Straight Talk About Statins

Most people taking a statin – 9 out of 10 – do NOT report muscle aches or weakness. Even among those who do, it is usually mild and can be managed.

The trick is that aches and pains are quite common among the age group of people who stand to benefit from statins. There are many other potential causes including exercise, overexertion, sitting for too long, low vitamin D levels, thyroid problems, and arthritis to name a few. Statins tend to affect the large muscles of the legs and arms, not the joints. So experts say if your knee, hip or shoulder bother you, it’s unlikely related to the statin. The good news is that even if you do develop muscle symptoms thought to be related to your statin, there are others you can try.

Bottom line: If you’re worried about it, ask your health care team to take a careful history of your aches and pains before you start on a statin. If you are already taking one and begin to have any muscle symptoms, your health care team can take steps to evaluate and manage them. Many times, it’s as easy as changing other medicines or boosting your vitamin D level.

While it’s true that we need some cholesterol for normal cell and body function, too much “bad” cholesterol can spell trouble. Over time, it can lead to a dangerous buildup of fat and plaque within the walls of your arteries. If this plaque breaks free or blocks the normal flow of blood, it can cause a heart attack or stroke.

Bottom line: Taking a statin – if your health team recommends one – along with exercise, and a healthy diet, is one of the best ways to treat high cholesterol and manage your risk for cardiovascular disease, heart attack or stroke.

There is no clear evidence that statins cause memory loss or problems with thinking. While the Food and Drug Administration added a safety alert label to statins in 2012, other medical experts including the Statin Safety Task Force have carefully looked at the research to conclude the evidence is weak if not nonexistent, even among people with Alzheimer’s disease.

Among those who have developed memory loss or confusion while taking statins, these side effects reverse once you stop taking the medication.

On the flip side, recent data suggest that statins may actually help ward off dementia. That’s because one of the potential causes of memory loss and altered thinking is dementia due to not enough blood flow to the brain, which statins can help with.

Bottom line: Memory problems from statins seem to be unlikely and, in most cases, it is doubtful that statins are the cause. The same process that affects the arteries that supply the heart also can affect the arteries of the brain (called atherosclerosis); this is also a common form of dementia (vascular dementia). Talk with your health care team if you have concerns.

There is a small, potential risk of developing type 2 diabetes as a result of taking a statin. However, experts say this is most often among people who likely would have developed diabetes anyway. For example, they already had borderline blood glucose levels (those nearing diabetes, but not quite) and other risk factors, such as being overweight or being insulin resistant. So while they might develop diabetes a little sooner – data show about one month earlier than they would have off the statin – the benefit of being on a statin becomes even more important because once you have diabetes, you're much more likely to develop cardiovascular disease.

Bottom line: If you are at a healthy weight and don’t have other risk factors, it is very unlikely that you would develop diabetes from taking a statin.

While early research showed a link between statins and liver damage, we now know it is rare. In fact, the FDA no longer recommends routine liver tests after starting statin therapy unless you begin to have signs and symptoms of liver damage. These would include: unusual fatigue, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes.

Your clinician may order a blood test to check your liver before starting you on a statin just to make sure your liver is healthy.

Bottom line: Statins are unlikely to hurt you liver. The benefit of preventing a stroke or heart attack far outweighs the small chance of any liver problems. If you’ve had liver problems or have hepatitis, be sure to tell your clinician. In many cases, you can still take a statin, but your liver levels will need to be checked.