Statins lower cholesterol by blocking the enzyme known as HMGR.

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For people on statins, muscle pain is not an uncommon side effect. Over 10% of those taking statins to lower their LDL cholesterol experience muscle pain, and according to one study a large percentage of those experiencing pain experience actual skeletal muscle damage[1]. Many of them have heard about and tried CoQ10 supplements to combat statins’ muscle pain side effects. For some, CoQ10 supplementation brings significant relief, and they can continue on their statin at the same dose. For others on statins, muscle pain improves slightly on CoQ10, but not enough. And others, unfortunately, get no benefit at all.

Statins, such as atorvastatin (Lipitor), simvastatin (Zocor) or rosuvastatin (Crestor) lower cholesterol by blocking the enzyme known as HMGR  which is responsible for cholesterol production in the liver. However, in blocking HMGR, statins also inhibit the production of other important compounds, including coenzyme Q10 (CoQ10). CoQ10 is produced by the human body and is necessary for the basic functioning of cells, and statins are known to deplete CoQ10 levels. Many patients experience muscle pain side effects from insufficient CoQ10 production.

Study shows L-carnitine benefits patients with gene defect  

A paper published in Expert Review of Cardiovascular Therapy and reported by Medscape suggests that another natural compound besides CoQ10 may be depleted in those experiencing statins’ muscle pain side effects: L-carnitine. Benefits from the supplement were studied by a group of researchers; they tested samples of blood and muscle from 132 patients experiencing statins’ muscle pain side effects.

Patients experiencing muscle pains on statins were 11-times more likely to have inherited a defective gene that makes them deficient in a carnitine-containing enzyme. This enzyme, known as carnitine palmitoyltransferase-2, uses carnitine to help the mitochondria inside muscle cells produce energy. People with this inherited enzyme deficiency require extra carnitine to help with energy metabolism inside muscle cells.

Combination of CoQ10 and L-carnitine benefits statin users

The researchers also found that 31% of muscle biopsies evaluated had carnitine “abnormalities.” Furthermore, almost 50% of the analyzed samples had CoQ10 levels that were significantly below normal. The researchers suggested that for those on statins, muscle pain may be in part due to the genetic abnormalities in carnitine enzymes; therefore, supplementing with l-carnitine and CoQ10 and may be a “rational approach” to treating certain muscle symptoms associated with statins, muscle pain being the primary side effect.

What are other L-carnitine benefits?

Aside from the promising research for statin users, L-carnitine benefits a wide range of health conditions including fatigue, diabetic neuropathy, memory impairment, male infertility, and heart disease. In particular, research suggests people with heart attack risk factors (such as high cholesterol) should consider taking supplemental l-carnitine. Benefits for heart patients include: decreasing angina (chest pain), reducing symptoms of heart failure, and improving exercise capacity for people with heart conditions.[2]

What to do for side effects from statins, muscle pain especially

So far, there are no randomized controlled trials evaluating L-carnitine supplementation for statins’ muscle pain side effects. But given the researchers’ findings and the safety of natural L-carnitine supplements, there’s no reason not to try this approach. The typical dose is 500-1000 mg L-carnitine two to three times a day. Acetyl-L-carnitine is the most easily absorbed and utilized form. Take this with at least 200 mg of CoQ10 for at least six weeks before making any conclusions regarding its success. Of course, by discontinuing your statins, muscle pain may be a thing of the past. Ditching your statin may be an appropriate option for some, as long as you make sure you are controlling your cholesterol and lowering your cardiovascular risk by using the appropriate natural therapies. Find out more about natural cholesterol-lowering remedies here.

Originally published in 2013.