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Statin Muscle Toxicity

Video updated 3/5/2012 to reflect new FDA warning labels citing risks of confusion, memory loss, new onset diabetes and muscle injury. Even people who don’t experience pain or weakness on cholesterol-lowering statin drugs may be suffering muscle damage.

October 1, 2010 |
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Transcript

Who needs lettuce/lentils/legumes, though, when we have Lipitor. This was actually a bad year for statins—the cholesterol-lowering drugs. We’ve known about their potential to damage the liver; that’s why you have to get regular blood tests to check your liver function. But there’s some new data this year on their muscle toxicity.
We’ve known that about 1-5% of patients suffer enough muscle damage to cause pain and overt weakness, but only about one in 6 or 7 million actually suffers enough muscle damage to kill them. It’s called fatal rhabdomyolysis, where your muscles break down so rapidly your urine starts looking like this as you literally start peeing your muscles down the toilet, then your kidneys fail and you die. But that’s like winning-the-lottery chances. There’s a 1 in 2 chance we’ll die of heart disease, so no surprise this is the #1 prescribed drug in the world.
But then this study was published last year. Normally if you have muscle pain on a statin, you go to your doctor and they take blood and see if you have elevated levels of muscle breakdown products in your bloodstream. If you don’t, they basically say it’s all in your head, go home and keep taking your medicine. What these researchers did, though, was they instead took these people and got muscle biopsies and proved, that even though their blood levels were normal they were indeed suffering muscle damage. The damage just wasn’t leaking into the blood stream. Well if that’s the case; if you can’t pick it up with the test, maybe everyone taking statins is suffering muscle damage whether they’re experiencing pain or not.
And that’s exactly what’s been found. Clear evidence of muscle damage in statin-treated patients. This is what your muscle is supposed to look like under a microscope. This is your muscle; this is your muscle on a statin drug.
Still, the degree of overall damage was slight. Most people don’t even feel any pain with statins, so what’s the big deal? This is the big deal. New study on statins, muscle function, and fall risk. Hundreds of older men and women followed for a few years and those who were on statins suffered greater declines in muscle strength and performance, and an increased risk of falls.
So we don’t want to be taking this drug unless we really need it. The problem is, because heart disease remains our #1 killer, most everyone does need it—except for one group. It’s our choice…

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out the other videos on cholesterol. Also, there are 1,686 other subjects covered in the rest of my videos--please feel free to explore them as well!

Be sure to check out my associated blog posts for more context: Soymilk: shake it up!Stool Size and Breast Cancer RiskCholesterol Lowering in a Nut Shell, Generic Lipitor is not the answer to our heart disease epidemicWhat is the best way to get vitamin B12?, and  Vitamin B12: how much, how often?

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • http://nutritionfacts.org/members/wayne/ Wayne

    Very interesting studies. Do you think the medical community knows this information given how readily statins are prescribed?

    • http://nutritionfacts.org/members/mgreger/ Michael Greger M.D.

      Postmarketing surveillance studies suggest that side-effects patients may by under-reporting adverse drug reactions to their physicians. For anyone on statins it’s critically important to let your doctor know immediately if you start experiencing muscle pain, tenderness, or weakness, lack of energy, fever, chest pain, nausea, extreme tiredness, unusual bleeding or bruising, loss of appetite, pain in the upper right part of the stomach, flu-like symptoms, yellowing of the skin or eyes, rash, hives, itching, difficulty breathing or swallowing, hoarseness, or swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.

      • Meyati

        It’s hard to report something when medical staff doesn’t believe in the condition. I had to fight and go to Urgent Care, ERs, and be a pain to my doctor-and I had black urine. My tendons went out 7 months after starting statin. I sat for over 3 hours in a room, when the UC doctor came in-he was screaming that he wouldn’t interfere with the meds my PCP gave me. I was in for back spasms-no falls, not hit, no bruising, no back problems-just statin toxicity. He took X-Rays and helped me in getting the diagnosis. When I was checking out. He ranted at the nurses for how they put me in that room and didn’t write down my complaint and let him judge if I had a side effect of statin, and they weren’t supposed to put patients in rooms and hope the patient left.  
        I really think that thousands of people aren’t diagnosed because of the hostility of the medical community.

  • http://nutritionfacts.org/members/ebaker0460_98/ ebaker0460_98

    In addition to muscle toxicity there is an increased risk of diabetes.

