What is a statin? Are statins safe? How do I lower my cholesterol and LDL?
What are statins?
Statins are a type of prescription medicine that are used to treat high cholesterol. High cholesterol increases the risk for serious ailments such as heart attack, stroke, and diseased blood vessels. Statins reduce the amount of cholesterol and bad fats in your blood, which reduces the risk of these dangerous conditions. Statins work by blocking the production of cholesterol.
What are the common side effects of statins?
Most people who take statin drugs do not experience any side effects. However, less than 10% of people taking statins will experience side effects. Make sure to review the safety information for these medicines.
Common side effects (1–10%):
- Muscle pain
- Muscle damage (elevated creatine kinase levels)
- Stuffy nose and sore throat
- Mouth and throat pain
- Flatulence, constipation, diarrhea, nausea
- Heartburn (reflux)
- Abdominal pain
Rare side effects (< 1%)
- Hair loss
- Cognitive impairment (memory loss, amnesia, confusion)
- Increased blood sugar and hemoglobin A1C
- New-onset diabetes mellitus
- Eye irritation
- Interstitial lung disease
- Liver damage
Do statins cause muscle damage?
Muscle pain and weakness are some of the most common side effects of statin use (around 10%). This is typically experienced as weakness, fatigue, and general soreness. For most people, this will not be anything more than some discomfort — there is no actual damage to the muscles that can be measured by blood tests or other special tests. And if you stop taking the medicine, these feelings go away. However, there are rare cases (< 1%) of actual muscle damage, which can be quite severe. If you are taking statins and have symptoms like this or you have other symptoms that you are concerned about, then you need to talk with your doctor right away.
Do statins cause diabetes? Will statins increase my blood sugar?
Most people (> 99%) who take statins will have no problems with increased blood sugar or developing diabetes because of the statins. However, there is a small risk that statin medications can increase blood sugar levels and even cause diabetes to develop in someone who did not have it before taking the medication. This small risk seems to be related to how much medicine you are taking. There is a higher risk in those who are on very high doses of statins, and there is a lower risk with those on lower doses. But even with high-dose statins, the risk of higher blood sugar or developing diabetes is still rather small — about 1 in 500 at the worst.
The big picture is that statins significantly reduce the risk of heart attacks, strokes, and bad blood vessel problems — as much as 20% to 30%. So the benefits of taking a statin really outweigh this small risk of an increased blood sugar level and possible diabetes. If you are concerned about your blood sugar or risk of diabetes, you need to talk to your doctor in person.
Do statins cause brain damage? Do statins cause dementia?
Statins do not cause dementia. There is a small number of people who can develop reversible confusion and/or memory loss after starting a statin (< 1%). If confusion and/or memory loss occurs, the use of the medication is stopped. These symptoms will then reverse, and things will go back to normal once the medication is stopped. The FDA changed the safety information for statins, which you should review. You should talk to your doctor if you have concerns about your memory or ability to think clearly while taking a statin.
Is it safe to take other medicines with statins? Can I drink grapefruit juice with statins?
You can take most medicines alongside statins with no problems. However, there are a few medicines that you need to avoid. Some medicines block the body’s ability to breakdown statins. This causes the level of statins to build up in your body. In these cases, you are at a very high risk for many negative effects such as muscle and liver damage, among others. Always make sure that your doctor knows about all your medications so you can make good and safe decisions about what to take or avoid.
There are some medicines that you should absolutely avoid while on statins. Meanwhile, there are others that will require you to take a smaller dose of your statin. And to make things even more confusing, not all statins are equal here. Some of them can be combined with these other medicines, while others cannot. The bottom line is to review your medicines carefully with your physician.
Here are some classes of medications that commonly cause problems with statins (not a complete list):
- Certain antifungal medications: itraconazole, ketoconazole, posaconazole, etc.
- Certain antibiotics: erythromycin, clarithromycin, telithromycin, etc.
- Certain HIV medicines (protease inhibitors): boceprevir, telaprevir, nefazodone, etc.
- Calcium channel blockers like verapamil, amlodipine, and diltiazem
And about that juice! Grapefruit juice can also block the breakdown of statins. It takes a lot of juice to do so, but it is still possible. Just make sure to drink less than a quart of grapefruit juice per day and you will be fine. Drinking any more than that while taking statins can put yourself at risk.