Evidence explainerCoQ10 (ubiquinol vs ubiquinone)

CoQ10 With Statins: Statins Do Lower It, but Does Taking It Ease Muscle Aches?

If a statin left your legs aching, someone has probably told you to try CoQ10. The first half of that advice is backed by solid data. The second half is a genuine coin flip in the research.

By Kymata Health editorial teamPublished October 9, 2026Last reviewed October 9, 2026

Medical review pending. Written by our editorial team from the studies cited below; a credentialed clinician has not reviewed it yet. Educational only, not medical advice.

Key takeaways

  • Statins lower circulating CoQ10: a meta-analysis of 12 trials (1,776 people) found this regardless of statin type, intensity or treatment length [1].
  • Whether CoQ10 eases statin muscle symptoms is disputed: a 2018 meta-analysis of 12 trials (575 patients) found lower pain, weakness and cramp scores, but a 2020 analysis of 7 trials (321 people) found no benefit [2][3].
  • NIH’s complementary-health center concludes the overall evidence does not support a benefit for statin muscle symptoms [4].
  • CoQ10 may interact with warfarin and insulin; side effects are usually mild (insomnia, digestive upset) [4].
  • Never stop or change a statin on your own; muscle symptoms are a conversation for your prescriber [4].

Safety at a glance

From our CoQ10 (ubiquinol vs ubiquinone) monograph. Published interactions and cautions only, each with its source.

Interactions

  • Warfarin. NCCIH: CoQ10 may interact with the anticoagulant warfarin.[1]
  • Insulin. NCCIH: CoQ10 may interact with insulin.[1]
  • Some cancer treatments. NCCIH: CoQ10 may not be compatible with some types of cancer treatment.[1]
  • Statins. A meta-analysis of 12 RCTs (n=1,776) found statins lowered circulating CoQ10, regardless of statin type, intensity or treatment length.[7]

Who should be careful

  • People on warfarin or insulin. NCCIH lists possible interactions with warfarin and insulin; dose changes of those medicines may need monitoring.[1]
  • People in cancer treatment. NCCIH notes CoQ10 may not be compatible with some cancer treatments.[1]
  • Pregnancy and breastfeeding. Insufficient safety data in our sources.[1]
  • Side effects. No serious side effects reported; mild insomnia or digestive upset may occur.[1]

Full CoQ10 (ubiquinol vs ubiquinone) safety section

The evidence, graded

Pulled from our monograph evidence tables. Grades follow our evidence-grading policy.

  • Grade CMixedMuscle symptoms in statin usersCoQ10 (ubiquinol vs ubiquinone) · Meta-analysis · n=575 · 2018 · PMID 30371340CoQ10 reduced muscle pain, weakness, cramps and tiredness scores versus placebo; creatine kinase did not change.
  • Grade CNo effectBlood pressureCoQ10 (ubiquinol vs ubiquinone) · Meta-analysis · n=50 · 2016 · PMID 26935713No significant change in systolic (-3.68 mm Hg) or diastolic (-2.03 mm Hg) blood pressure; authors judged the evidence moderate quality for no clinically significant effect.

Part one is true: statins lower CoQ10

CoQ10 is a compound your body makes and uses in energy production. A 2018 meta-analysis of 12 randomized trials with 1,776 participants found statin treatment lowered circulating CoQ10, and the drop did not depend on which statin, how strong, or how long [1]. That finding is why the "replace what the statin takes" idea took hold.

But a lower blood level does not prove that the muscle aches come from low CoQ10, or that topping it up will help. That is what the symptom trials tested [2][3].

Part two is disputed: muscle symptoms

A 2018 meta-analysis pooled 12 trials with 575 patients and found CoQ10 lowered muscle pain, weakness, cramps and tiredness scores compared with placebo, while creatine kinase (a muscle-damage marker) did not change [2].

A 2020 meta-analysis of 7 trials with 321 people reached the opposite conclusion: no benefit for statin-associated muscle pain and no effect on whether people stayed on their statin [3]. NIH’s National Center for Complementary and Integrative Health concludes that the evidence overall does not support a benefit [4]. We grade this outcome C, with a mixed direction, on the CoQ10 monograph.

What this means if your statin hurts

Muscle symptoms on a statin are worth raising with your prescriber, who can check for other causes and adjust the drug or dose. Some people try CoQ10 alongside that conversation; the evidence says it may or may not help, and serious side effects have not been reported [4].

Two practical cautions from NCCIH: CoQ10 may interact with warfarin and with insulin, and it may not be compatible with some cancer treatments [4]. If you use any of those, check with your clinician first.

Does the form matter?

The symptom meta-analyses do not specify which CoQ10 form was used [2]. Ubiquinol raised blood CoQ10 more than ubiquinone in one small study, but higher blood levels have not been shown to improve outcomes; see ubiquinol vs ubiquinone [5].

CoQ10 also did not meaningfully lower blood pressure in a Cochrane review, though only 50 people could be pooled [6]. For other heart-related supplements, read fish oil after 50 and berberine’s cholesterol data.

Quick answers

Should everyone on a statin take CoQ10?

The evidence does not show that. Statins lower blood CoQ10 [1], but trials of CoQ10 for muscle symptoms disagree [2][3], and NCCIH concludes the evidence does not support a benefit [4].

Is CoQ10 safe with statins?

No serious side effects were reported by NCCIH, and no statin interaction is listed there; its listed interactions are warfarin and insulin [4].

Keep reading

Full monographs

Related articles

Browse the full Supplement & Nutrient Encyclopedia or all supplement articles.

References

  1. [1]The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials. Eur J Med Res, 2018. PMID 30414615
  2. [2]Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc, 2018. PMID 30371340
  3. [3]Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis. Atherosclerosis, 2020. PMID 32179207
  4. [4]Coenzyme Q10. National Center for Complementary and Integrative Health (NCCIH), 2019.
  5. [5]Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clin Pharmacol Drug Dev, 2014. PMID 27128225
  6. [6]Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev, 2016. PMID 26935713

CoQ10 (ubiquinol vs ubiquinone) and other dietary supplements are not intended to diagnose, treat, cure or prevent any disease, and these statements have not been evaluated by the FDA. Talk to your clinician or pharmacist before starting a supplement, especially if you take prescription medicines. This page has no product or affiliate links.

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