A recent study that found statins increased fatigue (Arch Intern Med. 2012 Aug 13:1-2. DOI: 10.1001/archinternmed.2012.2171) doesn't surprise me. What does give me pause is that the researchers (and the media articles that followed) didn't mention the role coenzyme Q10 (CoQ10) plays in this equation.

The study, from University of California, Irvine, found men and women with high levels of low-density lipoprotein (LDL) cholesterol (115-190 mg/dL) who took either 20 mg of simvastatin (lipophilic statin) or 40 mg of pravastatin (hydrophilic statin) rated their fatigue as worse than those who took a placebo for six months. The effect was worse for the women in the study compared to the men. However, those on the statins did reduce their LDL levels.

As I noted in the recent INSIDER article "Raising the CoQ10 Quotient," CoQ10 shares the biosynthetic pathway with cholesterol, and statins are designed to block that pathway in the body. Other researchers have noted this phenomenon. A 2004 study from Columbia University noted even brief exposure to the statin atorvastatin causes a marked decrease in blood CoQ10 concentration, and those researchers said inhibition of CoQ10 synthesis could explain the most commonly reported adverse effects of statins, especially exercise intolerance, muscle pain and muscle deterioration (Arch Neurol. 2004 Jun;61(6):889-92).

CoQ10 is known to boost energy. It improved swimming endurance and had an anti-fatigue effect in mice in a 2010 study (J Med Food. 2010 Feb;13(1):211-5). And a 2010 review reported studies have confirmed CoQ10s effect in reducing fatigue and exercise-related damage, and improving physical performance (Nutrition. 2010 Mar;26(3):250-4).

It make sense that if one blocks his CoQ10 pathway with a statin, then his energy levels will go down; however, the researchers of this recent study didn't mention that. I'd like to see a study like this one, but with one group receiving a statin and supplementing with CoQ10. My guess is that their energy levels would be better than a group taking statins alone; perhaps their energy levels would be as high as those who take a placebo.

Oh, if only I had unlimited funds and a testing lab of my own.