Statins and Muscle Pain:
What Are The Risks?




Statins and muscle pain commonly go together. Studies suggest that 10% - 15% of patients who take statin drugs experience some muscle pain. The pain is usually more prevalent when patients begin statin treatment or when their dosage is increased.

Muscle pain associated with statin use may be mild and temporary. Or it may be severe and chronic… continuing after the patient discontinues using statins. In very rare cases patients die from severe muscle damage known as rhabdomyolysis.


Rhabdomomyolysis: Statins and Muscle Pain at the Rare Extreme


Rhabdomyolysis is the rapid breakdown of skeletal muscle (or rhabdomyo). It is due to muscle damage caused by physical force or biological or chemical influence. The muscle damage results in the release of products into the bloodstream such as myoglobin… a protein which is harmful to the kidney and can result in kidney failure.

Some estimates state that about 1 in 10,000 statin users develop rhabdomyolysis. The percentage goes up significantly if fibrate treatment is added. Grapefruit juice can also cause problems.

Muscle damage is normally associated with high levels of an enzyme known as creatine phosphokinase. A CPK isoenzymes test can detect CPK thereby suggesting that muscle damage has occurred. However, according to Richard H. Karas, MD, PhD, the test is not flawless. In an interview with WebTV he said… "We found that these patients can have evidence of microscopic damage to their muscles even with a normal CPK." In other words... muscle damage due to statin use can be present even when the CPK test is negative.

Dr. Karas – along with colleagues from Boston’s Tuft University as well as the University of Bern in Switzerland - studied samples from 83 patients. 44 of these had statin-related muscle pain lasting up to several months.

Among these there were many patients showing evidence of muscle damage even though their CPK levels were normal.

Dr. Karas is quoted in the July 7, 2009 issue of the Canadian Medical Association journal (CMAJ) as saying…

"Our findings call into question whether normal or mildly elevated levels of serum (CPK) can be used to exclude underlying and possibly ongoing muscle injury."
Does that mean heart patients should discontinue use of statins for fear of having undetected muscle damage? No! The percentage of patients using statins that suffer from life threatening rhabdomyolysis is extremely rare. However it is important to be aware of the slight – but potentially serious – side effects of muscle damage associated with statin use.




Statins and Muscle Pain on a Less Serious Level


Even when there is no threat to life, the combination of statins and muscle pain can be a nagging irritation. But do some statins cause muscle pain more than others?

Statins and Muscle Pain

There are actually two classifications of statins. Some are fat soluble. Others are water soluble. Fat soluble statins enter inside the muscle cell much more readily than water soluble statins. In theory – then – water soluble statins should be less likely to cause muscle pain.

So is the association of statins and muscle pain more prevalent in fat soluble statins?

There is no direct evidence to suggest that fat soluble statins cause more muscle pain than water soluble ones. However the connection of statins and muscle pain varies from patient to patient. That is… most patients experience no muscle pain with statin use.

Some patients experience muscle pain with one statin drug but not with another. Further… some patients experience muscle pain at the early stages of statin treatment. However, with continued use the pain goes away.

But what if it doesn't?
Many doctors recommend discontinuing statin use until muscle pain symptoms subside. Some will prescribe a different statin and monitor the patient’s response.




CoQ10, Statins, and Muscle Pain


A number of doctors associate the connection of statins and muscle pain with CoQ10 deficiency.

It is widely accepted that Coenzyme Q10 is essential for the production of cellular energy. Because of the high metabolic needs of the heart – Congestive heart failure has been linked to CoQ10 deficiency as well.

It is also known that statin use depletes CoQ10 levels. It is therefore suggested by many holistic doctors that patients using statins should supplement with CoQ10.

An article appearing in PubMed entitled "Effect of coenzyme q10 on myopathic symptoms in patients treated with statins" tested the relationship between statin induced muscle pain and CoQ10 supplementation. Patients were randomly assigned to two groups and evaluated after 30 days. The first group received 100 mg/day CoQ10. The other group received 400IU/day vitamin-E.
After a 30-day intervention, pain severity decreased by 40% (p <0.001) and pain interference with daily activities decreased by 38% (p <0.02) in the group treated with coenzyme Q10. In contrast, no changes in pain severity (+9%, p = NS) or pain interference with daily activities (-11%, p = NS) was observed in the group treated with vitamin E.
If the connection between statins and muscle pain is related to insufficient cellular energy then CoQ10 supplementing may help. Since CoQ10 deficiency has been connected to congestive heart failure, and statins are known to deplete CoQ10 levels - It is no wonder a number of doctors recommend CoQ10 supplements for patients using statins.

Click here to learn more about CoQ10.

Should you supplement with CoQ10 while using statins? There is evidence to support it. And because there are no known side effects with CoQ10 supplementation it is safe. Talk to your doctor.


Do You Have a Statin Story?



Have you used statins? Do you now? Are you close to someone who has used statins?

Have statins saved your life? Have they been a nightmare?

Please share your story with us. It doesn’t have to be bad news. But it can be. If you would like to share your story we would love to hear it.
How?
By having your own webpage here at Optimal-Heart-Health.com. It is easy and fun. You can tell us as much as you would like… or as little. And others can leave comments on your page. You can leave comments on others as well.

Simply use the link below to share your statin story with us.

Click here to Share Your Statin Story.

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