Are you struggling with muscle pain caused by a Statin drug? This video you can find
out 7 tips which can help with the muscle pain. Coming up next.
Can statins cause muscle pain?
Adverse events causing muscle pain and aches occur in varying frequency and according to
uptodate.com( a peer reviewed online journal) 2-11% have this type of pain with a lower frequency of 0.5% for myonecrosis
( a breakdown of your muscle tissue) and 0.1% for rhabdomyolysis. (This is a direct or indirect
injury of your muscle tissue which can lead to kidney failure) I will discuss all these
different muscle injuries later in this video.
In fact, the type of injury to your muscle has a variety of names. The most common being
a medical term referred to as myalgias. You will have a feeling of soreness, stiffness,
or tenderness in your muscles. Sometimes this is described as a cramp. The best way of comparing
this is if you ever had a viral infection like the flu that’s the type of pain you
may experience. Another type of injury to your muscles is refer to as myopathy which
just means your muscle is weaker. You may have pain and discomfort with this weakness.
Then there is a muscle inflammation where you will feel muscle discomfort and soreness.
This is called myositis. A step worse than this is a term called myonecrosis where because
of muscle breakdown a marker called CK is released and can be measured. The worst type
of this is rhabdomyolysis where during this muscle breakdown a protein is released from
your muscles and excreted in your urine. You can also have acute renal failure with this
condition. If you want to skip to the tips check the
time stamps in the section below.
If you are interested in a more detailed discussion of Atorvastatin and side effects, click on
this link above.
Clinical symptoms: Typically, your upper muscles in both your
extremities feel weak and sore. So things which you and I take for granted like getting
up from your chair, walking upstairs, raising your arms will be affected. Sometimes these
symptoms feel cramp like, and some patients even complain about tendon pain. As the tendons
are close to our joints and can be radiating this is also sometimes described as pain in
the joints. Usually, in my experience these symptoms can
occur within weeks after initiation of a statin drug, but sometimes this can occur after months
and sometimes after years. So, if you are having pain or soreness talk to your physician
about going off the drug. Symptoms should resolve typically within 2-4 weeks. Sometimes
it may last up to six months. Now, if you are unlucky and this disorder does not resolve,
and you continue to have symptoms you may have an immune mediating necrotizing myopathy.
This is due to antibodies being built against an enzyme in the muscle. This would probably
need a referral to a specialist as further work up would be needed include an MRI, and
a biopsy. Other disorders that may have been induced
by statin therapy is a condition called. mononeuritis multiplex. What does that mean? It happens
when there is damage to 2 or more nerve areas. This is a type of neuropathy when nerves are
affected. So you will experience a group of symptoms such as numbness, tingling, lack
of sensation, difficulty to control movement & pain. Another Statin induced disorder is
a myopathy or weakness around your eyes which mimics Grave’s disease’s eye ailment.
Risk factors: I am now going to list some Statin medications with an increased risk
for muscle injury: Lovastatin,(Mevacor) Simvastatin(Zocor) and Atorvastatin(Lipitor) The reason is the
way it metabolized in your body. Some other Statin drugs have a lower risk If you are
they are metabolized differently thus having less of a risk : Fluvastatin (Lescol) , Pravastatin
( Pravachol) and Pitavastin( Livalo).The ability to cause muscle injury among the different
statins also depends on the Statin dose. The higher the dose the higher the risk.
The other thing is that certain diseases such as hypothyroidism, renal failure, liver diseases,
ALS are also associated with a higher risk of muscle injury secondary to statins.
And as always, your genetics also plays a role if you are more susceptible to Statin
injury, so that might be a possible reason. I am going to list some drugs, which if you
are taking, you are more susceptible to muscle injury if taken together with Statins.:
HIV drugs, CCB, Amiodarone, Macrolide antibiotics such as Azithromycin, Erythromycin ,,anti-fungal
medications, cyclosporines, colchicine, fibrates, niacin. So talk to your Doctor if you are
on one of these drugs. If you are interested in the side effects
of other common medications click on this link above.
How we diagnose a muscle injury from Statins?
Physical examination including a detailed drug history.
CK However, there are some patients who have
muscle cramps and aches without an increase of this muscle marker(CK).Your health care
provider should have a high index of suspicion depite a normal ck value if you continue to
have symptoms. A trial without a statin with the permission from your Doctor maybe warranted.
QUESTION OF THE DAY? Are you on a STATIN and do you have muscle
aches. Leave you comments in the section below.
What are some things you and your Doctor can do if you do have muscle pain while on a Statin?
Here are the 7 tips: 1)Discontinue the drug waiting for resolution
of symptoms. Your symptoms, like mentioned earlier should resolve within a couple of
weeks. 2)Your doctor might lower the dose of the
Statin or even change the class of the Statin to an alternative class of drug.
3)Another approach is to give the drug every other day.
4)If symptoms persist switch to a non-statin therapy such as Niacin, Fibrate, or a newer
class of drugs called PCSK9 inhibitors or bile acid sequestrants such as Cholestyramine.
However, more importantly, lifestyle changes are the most important .I’ll rather have
you on no medications, because as you know if you have seen a lot of my video all drugs
have side effects and drug-drug interactions. My goal is to minimize or even eliminate drug
intake if possible. How can you do that. Lose weight and enjoy a diet rich in fiber, fruits, vegetables
and fish. Lean meat and chicken. Stay away from processed meat.
5)Sometimes Vitamin D is lower and your doctor might choose to re-challenge you once the
level has improved after being replenished with an appropriate dose of Vitamin D.
6) Your doctor might add Coenzyme Q10.Doses can range from 30-250 mg/day. Coenzyme Q10
plays a role in muscle cell energy production. Therefore, this supplement is suggested to
help muscle related problems caused by Statins. The studies are mixed and here is a meta analysis
on the screen which did show benefit. Have a discussion with your health care provider
about adding this supplement. 7)You might want to try taking in red yeast
rice. Red yeast rice is a fermented rice product.Red yeast rice has a compound similar to Lovastatin.
Red yeast rice is able to reduce your bad cholesterol called LDL and according to uptodate.com
by about 20-30%.( https://www.uptodate.com/contents/lipid-management-with-diet-or-dietary-supplements/abstract/85).
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