Question: I take 40 mg of Lipitor per day. To counteract the Lipitor damage to my liver I take 1000 mg of milk thistle & 100 mg of Co Q-10 per day. Do you think this will help or hurt?
Dr. Hibberd's Answer:
Neither milk thistle nor Co Q-10 will counteract liver damage seen with Lipitor (a statin drug). Liver effects of the statin drugs usually generate few, if any, symptoms. Periodic liver enzyme monitoring is required to detect damage early when the effects are reversible by either discontinuing or adjusting the statin dosage. We have no evidence that Co Q-10 will reduce liver damage caused by statins.
Milk thistle is not recommended and has no preventive role that I have good evidence for. It has not been FDA approved for treatment of any condition, but has been reported as "possibly" effective for treating cirrhosis. It has also been used in Europe to treat mushroom poisoning.
Co Q-10 is used to reduce the incidence of muscle cramps seen in some patients taking statin drugs. Statins commonly deplete Co Q-10 causing nuisance muscle cramps. While supplementation with Co Q-10 has not yet received FDA blessing, many who take it report a marked lessening of the muscle aches and fatigue.
If you have muscle cramps while taking a statin, be sure to stop the medication and see your doctor to evaluate whether you are suffering from a potentially life-threatening and rarer complication known as rhabdomyelosis. Rhabdomyelosis can be confirmed by an elevation in an enzyme called CPK. Rhabdomyelosis can also be a cause of serious renal (kidney) failure. Untreated, it may lead to unexpected death.
Once rhabdomyelosis has been eliminated, resumption of the statin with Co Q-10 supplementation (often 50-100 mg daily) may allow continuing the statin without the nuisance side effects while retaining the huge cardiac prevention benefits statins offer.
I know many physicians who routinely recommend supplementation with Co Q-10 to all their patients who use statin medications to pre-empt problems with nuisance muscle aches. But since Co Q-10 does not prevent or treat rhabdomyelosis, be sure to discuss your supplementation routines with your prescribing doctor(s).
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