Emily Moore and Diana Zuckerman, PhD
Statins are the most popular type of cholesterol-lowering medication and among the most widely prescribed drugs in the world. Popular brands include Lipitor, Zocor, Crestor and Vytorin. They prevent the body from making cholesterol and can help prevent heart disease and stroke. While these medications can substantially lower your cholesterol, the benefits do not outweigh the risks for everyone who has high cholesterol.
The greatest risks of statins are muscle pain, memory loss, forgetfulness, confusion, and high blood sugar levels that can result in Type 2 diabetes.
Several studies have found that people who take statins, especially at high dosages, are more likely to develop diabetes. This was first noticed when a clinical trial showed an unexpected 27% increase in new cases of diabetes among patients taking Crestor, compared with patients who took placebos.[end Hlatky MA. “Expanding the orbit of primary prevention–moving beyond JUPITER”. N. Engl. J. Med. November 2008; 359 (21): 2280-2.] An analysis in 2011 of five clinical trial studies found a link between the onset of diabetes and the use of high-dose statins (80 mg), compared to moderate doses of the same pills (40 mg, 20 mg, or 10 mg, depending on the study). In all five studies, patients who had suffered acute coronary syndrome (ACS) and patients who have stable coronary heart disease were more likely to develop diabetes if they were taking higher doses of statins.[end Preiss, D. Risk of Incident Diabetes With Intensive-Dose Compared With Moderate-Dose Statin Therapy. J Am Med. 22 Jun 2011; 305(24):2556-64.] Acute coronary syndrome is a medical term that includes any symptoms of an insufficient blood supply to the heart muscle. In addition, a study of women who were over 55 reported that taking a statin increased the risk of a new diagnosis of diabetes.[end Culver AL, Ockene IS, Balasubramanian R, et al. Statin use and risk of diabetes mellitus in postmenopausal women in the Women’s Health Initiative. Arch Intern Med. 2012;172(2):144-152.]
Since high doses of any statin can increase the risk of diabetes, doctors should check the blood sugar levels of a patient before starting them on treatment and put the patient on the lowest possible dose.
Memory loss, forgetfulness and confusion can occur in any age group with any statin product, according to the FDA. These symptoms were generally not serious and were reversible within a few weeks of stopping statin use.[end Food and Drug Administration. Consumer Update: FDA Expands Advice on Statins Risk. http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM293705.pdf] For those who are experiencing “fuzzy” thinking or similar symptoms, they should consult their doctor first before stopping statins.
Muscle damage from taking a statin, especially at high doses, is a well-known side effect of statin use. The FDA has added to their previous warnings by listing several medications that interact with one kind of statin –lovastatin, which is also known as Altroprev or Mevacor – and increase the risk of muscle damage. These medications include erythromycin (a common antibiotic) and protease in lovastatin.
Statins can also cause liver damage, so doctors should test liver function before starting a patient on statins, and test liver function afterwards only if the patient is displaying symptoms of liver failure. These symptoms include: jaundice (the skin becomes yellowish), bleeding easily, and a swollen belly.
While many doctors encourage all patients with high cholesterol to go on statins, their benefits are primarily for people who have already developed cardiovascular disease, such as a previous heart attack, stroke, or chest pain. High cholesterol is not the same thing as heart disease. If you have high cholesterol but haven’t been diagnosed with heart disease or cardiovascular disease, cholesterol-lowering drugs are unlikely to benefit you, according to well-respected cardiologist Dr. Rita Redberg, of the University of California at San Francisco. Dr. Redberg tells us that adults and children who have high cholesterol should focus on improving their health through healthier eating habits and exercise. If those efforts don’t have much impact on your cholesterol levels, they will still improve your health and help protect you from heart disease.
The possible side effects of statins, alone or in combination with other medications, can be serious. To find out more about different types of cholesterol-lowering medications and read a comparison of risks and benefits for particular brand name drugs, please check out Our Complete Guide to Cholesterol Medication.
All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.