David Leonardi, M.D. ABAAM, CNS

A List of Articles


The single best solution for statin side effects.

Click to Order

Statins and Memory Loss

David Leonardi, M.D., ABAAM, CNS

There are numerous case reports of individuals suffering memory loss from statins1,2,3,4,5. One literature review n 2003 summarized 60 case reports of memory loss in statin users6. Sixty cases of memory loss could be classified as rare considering there were about ten million Americans taking statins in 2003. Yet, if you’re taking a statin and feel that it’s causing memory loss, you could be right. Interestingly, however, in every study (clinical trial) I could find, except one, on statins and memory or cognitive function, statins were shown to either slow the rate of age-related cognitive decline or improve cognitive function in subjects who had impairment from an illness or injury7,8,9,10,11,12,13. Three of these were animal studies9,10,11 and the other four were human clinical trials7,8,12,13. In the one study I discovered that showed statin-related cognitive decline beyond just an individual case report, a cardiology clinic reported memory loss in four out of fifty patients studied (8%). This was not proven by cognitive testing but simply by patients claiming memory loss on a questionnaire14. Indeed, statin use is associated with a reduced risk of developing Alzheimer’s disease15, particularly simvastatin, which is one of the few lipid soluble statins that can cross the blood-brain barrier and exert an anti-inflammatory effect on the brain. In a large observational study, simvastatin reduced Alzheimer’s risk by 54% and Parkinson’s disease risk by 49%16.

Why would we see so many case reports of memory loss in statin users when so many clinical studies demonstrated significant brain and cognitive benefits? The most likely explanation is that, aside from identical twins, people are all genetically different from one another. While statins are healthy for the brain in the vast majority of us, some of us may have a particular genetic susceptibility to an aspect of statins that causes memory loss. Certainly that’s the case in regard to muscle pain from statins . If you feel your statin is causing memory loss, what can be done about it?

There is a great deal of published evidence that what statins do to muscle cells is also happening in neurons (brain cells). Because of genetic differences, a minority of us seems to be susceptible to the muscle issue and a much smaller minority to the memory issue. All the evidence thus far points to a reduction in energy production in cells, to which brain and muscle are most susceptible. The reduced energy production, so far, appears related to a relative deficiency on two critical nutrients: Coenzyme Q10 and creatine.

Creatine’s Potential Brain Benefit

Bullet Points:

  • Brain and muscle share the characteristic of variable energy demand, making them very dependent upon creatine for energy.
  • Brain and muscle take up creatine by the same mechanism, shown to be blocked by statins.
  • Because creatine supplementation is effective for statin-associated muscle pain and supplemented creatine does reach the brain, it stands to reason that creatine will also help with statin-related memory loss, although this has not yet been tested in human clinical trials.


Both brain and muscle are very dependent on creatine for adequate energy supply because their demand varies moment to moment according to activity levels (moving and thinking). All cells, including brain cells, ultimately use ATP (created from glucose using the electron transport chain) as an energy source. When the activity of a brain cell is accelerated, it doesn’t contain enough ATP to sustain the higher metabolic rate for very long. At some point early on, all the stored ATP (adenosine tri-phosphate) is depleted into low-energy adenosine di-phosphate (ADP). High-energy phosphate molecules are desperately needed to turn ADP back into ATP to prevent immediate and severe brain cell dysfunction. Of course, our brain cells don’t fail after 6 seconds of intense activity, so we know that they do obtain those phosphate groups to restore ATP. And the source of that phosphate group is creatine17,18. Scientists call this supply line the creatine-phosphate shuttle. When creatine enters the cell it collects a phosphate molecule via an enzyme called creatine kinase (CK) and can transfer (shuttle) that phosphate to ADP when needed to form ATP. You can find more about this on www.Wikipedia.org  or your favorite search engine. Brain cells are fragile and susceptible to insults from oxidative stress and exposure to toxins19. Energy supply is critical to enable brain cells to withstand oxidative and toxic stress and creatine has been shown to be neuroprotective in this regard20,21,22. In fact, studies are now underway investigating whether creatine can be therapeutic for neurodegenerative diseases including Parkinson’s, Alzheimer’s, Amyotrophic Lateral Sclerosis and Huntington’s diseases23,24. Orally supplemented creatine has been shown to be transported into the brain25, to reduce fatigue associated with mental tasks and to increase brain oxygen utilization26. Creatine has already been shown to be beneficial in an animal study of epilepsy27 and in a human clinical trial for depression28. There are numerous documented case reports of statin-associated memory loss and, while not yet proven, it is quite possible that reduced creatine availability to brain cells could be the cause29,30,31,32. No studies have been done yet to determine if statins interfere with creatine transport into brain cells but we already know that they block creatine transport into muscle cells33 and we know the mechanism for creatine transport into brain cells is identical to that for muscle: the sodium-potassium-ATPase pump. This pump, which actively transports creatine into the cell is dependent upon a gradient (unequal distribution) of chloride across the cell membrane. Statins have been shown to upset that gradient, which then reduces creatine transport into the cell. Supplementing creatine has been shown to remedy this problem for the muscle pain34, so it is highly likely that it will also be effective for the memory loss, particularly if used along with CoQ10.

