You should be aware of the potential side effects of statins if you and your doctor have made an educated decision to start statin use. Merck, a pharmaceutical giant, has already applied to the Food and Drug Administration three times to allow lovaststatin to be sold over-the-counter without a prescription. This could be dangerous considering the side effects. Statins should only be prescribed and not sold over-the-counter. If your doctor decides to give you statin drugs, the main side effect that he/she should discuss is liver dysfunction. He/she also recommends regular monitoring of your liver enzymes.
Liver Function
The statin dose can directly affect liver function. However, it has not been proven that liver dysfunction is related to cholesterol levels. The primary determinant of liver toxicity is statin dose, not cholesterol lowering. Alawi A, Alsheikh-Ali, et al. The Magnitude of Lipid Lowerinf and the Risk of Elevated Liver Enzymes, Rhabdomyolysis and Cancer. Large Randomized Statin Trials. J Am Coll Cardiology. 2007; 50(5):409-418.) Your doctor might tell you that as long your liver enzymes are three times higher than normal, which is three hundred percent, it is okay to continue staining.
This is a scary way to take medication. Is a slight reduction in the risk of developing heart disease worth a 300% increase in liver enzymes, which can indicate a significant decline in liver function? If you are taking statins, there are ways to protect your liver. First, discuss with your doctor the best schedule for checking the liver to ensure you are aware of the numbers. Request copies of all your bloodwork and create a chart to track their changes. A second important point to remember is that the same enzyme may be released by your muscles when you have liver dysfunction. It is called AST.
Side Effect
These side effects can be detrimental to muscle tissue and statins should be distinguished. If you are told you have a dysfunctional liver due to statins, make sure to ask if the elevated enzymes are actually from muscle injury and not the liver. To distinguish between the two, your doctor will need to check your creatine phosphokinase (or CPK) level. This would be elevated after muscle injury. You must also monitor your liver enzyme levels for signs of liver dysfunction.
These include a yellowish hue in your skin and whites of your eyes, pain at the upper right side of the abdomen, yellowish stool, tea-colored urine and generalized itching. Supplements that protect your liver from adverse effects of statin use are recommended. N-acetylcysteine (600mg twice daily) and alphalipoic acid (200% twice daily) are two of the supplements I recommend with great success. These are great for protecting and restoring damaged livers due to medication. I would also ensure that I get enough water. I would avoid milk thistle, a common herb to treat liver dysfunction.
Metabolism
It alters the rate at which medications can be metabolized by your liver. You are now in control of your liver! Let’s move on to the next body part. Patients often complain of aches and pains that don’t seem to be specific. Many times, aches and pains are directly related to statin use. Statins can cause a drop in coenzyme Q 10, which could be one of the key mechanisms that statin-induced muscle aches or myalgias. Coenzyme Q10 plays an important role in the production and storage of energy in the mitochondria in muscle cells. CoQ10 supplementation is recommended to prevent myopathy.
However, this has been proven to be beneficial in small studies. Even though there is a small possibility of muscle injury, it makes sense to give coQ10 (an antioxidant) when treating someone taking statins. It is important to determine whether it is appropriate to stop taking statins or to reduce the dosage as much as possible while still retaining the same benefits. It is incorrect to tell you that you have fibromyalgia because you have had this statin side effect. This is especially true if you were prescribed a painkiller for this side effect.
CoQ10
Merck, a manufacturer and marketer of statin drugs, actually patented the use CoQ10 to be mixed with statin drugs, knowing that the statin drug would indeed deplete patients of CoQ10. However, this patent was never used. This is regrettable. To this day, pharmaceutical companies have not made a significant effort to educate the medical community on statin’s effects on CoQ10 depletion. Myopathy is a condition that affects the brain and can be fatal. This side effect can be more common in certain patient populations.
Patients with underlying kidney dysfunction, a sluggish immune system, and those who are taking drugs that inhibit CYP3A4 (cyclosporine or gemfibrizole), or that block a detoxification pathway in their liver (erythromycin, HIV protease inhibitors, fibrates, niacin as well as many other medications) are at highest risk. In the coming years, pharmacogenetics will become more advanced and patients will be able to identify which drugs they will not tolerate before starting the drug. Technology is still in its infancy. Myalgia can be diagnosed by checking blood CPK levels.
Enzymes
This enzyme is released when muscle tissue has been destroyed. This number can be high or low depending on the severity of myopathy. Patients will often suffer from the side effects of statin therapy, even if their CPK levels are not elevated. CPK elevation can occur when there is significant muscle necrosis (or death) where the constituents from the muscle are released into circulation. CPK elevation can cause kidney dysfunction, alter the color of urine to reddish brown, and alter electrolyte balance to dangerous levels. This is known as rhabdomyolysis. It can be dangerous. Monitoring CPK levels is not enough. Your doctor must ask you about myalgia symptoms.
Although the above information is well-known to most doctors, simple and straightforward actions like coQ10 supplementation are often ignored. Side effects are often covered by non-steroidal antiinflammatory drugs or muscle relaxants, which are prescribed to counter the negative myopathic effects caused by statin drugs. These drugs can have side effects. The domino effect continues. In March 2004, a Lancet study revealed that statin use can cause myopathy similar to selenium deficiency. It has been established that selenium plays an important role in the metabolism of skeletal and cardiac muscles. Statins block a pathway that is required for the production selenoprotein. This could possibly lead to myopathy.
