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Sunday September 29, 2013 MYT 12:00:00 AM
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Research has found that one of the main reasons such a diverse range of side effects occur with statins is because the blockage of cholesterol production simultaneously blocks CoQ10 production in the liver. – Los Angeles Times
Anyone short of cash will tell you how awful it feels. But what if you run low on the currency of life, i.e. energy, how would you feel?
DONALD Lee is a slightly-rounded 48-year-old with few vices except for his bad cholesterol level, a price he pays for his extended love affair with good food.
Recently prescribed cholesterol-lowering statin drugs, his LDL plunged, but now he often wakes up tired and irritable, generally feels lousy, and life just seems very depressing. His friends attribute this to ageing, whilst his wife thinks it is stress.
Worse, the missus has also been nagging him about his bad memory. Lee is very puzzled about this as he simply cannot recall what she is talking about.
Know your statins
Lee joins the ranks of about 25 million statin users worldwide, many who are likely sharing his experience.
Forty years ago, no one really worried about their cholesterol levels.
In the 1980s, when tests for cholesterol became common, it was still largely ignored. Although the large Coronary Primary Prevention Trial in 1984 demonstrated that cholesterol-lowering could significantly reduce the risk of heart attacks and angina, doctors, including cardiologists, remained largely unconvinced.
However, massive advertising campaigns succeeded in convincing the public and doctors about the dangers of high cholesterol, and that statins were safe and would extend lives. Soon everyone became familiar with public health enemy No. 1 – bad cholesterol.
Today, patients brag about their cholesterol levels whilst physicians joke about adding statins to drinking water. However, a topic spoken far less about by patients who take statins every day – most for life – are its side effects.
Statins are a class of enzyme-inhibiting drugs (HMG-CoA reductase inhibitor) which works by blocking the production of cholesterol in the liver.
In doing so however, the production of certain important compounds that control vital functions in the heart, brain and muscle cells are also blocked, leading to various side effects. These include muscle pain and damage, commonly described as a soreness; tiredness or weakness in the muscles; cognitive side effects such as forgetfulness, confusion and depression; increased blood sugar or type 2 diabetes; and lethargy.
Although statin drugs have been in the market for over 20 years, the FDA only issued these new neurological and diabetic warnings on statin labels in Feb 2012.
Dr Ike Iheanacho, editor of the Drug and Therapeutics Bulletin, which conducts independent reviews of evidence on drugs, said most patients and doctors were unaware of the newly identified problems.
The CoQ10-statin connection
Co-enzyme Q10 (CoQ10) is an energy nutrient and antioxidant that is required to produce 95% of the energy we need to live. CoQ10 is so critical that our body naturally produces it as soon as we are born.
However, production decreases around the age of 25, after which levels steadily decline. By the time we approach our 40s, our cells have only about 40% of CoQ10 left.
Research has found that one of the main reasons why such a diverse range of side effects occur with statins is because the blockage of cholesterol production simultaneously blocks CoQ10 production in the liver.
Other drugs that reduce CoQ10 levels in the body include blood pressure pills, hormone replacement therapy (HRT) and oral contraceptives. Ageing compounded with drug intake is therefore leading to the creation of millions of critically CoQ10 deficient patients.
Drug-nutrient interactions are not a new phenomenon. For instance, all physicians are familiar with the necessity to add vitamin B6 to patients undergoing tuberculosis treatment with the drug isoniazid. Patients treated with the immunosuppressant drug methotrexate are also routinely given folic acid to help decrease the side effects of the drug.
Although the statin-CoQ10 drug-nutrient interaction is not widely publicised, it is certainly well-known in medical and pharmaceutical circles. As far back as the 1990s, a global manufacturer of two statin drugs (lovastatin and simvastatin) obtained two patents to combine CoQ10 with the statin drug in the same tablet to prevent liver and muscle damage.
Although these patents have not been acted upon, the basic science behind them is sound. Importantly, taking a CoQ10 supplement does not affect the cholesterol-lowering effect of statins.
Therapeutic CoQ10 efficacy is key
With so many CoQ10 formulations out there, it is not unusual for consumers and even prescribers to be confused. After 25 years of research, one key guiding principle to selecting an ideal CoQ10 formula is to be sure that it can produce CoQ10 blood levels of 3.5mcg/L.
This is the critical concentration that leads to benefits to the heart, brain and muscles.
In a hospital setting, doctors have to measure CoQ10 levels in the blood to be able to achieve clinical outcomes for their patients.
They don’t debate on whether to use 30mg or 100mg of CoQ10 when they have a patient whose heart is failing at the same rate as their CoQ10 levels.
Doctors simply have to use a CoQ10 formulation that can reach that proverbial 3.5mcg/L in the blood, so they can be sure that their patient’s heart function will improve.
Hydro-soluble CoQ10 is clinically proven to be therapeutic.
At a dose of two capsules twice daily, hydro-soluble CoQ10 has been shown to reach the therapeutic blood level of 3.5mcg/L in as soon as three to four weeks.
A study published in The New Zealand Medical Journal demonstrated how many CoQ10 formulations presented as oil-suspended or powder in capsules and tablets could only reach levels of 1.75mcg/L at best.
CoQ10 is a molecule that does not subscribe to the maxim that bigger is better.
It exhibits non-linear pharmacokinetics, which simply means that putting in too large a dose at any one time actually hampers its absorption, leading to greater wastage.
Now back to Lee who fitted the profile of an ageing, statin-challenged, CoQ10 deficient patient.
After being on hydro-soluble CoQ10, his wife happily reports living with a new, energised man looking and acting much younger than his 48 years.
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