In late 2003 and early 2004 the euphoria surrounding the discovery that high dose statins (HMG-CoA reductase inhibitors) will halt and even reverse arterial plaque led to widespread treatment. Compliance issues quickly became obvious. Many patients quit because of fatigue and muscle pain. Though these fatigues and pains were very probably not related fears arose that such fatigue may be linked to much rarer cases in which muscle wasting called rhabdomyolysis occurred. To date such a linkage is not established and though small studies have shown that Coenzyme Q10 can possibly reduce fatigue and pain there is no comparable utility for muscle wasting.  
In retrospect it should have been obvious. After all Merck & Co. scientists pointed out in an obscure patent June 12, 1990, that inhibiting HMG-CoA reductase enzymes also reduces endogenous biosynthesis of Coenzyme Q10, an essential co-factor for health, and therefore Coenzyme Q10 should be taken in conjunction with statins.
The National Cancer Institute has published facts about Coenzyme Q10 for patients with cancer or at risk for cancer. Although large clinical trials have not yet been done, the results from some small clinical trials substantially support Coenzyme Q10 supplementation for patients at risk.
It's ironic that when Japanese scientists moved rapidly to produce a prescription grade Coenzyme Q10 it caused the FDA to exercise extreme caution in not taking a position on the utility of Coenzyme Q10 which has delayed its use among American customers even up to the present day.
In fairness to the FDA, Coenzyme Q10 is known to be one of the most potent nutrients energizing cells by boosting mitochondrial energy levels and in raising energy levels by oxidising fats in the mitochondria. Such a process can also produce excess free radicals which are deleterious to cells and health. 
Further studies have demonstrated that Coenzyme Q10 is indeed a potent supplement and has significant health benefits. An FDA web publication clearly warns of the dangers of Co-enzyme Q10 depletion and proposes that statins bear a warning label. This has happened in Canada but not the USA. 
ErinPharm supports Julian Whitaker, MD, in his petition to the FDA May 22, 2002, that statin package inserts contain a warning that statins must be taken with Coenzyme Q10.
Warning: HMG CoA reductase inhibitors (statin drugs) block the endogenous biosynthesis of an essential cofactor, coenzyme Q10, required for energy production. A deficiency of Coenzyme Q10 is associated with impairment of myocardial function, with liver dysfunction and with myopathies (including cardiomyopathy and congestive heart failure). All patients taking HMG CoA reductase inhibitors (statins) should therefore be advised to take 50 to 200 mg per day of supplemental coenzyme Q10.
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John L. Fahey, Ph.D.

Life Extension Foundation Member.
It is important for those who take Coenzyme Q10 to recognise that the term is a general term covering structurally similar molecules found in bacteria, plants and mammals. Organic chemists refer to Coenzyme Q10 as Ubiquinone since it is  ubiqitous in nature. There are different kinds of Coenzyme Q10 depending on the source. The Coenzyme Q10 produced by the Japanese company Kaneka in a yeast fermentation process is bioidentical to the Coenzyme Q10 produced in the human body and is the only Coenzyme Q10 you should take. Coenzyme Q10 ubiquinone is converted to its active form Coenzyme Q10 ubiquinol when it reaches the mitochondria in the cells. The ubiquinol form of Coenzyme Q10 was made available from Japan in 2006. It was found to have much higher bioavailability than the ubiquinone form. More recently LIfe Extension Foundation scientists have increased bioavailability of the ubiquinol form even more with the addition of shilagit. Thus a small daily capsule of Coenzyme Q10 ubiquinol with enhanced mitochondrial support (shilagit) along with your dose of statin (preferably in the evening) will help offset the coenzyme Q10 depletion caused by the statin. 
ErinPharm applauds Dr. Isadore Rosenfeld for his advice to those taking statins that Coenzyme Q10 supplementation could help resolve statin side effects. His advice, on Fox News September 24, 2006, and repeatedly since then, again August 12, 2007, and again December 26, 2009, to the American population, is welcome support. His additional advice that pomegranate juice as the most powerful anti-oxidant drink of choice can reduce blood pressure and carotid artery plaque is eminently practical wisdom.
There are dramatic events taking place in cardiovascular research medicine that began with the introduction of statins. From 1993 to 2003 death rates from cardiovascular disease in the United States dropped 22.1%. This decline continues while even more momentous developments are expected in which statins to lower LDL-cholesterol and supplementation with Coenzyme Q10 to offset known side effects are only the beginning of aiming at a completely clear vascular system.

