Q: I am a 60-year-old woman in good health who enjoys exercising and eating fruits and vegetables. High cholesterol and blood pressure runs in my family and I am currently on medication which controls both.
I have recently been having muscle pain and stiffness in my thighs and lower back. How do I know if this is caused by the statin drug I am on or by the aging process? My doctor doesn’t want me to go off the statin, as my readings really go up then. Thanks for your help.
A: Statins are a class of drugs prescribed to lower cholesterol levels by inhibiting HMG-CoA reductase, which is an enzyme. High cholesterol levels increase a person’s risk for developing cardiovascular disease and other medical conditions and the use of statins have been found to prevent or substantially lower such an occurrence. As a point of information, as of four years ago, there were more than a half dozen statins on the market, with the best selling product being atorvastatin, a/k/a Lipitor. The manufacturer of this one product reported sales of $l2.4 billion dollars in 2008. Because of patent expirations, several generic statins are now available on the market at a reduced cost to purchasers.
Having said this, statins do have several unwanted but possible side effects, including muscle pain, abnormally high liver enzymes, muscle problems, and an increased risk for developing diabetes. These better known side effects are followed by neuropathy and sexual dysfunction. Anecdotal reports of significant cognitive decline have also been reported. Because of the volume of those anecdotal reports, the FDA mandated a statement to this effect on the manufacturer’s labeling. The effects are listed as rare and reversible when the product is discontinued.
Observational studies reveal that between 10 and 15% of individuals prescribed statin drugs do experience muscle pain. Rare reactions include muscle inflammation, myopathies and the destruction of muscle cells that can result in severe kidney disorders. While all commonly used statins can produce similar results, the newer ones on the market characterized by longer half-lives and more cellular specificity have had a better efficacy ratio to lower adverse rates.
Because you state your pain is in your thighs and lower back, I am not sure the statin is contributory. Sixty isn’t old if you are physically active and eat well-balanced meals. Unfortunately, you may be doing all the right things to keep your cholesterol levels down but because of heritage, you are having to take medication for full control. And, without knowing your full medical history, I cannot offer an opinion as to whether you should go off the drug or not. So here again, I don’t know if you can blame your pain on the aging process.
If you haven’t recently had one, I feel you need a complete examination, EKG and perhaps more lab testing as a baseline. While you have likely already had blood drawn, you should have periodic testing to be assured your liver enzymes are within normal limits. You might speak with your physician regarding a trial period of niacin or plant-based over-the-counter sterols and stanols to determine if the pain subsides. Only then will you have your answer as to whether there is a connection between the statin you are on and the pain you are experiencing.
