Statins ubiquinone

In a series of seven cases of neuropathy, all were axonal peripheral neuropathies and both thick and thin nerve fibers were affected (10). No cause of peripheral neuropathy other than statin treatment could be identified. In this series at least four of the cases were irreversible, probably due to long exposure to statins (4—7 years versus 1-2 years in previous reports). Besides an effect on ubiquinone, interference with cholesterol synthesis may alter nerve membrane function, since cholesterol is a ubiquitous component of human cell membranes. Neuropathy has not been observed in extensive long-term trials of lipid-lowering drugs. It could be due to patient selection, a low frequency of the adverse effect, or lack of attention to symptoms of peripheral neuropathy. The observed association may also not be causal. 

The weight of evidence supports the conclusion that the more expressed inhibition of HMG-CoA reductase by a higher statin blood level reduces the concentrations of other essential products, primarily of isoprenylated proteins and possibly ubiquinone, synthetized downstream from mevalonic acid within the peripheral cells. In parallel, it was also recognized that statins exert pleiotropic effects in various cells far beyond the originally described inhibition of hepatic cholesterol synthesis. All of these effects are considered to be class-specific for the statins. It is important to emphasize that the frequency of untoward side effects observed with the various statins can be related to their potency, the number of metabolic inter-... 

Peripheral neuropathy occurs with statins, and perhaps with all cholesterol-lowering drugs, and may be related to reduced production of ubiquinone, as suggested in a review (5). Moreover, it appears that once a statin produces a neuropathy, rechallenge with any other statin is likely to cause a recurrence. This is reported to occur 1-3 weeks after rechallenge, whereas the resolution takes 4—6 weeks after withdrawal (5). 

Johnson TE, Zhang X, Bleicher KB, Dysart G, Loughlin AF, Schaefer WH, Umbenhauer DR (2004) Statins induce apoptosis in rat and human myotube cultures by inhibiting protein geranylgeranylation but not ubiquinone. Toxicol Appl Pharmacol 200 237-250... 

Some patients on HMGCoA reductase Inhibitors (statins) experience muscle weakness. Secause the statins restrict the formation of ubiquinone, supplementation might be beneficial in some cases... 

Sakato K, Tanaka H, Shibata S, Kuratsu Y (1992) Agitation-aeration studies on coenzyme QIO production using Rhodopseudomonas spheroides. Biotechnol Appl Biochem 16 19-22 Schaars CF, Stalenhoef AF (2008) Effects of ubiquinone (coenzyme QIO) on myopathy in statin users. CiuT Opin Lipidol 19 553-557... 

Koumis, T, J.P Nathan, J.M. Rosenberg, and L.A. Cicero, Strategies for the prevention and treatment of statin-induced myopathy is there a role for ubiquinone supplementation Am J Health Syst Pharm, 61 515-519, 2004. 

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