Patients Taking Cholesterol Drugs May Need extra Coenzyme Q
by Richard Podell, M.D.

People who use Zocor®, Mevacor®, and Pravachol®-drugs that lower cholesterol and help prevent heart attacks-may want to consider supplementing their diets with coenzyme Q, because these drugs interfere with a key metabolic pathway, through which the body makes coenzyme Q. Additional, the drugs reduce existing coenzyme Q levels in muscle tissues. Coenzyme 0 is a vital component of the biochemical system our bodies use to produce energy, and low levels can lead to many complications.

The three drugs mentioned above reduce blood coenzyme 0 levels by 30 to 50%. The drug companies argue that we should not be alarmed at this because most people have more than enough coenzyme Q

I disagree. Whereas most of us may have coenzyme Q to spare, some people have less margin for error, Scientists are well aware that certain rare individuals have a genetically abnormal coenzyme metabolism, resulting in muscle pain and weakness. My concern is that, as with most genetic disorders, there may be a much larger additional group of people who have subtler, unrecognized defects. Normally, they may be fine, but the s on their system could lead to symptoms of coenzyme Q deficiency.

In fact, such symptoms do affect about one person in two hundred who take Zocor®, Mevacor®, and Pravachol® they develop muscle aches, weakness and fatigue, with a breakdown of muscle tissue. If not diagnosed in time, this muscle damage can lead to kidney failure and even death. Admittedly, we are not certain that low coenzyme Q is the cause of these symptoms, but many experts suspect that it is. I'd prefer to be safe, rather than son-y, and I recommend that all my patients who take Zocor®, Mevacor®, Pravachol® also take 60 to 120 milligrams daily of coenzyme Q.

If you are taking these cholesterol-lowering drugs and develop fatigue or muscle aches, notify your doctor promptly. Be sure the doctor checks the muscle enzyme CPK on a regular basis. This diagnostic procedure can detect early muscle damage, often before you develop symptoms.

Coenzyme Q has other potential uses. Most scientific research supports its use in treating people with congestive heart failure. The majority of double-blind studies of congestive heart failure patients show they improve with extra coenzyme Q. People who take coenzyme Q before heart surgery may have a better course after surgery, in part due to coenzyme antioxidant effects. Those with angina chest pain may also benefit, although that is not proved conclusively. Coenzyme 0 may also protect the heart against damage from certain cancer chemotherapy drugs such as Adriamycin®.

Coenzyme Q is widely found in whole foods, though not usually in concentrated amounts. Best sources include organ meat (liver, kidney, heart), muscle meats, fish, peanuts, spinach, soy, and nuts.

If you take a supplement of coenzyme Q, 60 to 120 milligrams is a reasonable dose. At these levels there have been no reports of harmful side effects. However, since there have been no studies of its use by pregnant or nursing women, these women should not take coenzyme Q. Oral supplements of coenzyme Q are best absorbed with fatty foods, so it may be best to take it with the largest meal of the day.

Important:    Discuss all nutritional supplements and concerns with your physician-even if your doctor does not "believe" in nutrition. Your doctor needs to know all important information relevant to your health. And knowing that you are interested motivates your doctor to gather knowledge about medical nutrition.

Podell, M.D., M.P.H., is a specialist in internal medicine, allergy, nutrition.

Reprinted from Nutrition Science News, a publication of New Hope Communications, March 1996