    Culver AL, Ockene IS, Balasubramanian R, et al. Statin use and risk of diabetes mellitus in postmenopausal women in the Women’s Health Initiative. Arch Intern Med 2012; DOI: 10.1001/archinternmed.2011.625. Available at: http://archinte.ama-assn.org/.
    Johansen KL. Increased diabetes mellitus risk with statin use. Arch Intern Med 2012; DOI: 10.1001/archinternmed.2011.625. Available at: http://archinte.ama-assn.org/.

  • http://nutritionfacts.org/members/caffreyc/ caffreyc

    I have high cholesterol – or did. I also am a compulsive eater who hasn’t resolved my issues entirely. But I don’t eat much meat and a year ago I tried halving my statin dose. My chronic pain diminished some – not entirely, but when you have a lot of pain, a little regular reduction helps a lot. My cholesterol tests seem to be OK and I may try stopping the med altogether.

    I also emailed your video to my doctor and to many of my friends.

  • http://nutritionfacts.org/members/wickedchicken/ wickedchicken

    I have been to a LOT of medical conferences, presentations, dietetics evenings, courses. I have never heard anyone mention of the vegan/pure vegetarian dietfor preventing anything!!!! Not a thing about it!!!In fact at a recent diabetes conference one doctor presented on how ALL diabetic or prediabetic patients should be on a statin despite their blood fat readings (even if normal).I wish I had this info at hand at the time, to question her!!!! This makes me more fuelled to change people’s attitudes to prevention. Thank you!

  • http://nutritionfacts.org/members/wickedchicken/ wickedchicken

    I have been to a LOT of medical conferences, presentations, courses. I have never heard any mention of the vegan/pure vegetarian dietfor preventing anything!!!! Not a thing about it!!!In fact at a recent diabetes conference one doctor presented on how ALL diabetic or prediabetic patients should be on a statin despite their blood fat readings (even if normal).I wish I had this info at hand at the time, to question her!!!! This makes me more fuelled to change people’s attitudes to prevention in the medical amd health professional community. hank you!

    • meyati

      Walking and moving around is a large part of lowering lipids and maintaining health. I just can’t do that. Fatigue is one of the side-effects of statin toxicity. I try to mop or do something-anything to keep from going quite insane. I finally got myself built up enough where I can drag water hoses around so my trees don’t die. I like to do woodwork, I work about 30 minutes and rest, even if I don’t feel tired. Once I didn’t feel tired, but slept on the couch for over 16 hours. I woke up 2X, and decided that I was too tired and hurt too much to go to bed.  I’m getting where I can take my dogs for short walks-My doctor started getting after me for weight gain-I told him that maybe I’d be lucky and have CVA and die-what difference does it make? It hurts to drive, I can’t wander around salvage yards and lumber yards. I ice my legs before I go, and ice when I get back. I hired a dog walker to walk and jog the coonhounds 2-6 miles 3X/week. You don’t know how much I miss getting out and being with people. I used to be a democrat county delegate for my ward- I can’t do stairs, I can’t stand in lines, I can’t sit for hours without ice-and I’m allergic to aspirin-acetaphimines.  If I got a million dollars, I’d get my feet amputated and prosthetics so I could be like the military and get out and do something.

      • LynnCS

        I’m so sorry for you.  I have felt like I couldn’t get off the couch too in the past.  I was not on statins, but other drugs.  I started a fruit and veg diet (no animal products) a year ago and now love to walk the loop down at the port here.  If I could tell anyone anything to help, it would be that it’s what you don’t eat/ingest more than what you do that will change your life.  You don’t want to lose any body parts, I know that.  You just want to feel well.  We have done a lot of damage to our bodies and there is a way out.  No animal products, no grains, no cooked foods.  Start juicing all possible vegs/greens and watch Youtube for people on the Raw Food who juice.  It will be a new life for you.  Good luck.

      • Nancy H

        Meyati:

        I am very sorry to hear of your trouble with walking and everyday activities. I am; however, very excited to share something that I’m positive will make a huge difference in your life! Send me an email at nancyhelmold@gmail.com. I look forward to talking with you.

  • Michael Greger M.D.

    Also be sure to check out my associated blog post Vitamin B12: how much, how often?!

    • LynnCS

      Thanks, Doc!  Can’t seem to pull up those posts, but I use the B12 patches every day and don’t want to use anything soy, but understand trying to make sure everyone updates their intake of plant foods. I am now on mostly raw fruits and vegis.  Not perfect, but I definitely thrive on it.  I so love that you do all this research for us.  Thank you. Lynn

      • Paul Spring

        Why no soy?

