Search Medication

Level Qualifying studies
A Systematic review or meta-analysis of human trials
B Human RDBPC trials. ≥ 2 studies and/or 1 study with ≥ 50 subjects
C Human RDBPC trials or RCTs. 1 study < 50 subjects
D Human trials or in-vivo animal trials
G No significant nutrient depletion research was found

Results for Atorvastatin: 4

Evidence Rating Scale

Copper

Summary: Statin treatment was associated with a significant reduction in mean serum copper (9%).

Statin treatment was associated with a significant reduction in mean serum copper (9%).

CoQ10

Summary: The meta-analysis showed a significant reduction in plasma CoQ10 concentrations following treatment with statins.

The meta-analysis showed a significant reduction in plasma CoQ10 concentrations following treatment with statins.

Regardless of its definition, statin intolerance is an important phenomenon, leading to a poorer control of the LDL cholesterol levels among high-risk Japanese patients. We need to understand the risk factors, as well as the potential nocebo effect, so that we can accurately discriminate the pseudo statin intolerance from true statin intolerance and reduce their LDL cholesterol more effectively using the golden standard drug. Alternatively, we could consider using other LDL-lowering therapies, such as ezetimibe, PCSK9 inhibitors and fibrates, or some agents that have been shown as add-on/alternative therapies to statins, such as certain nutraceuticals, or coenzyme Q107–9).

Several trials demonstrate coenzyme Q10 depletion subsequent to statin initiation.42,43 There is conjecture about this depletion as the cause of statin–associated adverse effects (e.g., myopathy) with exogenous coenzyme Q10 supplementation as a possible mediating treatment. This assertion is refuted by a more recent crossover trial44 that found no significant coenzyme Q10 drop after initiation of selected statins. Several doxorubicin (Adriamycin) trials, mostly in animal models, have noted a reduction in cardiac coenzyme Q10 depletion and cardiotoxicity associated with coadministration of coenzyme Q10. The clinical implications on disease state and adverse reaction profile with coenzyme Q10 supplementation in depleted states requires further evaluation.

Even brief exposure to atorvastatin causes a marked decrease in blood CoQ(10) concentration. Widespread inhibition of CoQ(10) synthesis could explain the most commonly reported adverse effects of statins, especially exercise intolerance, myalgia, and myoglobinuria.

In conclusion atorvastatin definitely decreased plasma CoQ10 levels and supplementation with CoQ10 increased their levels. These changes in plasma CoQ10 levels showed no relation to the changes in serum AST, ALT and CK levels. Further studies are needed, however, for the evaluation of CoQ10 supplementation in statin therapy.

P and A did not decrease CoQ10 despite a significant decrease in LDL levels. These findings suggest that HMG-CoA reductase inhibitors do not significantly decrease the synthesis of circulating CoQ10 in healthy subjects. Routine supplementation of CoQ10 may not be necessary when HMG-CoA reductase inhibitor therapy is administered.

In conclusion, long-term treatment with ATO might increase plasma levels of BNP in patients with CAD when it is accompanied by a greater reduction in plasma CoQ10. However, ATO-induced decreases in CoQ10 might not increase oxidative stress.

Selenium

Summary: During the 9-year follow-up, similar plasma selenium declines were observed in all the sub-groups (p=0.33) despite plasma selenium levels being higher in fibrate users and lower in statin users (p=0.0004). The mechanisms underlying these data are not yet totally understood, but considering the risk of selenium deficiency in the elderly and its relationship with poor health status further clinical trial is needed to verify the proposed hypotheses.

During the 9-year follow-up, similar plasma selenium declines were observed in all the sub-groups (p=0.33) despite plasma selenium levels being higher in fibrate users and lower in statin users (p=0.0004). The mechanisms underlying these data are not yet totally understood, but considering the risk of selenium deficiency in the elderly and its relationship with poor health status further clinical trial is needed to verify the proposed hypotheses.

Zinc

Summary: In addition to reducing serum total and low-density lipoprotein (LDL) cholesterol (p < 0.0001), statin treatment was associated with a significant reduction in mean serum zinc (9%, p = 0.03), copper (9%, p < 0.01), caeruloplasmin (24%, p < 0.05), and median CRP (45%, p < 0.03).

In addition to reducing serum total and low-density lipoprotein (LDL) cholesterol (p < 0.0001), statin treatment was associated with a significant reduction in mean serum zinc (9%, p = 0.03), copper (9%, p < 0.01), caeruloplasmin (24%, p < 0.05), and median CRP (45%, p < 0.03).

Not seeing what you need?

Reach out to us with feedback. We’re always looking for ways to help you