The Advantage of Buffered Creatine

Now, there is an important caveat here. Not all creatine is created equal. When creatine is consumed, before it’s absorbed into our system, much of it is immediately transformed to creatinine (note the extra “in” syllable in creatinine), a waste product of muscle that, when it accumulates, is poisonous. The names are very similar as are their chemical structures but they have a very different effects on the body. Creatine is the energy supply link in muscle cells and creatinine is a waste product that is poisonous at higher levels. When you take standard creatine, such as creatine monohydrate, you lose some of the benefit of the creatine because of its rapid conversion to creatinine and additional strain is placed on the kidneys, required to eliminate that extra creatinine. At the Leonardi Institute, we did a pilot study comparing the effect of standard creatine to a special buffered creatine, designed for maximal absorption into the body with little or no conversion to creatinine. We looked at the blood levels of creatine and creatinine before and after taking standard and buffered creatine. We compared the affect of a daily dose of 9 grams of standard creatine monohydrate to only 3 grams of buffered creatine on blood levels of creatine and creatinine in a crossover trial with a washout period in between. After a week of supplementation, here is what we found.

Creatine Type
Percent increase in
blood creatine per gram ingested per day
Percent increase in
blood creatinine per gram ingested per day

Per gram of product ingested each day, standard creatine monohydrate increased the blood creatine level by 14% while the buffered creatine increased it by 52%, a 3.6-fold difference. Meanwhile, gram for gram, neither the standard creatine monohydrate nor the buffered creatine increased the poisonous blood creatinine level but it dropped by more than double, gram for gram of creatine intake, using the buffered creatine (i.e. buffered creatine had a far more favorable impact). This would imply that, long term, the buffered creatine would be safer.

Clearly, the buffered creatine does more at a lower dose to bring creatine to the muscle and brain cells via the blood stream with no increase in blood level of the potentially harmful creatinine. And there is a very practical advantage: two capsules of buffered creatine can replace seven capsules (or a heaping teaspoon) of creatine monohydrate.

Memory Loss as related to CoQ10

All cells, including brain cells,  contain energy  factories called mitochondria.  It is in the mitochondria where sugar and fats are burned to produce energy in the form of adenosine triphosphate (ATP). Here’s a very simple sequence of how energy is produced from sugar in the mitochondria of our cells. When sugar is broken down, a compound is created called NADH. NADH is loaded with the energy from the sugar and is able to pass on the energy by transferring high-energy electrons down an assembly line of proteins that make up the “electron transport chain”. At each step, energy is extracted from the electrons. One of the key proteins in the electron transport chain is Coenzyme Q (also known as CoQ10). Statins reduce the body’s production of CoQ1034,35,36,37,38. Statin users have up to 40% lower CoQ10 levels in the blood  compared to non-users39. The reason is that CoQ10 is made in the body by the same enzyme that makes cholesterol (HMG CoA reductase) and statins are specifically designed to block this enzyme, which is precisely now they reduce cholesterol40,41,42,43. Since CoQ10 is a critical link in energy production in brain cells and statins deplete us of CoQ10, it’s no surprise that statins could cause memory loss in some genetically susceptible individuals. The obvious solution, then, would simply be to supplement CoQ10. However, it’s not that simple. There is only one clinical study I could find using CoQ10 to treat memory loss in statin users. It was effective in 4 out of 8 patients. The problem with this study is that those patients also stopped their statin medication, causing confusion as to what actually worked: CoQ10 or stopping the statin. Studies on the use of CoQ10 for the treatment of statin muscle pain are mixed. That is, some have shown significant benefit in relieving statin-associated pain,even while continuing their statin44,45,46 and others studies show no benefit47,48. Co Q10 is not the answer for everyone because there are genetic differences among us in regard to exactly where in our biochemistry statins invoke their energy interference within the muscle cell49. Some of us have susceptibility in one aspect of our chemistry and other’s of us in another aspect. That’s why creatine is so important, as discussed above. But even if you find that CoQ10 doesn’t resolve your memory loss, you should be aware of two other reasons to supplement it. First, CoQ10 depletion from statins can cause muscle weakness or discomfort mild enough to be beneath your radar. In other words, you may be weaker than you should be without even realizing it. Second, CoQ10 is critically important for normal function of heart muscle. Low levels of CoQ10 have been linked to a debilitating and dangerous condition called congestive heart failure due to reduced energy production in heart muscle50,51 and CoQ10 has been shown to correct it52,53,54,55. Finally, even in people not using statins, CoQ10 levels decline with age and even this normal depletion compromises heart function56,57. You don’t want to go through life with CoQ10 depletion.

