When the first statin, Mevacor (lovastatin), was launched by Merck back in 1987 it was hailed as a wonder drug. Here was a medication that dramatically lowered cholesterol and did not seem to have the same troublesome side effects of previous cholesterol-lowering drugs. The success of Mevacor led to the development of many other statins, including atorvastatin (Lipitor), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).
Cardiologists were enthusiastic about statins and it wasn’t long before primary care physicians hopped on the bandwagon. Over the last two decades tens of millions of Americans have taken one or more of these medicines in the hope of preventing a heart attack. Even people at relatively low risk for heart problems were often encouraged to take a statin “just in case.”
Not long after these drugs became popular, we started hearing from patients about debilitating adverse reactions. Many complained about muscle pain and weakness as well as arthritis, memory and mood problems, neuropathy (nerve pain), erectile dysfunction and elevations in blood sugar. Eventually, research confirmed that all of these are potential side effects of statins. They may not be as rare as many physicians imagined.
One adverse effect that seemingly escaped notice was fatigue. Lack of energy was not reported as a problem in clinical trials or in the official prescribing information that initially accompanied the drugs. Doctors rarely mention fatigue as a complication of statin therapy. Yet, many patients have reported that in addition to cognitive impairment and muscle pain, the lack of energy is overwhelming. Now, new research confirms that fatigue is indeed a side effect of statin therapy.
Beatrice Golomb, MD, PhD, directed the University of California, San Diego, Statin Study. Her most recent publication appears in the Archives of Internal Medicine (online, June 11, 2012) as a research letter. In this group of just over 1000 volunteers, roughly 15 percent experienced lack of energy or tired more quickly when they exercised. Women were especially vulnerable to this statin side effect. Dr. Golomb and her colleagues concluded:
“To our knowledge, this is the first randomized evidence affirming unfavorable statin effects on energy and exertional fatigue…Particularly for women, these unfavorable effects were not uncommon…Physicians should be alert to patients’ reports of exertional fatigue or diminished energy during statin use.”
To better illustrate how such symptoms affect real people, we share some stories and comments that have been posted to this website.
“My doctor has tried me on various statins for my high cholesterol, including Zocor, Crestor and Lipitor. On each of them I was just so exhausted I could barely get my daily routine accomplished. The last straw was when I was mowing the lawn, a chore I typically enjoy, and my legs felt so tired I could barely get across the lawn. I finally told my doctor that she had two choices: I could either exercise or I could take the drug. She chose exercise.”
“Our internist insists my 83-year-old husband continue on pravastatin after having been on Lipitor and other statins for decades. He has muscle weakness and pain, memory loss, extreme fatigue and difficulty walking. Some studies have indicated that after the age of 69, cholesterol medication is of no use. Must he continue this misery the rest of his life?”
“I started taking statin drugs about four years ago with no obvious side effects. My cholesterol gradually started climbing, so last year my doctor prescribed a double dose of Lipitor.
“Within three months I started having small changes that in retrospect I now attribute to Lipitor. I was only 52 years old and in March I could not plant four rose bushes. It became an all-day project that I would work on and have to sit in a folding chair. I thought I was just out of shape. In May I started feeling very bad. No energy, loss of appetite, extreme fatigue, muscle mass deterioration, constipation and inability to get up out of a chair without help. I also experienced neuropathy in my arms, shortness of breath, memory loss and inability to keep up with a conversation. All of this continued to get worse despite my repeated trips to my physician.
“My wife even handwrote a list of all the things that I had been experiencing, which I presented to my doctor. He chose to ignore my symptoms and did not address them.”
“My goodness, I was led to believe that ‘some light muscle cramping is possible, but very rare’. How stupid of me! I am now 60, but two years ago, I ran about 40 to 50 miles per week, with several marathons completed. After a few months on Crestor, I found my shoulders and back muscles just trashed after a day of sailing. It took over two months to recover.
“Later, I experienced severe leg cramps, in the latter stages of a 12-mile run. My doctor was adamant it was not the drug, so I kept running, but slowly, figuring I had just overdone it that one day and would gradually recover as usual.
“After three more months, I was almost paralyzed. When I drove for two hours, I could hardly climb out of my car! Then the doctor decided to reduce the dose; when that didn’t work, I was switched to simvastatin (Zocor). The Zocor label has a warning not to eat grapefruit. As a runner, I consume citrus fruit regularly, so that was THE day I decided not to take Crestor nor Zocor. My doctor continues to assertively promote this drug. I have since mostly recovered, but I still experience some weakness when running hills, and it takes me an unusually long time to recover from long runs.”
“I would like to hear if anyone out there taking SIMVASTATIN suffers from fatigue or memory problems. I take 20mg of simvastatin and since I have been taking it I know my short term memory is definitely fading.”
Some people may have to put up with some statin side effects, especially if they have suffered heart attacks or strokes or have serious heart disease. Others, however, may discover that statins impair their ability to exercise. Most physicians now think that exercise is essential for good health. It would be sad if people had to give up on vigorous physical activity because of statin side effects.
You can learn a lot more about the Dark Side of Statins by listening to our free “bonus” interview with Dr. Beatrice Golomb. She shares some of the latest information about troublesome statin side effects.
If you have a comment to share about statins (positive or negative) please share it below.
