Statins, Coenzyme Q10, Carnitine and Medscape based woo science.

[HysteryDiagnosis]

This article lays out the genetic flaws that can cause skeletal muscle function disorders and statin induced myopathies in persons taking statin drugs to reduce cholesterol.



http://www.medscape.com/viewarticle/537984

>>"We hypothesized that the prevalence of combined or single inherited metabolic gene defects would be higher among patients who suffer from statin myopathies than would be expected in the general population. Furthermore, since manifesting carriers for metabolic myopathies exist, we expected that symptoms in carriers may also be triggered by statins," Wortmann said. "People with these defects are usually asymptomatic until forced to depend on the metabolic pathway with the defect in it."<<

Coenzyme Q10, carnitine may be involved

Nearly half of the samples analyzed had coenzyme Q10 (ubiquinone) levels 2 to 4 standard deviations below normal. Statins inhibit the enzyme HMG-CoA reductase before the final formation of cholesterol in the mevalonate pathway, and this same pathway is used to synthesize coenzyme Q10. The result can be a deficit in the amount of coenzyme Q10 needed for optimal heart and skeletal muscle function.

The link between statin use and reduction in coenzyme Q10 levels has also been well studied by drug developers, and in fact 2 patents were issued to Merck in 1990 for combination statin/coenzyme Q10 formulations. One was meant "to counteract HMG-CoA-reductase-inhibitor-associated skeletal muscle myopathy < 2 >. The other was for "counteracting HMG-CoA-reductase-inhibitor-associated elevated transaminase levels" through "the adjunct administration of an effective amount of a HMG-CoA-reductase inhibitor and an effective amount of coenzyme Q10"< 3 >.

"In addition to coenzyme Q10 supplementation, which has been recommended for treatment of statin myopathy and which some patients do respond to, these data provide a rationale for consideration of the use of carnitine in these patients," Wortmann said. "For patients who do not respond to coenzyme Q10, I would suggest the use of carnitine."

[dixiegrrrrl]

1. Oddly enough, I sit here with my COQ10 and L-Carnitine in hand,

had paused to read the above.
I gave similar information to my "prescriber"...she was non-committal.
but then, I would never take statins, either.

thank for posting this.

[HysteryDiagnosis]

2. Waiting for the homeopathy slayers to come up with a reason why this is

BS. Tic toc, tic toc, tic toc.... crickets.

If these facts were presented at the Life Extension Foundation, Alternative Medicine, or any one of a hundred others, they would be throwing tomatoes and hooting woo science, no facts, this is a commercial site, blah blah blah...

[demosincebirth]

5. My wife was diagnosed with cardiomyopathy in '97. She wasn't in the best of

shape. Now forward to 2011. We have traveled to Europe, Mexico, Alaska and drove cross country three times since then...thanks to her sister who is a RN in Houston, in the cardiac ward. She knew of some patients of hers that had improved rather well considering the conditions they were in before by taking doses of, yes, Q-10. She is now on 400mg a day and has not regressed at all since starting Q-10, eleven years ago.

[dixiegrrrrl]

13. Yep. And in Europe, it is a common med for heart problems.

I have ordered extra amounts, given that Japan is the sole source of Ubiquinone, ( COQ10)
It is also used for diabetes, stabilizes blood sugar.

[emilyg]

14. I've been taking it for years.

[medeak]

3. Husband has Parkinsons we think caused by statin

Any wonder why lipitor suddenly put Q10 in formula few years ago? Many studies (abroad) show horrible consequences of statins. One in Germany show correlation of Parkinson's (husband became symptomatic of Parkinson's within months of taking lipitor). Dept head at Ohio State has been writing papers and petitioning FDA for 6 years. She and 5 others in US and Canada (the statinistas they are called) are fighting big pharma who are handing it out like candy and now want CHILDREN to take it. Don't get me started...have files and files from last 7 years. m

[HysteryDiagnosis]

8. Now listen carefully, go to this page, go to the bottom and listen. Then purchase

this book and read it.

http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=the+healing+power+of+8+sugars&x=0&y=0



Listen here:

http://www.glycostory.com/testimonials-search.asp?pageNo=2&nocache=5.329096E-02

[medeak]

16. appreciate

but links didn't make sense?

[HysteryDiagnosis]

17. Did you at least get the link to the book?? There may be trouble with the audio

at the second link.

[cleanhippie]

4. Can you clarify?

I am unsure as to what point you are trying to make.


I found this article on Medscape (the link you provided requires a login) that states this...

