Has your doctor prescribed a medication for cholesterol ? Have you ever felt aches and pains in your body, especially in your muscles, after starting the medication? If so, you're not alone. Many people who take statins , a type of cholesterol-lowering medication, have experienced this. But don't be alarmed. Let's take a look at why this happens, what can be done about it, and when we should be more concerned about it.
First, let's see, what is this statin?
Simply put, statins are a type of medication that doctors prescribe to lower the “bad” cholesterol, or LDL cholesterol, in our bodies. These are very important medications. Because they are a safe class of medications that have been proven to reduce the risk of serious conditions like heart attack and stroke. That’s why doctors all over the world are prescribing these medications so often.
Why does this medicine make my muscles hurt?
Doctors still can't say for sure what causes this. But there are several theories. One is that this medication may have a small effect on the way our muscle cells use energy. Think of our muscle cells as little engines. This medication may make a small difference in the way those engines work. Another theory is that this medication may cause a small leak of things like calcium and protein from the muscle cells. Some people may be more sensitive to these changes than others.
And there's another thing. That's the "nocebo effect." That is, if we think in advance, "Oh... if I take this medicine, my muscles will hurt," we are more likely to actually feel that pain. Even though this is a psychological thing, the pain is real.
This muscle pain, if it occurs, usually occurs within the first few months of starting the medication or after increasing the dosage. You may feel a persistent ache or weakness in your shoulders, thighs, hips, or where your hair is curled. Many people feel this pain equally on both sides of their body.
Who is at higher risk of developing this pain?
Not everyone who takes statins gets this pain. But some people are at a slightly higher risk. Let's see who they are.
| Risk factor | Description |
|---|---|
| Age | Being 80 years of age or older. |
| Body size | The risk is slightly higher for petite women. |
| Existing medical conditions | Having a pre-existing muscle disease, kidney, liver, or thyroid disease. |
| Medication dosage | Taking a high dose of statin medication. |
The most important thing is, don't stop taking the medicine as soon as you feel your muscles aching. Talk to your doctor first. He or she will give you the best solution.
Well, what do we do about this muscle pain?
When you tell the doctor about this, he will suggest several solutions for you. Let's see what they are.
Take a short break as advised by your doctor (Statin Vacation)
This involves stopping the medication for about 3 to 4 weeks under the guidance of your doctor. If the pain is caused by the statin, the pain should go away within this time. Another option is to take the medication every other day instead of every day. This may help lower your cholesterol without causing muscle pain.
Changing the dosage of medication
Sometimes, reducing the dose of your statin may help reduce or eliminate muscle pain. But there are pros and cons to this. Reducing the dose may cause your LDL cholesterol levels to rise again. So, this decision should be made after talking to your doctor.
Switching to another medication
If you have trouble with one type of statin, you may be able to get relief by switching to another type of statin. Or there are other non-statin cholesterol-lowering medications. You can ask your doctor about these.
| Non-statin drugs | How it works (in simple terms) |
|---|---|
| Ezetimibe | It prevents the body from absorbing cholesterol from the small intestine. |
| Bile acid sequestrants | It prevents cholesterol in the blood from being reabsorbed into the body. |
| PCSK9 inhibitors | Accelerates the process of removing LDL cholesterol from the body. |
| ACL inhibitors (e.g. Bempedoic acid) | Limits the production of "bad" cholesterol by the liver. |
Be careful about what else you take.
Be sure to tell your doctor about any other medications, herbal products, or vitamins you are taking, as some things can interact with statins and increase your risk of side effects. For example:
- Grapefruit juice
- Some high blood pressure medications ( Calcium channel blockers )
- Immunosuppressants
- Some antifungals and antibiotics
- Some types of hormones
Exercising
It's normal to feel sore after exercise. However, some research has found that moderate exercise can reduce muscle soreness caused by statins. If you're new to exercise, ask your doctor what exercises are right for you. However, if you're doing very strenuous exercise (like running a marathon), your pain may increase. In such cases, your doctor may ask you to stop taking your statin for a day or two.
Lifestyle changes
By eating a heart-healthy diet (high in fiber, low in saturated and trans fats ) and getting at least 150 minutes of moderate exercise per week, you can lower your “bad” (LDL) cholesterol and increase your “good” (HDL) cholesterol. It’s also important to quit smoking if you smoke. With these lifestyle changes, you may be able to reduce the dose of statins you need to take.
When is muscle pain an emergency?
Most of the time, muscle pain from statins is not harmful. However, very rarely , in only a few people out of a million who take statins, a serious condition called rhabdomyolysis can occur. This is when muscle cells are severely damaged. Taking high doses of statins or taking statins with other drugs increases this risk.
If you experience one or more of the following symptoms together, it may be an emergency. Call your doctor immediately . Or go to the Emergency Department (ETU) of your nearest hospital.
- Very severe muscle pain
- Red or dark brown urine
- Body becoming very weak
At a time like this, the doctor will perform blood and urine tests to confirm whether this condition exists.
Take-Home Message
- Statin is a very important drug for your heart health.
- Muscle pain is a common side effect of this medication, but most of the time it's not dangerous.
- Do not stop your statin medication for any reason without talking to your doctor .
- There are many ways to manage this pain. You can do things like change the dosage, switch medications, and make lifestyle changes.
- Severe muscle pain, dark urine, and weakness is an emergency. Go to a hospital's ETU immediately.
Statin, cholesterol, muscle pain, heart disease, side effects, Statin, cholesterol , Muscle Pain, Side effects, Rhabdomyolysis, heart health, pain management
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