Niacin, Simvastatin & Nutrient Depletion
Also searched as Simcor. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Niacin, Simvastatin has been associated with depletion of BETA-CAROTENE, PHOSPHATE SALTS and COENZYME Q10. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Niacin, Simvastatin long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Niacin, Simvastatin pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Niacin, Simvastatin
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
BETA-CAROTENE
Insignificant DepletionSIMVASTATIN (Zocor)
Clinical research shows that simvastatin can reduce serum levels of circulating beta-carotene, but this is probably only in proportion to the lowering of cholesterol (on which beta-carotene is transported). Supplements are not usually needed.
Beta-carotene is a plant pigment your body converts into vitamin A, which supports healthy vision, skin, and immune function. Because beta-carotene hitches a ride in the bloodstream on cholesterol particles, simvastatin's job of lowering cholesterol can bring beta-carotene levels down a little along with it. That said, this is rated as insignificant, meaning the drop tends to track with the cholesterol reduction rather than reflecting a true shortage in your body. Most people on simvastatin do not need to do anything about this, but if you have questions or eat a very limited diet, your pharmacist or doctor is a great person to check with.
What Vitamin A does & food sources
Vitamin A supports vision, immune function, and skin health.
Common food sources:
- Liver and fish oils
- Dairy and eggs
- Orange and yellow vegetables (as beta-carotene)
- Leafy greens
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider before supplementing vitamin A — status testing is not routine, and intake from food plus multivitamins is often already adequate.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Vitamin A is fat-soluble and accumulates; excess is harmful (and dangerous in pregnancy). Prefer food sources unless a clinician advises otherwise.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Avoid high-dose vitamin A in pregnancy or when trying to conceive unless a clinician directs it.
Learn more about this nutrient: Beta-carotene — uses, safety & interactions
References (2)
- Jula, A., Marniemi, J., Huupponen, R., Virtanen, A., Rastas, M., and Ronnemaa, T. Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men: a randomized controlled trial. JAMA 2-6-2002;287(5):598-605. PubMed
- Tonstad S, Silverstein M, Aksnes L, Ose L. Low dose colestipol in adolescents with familial hypercholesterolemia. Arch Dis Child 1996;74:157-60.
PHOSPHATE SALTS
Insignificant DepletionNIACIN
There is some evidence that niacin reduces plasma phosphate levels by interfering with active transport in the intestine. In people with metabolic syndrome and hyperlipidemia, taking slow-release prescription niacin (Niaspan, Abbott Labs) 2 grams orally daily for 8 weeks reduced plasma phosphate levels by approximately 15%. However, most people taking prescription niacin are unlikely to need phosphate supplements unless their dietary intake is low.
Phosphate is a mineral your body needs for strong bones, energy production, and keeping your cells working properly. There is some research showing that niacin may modestly lower phosphate levels in the blood, possibly by interfering with how the intestine absorbs it. That said, for most people on prescription niacin, this is rated as an insignificant concern, and a phosphate supplement is not something most people need. If you have questions about your diet or any symptoms, it is worth a quick chat with your pharmacist or doctor.
Learn more about this nutrient: Phosphate Salts — uses, safety & interactions
References (1)
- Hu, S, Shearer, GC, Steffes, MW, Harris, WS, and Bostom, AG. Once-daily extended-release niacin lowers serum phosphorus concentrations in patients with metabolic syndrome dyslipidemia. Am J Kidney Dis 2011;57(1):181-2. PubMed
COENZYME Q10
Insufficient EvidenceHMG-CoA REDUCTASE INHIBITORS ("Statins")
HMG-CoA reductase inhibitors can reduce serum coenzyme Q10 levels. They block the synthesis of mevalonic acid, which is a precursor of coenzyme Q10, in a dose-dependent manner. Taking atorvastatin 80 mg daily for 30 days reduces coenzyme Q10 serum levels by 52%, but atorvastatin 10 mg daily or pravastatin 20 mg daily do not have this effect in healthy people. In other research, taking simvastatin 20 mg daily for 4 weeks reduces serum coenzyme Q10 levels by about 32%, but muscle levels increase by 47%. Since coenzyme Q10 is transported with low-density lipoprotein (LDL) cholesterol, reduction in LDL cholesterol levels by a statin may increase the amount of free coenzyme Q10 in the blood that is available for uptake into muscles. There is no reliable evidence that statin adverse effects such as myopathy are linked to reduced coenzyme Q10 levels in the blood, or that taking coenzyme Q10 supplements reduces statin side effects.
