Do Statins Lower Your CoQ10 Levels? What the Research Shows
Cholesterol and CoQ10 share the pathway statins slow. Here is what that means, and what it does not.
Medically reviewed by Dr. Cheryl Burdette, ND · September 30, 2026
Yes. Statins measurably lower CoQ10 in the blood, and the reason is structural rather than incidental: statins block an enzyme the body also uses to make CoQ10. Whether that drop causes the muscle aches some people get on statins is still unsettled, and whether to add CoQ10 is a decision for the prescribing clinician.
Why do statins affect CoQ10 at all?
Cholesterol and CoQ10 share a manufacturing route. Cholesterol is produced through what is called the mevalonate pathway, and statins work by inhibiting HMG-CoA reductase, the enzyme that sets the speed of that pathway. CoQ10 is built on a branch of the same pathway, downstream of the same enzyme. Slowing cholesterol production therefore slows CoQ10 production as well.
This is a predictable consequence of how the drug works, not an unexpected side reaction. Anyone taking a statin is taking a drug that reduces output from the same pathway that produces CoQ10.
How reliably do statins lower CoQ10?
Blood CoQ10 falls consistently during statin therapy. Human studies dating back to the early 1990s have measured this repeatedly, and a 2007 review in Mitochondrion summarizing that literature reported statin-induced depletion in both blood and tissue, with the clearest effects in people who already had low CoQ10 — older adults and people with pre-existing heart failure.
One distinction matters and is usually skipped. Blood levels and tissue levels are not the same measurement. Muscle biopsy studies are smaller and less consistent than blood studies, and muscle is where the symptoms people worry about are reported. Those studies do exist: in one small randomized trial, CoQ10 measured directly in muscle fell with one high-dose statin regimen but not with another. A confirmed drop in circulating CoQ10 is not by itself proof of a drop inside the muscle cell.
CoQ10 production also declines with age on its own, independent of any medication. In an older population, the two causes overlap, which makes the individual contribution of a statin difficult to isolate.
Does low CoQ10 cause the muscle aches some people get on statins?
This is a plausible hypothesis that has not been confirmed. Muscle pain and cramping are among the most commonly reported statin side effects, and because statins lower CoQ10, researchers have theorized that the depletion explains the symptoms. The reasoning is that mitochondria, the part of the cell that produces energy in the form of ATP, rely on CoQ10, so a shortage could leave muscle cells short of energy.
Trials testing CoQ10 as a treatment for statin-associated muscle symptoms have produced mixed results. Of four pooled analyses of those trials, one found a benefit and three did not. A 2022 study of 511 statin users with a history of muscle symptoms found that taking CoQ10 was not associated with those symptoms resolving.
The authors of that 2022 study offered four possible reasons CoQ10 has not shown a consistent benefit. Any benefit may be real but too small to detect reliably. Statin-associated muscle symptoms are hard to tell apart from ordinary, non-specific aches. The doses tested may have been too low. Or the benefit may exist only in people who already have an established CoQ10 deficiency. They also note the simplest explanation, which is that CoQ10 may not be effective for this purpose.
None of these questions have been settled. Anyone reading a confident claim in either direction — that CoQ10 fixes statin muscle pain, or that the whole idea is baseless — is reading further than the evidence currently goes.
Should I take CoQ10 if I’m on a statin?
That decision belongs with the clinician who prescribed the statin, together with the patient’s own goals for overall health and wellness. A few facts are worth bringing to that conversation.
CoQ10 is a nutrient the body produces on its own. It is available without a prescription and is generally well tolerated. It is fat-soluble, which means it is absorbed better when taken with a meal containing some fat, which is why CoQ10 labels routinely say to take it with food.
Two cautions matter more than any of that. CoQ10 is not a substitute for statin therapy, and no one should stop, reduce, or change a prescribed statin because they have started a supplement. Supplements can interact with prescription medications in ways a label does not capture, so anything added alongside a prescription should be raised with a doctor or pharmacist first.
What doesn’t the research show about statins and CoQ10?
Three things are worth stating plainly, because the distance between them and what routinely gets claimed is where trust in this category is lost.
The research does not show that taking CoQ10 prevents heart disease. It shows that statins lower CoQ10 levels.* Those are different findings. One effect of a statin is to lower CoQ10, which the body makes and uses to meet its energy needs.
It does not show that CoQ10 can replace a statin. Statins have decades of cardiovascular outcome data behind them. CoQ10 does not, and positioning one as an alternative to the other is not supported by the evidence. CoQ10 has not been shown to lower lipids. It does not work the same way, or toward the same goal.
And it does not show that everyone taking a statin needs supplemental CoQ10. Whether an individual would benefit depends on their baseline level, their age, their symptoms, and clinical judgment.
Common questions
Do all statins lower CoQ10 to the same degree?
Not in any way that can guide a choice between them. Some individual studies have reported larger drops at higher doses, but a 2018 analysis pooling randomized trials found the reduction in blood CoQ10 did not depend reliably on the type of statin, its intensity, or how long it was taken.
Does taking CoQ10 interfere with how well a statin works?
CoQ10 supplementation is not understood to reduce a statin’s cholesterol-lowering effect. CoQ10 sits on a branch of the mevalonate pathway downstream of the point the statin inhibits, so supplementing it does not restore cholesterol production. Even so, any supplement taken alongside a prescription should be disclosed to the prescriber.
Is CoQ10 the same thing as ubiquinol?
Ubiquinol is one of the two forms of CoQ10. Ubiquinone is the oxidized form and ubiquinol is the reduced form, and the body converts between them. Supplements are sold in both forms.
Does everyone’s CoQ10 decline with age?
CoQ10 production declines with age as a general pattern, independent of medication. That is one reason the statin question comes up most often in people over 50, where two separate causes of lower CoQ10 overlap.
How would I know if my CoQ10 is low?
CoQ10 can be measured in blood, but the test is not part of routine bloodwork and is not commonly ordered. There is no reliable way to infer a level from symptoms alone. If it matters for a treatment decision, it is a question for your doctor rather than something to estimate.
*CoQ10 is not a replacement for statin therapy.
Sources
- Littarru GP, Langsjoen P. Coenzyme Q10 and statins: biochemical and clinical implications. Mitochondrion. 2007. doi:10.1016/j.mito.2007.03.002.
- Coenzyme Q10. StatPearls. NCBI Bookshelf ID: NBK531491.
- Chen W, Ochs-Balcom HM, Ma C, Isackson PJ, Vladutiu GD, Luzum JA. Coenzyme Q10 supplementation for the treatment of statin-associated muscle symptoms. Future Cardiol. 2022;18(6):461–470. doi:10.2217/fca-2021-0106. PMID 35297269. PMC9171566.
- Päivä H, Thelen KM, Van Coster R, et al. High-dose statins and skeletal muscle metabolism in humans: a randomized, controlled trial. Clin Pharmacol Ther. 2005;78(1):60–68. doi:10.1016/j.clpt.2005.03.006. PMID 16003294.
- Qu H, et al. The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials. Eur J Med Res. 2018;23(1):57. PMID 30414615.
