I refer to your article about co-enzyme Q10 in "Upfront", Best Practice
September issue. This article was very well presented and I'm quite sure that we'll have to "watch this space" on
CoQ10 as research emerges and pharmaceutical companies grapple on how to curb the profits made by supplement manufacturing
The importance of CoQ10 as an anti-oxidant in cell membrane protection and mitochondrial protection is well established.
It is also known to be an "energy stimulant" and "has a potential role as a neuroprotectant" (quotes from your article).
It is also well established that oxidative stress or free radical damage plays a major part in degenerative disease.
The statin drugs inhibit HMG-CoA reductase (the rate limiting enzyme for the synthesis of mevalonic acid), this results
in decrease in mevalonic acid, which consequently leads to a decrease in cholesterol and CoQ10.
I would therefore agree with your author that statins lower CoQ10 and I will accept that it is not the low Q10 levels
that are the cause for myopathy or myalgic pains. However, it still lowers CoQ10 (an important anti-oxidant). It will
therefore make "perfect sense" to advise our patients to take it as a supplement because we are giving them a drug that
lowers their bodies' production of this important nutrient. Do we really have to wait for "evidence" when we advise "common
sense" in GP practice all the time?
While I could agree with the author that a healthy diet should provide enough Q10 for the healthy person, I do not
agree that the diet will be providing enough of this nutrient if we are giving a drug that lowers CoQ10. You could just
the same argue that pregnant women should get enough folate from green-leaf veggies or red meat is enough to treat iron-deficiency
anaemia or rest home patients should spend their afternoons bathing in the sun for their vitamin D needs.
I believe that knowing of this potentially harmful effect of statin drugs, it may in future be unethical or even negligent
not to advise patients of using co-enzyme Q10.
Dr Werner Pohl
Gore Medical Centre
As always, we welcome alternative points of view on our material.
However scientific evidence can often be interpreted in opposing ways. It may be that a role for CoQ10 is found
in the future but currently there is a lack of evidence for the claims being made. The ethical responsibility of a
clinician, is to provide unbiased evidence in order for the patient to make a fully informed decision about their health.