Coenzyme Q10 is a natural compound your cells use to produce energy, and simvastatin may reduce the amount your body makes. Here is why: statins work by blocking a liver pathway called HMG-CoA reductase, and that same pathway also happens to produce coenzyme Q10, so the medication can cut production as a side effect. That said, the evidence on whether this actually causes harm is genuinely unclear, and researchers are still debating whether lower blood levels even translate to a real problem in muscles or elsewhere. If you are curious about your personal situation, it is worth raising the question with your pharmacist or doctor rather than starting a supplement on your own.
What Coenzyme Q10 (CoQ10) does & food sources
CoQ10 helps cells produce energy and acts as an antioxidant; heart and muscle tissue use it heavily.
Common food sources:
- Organ meats and fatty fish
- Whole grains
- Nuts and seeds
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
There is no routine blood test for CoQ10 in everyday practice. If you have new, unexplained muscle symptoms on a medication linked to CoQ10 (statins are the best-known example), talk to your prescriber before changing anything — symptoms have many possible causes and your prescriber has several options.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
CoQ10 is generally well tolerated, but evidence for supplementing (for example, for statin muscle symptoms) is mixed. It may also modestly affect warfarin — check with your pharmacist before combining.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Do not stop a prescribed medication because of this association — discuss any symptoms with your prescriber first.
Learn more about this nutrient: Coenzyme Q10 — uses, safety & interactions
References (12)
- Folkers K, Langsjoen P, Willis R, et al. Lovastatin decreases coenzyme Q levels in humans. Proc Natl Acad Sci USA 1990;87:8931-4. PubMed
- Mortensen SA, Leth A, Agner E, et al. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med 1997;18:S137-44. PubMed
- Ghirlanda G, Oradei A, Manto A, et al. Evidence of plasma CoQ10-lowering effect by HMG-CoA reductase inhibitors: A double blind, placebo-controlled study. J Clin Pharmacol 1993;33:226-9. PubMed
- De Pinieux G, Chariot P, Ammi-Said M, et al. Lipid-lowering drugs and mitochondrial function: Effects of HMG-CoA Reductase inhibitors on serum ubiquinone and blood lactate/pyruvate ratio. Br J Clin Pharmacol 1996;42:333-7. PubMed
- Bargossi AM, Grossi G, Fiorella PL, et al. Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med 1994;15:187-93. PubMed
- Watts GF, Castelluccio C, Rice-Evans C, et al. Plasma coenzyme Q (ubiquinone) concentrations in patients treated with simvastatin. J Clin Pathol 1993;46:1055-7.
- Hanaki Y, Sugiyama S, Ozawa T, et al. Coenzyme Q10 and coronary artery disease. Clin Investig 1993;71:112-5. PubMed
- Berthold HK, Naini A, Di Mauro S, et al. Effect of ezetimibe and/or simvastatin on coenzyme Q10 levels in plasma: a randomised trial. Drug Saf 2006;29:703-12. PubMed
- Fuke C, Krikorian SA, Couris RR. Coenzyme Q10: A review of essential functions and clinical trials. US Pharm 2000;25:28-41.
- Bleske BE, Willis RA, Anthony M, et al. The effect of pravastatin and atorvastatin on coenzyme Q10. Am Heart J 2001;142:E2. PubMed
- Rundek T, Naini A, Sacco R, et al. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Arch Neurol 2004;61:889-92.. PubMed
- Laaksonen R, Jokelainen K, Sahi T, et al. Decreases in serum ubiquinone concentrations do not result in reduced levels in muscle tissue during short-term simvastatin treatment in humans. Clin Pharmacol Ther 1995;57:62-6. PubMed
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Niacin, Simvastatin
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Niacin, Simvastatin & nutrients: FAQs
Does Niacin, Simvastatin deplete BETA-CAROTENE?
Should I take a supplement because I take Niacin, Simvastatin?
Should I stop taking Niacin, Simvastatin?
Where does this information come from?
Questions about Niacin, Simvastatin and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Niacin, Simvastatin are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.