Eating a healthy diet and exercising regularly are often the best ways to maintain healthy cholesterol levels. But if these steps aren’t enough, you may need extra help from prescription drugs called statins.

A few years ago, experts thought that only a certain group of patients should be treated with statins. These were people who had a history of coronary heart disease (CHD) or certain risk factors, such as a family history of CHD.

However, in 2013, the American College of Cardiology and the American Heart Association published new guidelines for statin use. These guidelines suggest that statins could benefit many more people. They recommend statins for people who:

  • have had a heart attack or stroke or who have peripheral arterial disease
  • have an LDL level of 190 or higher
  • have diabetes with an LDL level of 70 or higher
  • don’t have diabetes but do have risk factors for heart attack or stroke, such as smokers and people with high blood pressure

There are many different statins, and they are generally safe for most people to use. Statins can cause side effects, though. Read on to learn about statins, cholesterol, and safety.

The most common side effects of statins are:

  • muscle aches
  • nausea
  • gas
  • diarrhea
  • constipation

Most people are not bothered enough by statin side effects to stop taking them. Usually, your doctor can help you manage side effects by changing your dosage or prescribing a different statin.

However, statins can also cause some serious side effects. They’re rare, but it’s important to watch for them. Statins have been linked with:

  • liver problems
  • muscle problems
  • high blood sugar and diabetes
  • short-term neurological problems, such as mental fogginess or memory loss

A 2010 analysis of study results found that an increased risk of diabetes was the most common serious side effect of statins. Still, the risk is small and thought to be outweighed by the benefits.

Higher doses of statins bring greater risk of serious side effects. Also, some statins may have more side effects than others. For more information, read about six statins and their side effects.

Some people are more likely than others to have side effects from statins. You’re at higher risk if you:

  • are a woman
  • are older than 65 years
  • take more than one medication to lower cholesterol
  • drink more than two alcoholic drinks per day
  • already have kidney disease, liver disease, or diabetes

Statins can cause more side effects if they’re taken with certain medications. These drugs can cause statin levels to build up in your body. This may lead to dangerous liver and muscle problems. Drugs that may interact with statins include:

  • HIV drugs such as atazanavir, darunavir, fosamprenavir, and ritonavir
  • antifungals such as fluconazole, ketoconazole, and voriconazole
  • immunosuppressants such as cyclosporine and tacrolimus

Grapefruit may also interact with some statins. Ask your doctor how much grapefruit or grapefruit juice is safe for you to consume while you take a statin. For more information, read about how grapefruit and statins interact.

If you’d prefer to avoid the side effects of statin medication, there are a few natural statins you can discuss with your doctor. Some natural options that may help improve your cholesterol levels include:

  • red yeast rice
  • psyllium
  • fenugreek
  • fish oil

Be sure to talk to your doctor before trying these supplements. These options may have side effects, too.

Researchers continue to study the side effects and benefits of statins, and results suggest that the benefits outweigh the potential dangers. However, if you’re still concerned about statins and safety, talk with your doctor. They can help you decide if a statin is a good choice for you. Some questions you may ask include:

  • Would a statin be a good way to help lower my cholesterol levels?
  • Am I taking any drugs that could interact with a statin?
  • Am I at high risk of side effects from a statin?
  • Are there other ways I can help reduce my cholesterol levels?