If you’re taking statins and dealing with muscle pain, you might be wondering: how much CoQ10 should you take?
Some studies suggest that CoQ10 supplements could ease the discomfort. But how much is enough—and is more always better?
In this article, you’ll see what the research says, what dosage may work best, and what to consider before trying CoQ10 with your statin.
| 🔑 Key Takeaway ➤ Research shows mixed results—some people feel much better with CoQ10, while others notice little or no change. ➤ CoQ10 may help because statins can lower the body’s natural levels of it, which may affect muscle energy and cause discomfort. ➤ Studies suggest that 100 mg per day can reduce pain and improve daily activities, while 200 mg may provide even more relief in some cases. ➤ CoQ10 is generally safe and well tolerated, especially when taken with food that contains fat to help the body absorb it. ➤ Most people don’t experience side effects, but mild stomach upset can happen and is usually improved by taking it with meals. ➤ People with diabetes should talk to their doctor first, as CoQ10 might lower blood sugar levels. It’s best to take CoQ10 every day, ideally with dinner or another fatty meal, to help your body absorb it and get consistent results. |
Understanding Statin-Induced Muscle Symptoms (SAMS)
Statins are medicines that help lower cholesterol. They protect your heart, but sometimes they can cause muscle problems. These are called Statin-Associated Muscle Symptoms (SAMS). But why does this happen, and how can we help people who need statins but also feel muscle pain?
Statin-Associated Muscle Symptoms
SAMS range from mild aches to more severe issues like muscle damage. These symptoms are a serious concern because they cause many patients to stop taking statins. And when patients stop their treatment, their risk of heart problems can go up.
According to a study, while industry-funded trials report a SAMS rate of less than 1%, other clinical trials show a rate of 10–25%. In observational studies, the numbers rise even higher—up to 60%. That’s a lot of people possibly affected.
What does that mean in practice? It means many patients might miss out on the heart-protective benefits of statins because of muscle symptoms. When patients stop statins, healthcare costs also rise because they may end up needing more expensive treatments.
So, it’s crucial to understand why these muscle symptoms happen. Could there be something happening deep inside the muscle cells?
Why Do Statins Cause Muscle Pain?
One theory is that statins lower levels of CoQ10 in your body.
CoQ10 is important for creating energy in your muscle cells. According to the same study above, statins block the mevalonate pathway—a pathway the body uses to make cholesterol. But that same pathway also helps make CoQ10.
So, if you block cholesterol production, you might also block CoQ10.
Evidence from muscle biopsies supports this idea. One study found that patients with SAMS had signs of mitochondrial problems in their muscle tissue. For example, they found ragged red fibers and lower cytochrome oxidase staining—both signs of impaired energy production.
Another study also found that people taking statins didn’t respond well to exercise. In a 12-week training program, those not taking statins improved their oxygen uptake by 10%. But those on 40 mg of simvastatin only improved by 1.5%. That’s a big difference. And muscle biopsies from this study showed that mitochondrial enzymes went up with exercise in the statin-free group—but not in the statin group.
CoQ10 Levels
There’s also solid data showing that statins lower blood levels of CoQ10.
In a meta-analysis of eight placebo-controlled trials, the researchers found an average CoQ10 drop of 0.44 μmol/L. This drop was significant in nearly all the studies reviewed. Why does this happen? One reason might be that CoQ10 is transported in LDL and VLDL, the same particles that statins reduce. So, less LDL might mean less CoQ10 in the bloodstream.
Still, researchers are not sure whether these lower levels in the blood cause the muscle pain, or are just a side effect.
Looking deeper, some studies checked CoQ10 levels inside the muscles. One study reported reduced muscle CoQ10 during statin treatment. But not all studies agreed. Another study found no significant drop in muscle CoQ10 levels during statin use.
Genetics might also play a role. According to a study, people with certain versions of the CoQ2 gene had over twice the odds of developing statin intolerance. In another study, the researchers compared 377 patients with SAMS to 416 who didn’t have symptoms. They found genetic differences in ATP2B1, DMPK, and COQ2—three genes linked to muscle function and CoQ10 production.
These findings suggest that some people may be genetically more likely to develop SAMS.
Optimal CoQ10 Dosage for Statin Users
Now, how much should you take, and does it really work?
Several studies have tested whether Coenzyme Q10 (CoQ10) supplements can help. One study included 32 patients taking statins who were experiencing myopathy—muscle pain or weakness. These patients were randomly assigned to take either 100 mg/day of CoQ10 or 400 IU/day of vitamin E for 30 days. After the trial, 16 out of 18 patients who received CoQ10 reported pain relief. Pain intensity dropped by 40%, and interference with daily activities improved by 38%.
In contrast, the vitamin E group showed no significant improvements. This suggests that 100 mg daily of CoQ10 may be helpful for reducing muscle symptoms caused by statins.