The focus is now on raising HDL-cholesterol. Leading cardiologists have begun to discuss the eradication of heart attack. The first frontier clinical trials by Pfizer with torcetrapib/lipitor raised HDL-cholesterol by substantial amounts but were terminated December 2, 2006, because of unacceptable mortality data.  Currently clinical trials with anacetrapib (Merck) shows remarkable increases in HDL-cholesterol levels without the problems found with torcetrapib.    
The Life Extension Foundation (LEF) is the leading source of high quality vitamins and supplements in the United States. It is non profit and led by a distinguished panel of longevity scientists and physicians. For an initial membership cost of $75 members have access to the Life Extension Buyers Club, full panel blood work at centers across the country and direct phone links to expert medical advice. Membership fees support research into means of extending human lifespan. A monthly magazine is the cutting edge of knowledge about longevity.  
Since the conceptual logic of raising HDL-cholesterol levels, while reducing LDL-cholesterol levels with a statin, remains intact the race by other pharmaceutical companies to develop a safe HDL elevating molecule have become more vigorous. There are clinical trials under way with other molecules in this class, the CETP inhibitors, cholesteryl ester transfer protein inhibitors. Reported Phase II trial data reveals that anacetrapib elevates HDL-cholesterol levels by 136% at the highest daily dose. 
In a remarkable recent development the Japanese company supplying Coenzyme Q10 has succeeded in producing a stabilized ubiquinol form of CoQ10. In this form the metabolite is immediately bioactively available to the mitochondria. The ubiquinol form is up to eight times more bioactive than the ubiquinone form and persists in the blood circulation for far longer. 
LEF has begun to sell the ubiquinol form as Super Bioactive CoQ10 Ubiquinol and even more recently with a mitochondrial enhancer increasing the bioavailability even further.
ErinPharm recommends Brownwood Acres as the best source of pomegranate juice and pomegranate concentrate.
The information, opinions, and advice given here are my own. I have no connection to any pharmaceutical company or medical group. I am an optimist. I see the future with a sense of wonder.
A stage in statin trials has now been reached in which serious medical discussion is directed toward the prospects of lowering LDL-cholesterol even further below present target ranges in order to get a greater decline in the incidence of cardiovascular disease. It is possible that almost all members of the population could benefit from LDL-cholesterol reduction therapy, that future target ranges could be for lower than 50 mg/dL (~ 1.31 mmol/L) of LDL-cholesterol, and that lower target levels may become the focus of attention as more trial data accumulates. Discussion has begun on the variability and levels of particle sizes for the cholesterol transport proteins; beginning a more detailed and real look at the range of these proteins that we simplify into HDL, LDL, VLDL and triglycerides. This brings us to a new plateau in the elimination of heart attack, stroke, and peripheral artery disease.   
A lower cholesterol is just the start to adjusting HDL-cholesterol, LDL-cholesterol, and triglycerides while you add an exercise program and improved nutrition to gain optimal healthy longevity.
An NIH double-blind safety assessment of Kaneka Co-enzyme Q10 up to a daily 900 mg dose established it is well tolerated and safe.
It is worthy of note that those who take Coenzyme Q10 are also increasing the availability of this essential nutrient to the energy powerhouse of the cell - the mitochondria - and thus enhancing cellular metabolism.
Mitochondrial enhancement  
Do not eat grapefruit or drink grapefruit juice while taking a statin medication. It is wise to recognise that consumption can cause inhibition of statin elimination thus leading to an unwanted buildup in blood concentration. Other fruit juices have similar effects though to a lesser degree depending on the fruit. It has even been suggested that with suitable medical monitoring reduction of statin dose could be achieved using concomitant natural fruit juices.
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Be aware that taking Coenzyme Q10 to offset the aches and pains associated with taking a statin is not a proven therapy and small studies have given results ranging from some relief of pain to no observable reduction. Significant side effects should be a reason to immediately discontinue taking the statin. 
This topic is controversial.

                                Coenzyme Q10  

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I invite you to become a member of The Life Extension Foundation........John Fahey