Cholesterol itself is not bad for you. In fact, the body produces it naturally. It’s when the body gets too much cholesterol, often with help from your diet, that it becomes dangerous.

You should ideally aim to have your total cholesterol level less than 200 mg/dL and your LDL, or “bad,” cholesterol level less than 100 mg/dL. High cholesterol is categorized by total cholesterol levels that are 240 mg/dL and above, and LDL cholesterol levels that are 130 or higher mg/dL. HDL, or “good,” cholesterol helps to protect against heart disease, so the higher your number, the better. Levels less than 40 mg/dL can increase your overall risk of heart disease.

What Are Statins?

Statins are a commonly prescribed drug used to treat high cholesterol. They work by blocking the enzyme that makes cholesterol in the body. In many cases, people treated with statins respond well and their cholesterol levels are lowered. In other instances, a person can develop statin intolerance, which can be dangerous.

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What Are the Symptoms of Statin Intolerance?

Statin intolerance can occur when a person develops side effects from statin use. There are several different symptoms that you may experience. The most commonly experienced statin intolerance symptoms are muscle pains or cramps, which are also called myalgias.

You may experience muscle inflammation and an elevated marker of muscle injury called creatine kinase. You may experience these symptoms or similar ones while taking statins, but they may or may or may not be a result of the medication. Your doctor will conduct tests and get background information to find out for sure.

Statins can also cause liver and muscle toxicity. In severe cases, people have developed rhabdomyolysis. This is a rare condition in which muscle cells break down in the body. It causes severe muscle aches and weakness through your entire body, as well as dark or cola-colored urine. If this condition is not treated, it can lead to liver damage and even death.

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How Is a Statin Intolerance Diagnosed?

Since statin intolerance can mimic other potential health problems, your doctor will take steps to diagnose you correctly. Your doctor may have you stop taking statins for a period of time and see if your symptoms stop. They will then slowly reintroduce the drug to see if your symptoms start again.

Your doctor may also do any of the following:

  • a full medical evaluation
  • a blood test to show if you have any abnormalities, such as high levels of creatine kinase or liver damage
  • review of your family history to see if others in your family have statin intolerance
  • genetic tests to see if you are genetically more prone to side effects from statins
  • a muscle biopsy, where your doctor will remove a small amount of muscle for testing
  • symptom questionnaire, where you will be able to describe your symptoms
  • a muscle strength test to evaluate the strength of your muscles

Your doctor may also have you stop using statins. You may get a blood test to show if you have any abnormalities such as high levels of creatine kinase or liver damage.

What Are the Risk Factors?

Certain factors may put you at an increased risk for statin intolerance:

  • 80 years or older
  • female
  • Asian ethnicity
  • certain preexisting conditions, such as neuromuscular, kidney, or liver conditions
  • excessive alcohol consumption
  • excessive exercise
  • grapefruit juice consumption

How Is Statin Intolerance Treated?

Many statin problems are related to dosage. Your doctor may reduce the amount you are taking to see if that helps with your symptoms. He or she may prescribe a lower dosage or even decrease the number of days per week you take your medicine.

Lifestyle changes are also encouraged. A healthy diet can help lower cholesterol naturally and decrease your cardiovascular risks.

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Your doctor may change which statin you’re taking. There are several statin options, and you may have a better reaction with a different type. There are also non-statin cholesterol-lowering drugs your doctor may prescribe.

When to Talk to Your Doctor

If you think you’re experiencing statin side effects, you should talk to your doctor. Your side effects could be from a different medication you’re taking, or they could indicate an underlying condition.

Resolving your symptoms may be as simple as switching your medicines. Statins are the most popular and effective cholesterol medicine, but there are alternatives on the market.

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Statin tolerance is very serious, so always talk to your doctor before you stop taking your medicine or begin taking any new medicines.

High cholesterol is very dangerous so never gamble when it comes to your treatment. Your doctor can help to figure out if you are suffering from statin intolerance or another health problem and come up with the best treatment plan.