But that’s not the only study worth noting. One study also explored the effects of CoQ10, this time using a higher dose—50 mg twice a day for a total of 100 mg daily—on 50 statin users. After 30 days, 75% of patients taking CoQ10 reported reduced muscle pain. The Pain Severity Score dropped from 3.9 to 2.9, and the Pain Interference Score went from 4.0 to 2.6. These numbers show how CoQ10 can ease the discomfort that sometimes comes with statin use.
What Happens When the Dose Goes Higher?
More research looked into even higher doses. In one study, patients with statin-associated myopathy were given 200 mg of CoQ10 daily, either with or without selenium.
Muscle pain dropped significantly in 77% of those who took CoQ10, while muscle weakness improved in 92%, and cramps in 85%. Tiredness improved in all participants who had it before treatment. This data shows that 200 mg per day may offer even greater relief from muscle-related statin side effects.
However, not every trial showed the same results. In another study, patients with previous statin-related myopathy were given 200 mg/day of CoQ10 for 12 weeks. Sadly, the supplement didn’t help them tolerate statins better. There was no significant difference in pain relief compared to those taking a placebo.
| ✂️ In Short 100 to 200 mg per day could potentially help. But the research is mixed, and not all studies found benefits. Some people feel better, while others notice no change. It may depend on individual differences, the severity of symptoms, or even the type of statin used. One final point—plasma levels of CoQ10 often rise with supplements, but that doesn’t always mean the muscle tissues get more CoQ10. One study found a 131% increase in plasma CoQ10, yet still no symptom relief. That means more research is needed to understand exactly how and where CoQ10 works in the body. If you’re struggling with statin-related muscle pain, a trial of CoQ10—starting around 100 to 200 mg daily—might be worth considering. Just talk to your doctor before you start. |
Safety and Tolerability of Coenzyme Q10
According to the Mount Sinai Health Library, Coenzyme Q10 (CoQ10) appears to be safe for adults when taken in recommended doses.
The most commonly reported side effect is mild stomach upset. This side effect happens only occasionally and usually improves when CoQ10 is taken with food. Because CoQ10 is fat-soluble, it is best absorbed with a meal that contains fat. This not only helps with absorption but also seems to reduce the chance of gastrointestinal discomfort.
No major side effects have been observed in clinical use. Even studies that used higher doses which tested 300 mg/day, did not report dangerous reactions. This points to good tolerability, even when the dosage increases for therapeutic reasons.
| ⚠️ Important Considerations People with diabetes should be extra careful. CoQ10 may lower blood sugar levels, so if you have diabetes and take insulin or other blood sugar-lowering medications, adding CoQ10 could cause your blood sugar to drop too low. It is advised that patients with diabetes speak with their doctor before taking the supplement. Pregnant and breastfeeding women should also proceed with caution. Researchers have not done enough studies to confirm the safety of CoQ10 during pregnancy or lactation. Without this data, it’s impossible to know if it’s safe for the baby. Therefore, CoQ10 should only be used during pregnancy under a healthcare provider’s supervision. |
When and How to Take It
Since CoQ10 is fat-soluble, the body absorbs it best when taken with a meal that contains fat. This can be something as simple as a spoonful of peanut butter, some olive oil on your salad, or a slice of avocado. Taking CoQ10 on an empty stomach might reduce how much your body can use.
Also, consider taking CoQ10 in the evening or at night. Some experts believe that the body may process CoQ10 more effectively at that time, although this isn’t proven in all studies. Still, if you’re wondering when to take it, pairing it with your dinner is a good starting point.
Like many supplements, CoQ10 works best when taken every day. Skipping doses can lower its effects, especially if you’re using it to manage symptoms or support heart function.
Final Words
For many, 100 to 200 mg per day has been linked to less muscle pain and better daily comfort. Some feel a clear difference. Others feel none at all. That’s because your response might depend on genetics, the statin type, or how your body handles CoQ10.
Still, one thing is clear—statins can lower your natural CoQ10 levels, and this might explain some of the muscle problems. Adding CoQ10 could help restore that balance.
Just remember to take it with food, stay consistent, and talk to your doctor first.
Frequently Asked Questions
Does CoQ10 help with heart problems?
It can. People with heart failure or chest pain (angina) may feel better with 60–300 mg daily. It helps improve heart function and may reduce hospital visits.
Can CoQ10 help migraines?
It might! Taking 300–400 mg a day has helped some people get fewer and milder migraines. It works by lowering inflammation and stress in your body.
Does CoQ10 help with aging?
Yes, it might help you feel more energetic as you age. Older adults often take 100–200 mg a day to support muscle strength and heart health.
Is CoQ10 good for diabetes?
It can help! People with diabetes often have low CoQ10 levels. Taking 100–300 mg a day may help with blood sugar and insulin control.
Can CoQ10 improve fertility?
Yes. CoQ10 may improve sperm health in men and egg quality in women. Men usually take 200–300 mg, and women take 100–600 mg daily.
