7 Reasons Not to Dismiss Statin-Caused Pain
Muscle pain can often be treated, and might signal a more serious health issue
Most people who take statins suffer no side effects from the cholesterol-lowering drugs. A small but significant number, however, develop mild to crushing muscle pain. In rare cases, the drugs can lead to permanent muscle damage, kidney problems, and death. Doctors disagree about the frequency of statin-induced muscle pain; clinical trials put the number at around 3 percent, though some doctors estimate that as many as 10 to 15 percent of statin patients are affected to some degree. Are you among them? Here are seven reasons not to dismiss the discomfort as a harmless symptom of age:
1. Your doctor might. There's evidence in the medical literature that patients on statins don't report any more muscle pain than those on a placebo, which causes many doctors to disregard any complaints. One 2007 study showed that when patients suggested a link between their pain and statin use, nearly half of doctors dismissed the possibility. Also, some hospitals offer financial incentives to doctors who keep their patients' cholesterol levels low, which encourages them to overlook side effects, says Beatrice Golomb, an associate professor of medicine at the University of California-San Diego School of Medicine and the lead investigator behind a research project that tracks the side effects of statins.
2. Mild pain might be just the beginning. "Every patient who starts statins should monitor mild muscle pain," says Ronald Krauss, an expert on cholesterol and senior scientist at Lawrence Berkeley National Laboratory. "The mild pain can lead to more severe damage down the line," he says. There's a blood test available that can determine the extent of muscle damage.
3. Slight prescription changes might solve the problem. As my colleague Avery Comarow has reported, taking a lower dose or an alternative brand can make all the difference.
4. For some patients, the benefits of statins may not outweigh the risks. Though there's strong evidence that middle-aged men at a high risk of heart problems—who have diabetes, for example—survive longer on a statin, the evidence is hardly as robust for other patient populations, most notably women. Other risk factors that people should weigh in deciding on treatment: age, smoking history, blood pressure, HDL levels, and a family history of early heart disease.
5. You may have a genetic predisposition to statin-related side effects. There's growing understanding that specific genetic variants put people at a high risk of developing statin-induced side effects. Just today, researchers published a study in the New England Journal of Medicine that shows a strong link between a genetic variant called SLCO1B1 and adverse effects associated with simvastatin (Zocor). It's already known that statin intolerance tends to run in families. In the future, research such as this will likely allow doctors to tailor treatment more effectively.
6. There's quality of life to consider. For some people, statins can take a real toll on quality of life. Not being able to walk down the stairs without pain, say, or participate in cherished hobbies can put people experiencing strong adverse effects of statins into quite a funk that can lead to depression or other health problems. Athletes, for example, have a particularly hard time adjusting to statins, says Golomb. Some decide that reducing their heart risk isn't worth a diminished quality of life, she notes.
7. There are alternatives to statins. Statins can dramatically decrease cholesterol levels, but they're not the only option. Lifestyle changes, including the right diet, exercise regime, and dietary supplements, can also reduce LDL cholesterol levels.
Reader Comments
Statins hate me
I am a 62 yr. old female who is very active. UNTIL I TAKE STATIN DRUGS. I have been on several statin drugs over the course of five years. Every single one of them, no matter what strength, gives me severe muscle/neck pain. I have cervical spurs on my spine and the statin drugs just want to make that pain ten times worse than it really is. Every single time I try a new statin drug, within three weeks I cannot turn my head or look down. My doctor does not think it is the statin drug and he gets upset when I take myself off of them. But in every case, when I stop taking them, the pain goes away. I have just been given 5 mg Crestor and thought maybe that might work for me. Last week I fell while walking my dogs and thought I had pulled my neck muscles. But, then again..... it is about the time for the statin drug to kick in so I can hardly move my head. I am stopping the Crestor on my own because my doctor can't see me for another week. If the pain is gone by then, I will KNOW it is the statin drug.
My numbers are 230 which isn't good, and on a statin drug the number goes down to about 140. But if I am depressed and in pain all of the time, how can that be good?
statins
I had found a perfect description of how I feel and my granddaughter deleted before I had a chance to print it. I have the desire to cry when I walk up stairs, Legs hurt terrible, feet hurt andheels,Get sudden pain here and there like a big needle in every part of money,balance off, memory off like say the closet when I mean the cellar, balance a little off, tired, vision is out of wack and I have ocular migraines, legs hurt just to touch them. I feel like a hypochroniac but I am not.
Statins
I have been on statins since 12/02. The doctors typically started me on the lowest dose then elevated me to the maximum dose because I had such lousy results. I have been on Zocor, Lipitor, Crestor, Crestor & Zetia, Vytorin, Whelchol, Simvastatin and now Prevastatin. Typically when I first take the new statin, my total cholestoral will go down maybe 30 points. Then it levels off and I am instructed to increase the dosage. The lowest reading I have ever had in the 7 years ws back in 2003 when it was 193. I have complained over the years about my leg pain and the difficulty of manuvering any inclines (hills, stairs etc.). I even was given a test for PAD--that was negative. My legs would get worse everytime the statin dosage was increased. I am a Type II diabetic on oral medication and also have hypertension that is controlled with 3 medications. As a diabetic is is extremely important to exercise. I have complained to my doctors about the difficulties I have exercising with the leg pain. The doctors say that "we can't do nothing". So without my doctor's knowledge, I reduced my Prevastatin from 80mg to 40mg. My legs still hurt but not as much on a lower doseage but I am able to walk up and down hills without crying in pain. I saw a study that is underway at the University of Buffalo that is aimed at determining if there is a genetic basis that determines who is vulnerable to the reaction of muscle pain and statins. they want to track down the genes that may be responsible. I e-mailed them today to see if I could participate. I know because of my diabetes, hypertension and family history of heart disease, that I am a high risk for a heart attack or stroke. My feeling is, why take a medication if it does nothing and it makes you feel miserable? I was taken off statin for 4 months and my highest reading was 325. Bottom line, some of us should not be taking statins!
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