While your diet contributes to cholesterol in the body, around 80% of the total cholesterol is synthesized in your liver. This is what makes Lipitor, Crestor, Vytorin, Caduaet and other statin drugs so effective.

Cholesterol synthesis is a lengthy process that begins with a molecule called Acetyl-CoA which is used in various functions throughout the body. There are more steps than the those in the diagram above, but I removed the non-essential steps to help focus on how statins work. Once Acetyl-CoA is transformed into another substrate called HMG-CoA, statin drugs do their work. They inhibit an enzyme called HMG-CoA Reductase that transforms HMG-CoA into Mevalonate. Without mevalonate, which is the next substrate needed, cholesterol synthesis can no longer move forward. This is great news if you have hypercholesterolemia. But there is one small problem.

Somewhere alone the process of cholesterol synthesis is a substrate formed called Farnesyl-PP. This is an important substrate for the fact that it is needed to form two important compounds. Cholesterol is one and CoQ-10 is another. Statins stop the production of farnesyl-PP by inhibiting the process way back at the HMG-CoA step. So, it inhibits the production of both cholesterol (good) and CoQ-10 (very bad!).

Considering that CoQ-10 production is generally decreased the older we get, this inhibition by statin drugs is important because CoQ-10 is used in nearly every cell in the body. It is an essential anti-oxidant used in the production of ATP, which every cell in your body uses for energy. There has been some evidence that reduced CoQ-10 can even contribute to heart disease, has been used for treatment of migraines, cancer, hypertension and has shown to be beneficial for those following episodes of cardiac arrest. I’ve included some research papers at the end for further reading on these topics if you are interested.

So the long and short of it is, supplementation with CoQ-10 should be essential if you are on statin drugs and are even a good idea in those getting older in age or looking for a good anti-oxidant to supplement with. The thing that is interesting is that the medical community knows of this side effect, but rarely suggests supplementation of CoQ-10. So next time your in, ask your doctor about it.

Now I think I have written enough… see you next time.

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Lipid-lowering drugs and mitochondrial function: effects of HMG-CoA reductase inhibitors on serum ubiquinone and blood lactate/pyruvate ratio

Muscle Coenzyme Q10 Level in Statin-Related Myopathy

Influence of CoQ10 on Autonomic Nervous Activity and Energy Metabolism during Exercise in Healthy Subjects

Effect of coenzyme Q10 administration on endothelial function and extracellular superoxide dismutase in patients with ischaemic heart disease: a double-blind, randomized controlled study

Randomized, Double-blind, Placebo-Controlled Trial on Symptomatic Effects of Coenzyme Q10 in Parkinson Disease

Effect of Coenzyme Q10, Riboflavin and Niacin on Serum CEA and CA 15-3 Levels in Breast Cancer Patients Undergoing Tamoxifen Therap

Coenzyme Q10 Combined With Mild Hypothermia After Cardiac Arrest

Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes

But I’ve already talked about that in previous posts. What I want to talk about today is the dangers of oxidative stress and the importance of taking anti-oxidant supplements if you are not getting enough from your diet.

Oxidative (or peroxidative) damage occurs when free radicals “steal electrons” from lipids (or fatty acids). The free-radical reaction happens in three different steps:

1.) Initiation – is the formation of a free radical. Most often this is an oxygen molecule. We use oxygen every second of our life to make energy called ATP. And our body is pretty good at it. However, nothing is 100% effective and every so often something goes wrong and the result is an oxygen free radical. These free radicals entire purpose in life is to find an electron in order to make themselves a stable molecule. They often accomplish this by stealing it from the nearest molecule it can get it from.

2.) Propagation is the second step. Once an Oxygen free radical steals an electron from a fatty acid, the oxygen molecule is stable but the fatty acid then becomes unstable and becomes a free radical itself. This reaction continues over and over again.

3.) The third and final step in free radical reactions is Termination. This is where propagation ends due two every cell being satisfied with a stable number of electrons. This happens one of two ways. Either another free radical (of the same species ie. two oxygen free radicals) meets up with the original free radical and share an electron making both free radical molecules stable (this is unlikely to happen due to the distance between free radicals in comparison to other cells). Or, an anti-oxidant donates an electron to a free radical making it stable.

The beautiful thing about anti-oxidants is that they have the ability to donate an electron without becoming unstable. This allows free radicals to become stable, and keep anti-oxidants stable, there by putting an end to the propagation step of the free radical reaction.

One of the most important anti-oxidant is Vitamin E which is a fat soluble vitamin and is also embedded in cell membranes. When free radicals come along, Vitamin E donates a hydrogen molecule to it which turns it into a harmless metabolite. This is such an important reaction that some research suggests that:

…vitamin E and related nutrients may collectively be important in protecting the body against and treating conditions related to oxidative stress such as aging, arthritis, cancer, cardiovascular disease, cataracts, diabetes, infection, and some cases of Alzheimer’s disease (Mahan 79).

For this reason, increasing the amount of anti-oxidants in your diet is important if you are also increasing the amount of Omega-3 fatty acids in your diet. While some doctors believe that supplementing with Omega-3 is worth it even if you are not supplementing with anti-oxidants, in my humble opinion, the importance of free radical scavenging by anti-oxidants is hard to over-emphasize and should probably be done with or without supplementing with fatty acids.

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