Young and colleagues<4> conducted a randomized controlled trial of 44 patients with previous statin myopathy. Patients were randomly assigned to CoQ10, 200 mg (Q-Gel®; Tishcon Corporation; Salisbury, Maryland) daily, or placebo for 12 weeks, combined with simvastatin, titrated every 4 weeks from 10 mg to a maximum of 40 mg daily. Although CoQ10 serum levels increased in the treatment group and decreased in the placebo group, myalgia scores, number of patients continuing to receive simvastatin, and number of patients titrated to simvastatin, 40 mg daily, were the same in both groups.<4>

Mabuchi and colleagues<5> studied 49 patients with hypercholesterolemia (but no history of myopathy) who were randomly assigned to CoQ10, 100 mg (Kaneka; Osaka, Japan) daily, or placebo in combination with atorvastatin, 10 mg daily for 16 weeks. CoQ10 serum levels increased in the treatment group and decreased in the placebo group, but indicators of muscle injury, including serum aspartate aminotransferase, alanine aminotransferase, and creatine kinase, did not differ between groups.

In summary, more research is needed to determine whether CoQ10 is useful for treatment of statin myopathy. Coenzyme Q10 might be worth a try (with careful monitoring) in patients with mild statin-induced myopathy. No research is available to support the use of CoQ10 for prevention of statin myopathy.

http://www.medscape.com/viewarticle/709107

[demosincebirth]

6. There will never be research into Q-10, unless its totally funded by the

government. The reason is that no pharmacy company can patent it. Its a natural enzyme. We all have it.

[HysteryDiagnosis]

7. At the end of the OP it states:

"In addition to coenzyme Q10 supplementation, which has been recommended for treatment of statin myopathy and which some patients do respond to, these data provide a rationale for consideration of the use of carnitine in these patients," Wortmann said. "For patients who do not respond to coenzyme Q10, I would suggest the use of carnitine."

What I am trying to indicate is that meds alone often do not fit the bill. Where CoQ10 doesn't work carnitine may. This is what carnitine did for this group of subjects. A significant reduction in glycemia is nothing to sneeze at, not to mention the other markers, however there are those who preach on the internets that nutritional supplements are a waste of time and money. They are not, and people need to know that.

Effects of simvastatin and carnitine versus simvastatin on lipoprotein(a) and apoprotein(a) in type 2 diabetes mellitus.

Galvano F, Li Volti G, Malaguarnera M, Avitabile T, Antic T, Vacante M, Malaguarnera M.

University of Catania, Department of Biological Chemistry, Medical Chemistry and Molecular Biology, Viale A. Doria 6, 95125 Catania, Italy.
Abstract

AIM: The aim of the present study was to compare the effects of simvastatin and L-carnitine coadministration versus simvastatin monotherapy on lipid profile, lipoprotein(a) (Lp(a)) and apoprotein(a) (Apo(a)) levels in type II diabetic patients.

PATIENTS/METHODS: In this double-blind, randomized clinical trial, 75 patients were assigned to one of two treatment groups for 4 months. Group A received simvastatin monotherapy; group B received L-carnitine and simvastatin. The following variables were assessed at baseline, after washout and at 1, 2, 3 and 4 months of treatment: body mass index, fasting plasma glucose, glycated hemoglobin, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, Apolipoprotein A1, Apo B, lipoprotein(a) and apoprotein(a).

RESULTS: At the end of treatment in the carnitine and simvastatin combined group compared with the simvastatin alone group, we observed a significant decrease in glycemia (p < 0.001), triglycerides (p < 0.001), Apo B (p < 0.05), Lp(a) (p < 0.05), apo(a) (p < 0.05), while HDL significantly increased (p < 0.05).

CONCLUSIONS: The coadministration of carnitine and simvastatin resulted in a significant reduction in Lp(a) and apo(a) and may represent a new therapeutic option in reducing plasma Lp(a) levels, LDL cholesterol and Apo B100.

[Peace Patriot]

9. Doesn't Canada's health system require inclusion of CoQ-10 in Lipitor, simvastatin and other such

drugs?

What is the relationship of CoQ-10 to carnitine? (Same function? Different function? Should carnitine be added to CoQ-10 for statin drug patients?). I don't quite understand what carnitine does.

[HysteryDiagnosis]

10. From what I have Googled, (I kid) carnitine or L-carnitine is some

wicked bad stuff. 13 should be told about this, perhaps Dr. House isn't reading his own medical journals.

http://www.ncbi.nlm.nih.gov/pubmed/19932584
Neuroprotective effects of L-carnitine in a transgenic animal model of Huntington's disease.