Sources
- Zaleski, A. L., Taylor, B. A., & Thompson, P. D. (2018). Coenzyme Q10 as treatment for statin-associated muscle symptoms—A good idea, but…. Advances in Nutrition, 9(4), 519S–523S. https://doi.org/10.1093/advances/nmy010.
- Phillips, P. S., Haas, R. H., Bannykh, S., Hathaway, S., Gray, N. L., Kimura, B. J., Vladutiu, G. D., & England, J. D. (2002). Statin-associated myopathy with normal creatine kinase levels. Annals of Internal Medicine, 137(7), 581–585. https://doi.org/10.7326/0003-4819-137-7-200210010-00009.
- Mikus, C. R., Boyle, L. J., Borengasser, S. J., Oberlin, D. J., Naples, S. P., Fletcher, J., Meers, G. M., Ruebel, M., Laughlin, M. H., Dellsperger, K. C., Fadel, P. J., & Thyfault, J. P. (2013). Simvastatin impairs exercise training adaptations. Journal of the American College of Cardiology, 62(8), 709–714. https://doi.org/10.1016/j.jacc.2013.02.074.
- Banach, M., Serban, C., Sahebkar, A., Ursoniu, S., Rysz, J., Muntner, P., Toth, P. P., Jones, S. R., Rizzo, M., Glasser, S. P., Lip, G. Y. H., Dragan, S., & Mikhailidis, D. P. (2015). Effects of coenzyme Q10 on statin-induced myopathy: A meta-analysis of randomized controlled trials. Mayo Clinic Proceedings, 90(1), 24–34. https://doi.org/10.1016/j.mayocp.2014.08.021.
- Päivä, H., Thelen, K. M., Van Coster, R., Smet, J., De Paepe, B., Mattila, K. M., Laakso, J., Lehtimäki, T., von Bergmann, K., Lütjohann, D., & Laaksonen, R. (2005). High-dose statins and skeletal muscle metabolism in humans: A randomized, controlled trial. Clinical Pharmacology & Therapeutics, 78(1), 60–68. https://doi.org/10.1016/j.clpt.2005.03.006.
- Lamperti, C., Naini, A. B., Lucchini, V., Prelle, A., Bresolin, N., Moggio, M., Sciacco, M., Kaufmann, P., & DiMauro, S. (2005). Muscle coenzyme Q10 level in statin-related myopathy. Archives of Neurology, 62(11), 1709–1712. https://doi.org/10.1001/archneur.62.11.1709.
- Oh, J., Ban, M. R., Miskie, B. A., Pollex, R. L., & Hegele, R. A. (2007). Genetic determinants of statin intolerance. Lipids in Health and Disease, 6, Article 7. https://doi.org/10.1186/1476-511X-6-7.
- Ruaño, G., Windemuth, A., Wu, A. H. B., Kane, J. P., Malloy, M. J., Pullinger, C. R., Kocherla, M., Bogaard, K., Gordon, B. R., Holford, T. R., Gupta, A., Seip, R. L., & Thompson, P. D. (2011). Mechanisms of statin-induced myalgia assessed by physiogenomic associations. Atherosclerosis, 218(2), 451–456. https://doi.org/10.1016/j.atherosclerosis.2011.07.007.
- Caso, G., Kelly, P., McNurlan, M. A., & Lawson, W. E. (2007). Effect of coenzyme Q10 on myopathic symptoms in patients treated with statins. The American Journal of Cardiology, 99(10), 1409–1412. https://doi.org/10.1016/j.amjcard.2006.12.063.
- Skarlovnik, A., Janić, M., Lunder, M., Turk, M., & Šabovič, M. (2014). Coenzyme Q10 supplementation decreases statin-related mild-to-moderate muscle symptoms: A randomized clinical study. Medical Science Monitor, 20, 2183–2188. https://doi.org/10.12659/MSM.890777.
- Fedacko, J., Pella, D., Fedackova, P., Hänninen, O., Tuomainen, P., Jarcuska, P., Lopuchovsky, T., Jedlickova, L., Merkovska, L., & Littarru, G. P. (2013). Coenzyme Q(10) and selenium in statin-associated myopathy treatment. Canadian Journal of Physiology and Pharmacology, 91(2), 165–170. https://doi.org/10.1139/cjpp-2012-0118.
- Young, J. M., Florkowski, C. M., Molyneux, S. L., McEwan, R. G., Frampton, C. M., George, P. M., & Scott, R. S. (2007). Effect of coenzyme Q10 supplementation on simvastatin-induced myalgia. The American Journal of Cardiology, 100(9), 1400–1403. https://doi.org/10.1016/j.amjcard.2007.06.030.
- Lee, B.-J., Tseng, Y.-F., Yen, C.-H., & Lin, P.-T. (2013). Effects of coenzyme Q10 supplementation (300 mg/day) on antioxidation and anti-inflammation in coronary artery disease patients during statins therapy: A randomized, placebo-controlled trial. Nutrition Journal, 12, Article 142. https://doi.org/10.1186/1475-2891-12-142.