Statins are drugs that can be helpful in lowering LDL (“bad”) cholesterol. But statin side effects like liver damage and memory issues can also occur. Your doctor can help you weigh the pros and cons.

Statins are a class of drugs that lower the levels of artery-clogging LDL (“bad”) cholesterol in the bloodstream. Reducing LDL decreases the risk of heart attacks and strokes, especially in people who have other risk factors.

Your doctor may recommend a statin if you have high cholesterol that you have not been able to manage with diet, exercise, or weight loss. You also may be prescribed a statin if you have had a heart attack or other condition that was caused by blockages in your arteries.

Heart disease is a very common health condition and high cholesterol is an important risk factor for developing it. Heart disease is also the leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC).

This prevalence of heart disease-related deaths and the fact that statins are effective and tolerated well by most people are the reasons statins are so widely used.

In fact, according to data from the CDC, cholesterol-lowering drugs are one of the most frequently prescribed drug classes in the United States, along with pain-reducing drugs and antidepressants.

When analyzing trends over the past decades, they noted that statin use increased from 18 to 26 percent between 2003 to 2012. By 2012, 93 percent of adults who used a cholesterol-lowering medication were using a statin.

Guidelines by the American Heart Association (AHA) recommend cholesterol-lowering drugs for people that fall into one of four categories:

  • people with a history of cardiovascular disease caused by atherosclerosis, which is a buildup of plaque on the walls of the arteries
  • people with high levels of LDL (greater than 190 mg/dL)
  • people between the ages of 40 and 75 who have diabetes
  • people between the ages of 40 and 75 who have elevated LDL levels (70 to 189 mg/dL) and a greater risk of developing cardiovascular disease due to atherosclerosis over the next 10 years

Cholesterol is a waxy, fatty steroid. It comes from the food you eat and is also produced in your body, mainly in your liver. Your body needs cholesterol for things like:

  • cell production
  • sex hormones
  • digestion
  • converting sunlight to vitamin D

Cholesterol travels via your bloodstream. This is where LDL cholesterol can form plaques. Plaques are thick, hard deposits that cling to the walls of arteries and restrict blood flow.

It’s also possible for pieces of plaque to break off and move into the bloodstream. When this happens, blood clots can form, which can lead to a stroke and other serious health conditions.

Statins work by inhibiting an enzyme that your liver needs to produce LDL cholesterol. Statins also minimally increase HDL (“good”) cholesterol, which is responsible for moving bad cholesterol from your arteries back to the liver.

Like any medication, taking statins can lead to side effects. The exact side effects you may experience can vary from statin to statin.

Generally speaking, the side effects people experience from statins may improve with time or by switching to another statin.

Now let’s explore some of the more notable side effects of statins that you may have heard about.

Statin effects on muscles

Muscle-related symptoms can commonly occur due to statin use. This typically presents as muscle pain and sometimes muscle weakness.

These effects tend to be dose-dependent. That means they increase as your dose of statins increases. Because of this, they usually go away when statin dosage is lowered.

There are times when you may be at a higher risk for statin-related muscle symptoms. These include after:

  • starting on statins for the first time
  • increasing the dose of your statins
  • taking another drug that interacts with your statins

Rhabdomyolysis is a serious condition where cells of muscles become damaged. However, this effect is very rare, occurring at an estimated rate of less than 0.1 percent.

Rhabdomyolysis is more likely to occur in people who are taking statins with other medications that carry a similar risk. In fact, it’s estimated that 50 percent of cases of rhabdomyolysis related to statins are due to drug interactions.

Statin effects on liver function

It’s possible for statins to cause an increase in liver enzymes that help digestion. This side effect is typically temporary, does not cause symptoms, and often resolves on its own.

Sometimes, liver damage can occur. However, this is rare. A 2017 review of research notes that liver damage only occurs in about 1 in 100,000 people that use statins.

While the Food and Drug Administration (FDA) used to recommend occasional testing of liver enzymes in people taking statins, this is no longer the case.

This change was made based on the fact that serious liver injury is rare and testing for elevated liver enzymes cannot effectively treat or prevent liver damage from happening. Instead, testing liver enzyme levels is recommended before a person starts taking statins.

Statin effects on blood sugar

Taking statins can also result in an increase in blood sugar levels and can also increase the risk of developing diabetes. People who develop diabetes while using statins often have other preexisting risk factors for diabetes, according to a 2017 research review.

An older 2010 review of studies included 13 clinical trials on statins. It found that statin use was associated with a 9 percent increase in the risk of developing diabetes over a period of 4 years. Within the study population, this came out to about 1 in 255 people on statins developing diabetes.

However, the researchers also noted that the risk of developing diabetes while on statins was low compared with the reduced risk of cardiovascular events like heart attack and stroke that statins have.

A 2021 study also linked statins with diabetes progression in people who already have diabetes. This included a higher risk of starting insulin treatment, having significant hyperglycemia, and experiencing complications due to high blood sugar.

Neurological side effects of statins

There have been concerns about statins impacting a person’s ability to think, particularly their memory. In fact, the FDA requires that drug labels for statins contain information about cognitive side effects like memory loss and confusion.

Several studies, such as ones from 2014 and 2015, have analyzed reports of the cognitive effects of statins. Overall, they’ve found that there’s minimal evidence that statins cause clear cognitive impairment.

Other things to keep in mind

You should not take statins if you are pregnant, nursing, or have active liver disease. There are also medications you should not take with statins. Check with your doctor or pharmacist before starting statin therapy.

While taking statins, do not eat grapefruit or drink grapefruit juice. Grapefruit can interfere with enzymes that metabolize statins. You can end up with too much of the medication circulating in your bloodstream, which increases your risk for severe side effects associated with statins.

In a 2018 scientific statement, the AHA asserts that, for people who statin treatment is recommended for, the benefits of statins “greatly outweigh” the risks. This statement was made after reviewing data from many clinical trials, reviews of studies, and observational studies.

Additionally, a 2013 review of 135 randomized controlled trials found that side effects varied depending on which statin a person took. The study concluded that statins are generally safe and serious side effects were not common.

Are statins good or bad for you? Ultimately, it depends on your risk factors and your health status.

Talk with your doctor about your cholesterol numbers and risk of heart disease. They can let you know if statins are recommended for your individual situation.

What is the most common side effect of statins?

The types of side effects that you may experience can depend on the type of statin that you’re taking. According to the National Health Service (NHS), some of the common side effects of statins can include:

  • muscle pain
  • fatigue or weakness
  • dizziness
  • headache
  • digestive symptoms, like nausea, diarrhea, or constipation

According to a 2019 review of research, muscle pain is one of the leading reasons that people stop taking statins.

Is taking statins worth the risk?

Generally speaking, the benefits of statins outweigh the risks in people with high cholesterol or heart disease, both of which put youn at risk of serious cardiovascular events.

Your doctor can give you a better idea of whether statins are right for you individually.

Can you just stop taking statins?

Stopping statins can be harmful. When you stop taking statins, your cholesterol levels can return to high levels. The National Heart, Lung, and Blood Institute notes that stopping statins on your own increases your risk of a repeat cardiovascular event or death.

If you’re experiencing unpleasant side effects due to statins, it’s important to talk with your doctor about them. They may be able to switch you to a different statin, which can potentially help reduce your side effects.