Dear Dr. Edelman,
I think my statin might be causing muscle aches. What should I do? Are there any other options for me?
Dr. Edelman: First of all, let me start by saying that managing cholesterol is one of the most important things you can do to prevent heart attacks and strokes, and statins are one of our best lines of defense as they lower the LDL or “bad” cholesterol. Statins are highly effective at lowering LDL levels and safe for most people, but one of the most common questions I get asked from my patients on statins is whether or not they could be contributing to their muscle pain. (I always tell them, if your pain is in your neck, first check to see if it’s your mother-in-law!)
The vast majority of people taking statins won’t experience any side effects at all, but a minority of folks can have them. A few factors can contribute to increased risk: if you’re on more than one cholesterol-lowering med, if you’re female, if you’re over 80, if you have a small body frame, if you have kidney or liver disease, if you drink alcohol in excess, or if you have certain conditions like hypothyroidism or certain neuromuscular disorders. Some drugs may also interact with statins, so be sure your doctor knows all the medications you take.
If your muscle aches are bothering you enough that you’d like to try some alternative treatments, here are some options to discuss with your doctor:
- Try going off your statin temporarily. This can help you determine if it’s really the medication that’s causing your pain, or if it’s something else. If the muscle aches go away then you can also restart the statin to see if it comes back as a double check to make sure you are not a hypochondriac. 🙂
- Try a different statin. Your doctor can discuss the various options with you. This will occasionally work and is worth a try.
- Try lowering the dose of your statin, or try taking it every other day if you’re a candidate for this type of dosing schedule.
- Try a different type of cholesterol medication with the advice of your physician like ezetimibe (Zetia), Nadolol (Corgard), or a PCSK9 inhibitor such as Praluant or Repatha.
Some people take coenzyme Q10 supplements to help with muscle aches, but more studies need to be done to prove their effectiveness.
Whatever you do, do NOT stop taking your statin for any length of time without first talking with your provider. Statins have been proven with multiple and large clinical studies to save more lives than almost any other drug developed for heart disease, and the risk of serious side effects is very low. The bottom line is that statins reduce heart attacks and strokes, especially in people with diabetes.
I believe I heard dr Steve and dr Jeremy use the PCSK9 inhibitors (correct me if I am wrong). Do you two have body aches or is there another reason for the use? Also, how long does one have to quit the statins to see if it is the statins causing the muscle pain?
Jeremy had severe muscle aches with statins which is why he’s on a PCSK9 inhibitor. For me, my LDL was not at goal with satins alone, so that’s why I’m on one. And to answer part 2 of your question…4-5 days.