Vamos E, Voros K, Vecsei L, Klivenyi P.

Department of Neurology, Albert Szent-Gyorgyi Clinical Centre, University of Szeged, Semmelweis str u. 6., 6725 Szeged, Hungary.
Abstract

Huntington's disease (HD) is an autosomal dominant inherited disorder, caused by an expanded polyglutamine region of a protein called huntingtin. The excitotoxicity, oxidative damage, mitochondrial dysfunction and altered membrane transport may have important roles in the pathogenesis of HD. L-carnitine plays a role in facilitating the mitochondrial transport of fatty acids, but it also protects the cells from oxidative damage. The aim of our study was to examine the effects of the intraperitoneally administered L-carnitine on the survival, behaviour and immunohistochemical changes in the N171-82Q transgenic mouse model of HD.

Following L-carnitine administration the survival was improved by 14.9%. The motor activity was significantly ameliorated as compared with the control transgenic group. The L-carnitine treatment significantly reduced the neuronal loss and the number of neuronal intranuclear aggregates. These results suggest that L-carnitine may exert a neuroprotective effect by decreasing the oxidative damage.
(c) 2009 Elsevier Masson SAS. All rights reserved.

[Peace Patriot]

15. I just Googled L-carnitine and CoQ10 together, to try to get an explanation of the difference

and I see that all kinds of vitamin sites sell them as ONE supplement. They seem very popular as a combo.

Here's a long description of L-carnitine and CoQ10, which explains what they do in the body, and rare disorders that they are prescribed for, but--amazingly--contains not one word about the statin drugs. Absolutely useless discussion as to statins--the side effects from which are driving the big sales of these supplements.

http://www.mdausa.org/publications/quest/q61coq10.html

Ah, MDA is a muscular dystrophy non-profit.

http://www.mdausa.org/about.html

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There seems to be a consensus that L-carnitine and CoQ10 don't have side effects.

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Here's a pretty good article on simvastatin (Zocor) and CoQ10, but there is disinformation in it of low incidence of muscle pain, muscle atrophy and other side effects of statin drugs. These symptoms are MUCH MORE common than this article, Big Pharma and most doctors say. See the Peoples Pharmacy blog (url below) for the real story.

--

Coenzyme Q10: Flexing different muscles against statins
by Anthony L. Almada, BSc, MSc

Coenzyme Q10 (CoQ10) is a veteran player on the dietary supplement market, having enjoyed two decades of activity as a heart health supplement. CoQ10 fits into the small niche of dietary supplements that are characterized by being (1) manufactured by the body, (2) available from foods, and (3) can be reduced by drugs or disease. CoQ10 has an integral role in cell energy production and also serves as a fat-soluble antioxidant.

Your CoQ10 supply can be threatened by a group of drugs called statins, which have risen to global prominence. Statins are embraced as the drug of choice for producing favorable changes in blood cholesterol profiles and reducing the risk of heart disease. However, the way in which they exert their lipid-lowering effects happens to intersect with the same biochemical pathway that regulates the body's CoQ10 synthesis capacity. Thus, statins have the potential of reducing CoQ10 concentrations in the body.

One study published in the Journal of the American Medical Association found that use of the statin drug simvastatin (Zocor) produced notable drops in blood CoQ10 concentrations. In one of the only studies that has peered into muscle "under the influence" of statins, European researchers found that 8 weeks of either simvastatin or atorvastatin (Lipitor; another statin drug) induced similar reductions of blood CoQ10 in men with elevated blood lipids. Only high dose simvastatin produced a sharp drop in skeletal muscle CoQ10 content.

Two of the more common adverse side effects associated with statin therapy are elevation of liver enzymes ( chemical hepatitis) and myopathy, a condition characterized by skeletal muscle weakness, pain, and reductions in the integrity of muscle cells. Indeed, reports of liver failure and over 100 deaths associated with the use of cerivastatin (Baycol) ultimately led to its removal from the market in 2002. Because of skeletal muscle's high energy demands, energy production and muscle cell integrity are vital aspects of well functioning tissue. Because CoQ10 content can vary between muscle types, and blood concentrations may show seasonal and racial differences, a certain minority of individuals may be at higher risk of statin-associated adverse effects that are suggestive of CoQ10 depletion in tissues. Indeed, 1-5% of those using statins manifest muscle weakness and pain.