The Safest, Most Economical and Simplest Solution

As a result of the overwhelming benefits of both CoQ10 and buffered creatine we’ve discussed, along with the benefit of vitamin D3  in those with insufficient levels, I decided to combine CoQ10, buffered creatine and vitamin D3 into one simple nutritional supplement called Statin Sidekick™.  I believe Statin Sidekick is critically important for anyone taking a statin medication along with anyone physically active and interested in insuring a steady supply of energy to muscle and brain cells. Two capsules of Statin Sidekick provides a proprietary blend of buffered creatine and CoQ10 totaling 1,500 mg along with 2,000 iu of vitamin D3. These three ingredients are included in the most optimal ratio based on published clinical trials, our original research and our patient experience at the Leonardi Institute. The recommended dose is 2 to 3 capsules twice a day (always with food) for the first week (called a “loading dose”) followed by 1 to 2 capsules twice a day thereafter. There appears to be a benefit in stopping your statin for the first week while taking the loading dose of Statin Sidekick but we don’t recommend this without first checking with your practitioner. If you notice muscle aching that you feel is related to your statin while taking Statin Sidekick™, simply increase the dose back up to 3 capsules twice a day. Of course, you should also notify your physician that your statin is causing you pain. You may adjust the dose of Statin Sidekick back and forth to see what dose you personally require to eliminate statin-related muscle aching while optimizing muscle energy availability and performance. In unusual circumstances, a few people may even require 4 capsules twice a day. Detailed dosing instructions are included with each order. If 4 capsules of Statin Sidekick twice daily doesn’t relieve your statin side effects, the next logical step might  be to discuss with your practitioner, either an alternative statin or a lower dose of the same statin while continuing Statin Sidekick. If you’re unsuccessful with that approach you may want to discuss statin alternatives with your practitioner.

Statin Sidekick is an essential nutrient for anyone taking a statin. It provides that margin of safety and peace of mind that you’re getting the best possible performance from your brain and muscles while reducing the risk of memory loss and muscle pain that can accompany statin use. If you would like to order Statin Sidekick, it is available on our Cycle-Breakers.com website by clicking here. Statin Sidekick is carefully tested and manufactured in full compliance of U.S. government Good Manufacturing Processes (GMP).

Statin Sidekick Supplement Facts

Serving size 2 capsules
Servings per Container 30 (60 capsules)

Active Ingredients
Amount per Serving
Vitamin D32,000 iu500
A proprietary blend of Kre-Alkalyn® (buffered creatine) and Coenzyme Q101500 mgDRV not established

Directions: Take 2-3 capsules twice daily WITH FOOD (within 45 minutes of a meal). You may reduce the dose after the first week if you remain free of statin side effects, or increase the dose if needed.


1Pharmacotherapy. 2001 Jun;21(6):767-9.Simvastatin-associated memory loss.

2Ann Pharmacother. 2006 Oct;40(10):1880-3. Epub 2006 Aug 29.
Simvastatin-induced decline in cognition.

3Pharmacotherapy. 2006 Aug;26(8):1190-2.
Short-term memory loss associated with rosuvastatin.

4Pharmacotherapy.2003 Dec;23(12):1663-7.
Cognitive impairment associated with atorvastatin and simvastatin.