        • LynnCS

          Good question. It says that was a year ago. I have been on The McDougall Plan since then and feel great. Still don’t really eat soy. No place for it on my plan. I do eat beans, but all whole foods, so no soy products. No refined or processed foods. Thanks for asking.

  • LynnCS

    I’m assuming “Pure Vegetarians” means Vegan?  No animal products.  Why can’t they just say that if you stop eating animal products, you’ll get better?  Either they don’t believe it, or they are in the pockets of the animal product and pharma folks. The latter, I believe.  Maybe both. 

  • Diamondlotus

    Excellent article!  Thanks!

  • Glenn

    Only pure vegetarians…do not need statins? This is confusing. Vegans can have high cholesterol due to the body’s production of it. Does this mean that vegans who have high cholesterol need not take statins?

    • http://www.DonForresterMD.com/ Don Forrester MD

      The specific studies have yet to be done to answer your question. That said the current recommendation based on the best studies (i.e. epidemiological and clinical) and our understanding of the biology is that your goal should be a Total Cholesterol < 150 or LDL Cholesterol < 90. There are folks who follow a whole food plant based diet who don't achieve these levels. There some other modifications lowering fruit intake and nut intake that can be tried beyond that before using medications. The best guidelines I have seen is an article written by Dr. McDougall available for free on his website. The article, Cleaning Out Your Arteries, is in his June 2003 newsletter. Many physicians are recommending lower levels but the best clinical long term results have been demonstrated by Dr. Caldwell Esselstyn. His book, Preventing and Reversing Heart Disease, describes his approach. There are patients who even though they follow the best diet may need to take a medication to lower cholesterol. To avoid the problems with statins there are other alternatives so you need to work with your physicians to work out what is best for you. Of course you need to keep tuned as the science keeps changing.

  • Christine

    In 3 short months on statins, I watched my mom’s muscles waste away until her skin hung off of her body and she could no longer climb stairs / walk (she was only 73 and was a tough as nails woman). I now know that cholesterol can be lowered to healthy levels via a low fat, vegan diet. I wish I knew this then… :-(

    • LynnCS

      You’re a good daughter to feel that way, but we can only do what we can with what we know. My mother died of colon cancer at 76. I’m 75 now. I wish a lot of things. I wish I knew better and would have had enough influence to change things, but I do know that our mothers would want us to do better for ourselves now with the information that we have. After I posted here to not eat grains, I found the McDougall way of life. I believe it is a life saver, so I’m excited for my colon and every daughter who doesn’t have to take statins or eat fatty foods and can save themselves. I didn’t always do it when I was young so I thank my mom often, these days, for paving the way, and teaching me through her experiences.

      • Christine

        Thanks Lynn, I certainly changed my way of eating after my Mom died, and two years ago I took the T. Colin Campbell Foundation Plant Based Nutrition Program from eCornell. That information completely changed the way I look at food, and I’m so thankful I did it. I’m glad you discovered the McDougall info – he was one of the lecturers in the program and he makes some great points. Best of luck to you!

  • Candace

    I am a massage therapist. I have noticed that some of my clients on statins seem to have hardened bodies. I didn’t know if this was due to a dehydrating effect. The muscles and even the fat tissue feels thick. There muscles are usually hypertonic all over. I didn’t know if the medication or the high cholesterol itself did this.

  • Ema

    I was on Zocor for 3 months and couldn’t figure out why I was finding it harder and harder to do anything – then it hit me. I went off Zocor immediately but 4 years later, I am still unable to build up muscle properly. This drug ruined my life.

  • HealthyLiving

    Thank you for publishing this, Dr. Greger. It feels good to have confirmed what my body has always “known”.

    Diagnosed with Familial Hypercholesterolemia at age 22, my overall cholesterol level has been high since it was first checked almost 20 years ago. In October of 2011 it was in the 400 range. As a reference, my siblings’ cholesterol range is between 400-500, despite the fact that they are athletic and thin. Neither of them is taking statins, backed by the advice from a cardiologist at an internationally renowned research hospital. This MD believes that cholesterol, its effect on the arteries/body and whether it indeed needs to be regulated with medicine is not that straightforward at all.