It's prudent to inform your medical professional about your use of CoQ10 supplements if you are on statin therapy.

http://www.nutritionexpress.com/article+index/health+conditions/heart+health/showarticle.aspx?articleid=262

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SOME VERY INTERESTING COMMENTS FROM THE PEOPLES PHARMACY BLOG:

joanne replied to comment from JGW | August 2, 2010 8:35 PM | Reply

I was put on statins twenty years ago because I had high cholesterol. X-ray showed normal lungs, normal heart. I took the statin for about a year and then dropped it. Four years later, a chest X-ray showed pulmonary fibrosis (interstitial lung disease), and in general a pretty bad picture. Now, twenty years later, in Nov of 2009 the European Pharmacovigilance Study Committee of the European Medicines Agency came out with the warning to doctors to stop statins immediately should interstitial lung disease appear.

I also have heart problems now. Too bad I didn't catch on a long time ago, because doctors keep on trying to force statins on me. Finally, my cardiologist at Mayo Clinic says no more statins for me because I confronted him with the evidence and with studies from the internet and with the patents Merck applied for back in 1980 regarding helping to prevent heart damage caused by statins by adding CoQ10 plus some other chemicals to their statin - which they never made, of course, because it would cast a bad shadow on their great money maker, statins!

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Condoline | February 21, 2011 12:14 AM | Reply

I too have been studying the statin research for over a year, including research done by biochemists and biologists. The conclusions I came to are several:

(a) any doctor who prescribes statins is playing Russian roulette with his patient's health. Adverse side effects may arrive tomorrow, or months hence, or several years after starting on the statin, but they will arrive, and they could be severe.

There is no way for a doctor to know, at present, what will happen with any individual patient, especially since some ultimately fatal side effects such as pulmonary fibrosis may not be noticed for many years unless X-rays are taken before and after the first months on a statin because there isn't much the patient will notice by way of breathing difficulty for possibly ten or fifteen years.

(b) cholesterol is not the problem. It never was the problem. Cholesterol is essential for health and well-being and there is no such thing as "bad" cholesterol. What the problem is, isn't quite for sure known, but it could be inflammation (among other possibilities. Research is ongoing).

(c) there hasn't been enough research to determine whether or not taking the essential co-enzyme Q10 while taking statins will be helpful in preventing bad side effects; it may be that the depletion of Q10 - which happens when cholesterol levels are brought down - is only part of the story. We do know that doctors in Japan and elsewhere around the world use Q10 to treat cardiac arrhythmias, congestive heart failure, ischemic injury, angina, high blood pressure and heart muscle weakness. We also know it helps with breathing difficulties due to statin damage to the lungs because it is part of the respiratory chain (helps cells utilize oxygen), and over a few months it even gets rid of the tough flaky skin around your heels, in case you're interested! Dosage needs to be over 200 mg per day to be effective, and dosages up to 1200 mg have been determined to be totally safe.

(d) don't stop statins suddenly!! Phase them out slowly over 3 or 4 weeks. Otherwise, you will experience statin rebound, which with some unfortunate people can be a living nightmare until the body settles down. In fact, statin rebound can even cause a heart attack. I read a biochemist's account of what happens when statins are suddenly withdrawn, and it scared the living daylights out of me.

http://www.peoplespharmacy.com/2007/09/12/can-statins-cau/

[aquart]

11. Coenzyme Q10 is a miracle substance.

I don't understand how it clears up abscesses and gum infections in three days. It's ridiculous. I was in total terror, not to mention pain, and it fixed it.

And then there is Lysine for a cold sore outbreak. Poof! Gone.

[HysteryDiagnosis]

12. I break the gelcap in my mouth sometimes, recently to help out with an injury

that was pretty bad. Some good shit yeah.... glad it worked for you. It is a ubiquitous nutrient/enzyme, it is contained in every cell, however our hearts and livers contain 10x as much since they do so much more work. I have read about athletes using it now for muscle recovery, makes sense.

[grasswire]

18. that I did not know

Wow. I swear by CoQ10 anyhoo.

[grasswire]

19. I will never, ever, ever take a statin

And I will continue to fire doctors who try to talk me into it.

[Abq_Sarah]

20. I fired my first doctor over 10 years ago

Over recommendations for statins and a low fat diet.

Instead I went on a low carb diet, lost the excess 60 lbs in 8 months and my triglycerides dropped like a rock. All the general "feeling like crap all the time" symptoms went away after the first month. Doctors aren't infallible and "the general scientific consensus" isn't always right.