con-dree-ah). Coenzyme Q10 is essential for the production of ATP (adenosine triphosphate), a basic currency for energy in the body.

All of us need could do with maintaining coenzyme Q10 levels, and this has particular relevance to individuals who take statins: these drugs impair the product of coenzyme Q10. There is plenty of evidence in animals and humans that statins can indeed deplete the body of coeynzme Q10 [1].

The heart is a muscle, the cells of which contain mitochondria which depend on coenzyme Q10. Back in January, I wrote a post which explored the possibility that statins may be contributing to increasing incidence of heart failure (weakened heart function that can lead to symptoms such as fatigue, breathlessness and swelling in the legs).

The role of coenzyme Q10 depletion in heart has been highlighted by studies in which supplementation with it has been found to improve heart function [2]. Recently, though, there were reports (example here) of a new study which appears to have found that coenzyme Q10 supplementation can prevent major cardiovascular events (such as heart attacks) and save lives.

The research was led by Professor Svend Mortensen from Copenhagen, Denmark. In the study, individuals with severe heart failure were given 100 mg of coenzyme Q10, three times a day in addition to their normal care for 2 years. Outcomes were compared with a similar group receiving normal care and a placebo.

According to the report, coenzyme Q10 therapy essentially halved the number of 'major adverse cardiovascular events'. It also, apparently, halved the overall risk of death too.

If you follow this trail of evidence, it's not too far-fetched to suggest that while statins may 'save lives' in the relative short-term by reducing the risk of, say, heart attacks, they may possibly cause some people to perish in the long term as a result of chronic coenzyme Q10 depletion and associated heart failure.

One of the studies referred to above [1] contains a notable quote:
Statin-induced CoQ10 deficiency is completely preventable with supplemental CoQ10 with no adverse impact on the cholesterol lowering or anti-inflammatory properties of the statin drugs. We are currently in the midst of a congestive heart failure epidemic in the United States, the cause or causes of which are unclear. As physicians, it is our duty to be absolutely certain that we are not inadvertently doing harm to our patients by creating a wide-spread deficiency of a nutrient critically important for normal heart function.
The authors of this study make a good point, I think, and it's perhaps something we doctors should take heed of.


1. Langsjoen PH, et al. The clinical use of HMG CoA-reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications. Biofactors 2003;18(1-4):101-11

2. Fotino AD, Effect of coenzyme Q10 supplementation on heart failure: a meta-analysis. Am J Clin Nutr. 2013;97(2):268-75