FROM: The American Chiropractor 2004 (Sep 30); 26 (6)
David Seaman, D.C., M.S., D.A.B.C.N., F.A.C.C.
A list of the commonly prescribed statins include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), prosuvastatin calcium (Crestor), and simvastatin (Zocor). One statin drug that is no longer being used is Baycol, made by the Bayer Company.
A USAToday.com article, posted on June 8, 2004, stated that, “Bayer pulled Baycol after reports that 31 people taking the drug died of a rare but dangerous side effect called rhabdomyolysis, a toxic breakdown of muscle tissue that can lead to kidney failure. All statins have been associated with muscle problems, most of them not fatal, and patients are warned to report to their doctors any symptoms such as muscle pain, weakness, fatigue, dark urine, nausea and vomiting.”
We need to focus on the statement that, “All statins have been associated with muscle problems.” In fact, muscle pain is very common in those taking statins. All DC’s reading this article right now can think of numerous patients in their practice who are suffering with aches and pains that never existed prior to taking statins to combat a clinically insignificant level of cholesterol.
Long term use of statins is known to substantially increase the risk of developing polyneuropathy in some patients.
 Statins also commonly cause fatigue  and memory loss and cognitive defects.  Severe irritability and aggression have also been attributed to statin use. 
How do statins lower cholesterol and cause muscle symptoms?
Believe it or not, the enzyme that is inhibited by statins results in less cholesterol synthesis and also less ATP synthesis. Reduced ATP synthesis is thought to damage muscles for several reasons. The name of the enzyme inhibited by statins is HMG-CoA reductase, and it is the rate-limiting enzyme in the synthesis of an important precursor molecule called farnysl pyrophosphate, from which our body makes cholesterol and coenzyme Q10 (CoQ10). Without CoQ10, ATP synthesis is significantly compromised. Think about this for a moment… The human body utilizes the same biochemical pathway to produce both cholesterol and ATP, which means that the body views cholesterol synthesis on the same level of importance as ATP synthesis. I can’t think of many interventions more ridiculous than one that would inhibit the biochemical pathway that results in the production of the body’s currency for energy (ATP) and, therefore, life itself.
The likely mechanism of statin-induced muscle pain is due to inhibition of CoQ10 synthesis and the subsequent inhibition of ATP synthesis. Research has demonstrated that we get about a 25% reduction in CoQ10 when taking statin drugs.5 This is especially problematic for the elderly, for it is known that aging is associated with a significant reduction in CoQ10 synthesis. 
In addition to driving ATP synthesis, CoQ10 also functions as an important antioxidant and regulates global gene expression of skeletal muscle,  so it should not be a wonder that muscles suffer with statin use.
What should you do for your patients?
Most importantly, provide your patients with good information, and the references for this article should suffice. Statin drugs are not a healthy choice; let the evidence speak for itself. To remedy the effects of statin use, patients should supplement with CoQ10. At least 100 mg seems reasonable, although the amounts are likely to vary from individual to individual. Fortunately, CoQ10 supplementation is without detrimental side effects. You should also make sure your patients are taking a multivitamin/mineral, magnesium and EPA/DHA. And for those who do need to modify their cholesterol levels, policosanol is a viable alternative. Policosanol is known to lower the dangerous LDL-C molecule while raising HDL levels,  without causing the detrimental side-effects associated with statins. In another study with type II diabetic patients, policosanol was compared to lovastatin, and the authors concluded that, “policosanol administered at 10 mg/day produces more advantageous changes in HDL-cholesterol and has a better safety and tolerability profile than lovastatin 20 mg/day.”  This study also demonstrated that policosanol, but not lovastatin, resulted in a significant elevation of HDL cholesterol. 
Irresponsible drug companies
I am not one to criticize drugs in general, because, when used properly, drugs can be life saving. However, at times, the deception and perhaps even fraud becomes too appalling. It turns out that the statin-producing drug companies knew from the onset that statins block CoQ10 synthesis, and that this side-effect could be detrimental to our health. In fact, the companies that patented the statin drugs also patented drugs that contained a statin/CoQ10 combination.  All you need to do is go to www.uspto.gov and put in the patent numbers provided in reference #9, and you can see for yourself. Shockingly, not one statin drug to date has included CoQ10…so millions have unnecessarily suffered and will continue to do so.
Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the faculty of Palmer College of Chiropractic Florida and on the postgraduate faculties of several other chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. Dr. Seaman believes that chiropractors should be thinking like chiropractors, while providing nutritional recommendations. Doctors and patients who follow his programs report improved feelings of well-being, weight loss, dramatic increases in energy, and significant pain reduction. Dr. Seaman can be reached by e-mail at email@example.com.
1. Gaist D, Jeppesen U, Andersen M, Garcia Rodriguez LA, Hallas J, Sindrup SH.
Statins and risk of polyneuropathy: a case-control study.
Neurology 2002; 58(9):1333-7
2. Golomb BA.
Statin adverse effects: implications for the elderly.
Geriatric Times Vol V(3); May/June 2004;
3. Wagstaff LR, Mitton MW, Arvik BM, Doraiswamy PM.
Statin-associated memory loss: analysis of 60 case reports and review of the literature.
Pharmacotherapy 2003; 23(7):871-880.
4. Golomb BA, Kane T, Dimsdale JA (2004),
Severe irritability associated with statin cholesterol-lowering drugs.
5. Crane FL.
Biochemical functions of coenzyme Q10.
J Am Coll Nutr 2001; 20(6):591-598
6. Linnane AW et al.
Human aging and global function of coenzyme Q10.
Ann NY Acad Sci 2002; 959:396-411
7. Varady KA, Wang Y, Jones PJ.
Role of policosanols in the prevention and treatment of cardiovascular disease.
Nutr Rev. 2003; 61(11):376-83
8. Crespo N, Illnait J, Mas R, Fernandez L, Fernandez J, Castano G.
Comparative study of the efficacy and tolerability of policosanol and lovastatin in patients with hypercholesterolemia and noninsulin dependent diabetes mellitus.
Int J Clin Pharmacol Res. 1999;19(4):117-27
9. Patent #s 4,929,437; #4,933,165; #5,082,650; #5,316,765
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