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High Cholesterol Message Board


High Cholesterol Board Index


[QUOTE=zip2play]...Can you see what you can dig up as to the link between statins and myalgia. Not the incidence, but rather the CAUSATIVE rationale. I think it's real and simply cannot find what it is about the reduction of cholesterol (or the mevalonate precurser) that HURTS. Can it have to do with alternate chemicals that are produced INSTEAD of the normal pathways. Or does the statin inhibit OTHER enzymes than just the Hmg_CoA. Enzymes perhaps that the muscles need for proper functioning?[/QUOTE]

The answer is likely statin induced Co-Q10 depletion.

Here is a cut-and-paste on the subject:

How Statins Work:

The process begins with acetyl-CoA, a two-carbon molecule sometimes referred to as the "building block of life." Three acetyl-CoA molecules combine to form six-carbon hydroxymethyl glutaric acid (HMG). The step from HMG to mevalonate requires an enzyme, HMG-CoA reductase. Statin drugs work by inhibiting this enzyme--hence the formal name of HMG-CoA reductase inhibitors. Herein lies the potential for numerous side effects, because statin drugs inhibit not just the production of cholesterol, but a whole family of intermediary substances, many if not all of which have important biochemical functions in their own right.

Mevalonic kinase is the enzyme that facilitates the next step beyond HMG-CoA reductase.

Cholesterol is one of three end products in the mevalonate chain. The two others are ubiquinone and dilochol. Ubiquinone or Co-Enzyme Q10 is a critical cellular nutrient biosynthesized in the mitochondria. It plays a role in ATP production in the cells and functions as an electron carrier to cytochrome oxidase, our main respiratory enzyme. The heart requires high levels of Co-Q10. A form of Co-Q10 called ubiquinone is found in all cell membranes where it plays a role in maintaining membrane integrity so critical to nerve conduction and muscle integrity. Co-Q10 is also vital to the formation of elastin and collagen. Side effects of Co-Q10 deficiency include muscle wasting leading to weakness and severe back pain, heart failure, neuropathy and inflammation of the tendons and ligaments.

The most common side effect is muscle pain and weakness, a condition called rhabdomyolysis, most likely due to the depletion of Co-Q10, a nutrient that supports muscle function. The test for muscle wasting or rhabdomyolysis is elevated levels of a chemical called creatine kinase (CK). But many people experience pain and fatigue even though they have normal CK levels.





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