What Are the Side Effects?
All medicines can have side effects. With statins, the most
common one is muscle pain. Anywhere from 5% to 20% of people who take
statins report having it. And it's more common among people taking
high doses. But it's not clear if those muscle symptoms are actually
related to statins, or if something else is to blame.
"Most people can tolerate these
drugs, but a handful of my patients do have muscle aches,"
Steinbaum says. If that happens, switching to a different statin,
lowering your dose, or taking your pill every other day instead of
daily might help. Talk to your doctor before you change how you take
any medicine.
In very rare cases, statins can cause
severe muscle damage that can be life-threatening. This may happen
with certain statins, especially if it interacts with another drug
that you take. Be sure to review all your prescription and
over-the-counter medications and supplements with your doctor.
Other rare side effects include liver
injury, so ask your doctor how often your liver enzymes should be
tested. Ongoing liver monitoring is no longer recommended, but
Steinbaum still advises it: "I still do liver checks often,
because if you're taking a statin along with even something like
Tylenol, you could have damage."
Memory loss or confusion and neuropathy
(a pins and needles sensation) have also been reported, though they
seem to be rare and more likely at very high doses. The FDA hasn’t
concluded that statins cause those problems.
You might have also heard that taking a
statin could raise your risk of developing type 2 diabetes. Research
has found that some people do get a small rise in their blood sugar
levels while they take a statin, but it's hard to say that these meds
actually cause diabetes.
"I really looked at the data
long and hard, and what I gathered is that most of the people who
developed diabetes [after starting a statin] were going to get it
anyway," Steinbaum says. "They were already at very
high risk thanks to metabolic syndrome, being overweight, or other
factors."
Cost may also be another issue for some
people, though Nissen points out that you can now get some generic
statins for as little as $10 per month.
What Else to Keep in Mind
Whether or not you choose to take a statin, lifestyle changes
still matter. "About 80% to 90% of the time, heart disease
is preventable through modifiable risk factors," Steinbaum
says. She notes that eating a healthy diet (including limiting
sugar), being active, not smoking, and keeping your weight down are
all key.
Still, there are other things you can’t
change, like your age and your genes. Although diet and exercise are
a must, they aren’t enough for everyone. Still, overhauling your
habits might mean that you can take less medication, which can mean a
lower risk of side effects.
Still on the fence? Talk to your
doctor, and ask for more information that may help you decide.
Make sure you talk about “risk
factors” that are not part of the latest risk calculator from the
AHA and ACC. Those might include your family history, C-reactive
protein levels (a marker of inflammation), or a personal history of
gestational diabetes (a type of diabetes that only happens during
pregnancy).
Your doctor may consider other things,
too. Steinbaum sometimes orders imaging tests to look for
calcification in the arteries or measure the thickness of the carotid
artery, which carries blood from the heart to your brain, before she
decides whether to recommend a statin for a particular patient. But
those aren’t routine tests.
Although statins are still a go-to
medicine, there is no one-size-fits all prescription. And if they
don’t help you enough (along with diet and exercise), or you can’t
take them because of side effects, there are also other types of
cholesterol-lowering medicines.
It’s best to have an open, ongoing
conversation with your doctor about the risks and benefits. Let them
know how you’re doing. "If your doctor isn't having a
dialogue with you about it," Nissen says, "you might want
to find another doctor."
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