‘Mystery’ Statin Side Effect Explained; Here's Why Cholesterol Drugs Cause Muscle Pain

A

certain side effect that many people get when taking cholesterol-lowering medication like statins has been a big puzzle to doctors for a long time. However, recent studies have uncovered key causes and why they occur. For those having muscle pain, weakness, or tenderness and fatigue, it could be due to a leak of calcium in the cells.

Calcium leak makes it worse

According to new research by Columbia University's Vagelos College of Physicians and Surgeons, for some, this leak can lead to issues with ryanodine receptors or reduced coenzyme Q10, which can cause muscle weakness. However, many of the reported cases may also be due to something known as the nocebo effect - not directly caused by the drug but by the negative expectations of side effects. Among the most commonly prescribed statins, Atorvastatin (Lipitor) and Simvastatin (Zocor) are among the best ones to help control high cholesterol levels. Doctors typically recommend atorvastatin as the first choice for stronger treatment, but there are other options available, such as rosuvastatin, Pravastatin, and Fluvastatin. Most of these medications lead to myalgia – also known as muscle pain, tenderness, or weakness- in a lot of people. While it is rare to have actual muscle damage, many also do not have it. The symptoms that are usually present are soreness or fatigue, and, in rare cases, can lead to severe muscle breakdown.

What does the research say?

Scientists say the side effects happen when statins bind to a protein in muscle cells, which leads to a leak of calcium ions into the cells. Statins then cause spontaneous and irregular releases of calcium from storage compartments in muscle cells, thereby causing damage, weakness, and pain. “A discovery may explain why so many people abandon cholesterol-lowering statins because of muscle pain and weakness. Researchers found that certain statins can latch onto a key muscle protein and trigger a tiny but harmful calcium leak inside muscle cells,” read the summary of the study. “That leak may weaken muscles directly or activate processes that slowly break them down, offering a long-sought explanation for statin-related aches." “It is unlikely that this explanation applies to everyone who experiences muscular side effects with statins, but even if it explains a small subset, that’s a lot of people we could help if we can resolve the issue,” Andrew Marks, chair of the Department of Physiology and Cellular Biophysics at the Vagelos College of Physicians and Surgeons, told the Daily Mail. "I’ve had patients who’ve been prescribed statins, and they refused to take them because of the side effects. It’s the most common reason patients quit statins, and it’s a very real problem that needs a solution,” he added.Also read: Scrolling Your Phone in Bed and 4 Other Daily Habits That Secretly Wreck Your Heart Health

How do statins work?

Statins help lower "bad" LDL cholesterol by inhibiting HMG-CoA reductase, an enzyme in the liver responsible for producing cholesterol. By reducing liver cholesterol synthesis, they trigger an increase in LDL receptors on liver cells, which accelerates the removal of LDL from the blood, reducing cardiovascular risk, stabilizing plaques, and decreasing inflammation. Statins are highly effective when taken at night since the majority of cholesterol production occurs then. They are also a long-term treatment, and so, if you stop them, the cholesterol levels will rise again.