Latest News on Statin Side Effects

Carole Jackson from Bottom Line's Daily Health News wrote the following article about statin side effects.


Sometimes it seems as if everyone over age 50 takes statins -- women and men, middle aged and elderly, and lots of people whose cholesterol levels are barely a blip over normal. In fact, lipid-regulating drugs are among the most common prescriptions in this country -- but their side effects are a troubling but seldom acknowledged issue, even by the doctors prescribing them. Beatrice A. Golomb, MD, PhD, at the University of California, San Diego, a leading researcher in this area, recently published a review analyzing nearly 900 studies on the many problems associated with statin use. Not only is this the most complete analysis ever published, her paper also explains why some people are at higher risk for problems than others.

SIDE EFFECTS

Based on patient reports, the number-one statin side effect, which is also the most recognized, concerns adverse effects on muscles including muscle pain, fatigue and weakness. (There is also an association with a rare but potentially devastating muscle condition called rhabdomyolysis, which causes severe muscle damage that can produce toxins that can eventually lead to renal dysfunction and possibly death.)

Second on the list is cognitive problems, including some that are dementia-like. Third place goes to peripheral neuropathy, which causes tingling, pain and numbness in the feet and hands. Other side effects are less frequent but wide ranging, from blood-glucose increases to sleep disruption and atrial fibrillation, as well as -- and this should get some attention -- sexual dysfunction.

It’s widely known that statins decrease coenzyme Q10, harming the mitochondria, which are the power producers in our cells. Dr. Golomb says this explains why people at highest risk for statin side effects are those who already have conditions that adversely affect mitochondria function -- high blood pressure, diabetes, thyroid problems or simply being older. CoQ10 is helpful in minimizing mitochondrial damage, which is obviously especially important for people with these pre-existing conditions -- but as noted, statins deplete this coenzyme. Dr. Golomb noted that this may be why statins aren’t as helpful for people who are over 70 or so.

Observational studies indicate that 10% to 30% of people taking statins will likely experience side effects, and that women seem to be at higher risk than men. Are you wondering why these problems aren’t frequently reported in clinical trials on statins? According to Dr. Golomb, one reason is because participants selected for such studies tend to exclude those most likely to have side effects -- such as people who take other medications along with those who have other health problems. Pharmaceutical companies pour millions of dollars into clinical trials, which are designed to, as Dr. Golomb puts it, "showcase the benefits" of the drugs. However, there are no corresponding interest groups to make sure that the other side also gets heard -- and people at higher risk for side effects are not excluded from taking the drugs once they are on the market. Keep in mind that one-fifth of all fully tested drugs put on the market are ultimately withdrawn or receive a black box warning. The reason: Once a larger and broader population takes a drug over a longer period of time, potential problems not shown in clinical trials will surface.

With so many people taking statins, it’s particularly important to be alert to problems that develop after you start taking these drugs. Side effects can become progressively worse, so it’s vital to investigate any possible ones immediately -- by stopping the drug to see if the problem reverses or stops. The good news is that many side effects are at least partially reversible, says Dr. Golomb. Potency of the statin increases the risk of side effects, so be especially suspicious if problems develop when you are taking a high dose. Taking less may be a solution, if you and your doctor feel you really need to be on statins.


Source(s): Beatrice Golomb, MD, PhD, University of California, San Diego.