Do I Have Statin Intolerance?

Medically reviewed by Alyson Lozicki, PharmD on December 11, 2017Written by Brian Wu, PhD on December 11, 2017

Healthy cholesterol levels

Cholesterol is not bad for you. The body produces it naturally. But when the body gets too much cholesterol from your diet it becomes dangerous. There are no longer specific levels of “good” and “bad” cholesterol that everyone should have to be considered healthy.

Each person has different health factors that determine their risk for developing heart disease. Your ideal levels of cholesterol may be different for someone else. Your cholesterol numbers, your age, other health problems, and whether you smoke will also determine your ideal cholesterol level and if you need medication.

What are statins?

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

What are the symptoms of statin intolerance?

Statin intolerance occurs when a person develops side effects from statin use. There are different symptoms you may experience. The most common is muscle pains or cramps, 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. These symptoms may not be a result of the medication, but your doctor will conduct tests and get background information to find out.

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

How is a statin intolerance diagnosed?

Your doctor will take steps to diagnose you since statin intolerance can mimic other health problems. Your doctor may have you stop taking statins to see if your symptoms stop and then slowly reintroduce the drug to see if your symptoms return.

Your doctor may also:

  • perform a full medical evaluation
  • perform 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
  • conduct genetic tests to see if you are genetically prone to side effects from statins
  • conduct a muscle biopsy to remove a small amount of muscle for testing
  • require a symptom questionnaire, where you describe your symptoms
  • conduct a muscle strength test to evaluate the strength of your muscles

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 it reduces your symptoms. They 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.

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. Your doctor may also prescribe non-statin cholesterol-lowering drugs.

When to talk to your doctor

You should talk to your doctor if you think you’re experiencing statin side effects. A different medication you’re taking could cause side effects could cause or 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.

Outlook

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

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

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