5BMJ Case Rep.2009;2009. pii: bcr06.2008.0033. doi: 10.1136/bcr.06.2008.0033. Epub 2009 Feb 26.
Transient global amnesia associated with statin intake.

6Pharmacotherapy. 2003 Jul;23(7):871-80.
Statin-associated memory loss: analysis of 60 case reports and review of the literature.

7J Neurol Neurosurg Psychiatry. 2005 Dec;76(12):1624-9.
Lipid lowering agents are associated with a slower cognitive decline in Alzheimer’s disease.

8Neurology. 2005 Nov 8;65(9):1388-94.
Statins and cognitive function in the elderly: the Cardiovascular Health Study.

9J Neurosurg. 2005 Oct;103(4):695-701.
Effect of atorvastatin on spatial memory, neuronal survival, and vascular density in female rats after traumatic brain injury.

10Ann Neurol. 2006 Dec;60(6):729-39.
Simvastatin enhances learning and memory independent of amyloid load in mice.

11Yakugaku Zasshi. 2007 Jul;127(7):1125-37.
Reversal of memory deficits by Atorvastatin and Simvastatin in rats.

12Neuroepidemiology.2007;29(3-4):201-7. Epub 2007 Nov 27.
Lipid-lowering agents and the risk of cognitive impairment that does not meet criteria for dementia, in relation to apolipoprotein E status.

13J Alzheimers Dis. 2008 Mar;13(2):187-97.
Effects of simvastatin on cerebrospinal fluid biomarkers and cognition in middle-aged adults at risk for Alzheimer’s disease.

14Biofactors. 2005;25(1-4):147-52.
Treatment of statin adverse effects with supplemental Coenzyme Q10 and statin drug discontinuation.

15Riv Biol.2006 May-Aug;99(2):210-5.
[The role of cholesterol in Alzheimer’s neuro-pathogenesis].

16BMC Med. 2007 Jul 19;5:20.
Simvastatin is associated with a reduced incidence of dementia and Parkinson’s disease.

17Adv Exp Med Biol. 1982;151:115-25.
The creatine-creatine-phosphate shuttle for energy transport-compartmentation of creatine phosphokinase in muscle.

18Annu Rev Biochem. 1985;54:831-62.
The creatine-creatine_phosphate_energy_shuttle.

19Nutrients.2011 Aug;3(8):735-55. doi: 10.3390/nu3080735. Epub 2011 Aug 10.
Metabolic agents that enhance ATP can improve cognitive functioning: a review of the evidence for glucose, oxygen, pyruvate, creatine, and L-carnitine.

20Pediatr. Res. 1998, 43, 8–14.
Creatine protects the central respiratory network of mammals under anoxic conditions.

21Brain Res. 1999, 816, 124–130.
Exogenous creatine delays anoxic depolarization and protects from hypoxic damage: Dose-effect relationship.

22Pediatr. Res. 1998, 44, 410–414.
Creatine increases survival and suppresses seizures in the hypoxic immature rat.

23J Neurochem. 2010 Oct;115(2):297-313. doi: 10.1111/j.1471-4159.2010.06935.x. Epub 2010 Aug 25.
Synthesis and transport of creatine in the CNS: importance for cerebral functions.

24Springer: Berlin, Germany, 2007; pp. 309–334.
Creatine and Creatine Kinase in Health and Disease.

25Mol Cell Biochem. 2003 Feb;244(1-2):143-50.
Creatine deficiency syndromes.

26Neurosci Res. 2002 Apr;42(4):279-85.
Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation.

27Amino Acids. 2013 Mar;44(3):857-68. doi: 10.1007/s00726-012-1408-6. Epub 2012 Oct 12.
Acute creatine administration improves mitochondrial membrane potential and protects against pentylenetetrazol-induced seizures.

28Am J Psychiatry. 2012 Sep;169(9):937-45. doi: 10.1176/appi.ajp.2012.12010009.
A randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorder.

29Pharmacotherapy. 2001 Jun;21(6):767-9.
Simvastatin-associated memory loss.

302006 Oct;40(10):1880-3. Epub 2006 Aug 29.
Simvastatin-induced decline in cognition.

31Pharmacotherapy. 2006 Aug;26(8):1190-2.
Short-term memory loss associated with rosuvastatin.

32Pharmacotherapy. 2003 Dec;23(12):1663-7.
Cognitive impairment associated with atorvastatin and simvastatin.

