03/11/2026
Let’s talk about Cholesterol, Statins, & CoQ10 (blog post, long)
https://mercantileapothecary.com/blogs/the-herbal-audit/let-s-talk-about-cholesterol-statins-and-coq10
For decades we’ve been told that cholesterol is bad, cholesterol clogs arteries, and lowering it prevents heart disease, but the truth is actually much more interesting than that.
Cholesterol is not a toxin. It is not metabolic garbage. Your body makes it on purpose because it needs it. In fact, cholesterol is one of the most important structural molecules in the human body.
Your brain is about 25% cholesterol by dry weight. Every single cell membrane in your body contains cholesterol. It keeps those membranes flexible, stable, and able to communicate with other cells. Cholesterol is also the raw material used to make estrogen, progesterone, testosterone, cortisol (also NOT a bad guy, subject for another day), vitamin D, and bile acids (needed to digest fat)
Without cholesterol, the body quite literally can’t function. Which is why your liver manufactures it constantly.
The body produces cholesterol through a sequence of biochemical reactions known as the mevalonate pathway (had to look up the name of that one). But this pathway does more than make cholesterol. It also produces several other vital compounds, including Coenzyme Q10 (CoQ10), which plays a central role in cellular energy production, as well as molecules involved in cell maintenance and communication. All of these substances being created along the same metabolic pathway becomes important when we look at how statins work.
Statin medications lower cholesterol by blocking an enzyme that the mevalonate pathway depends on. When this enzyme is inhibited, the body’s production of cholesterol decreases, which is the intended effect of the drug. However, because this pathway also produces CoQ10, suppressing it can reduce CoQ10 levels as well. Since CoQ10 is required by every cell to generate energy, especially in tissues with high energy demands like the heart and muscles, its depletion helps explain some of the side effects people experience while taking statins.
CoQ10 is particularly critical for:
Heart muscle
Skeletal muscles
Brain tissue
Mitochondrial energy production
Low CoQ10 is one of the most widely recognized contributors to the classic statin side effects.
Many people on statins report symptoms such as:
Muscle pain
Muscle weakness
Fatigue
Exercise intolerance
Brain fog
Memory issues
These symptoms make biological sense if cellular energy production is impaired. This is why many physicians recommend CoQ10 supplementation for patients taking statins.
Now, let’s dig a little deeper into the cholesterol “clogging” story.
Another piece of the puzzle that rarely gets explained well is why cholesterol appears in artery plaques in the first place. Cholesterol doesn’t just randomly decide to clog arteries. It shows up at sites of damage and inflammation. Arteries are constantly exposed to blood pressure stress, blood sugar spikes, oxidative damage, inflammation, smoking toxins, and metabolic dysfunction.
When the artery wall becomes damaged, the body sends repair materials. Cholesterol is one of them. Think of it less like sludge and more like a biological patch. Nature’s spackle. It’s part of the repair crew. If the underlying damage continues over years, those repair patches accumulate and eventually form plaques. So the deeper, and I believe more important, question becomes: What is damaging the artery wall in the first place?
This is where factors like inflammation, insulin resistance, blood sugar, smoking, and oxidative stress play much larger roles than cholesterol alone.
To be clear, statins absolutely do reduce cardiovascular events in some high-risk populations. I never said they didn’t. People with prior heart attacks or significant arterial disease often benefit from them. But the conversation becomes more complicated when statins are prescribed broadly without addressing the root causes of vascular damage. Or worse, prescribed as a “preventative” when cholesterol numbers are normal to begin with.
***Lowering cholesterol is not the same thing as restoring metabolic health.***
If someone is taking a statin, there are a few supportive strategies often discussed with physicians:
1. CoQ10 supplementation: Because statins suppress its production.
2. Anti-inflammatory nutrition: Reducing refined sugar, processed foods, and especially processed oils.
3. Blood sugar control: Insulin resistance damages arteries more than cholesterol does.
4. Movement: Exercise improves mitochondrial function and vascular health.
5. Nutrient-dense foods: Magnesium, omega-3 fats, and polyphenols all support cardiovascular function.
6. Restorative sleep, restorative sleep, restorative sleep!
Herbal medicine can also support circulation, inflammation balance, metabolic health, stress/anxiety relief, and sleep. Come talk to me and let's figure out the best options for you.
The takeaway? Cholesterol is not the villain we once thought it was. It is a vital structural molecule, hormone precursor, and repair tool used throughout the body. Artery disease is far more complex than a single number on a lab test.
We are much more successful when we stop fighting our bodies and start supporting them.
When we understand how the body actually works, the story becomes less about “good vs bad” molecules and more about restoring balance to the system as a whole.
And that is always a more useful place to start 💚
For decades we’ve been told that cholesterol is bad, cholesterol clogs arteries, and lowering it prevents heart disease, but the truth is much more interesting than that. Cholesterol is not a toxin. It is not metabolic garbage. Your body makes it on purpose because it needs it. In fact, cholestero...
