BLOG.ADVANCED-MEDICINE.COM: Question from Patient Suffering from Statin Side Effects

Question from Patient Suffering from Statin Side Effects

Dear Dr. Kroner,

Thank you for this (Statin Side Effects) article. I was started on Pravachol 20 mg po q day approx. 6 weeks ago. After taking it for just 2 weeks, I stopped due to severe, activity-limiting muscle aches ( arms, thighs) and arthralgias (particularly in forearms, elbows, wrists and hands) accompanied by fatigue. These sx have persisted for 4 weeks now with a little improvement, but I'm still not able to do my usual moderate, regular exercise routine and feel exhausted. How long do these sx take to resolve? Are the arthralgias typical? Should I try CoQ10?

I'm an active, healthy 51yo female. My doctor doesn't think my sx are statin-related, wants me to try a lower dose or another statin, which I won't attempt until these sx resolve completely and I've investigated this further. Thank you for your thoughts. -

- Female (Anonymous) from Maryland

Hi,

Thank you for your note.

I am sorry to hear about your side effects. I see the side effects of myalgias and fatigue related to statin use regularly. On one occasion, I have witnessed arthralgia as a side effect. It may take up to 3 months for symptoms to resolve.

The most important thing to understand is whether or not you need the statin in the first place.

What is your risk of heart disease? Did your doctor recommend a coronary calcium score in order to figure out whether or not you have plaque in your arteries? One of the indications for statin use, according to the American Heart Association is coronary artery disease. I would also want to know what your other risk factors are: such as diabetes, smoking history, obesity, insulin resistance, sedentary lifestyle, family history of early onset coronary artery disease, etc.

I would want to perform blood tests that further risk stratify you: I would check a VAP cholesterol panel to assess your LDL particle size (the larger the LDL particle size, the less the chance that it will cause plaque formation), homocysteine, cardio-CRP, Lipoprotein (a), uric acid, HgA1C, fasting glucose, fibrinogen, fructosamine, etc. This will help to determine the degree to which you need the statin. I would definitely assess your baseline coenzyme Q 10 levels via a blood test. An average amount to take in the setting of statin use would be 100 - 200 mg of ubiquinol - the more bioactive form of coq10 daily with breakfast.

Hope this helps. Stay well.

Best,

Dr. Zina Kroner

Internist