33Circulation. 2006;114:II_288.
Lipid and Lipoprotein Metabolism: Clinical V Abstract 1495: Serum Creatine/Creatinine Ratio Elevation and Statin Myalgia

34Ann Intern Med. 16 November 2010;153(10):690-692.
Creatine Supplementation Prevents Statin-Induced Muscle Toxicity

35J Clin Pharmacol. 1993 Mar;33(3):226-9.
Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study.

36Mol Aspects Med. 1997;18 Suppl:S137-44. 
Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors.

37Arzneimittelforschung. 1999 Apr;49(4):324-9.
Effect of treatment with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on serum coenzyme Q10 in diabetic patients.

38J Atheroscler Thromb. 2005;12(2):111-9.
Reduction of serum ubiquinol-10 and ubiquinone-10 levels by atorvastatin in hypercholesterolemic patients.

39J Atheroscler Thromb. 2005;12(2):111-9.
Reduction of serum ubiquinol-10 and ubiquinone-10 levels by atorvastatin in hypercholesterolemic patients.

40Rakel: Textbook of Family Medicine, 8th ed.
Copyright © 2011 Saunders, An Imprint of Elsevier

41Mol Aspects Med. 1997;18 Suppl:S137-44.
Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase_inhibitors.

42J Clin Pharmacol. 1993 Mar;33(3):226-9.
Evidence of plasma CoQ10 -lowering effect by HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study.

43Arzneimittelforschung. 1999 Apr;49(4):324-9.
Effect of treatment with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on serum coenzyme Q10 in diabetic patients.

44Invest New Drugs. 2001;19(1):81-3.
Phase II study of high dose lovastatin in patients with advanced gastric adenocarcinoma.

45Am J Cardiol. 2007 May 15;99(10):1409-12. Epub 2007 Apr 3.
Effect of coenzyme q10 on myopathic symptoms in patients treated with statins.

46Biofactors. 2005;25(1-4):147-52.
Treatment of statin adverse effects with supplemental Coenzyme Q10 and statin drug discontinuation.

47Am J Cardiol. 2012 Aug 15;110(4):526-9. doi: 10.1016/j.amjcard.2012.04.026. Epub 2012 May 18.
Effect of coenzyme Q10 supplementation on statin-induced myalgias.

48Am J Cardiol. 2007 Nov 1;100(9):1400-3. Epub 2007 Aug 16.
Effect of coenzyme Q(10) supplementation on simvastatin-induced myalgia.

49Atherosclerosis. 2011 Oct;218(2):451-6. doi: 10.1016/j.atherosclerosis.2011.07.007. Epub 2011 Jul 20.
Mechanisms of statin-induced myalgia assessed by physiogenomic associations.

50J Am Coll Cardiol. 2008 Oct 28;52(18):1435-41. doi: 10.1016/j.jacc.2008.07.044.
Coenzyme Q10 Coenzyme Q10: an independent predictor of mortality in chronic heart failure.

51Pharmacol Ther. 2009 Dec;124(3):259-68. doi: 10.1016/j.pharmthera.2009.07.003. Epub 2009 Jul 25.
Role of coenzyme Q10 (CoQ10) in cardiac disease, hypertension and Meniere-like syndrome.

52Herz. 2002 Mar;27(2):174-8.
Conditioned nutritional requirements: therapeutic relevance to heart failure.

53Am J Clin Nutr. 2013 Feb;97(2):268-75. doi: 10.3945/ajcn.112.040741. Epub 2012 Dec 5.
Effect of coenzyme Q supplementation on heart failure: a meta-analysis.

54Biofactors. 2003;18(1-4):79-89.
Overview on coenzyme Q10 as adjunctive therapy in chronic heart failure. Rationale, design and end-points of “Q-symbio”–a multinational trial.

55J Cardiovasc Nurs. 2002 Jul;16(4):9-20.
Coenzyme Q10 and cardiovascular disease: a review.

56Lipids. 1989 Jul;24(7):579-84.
Age-related changes in the lipid compositions of rat and human tissues.

57Biofactors. 1999;9(2-4):291-9.
Coenzyme Q10 improves the tolerance of the senescent myocardium to aerobic and ischemic stress: studies in rats and in human atrial tissue.

© Copyright David Leonardi, M.D. All rights reserved. 2019