Start Here TDG Five-Test Programme Resilient Gut System Stress Programme Initial Consultation — £145 Movement & Training AIdan Concierge Products Blog Learn Clinical Diagrams Resources Beyond the Mainstream Book a Call
Supplement of the Month Edition 02 · June 2026

CoQ10 and Statins —
What the Trials Show

Statins lower the body's own CoQ10. Whether taking CoQ10 helps the muscle symptoms some people get on statins is less clear than this page used to say. Here is what the trials show, how they used it, and when it's worth a try.

Stephen Duncan
BSc (Hons) · PG Dip · MSc · FDN-P · Working With People Since 1988
June 2026 · corrected October 2026
8 min read
Corrected October 2026
What changed and why
This edition was titled "The Supplement Every Statin Patient Should Be Taking" and rated the evidence "High". That isn't supported. Three meta-analyses of CoQ10 for statin muscle symptoms disagree. The largest analysis of statin trials found most muscle symptoms in people taking statins weren't caused by the statin. The page also gave the wrong dose for the Caso trial (it was 100 mg a day, not 600 mg). It reported a blood-pressure figure without the Cochrane review that found no clear effect, and it included a client example. All of that is corrected below. Doses now appear only in the "How much" block. What changed and why →

Every month in this series I pick one supplement and set out what it does, the human evidence, the forms, who it might suit, and the cautions. No affiliate links. Just the honest picture, including where the evidence is weak.

This month: CoQ10, and the question most people ask about it. If you take a statin, should you take CoQ10 too?

Why statins and CoQ10 are linked

Statins lower cholesterol by blocking an enzyme early in the mevalonate pathway. The same pathway also makes CoQ10, so blocking it lowers the body's own CoQ10 production as well. That much is established biochemistry, and studies consistently find lower blood CoQ10 in people taking statins.

What isn't established is the next step. Lower CoQ10 in the blood hasn't been shown to cause the muscle symptoms some people get on statins, or to harm the heart. That's a plausible idea. Grade: mechanistic. The way to find out is to give CoQ10 to people with statin muscle symptoms and see whether they improve. That has been done, and the results are below.

CoQ10: how strong is the evidence?
Statin muscle symptoms
Mixed
Heart failure (with your cardiologist)
One positive trial
Blood pressure
No clear effect (Cochrane)
Migraine prevention
One small positive trial

Statin muscle symptoms: what the trials show

First, how often the statin is the cause. The Cholesterol Treatment Trialists pooled 19 double-blind trials of statin versus placebo in nearly 124,000 people. Muscle pain or weakness was reported by 27.1% of people on a statin and 26.6% on placebo. There was a small excess in the first year, more with high-intensity statins. Overall, more than 90% of muscle complaints in people taking statins weren't caused by the statin (CTT 2022). That doesn't mean symptoms aren't real. It means the statin is often not the reason, and stopping it isn't the only option to consider.

Then, whether CoQ10 helps. Three meta-analyses of randomised trials disagree:

All the trials were small and short (30 to 90 days), at doses from 100 to 600 mg a day. One often-quoted trial, Caso 2007, gave 100 mg a day for 30 days to 18 people (against vitamin E in 14), and pain severity fell by 40%. Grade: mixed.

What I now suggest
If muscle symptoms persist on a statin
Talk to your prescriber first. They may check things like thyroid function, vitamin D, creatine kinase and other medicines, or try a different statin or dose. If you both want to try CoQ10, it's worth a time-limited trial with a symptom diary, scoring the pain daily before and during. Stop if nothing has changed by the end of the trial period. Don't stop a statin on your own. I no longer say every statin patient should take it.

Other uses

Heart failure. In Q-SYMBIO, 420 people with moderate to severe heart failure took CoQ10 (100 mg three times a day) or placebo, on top of their usual treatment, for 2 years. Major cardiovascular events were lower with CoQ10 (15% vs 26%), as were cardiovascular and all-cause deaths. The trial's short-term primary endpoints at 16 weeks showed no difference. It is one trial and hasn't been repeated at that size (Mortensen 2014). Grade: one positive trial. If you have heart failure, this is a conversation for your cardiologist, not a self-care decision.

Blood pressure. This page previously said CoQ10 lowers systolic pressure by about 11 mmHg (Rosenfeldt 2007). That analysis was mostly of open-label studies. A Cochrane review, limited to double-blind trials at acceptable risk of bias, found no significant effect on systolic or diastolic pressure (Ho 2016). Grade: no clear effect.

Migraine. In 42 people with migraine, CoQ10 (100 mg three times a day) for three months halved attack frequency in 47.6%, against 14.4% on placebo (Sándor 2005). Grade: one small positive trial.

"Production declines with age." Often said, and a reasonable idea. But taking CoQ10 for general energy in healthy older adults hasn't been tested in trials that show a benefit. Grade: untested.

Forms

CoQ10 is sold as ubiquinone (the oxidised form) or ubiquinol (the reduced form). Most of the trials above used ubiquinone. Ubiquinol is often said to be better absorbed, especially in older adults. That's an absorption claim, not an outcome one: no trial has shown ubiquinol improves symptoms more than ubiquinone. Grade: untested for outcomes. CoQ10 is fat-soluble, so take it with food that contains fat. I've removed the brand I used to name here.

Can a test show whether you need it?

Blood CoQ10 can be measured by some specialist labs, though what level is "too low" in someone on a statin isn't defined. Organic acids markers such as succinate are sometimes read as signs of a mitochondrial bottleneck. Whether they predict who will benefit from CoQ10 hasn't been tested. Grade: untested. I use them as one lead among several, not as a reason to start CoQ10 on their own.

How much: what the trials used

Tested dose:

  • Statin muscle symptoms: 100 to 600 mg a day for 30 to 90 days, with mixed results (Kennedy 2020; Qu 2018; Kovacic 2025). Caso 2007 used 100 mg a day for 30 days.
  • Heart failure: 100 mg three times a day for 2 years (Mortensen 2014), alongside standard treatment and only with your cardiologist.
  • Migraine: 100 mg three times a day for 3 months (Sándor 2005).

Upper limit: no official upper limit (EFSA, the UK EVM and the NHS have not set one). A 2006 risk assessment proposed 1,200 mg a day as an "observed safe level". It was written by authors from a supplement industry body (Hathcock 2006).

How long, and when to stop: the length of the trial for your use (about 1 to 3 months for muscle symptoms or migraine). If your diary shows no change by then, stop.

Check first if: you take warfarin (one of the cautions below); you take blood-pressure medicines; you are having chemotherapy; or you are pregnant (insufficient safety data).

Grade: mixed for statin muscle symptoms; one positive trial each for heart failure and migraine; no clear effect on blood pressure.

Cautions

For the wider statin question, including who benefits, by how much, and where the critics are right, see LDL, statins and the evidence.

Sources

Supplement of the Month Series
Ed. 01Magnesium — Eight forms, the evidence, and why the cheap one stays in your gut
Ed. 02CoQ10 — You are here

On a statin and struggling with it?

Start with your prescriber. If you want help looking at the wider picture (sleep, training load, nutrition, other medicines and what your blood tests show) alongside that conversation, an Initial Consultation is the place to start.

Book an Initial Consultation (£145) →

Read next: Beyond “Your Cholesterol”: The Heart Markers That Matter: the markers, the bands, and where the statin critics are right and wrong.