Patients who experience muscle soreness and fatigue while taking the statins seem to get relief by simultaneously ingesting coenzyme Q10 30 mg. Do any clinical studies support use of this complementary medicine?—MARY CLARK, RN, PA-C, Clarks Summit, Pa.

Depletion of coenzyme Q10 is suspected of playing a role in the development of myopathy in patients who take statins. Decreased pain in such patients treated with coenzyme Q10 was seen in one small study (Am J Cardiol. 2007;99:1409-1412) but not in another (Circulation. 2006;114:II_41-II_42). Experts suggest that a trial of this supplement is not inappropriate but that it be stopped in the absence of clear benefit (see Miller ML and Rosenson RS. Muscle injury associated with lipid lowering drugs. In: Rose BD, ed. UpToDate. Wellesley, Mass.: UpToDate; 2009). A much higher dose of coenzyme Q10 (150-200 mg daily) is used than the one cited by Ms. Clark.—Reuben W. Zimmerman, PA-C (133-3)