Coenzyme Q10 | Statins | Diabetic Neuropathy

coq10Coenzyme Q10 is a special nutrient present throughout your body. It plays an important role in helping you make energy and some research suggests it may suppress diabetes nerve damage known as diabetic neuropathy.

Many people with prediabetes metabolic syndrome and diabetes are on statin medicines since abnormal cholesterol levels usually go hand-in-hand with these medical conditions. As a matter of fact, as I’m sure regular readers know, one of the components of metabolic syndrome is decreased levels of  “good” HDL- cholesterol.  Statins are currently among the most widely prescribed drugs on the market. They are used to lower unhealthy cholesterol levels by inhibiting an enzyme that goes by its abbreviated name of HMG-CoA reductase. For those of you who just can’t get enough science lingo, that’s short for 3-hydroxy-3-methylglutaryl-CoA reductase. Now you know why it has been abbreviated ;-).  By inhibiting this enzyme needed for your body to make cholesterol, statins decrease the amount of cholesterol made within your body. The “problem” is Coenzyme Q10 (CoQ10) is made by your body along the same pathway as cholesterol, so by inhibiting HMG-CoA, not only is cholesterol production inhibited, but CoQ10 production is also inhibited.  I have written about potential problems with CoQ10 inhibition here. Statin medicines have shown benefits for cardiovascular problems, and they likely have a place in your health care, but like any drug, you should also know they are not without side effects. Something for you to discuss with your doctor.

Where did statins come from anyway?

fungus germsInterestingly, statins were initially discovered from natural statin compounds produced by some types of fungus. While HMG-CoA is an enzyme involved in the production of cholesterol in humans, it is also found in fungus. It is used by fungus to make a cholesterol-like compound they need to live. Certain types of fungus have evolved to make statins allowing them to interfere with the growth and development of other non-statin producing fungus giving them a competitive survival advantage over their fellow non-statin producers. Even in the invisible world, nature is competitive. Red Yeast Rice is a cholesterol-controlling supplement used by many people as an alternative to prescription treatment for abnormal cholesterol levels. It gets its cholesterol-lowering activity from a yeast that grows on the rice.  This yeast produces “statins” that inhibit cholesterol synthesis.  Red yeast rice actually contains 14 active compounds known as “monacolins” that inhibit cholesterol synthesis in the liver.  One of them is Monacolin K which is actually the prescription statin known as “lovastatin.” Although some studies have suggested that red yeast rice may be effective and safe for cholesterol-lipid lowering, since monacolin levels are not standardized among the various red yeast rice products on the market, in many cases, you really do not know what you are getting.  Citrinin, a kidney-toxin produced by some fungus, has been found in some red yeast rice supplement formulations.  That is not necessarily a reason not to use this supplement, just be careful, and use a quality red yeast rice supplement if you take this product.  Also let your doctor know if you take this supplement.

How Does HMG-CoA relate to CoEnzyme Q10 (CoQ10)?

As I mentioned above, a potential problem with statins is that by inhibiting HMG-CoA, they also inhibit the production of CoQ10 – an important compound for energy production in your body. In other words, statins have been known to decrease CoQ10 because in the process of blocking your body’s ability to make cholesterol, they also block your body’s ability to make CoQ10. I recently posted about the benefits of taking a CoQ10 supplement if you are taking a statin medicine to help you improve your cholesterol level.  Eating proper food is most important for healthy levels of the different types of cholesterol. I have posted about what this means here. If you get some exercise regularly, and eat in a way that will control blood sugar levels, through an improved metabolism, your cholesterol levels will likely fall in line as well. In addition to the muscle side effects I have mentioned, there is some evidence statins may also potentially raise blood sugar levels. Fortunately this doesn’t appear to be a “strong” side-effect and does not happen to most people.  Do not stop taking your statin medicine, but talk to your doctor about changes you can make in your life to try to get you off the medication “naturally.” It involves the “lifestyle prescription” we talk about here at Nutrientology.  The same lifestyle that improves blood sugar levels and decreases insulin resistance favors healthy cholesterol levels.

CoQ10 may play a role in prediabetic and diabetic neuropathy nerve damage

neuron nerveIn addition to playing a role in your energy production, CoQ10 is a strong anti-oxidant/anti-inflammatory and preliminary animal studies suggest that CoQ10 may also support keeping your nerves healthy.  People with borderline diabetes, often called pre-diabetes, and especially those with full diabetes, are prone to nerve damage in the feet and legs known as peripheral diabetic neuropathy. Borderline diabetics may be susceptible to nerve damage because of the insulin resistance of prediabetes. It appears CoQ10 may play a role in maintaining nerve health. We are not certain if this holds true in people, but some studies using animals suggest that a CoQ10 supplement can help diabetic nerve damage. Medical researchers have used obese diabetic mice with neuropathy as an experimental model to see what the effect of taking a CoQ10 supplement would have on their nerves. They looked at how much of the different amounts of chemicals known to damage nerves the mice had when taking a CoQ10 supplement, and the effect on different body areas of the mice after giving them CoQ10. It appears CoQ10 decreases oxidative stress in the brain and spinal cord and in the peripheral nervous system by its ability to act as an anti-oxidant in these areas, thereby helping to support nerve health. The authors concluded:

 CoQ10 might be a reasonable preventative strategy for long-term use and using CoQ10 treatment may be a safe and effective long-term approach in the treatment of diabetic neuropathy.”

Got time for one more CoQ10 diabetes nerve damage study?

Another study using diabetic mice as a model for human diabetes looked at the effect of 6 months of treatment with CoQ10 on neuropathy. The diabetic mice had common findings of diabetic neuropathy seen in people:

  • loss of sensation
  • decrease physical pressure sensation
  • decreased hot and cold  sensitivity
  • decreased nerve conduction speed
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The researchers found that all these nerve damage changes were virtually completely absent after the 6 months of daily CoQ10 treatment.  A little hard to believe, and unfortunately not that easy for humans, but CoQ10 may provide some benefit to people with pre-diabetes and diabetes, especially if on a statin medicine. In addition to considering a CoQ10 supplement if you are on a statin medication, you may also consider CoQ10 to help prevent, or perhaps even help decrease, the symptoms of nerve damage due to increased blood sugar levels found in prediabetes-metabolic syndrome and diabetes.

You do not want to live a life with diabetes complications – prevent, stop and reverse prediabetes now. Learn how to prevent diabetes by staying in touch with Nutrientology and becoming part of the family.

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About Robert Creighton

Dr. Creighton is a podiatrist and foot surgeon with over 26 years in podiatric practice treating thousands of patients afflicted with the physiological, physical, and psychological side effects and complications of diabetes and pre-diabetes metabolic syndrome. He believes these disorders present a pressing public health concern that need to be more actively addressed in a multidisciplinary way. Dr. Creighton graduated from what is now the Temple University School of Podiatric Medicine after receiving his undergraduate degree in Biology. He is certified by the American Board of Foot and Ankle Surgery, a member of the American Public Health Association, an American College of Sports Medicine certified personal trainer and a Member of the American Nutrition Association.

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