    In my twenties I was prescribed statins, and took several brands for a total of about two years. After complaining of muscle pains that kept me up all night, as well as other ailments, my PCPs kept switching me from one pharma product to the next. Finally, despite being told repeatedly it was important to stay on the statins, I decided that they were probably the culprit for many of the ailments I started having, ailments very a-typical for a twenty-something year old, and I stopped taking them. I changed my diet moderately, and exercised, hoping it was going to be enough to battle cholesterol. Fast forward 14 years, when I was diagnosed with breast cancer. Since then, I have spent much of my time doing research on “healthy living”, or what is known about it thus far. – In an effort to recover from “treatment” and avert possible recurrence, I have drastically altered my diet. With a homeopathic doctor’s guidance, these are some of the changes I implemented: Increased intake of vegetables, especially cruciferous vegetables, as well as fruit, nuts and seeds. I reduced my intake of meat and dairy products, as well as cut out coffee, and replaced it with organic green tea, or ginger “tea” (hot water with fresh pieces of ginger). One other change to my diet – I started taking Curcumin pills daily, which greatly seem to reduce the arthritis pain that began immediately following my chemotherapy “treatments”. Lastly, I use grapeseed oil for cooking, and on days I don’t use it, I take a grapeseed supplement.

    In less than a year after implementing these changes, my overall cholesterol level went down nearly 100 points, albeit allowing myself to “cheat” quite a bit (eating Pizza and/or processed foods, having Starbucks etc). In the past few months I have minimized those “cheats”, and therefore I am really curious to see what my cholesterol levels (HDL, LDL, tri-gyc) will be at my next blood draw in April. – Based on my personal experience, I will continue to do what I am doing, and would never agree to go back on statins. However, it would be gratifying – and beneficial to other people, if conventional medicine finally acknowledged the problems with statins, and scientists/researchers started looking into other options of solving the underlying condition.

    • Paul Spring

      Great story! Given Dr. Greger’s videos on the downside of meat and dairy, have you thought of going totally plant-based for a month or two to see if things improve even more?

  • Victor

    Isn’t your heart a muscle? Don’t statins damage heart tissue as they damage the rest of your muscle’s?

    • meyati

      My doctor ran a cat scan. They seem OK. He was really worried-it centered on my legs, which seems to happen to most people to varying degrees.

  • Christie

    I think i have had all the lowering cholesterol tablets in the book, after a year or so the problems start. My problem is the high trigs; i was taking Vytorin and now they have added Lopid. I hate these tablets but without them I’ll get embolism (lung and spleen)

  • Lawrence

    Sources Cited – second link goes to the third citation. The correct article can be found here http://www.ncbi.nlm.nih.gov/pubmed/19633029

  • Penelope H

    There’s lots of information out there on the problems with statins … So where does that leave those of us whose cholesterol is high without them? I have been vegan/no added fat or oil/whole foods for 2.5 years now (had a blockage) with very little straying (some dark vegan chocolate, white rice at restaurants, that sort of thing). I ride my horses, kayak and run on the treadmill (not every day). I’m 5’3 and 130 lbs. and when I go off my statin (generic Lipitor) my cholesterol goes to 220 ( in the 150s on it). So, yup, there’s places to improve, but… If I go off the statin am I putting myself at risk of the blockage (or heart attack or stroke) again? I haven’t been able to find a doctor who has much experience with this way of eating.

    • http://www.DonForresterMD.com/ Don Forrester MD

      If you have had a blockage and are tolerating the statins it sounds like you will need to stay on them. You can fine tune the diet a bit and need to work with your physicians of course. I realize it is difficult to find a physician knowledgeable and experienced in this area. There is Dr. Esselstyn in the Cleveland area and Dr. Baxter Montgomery in the Houston area. Dr. McDougall wrote an excellent newsletter on how he uses statins and one on cleaning out your arteries… see his newsletters May 2007 and June 2003. I don’t view rice as going off the “diet”. Composed of mainly starches and with no cholesterol which are long chains of glucose molecules it is not associated with inflammation… at least I have seen no good studies on that. It is true that if you are fat from eating calorie dense foods your adipocytes aka fat cells will put out inflammatory compounds so it is important to maintain ideal body fat content for women about 18%. Of course I would recommend going with brown rice as the extra fiber will help lower your cholesterol. We do need more studies on the various populations with and without arterial disease as far as primary and secondary prevention goes. Dr. Esselstyn will have a paper published this year on the success of patients he has treated. His book on preventing and reversing heart disease is an excellent resource. You need to stay tuned to NutritionFacts.org and other commercial free reliable websites such as John McDougall’s to keep up with the important developments.

  • Brian R Gard

    Every day I tell folks about Dr Gregor’s presentations and changing to a plant based diet, about 1 person out of 40 has any interest in it. Amazing, folks seems to think they have to suffer and only surgery and medicine can keep them alive – suckers!