Muscle aches not usually due to statin

Dear Dr. Roach: Is it necessary to take CoQ10 with pravastatin?

A.D.

Answer: Pravastatin, like all statins, can cause side effects, including muscle aches. In most people taking statins, muscle aches are not due to the statin. Recent studies showed that the likelihood of muscle aches was just about the same whether they were taking a placebo pill or a statin and didn’t know it.

Coeznyme Q10 is part of the metabolic pathway of many statins, and there has been a theory that depletion of CoQ10 is responsible for muscle aches.

But randomized, controlled trials have shown that treatment of muscle aches with CoQ10 is not much better than placebo, and there is no good evidence that CoQ10 can prevent muscle aches. Pravastatin, in particular, does not deplete CoQ10 the way atorvastatin does, for example.

Even though I don’t recommend CoQ10 to treat or prevent muscle aches, it’s considered safe and is not particularly expensive. I don’t insist people stop it, especially if they feel it helps.

Dear Dr. Roach: My daughter is still nursing her 10-month-old son. She decided to get the Pfizer vaccine and continue breastfeeding. Her doctor did not advise her against it. Do you have an opinion or more information about this matter? I’ve read that COVID antibodies are present in breastmilk.

B.H.

Answer: COVID-19 vaccination is recommended for women who are breastfeeding. There is data to show that the vaccine is effective for the breastfeeding woman, but there is little data about the effect on the baby. It is true that breastmilk does have antibodies to COVID-19, but how effective these may be at preventing disease in the baby is not clear. It is clear that there is no way that either the mother or baby could get COVID-19 from the vaccine.

Because women who are pregnant or have recently been pregnant are at higher risk for severe disease if infected with COVID-19, pregnant and breastfeeding women are especially recommended to get the vaccine.