If you have had a heart attack and take statins to lower
cholesterol, you probably should continue to do so. Statins help
to prevent further heart attacks and strokes.
However, if you have never had heart disease and are taking
statins to help prevent a heart attack, you may want to check with
your doctor. Statins help to prevent heart attacks in only two
out of 100 people who have never had heart attacks. They also cause
diabetes, memory loss, and muscle pain and can interfere with your
ability to exercise.
STATINS INCREASE DIABETES RISK: Statins raise blood sugar
levels and increase risk for developing diabetes (JAMA, June 22,
2011; 305(24):2556-64). The US Food and Drug Administration has
recommended that statins have labels stating that they increase
risk for diabetes and memory loss. These side effects increase
with higher doses and potency of statins. With 20 million
Americans currently taking statins, this means 100,000 new cases
of diabetes.
STATINS DELAY RECOVERY FROM EXERCISE: Statins can interfere
with your ability to exercise, a potent preventative of heart
attacks. Athletes train by taking a hard workout that damages
muscles and feel sore on the next day. They then take easy
workouts until the soreness goes away. Statins increase muscle
damage from exercise (Am J Cardiol. January, 2012;109(2):282-7).
Therefore they delay muscle recovery from hard exercise. So you
can't take as many intense workouts on statins. This prevents you
from competing at your best and even from gaining the healthful,
heart-attack-preventing benefits of exercise.
STATINS CAUSE MUSCLE PAIN (MYOPATHY): Statins cause muscle
pain and weakness in 10 to 20 percent of people who take them
(New England Journal of Medicine, March 8, 2012). If you take
statins and have muscle weakness, it is likely to be caused by
the statins if the weakness is primarily in your hands, feet and
lower legs. Weakness in the thighs and upper arms is usually
caused by nerve damage, not by statin-induced muscle damage.
WHAT FACTORS INCREASE RISK FOR MUSCLE DAMAGE? You are
at increased risk for statin-induced muscle damage if you are
older than 60, have a low functioning thyroid gland, liver damage,
or are overweight. The higher the dose of statins, the more likely
you are to have muscle damage.
Drugs taken with statins that markedly increase muscle damage
include:
* other drugs to lower cholesterol (fibrates, gemfibrozil),
* drugs to lower high blood pressure (calcium-channel blockers),
* drugs to shrink an enlarged prostate (doxazosin, and finasteride).
COMMON BRAND NAMES OF STATINS: Lipitor (atorvastatin),
Lescol (fluvastatin), Mevacor (lovastatin), Altoprev (lovastatin
extended-release), Livalo (pitavastatin), Pravachol (pravastatin),
Crestor (rosuvastatin), Zocor (simvastatin), Advicor, Vytorin,
Simcor.
Gabe Mirkin, M.D.
10901 Connecticut Avenue, Kensington MD 20895, USA