Cholesterol-lowering statin drugs and muscle pain

Dear Dr. Mirkin:

Why do cholesterol-lowering statin drugs cause muscle pain and muscle damage?

Answer: We don’t know. Only a small percentage of those who take statin drugs suffer muscle pain and damage, those most likely to have muscle pain from statins are the ones who exercise. The more vigorously you exercise, the more likely you are to suffer muscle pain and damage from statins.

A recent study from Texas A&M shows that among older men who start a muscle strengthening program, those who have the highest rise in blood levels of the bad LDL cholesterol are the ones who gain the most muscle strength and size (Journal of Gerontology, May 6, 2011). Every cell membrane is made up of millions of cholesterol molecules. This study implies that the so-called "bad" LDL cholesterol can be good because it brings cholesterol to the damaged muscle to hasten healing and promote muscle growth.

All training for strength involves taking a workout so intense that it damages the muscles and causes soreness on the next day. Then you are supposed to have easy workouts for as many days as it takes for muscles to heal and the soreness to diminish. When your muscles feel better, you take another hard workout that damages your muscles again.

Statin drugs block the “bad” LDL cholesterol and delay healing, so it can take longer for athletes to recover from their hard days and they are not able to be as competitive as they would be if they were not taking these drugs.

If you take statins, you should realize that most people can lower their bad LDL cholesterol without taking drugs. However, many people are not willing to make the necessary lifestyle changes:

  • lose excess weight
  • avoid sugared drinks and foods with added sugar
  • eat large amounts of fruits and vegetables
  • avoid red meat
  • get blood levels of vitamin D3 above 75 nmol/L (30 ng/L)
  • check with your doctor and start an exercise program or increase the intensity of your current exercise. People with blocked arteries leading to the heart can suffer heart attacks when they exercise intensely.
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Dr. Gabe Mirkin

A practicing physician for more than 40 years and a radio talk show host for 25, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is one of a very few doctors board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology.

Dr. Mirkin's latest book is The Healthy Heart Miracle, published by HarperCollins. His daily short features on fitness have been heard on CBS Radio News stations since the 1970's.

He has written 16 books including The Sportsmedicine Book, the best-selling book on the subject that has been translated into many languages. Dr. Mirkin did his residency at the Massachusetts General Hospital and over the years he has served as a Teaching Fellow at Johns Hopkins Medical School, Assistant Professor at the University of Maryland, and Associate Clinical Professor in Pediatrics at the Georgetown University School of Medicine.


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  1. Ricardo36 says

    I have FMS & CFS, the least amount of pravachol prescribed to me tripled my pain index. I said GOOD BYE to it and the M.D. that prescribed it to me!

  2. Mountain Wizard says

    In Traditional Chinese Medicine there is considered to be direct relationship between liver health and the muscles. So if the liver is being stressed by the use of statins the it would make sense that the muscles would be painful and or suffer damage. It is a common case of Traditional Allopathic Medicine’s approach that the Cure is worse then the Disease. When you do not fully understand how something works then the Solution can create problems worse then leaving something alone. All too common in our current society, we keep chasing Solutions when we might do better working on our understanding more.

  3. Lori says

    It’s pretty well known that statins rob the body of CoQ10 which may be related to the muscle pain. There’s also some speculation that muscle damage may occur in some statin users who have no pain, and there is also some speculation that calcium dysregulation is involved.
    Statin use is also associated with diabetes, depression, brain problems, low sex drive, and even cancer. Telling folks to avoid eating red meat may actually be counter-productive as CoQ10 is found in grass fed meats. For more info on statin problems, go to Seriously, lowering “bad” cholesterol (there’s really no such thing) to the point where it barely exists may be life-threatening (ten years ago it was acceptable for adults to have LDL levels from 80 – 190), but it’s a lottery win for pharma!

  4. Anonymous says

    Again we always go back to the traditional, cholesterol is bad for you, not taking in consideration that this vital nutrient is good for what ails a person when a person exercises the liver automatically will send LDL to do a job and then HDL will do its job, as in inflammation the body is sending signals, as is CRP, now we continue with all LDL tradition but no one points out about (homocysteine) and how critical is to keep it at bay. JAM

  5. Scooter says

    Shouldn’t the last lifestyle change read: ‘Check with your doctor BEFORE you start an exercise program?’

  6. Mari says

    Grass fed red meat is not bad for you. The ‘avoid red meat’ message is as incorrect as low cholesterol will save your life’

  7. lexicop says

    “Avoid red meat.” No sensible, well-read, health-conscious person would put any trust in a doc who makes this recommendation. Good grief. It’s the same knee-jerk advice you get with respect to the sun (sunscreen!), salt (avoid it!), fat (saturated fat’s a killer!), eggs (death in a shell!), butter (you get the idea. . . .). Steak, eggs, butter: They all taste great and are good for your health. Salt is necessary for life itself and does not cause high BP. The sun’s rays make your body produce vitamin D, which fights cancer (among many other benefits).

    Other news this week has actually exposed the lies told by the “no red meat” lobby in order to promote their sickly, PC view. “No red meat” is politics, not health.

    Oh, yes: There is no such thing as “bad” cholesterol; at least the doc seems to sense this. . . . (So why exactly ought we to “avoid red meat”?).

  8. A2, R.Ph. says

    What really ticks me off is the lack of COMMON SENSE among our so called healers. Considering all the problems statins cause to muscle tissue, why even use it for cardiovascular therapy? Is not the HEART practically NOTHING BUT MUSCLE!? It should be a no-brainer that statin therapy will lead to congestive heart failure down the road. I can hear the Cardiologist, “Oh, I saved your loved one from a heart attack but his/her heart was just too weak to pump anymore.”

  9. JADE says

    I also have FMS & CFS and since I said goodbye to Lipitor and replaced it with Red Yeast Rice, not only my fibromyalgia pain have decreased, I can squezze my arm without screaming but also my cholesterol went down to my GP satisfaction…that he decided to lower the Lipitor’s dosage!
    I never told him that I was seeing a naturopath….as he doesn’t believe in it…

  10. BEANS says

    My wife and I have been taking Lipitor for over 5 years. Our Chloresterol has lowered significantly and we have had no side effects, including muscle pain or liver damage. I have exercised and worked out without muscle pain. So I think the problems have to do with other physical problems per individual that are affected by the Statins and the exercise. Many of us do have problems that are built in our minds that are not exactly physical. And so the pain. Many of us have negative problems because we take medicine and some think that is not a normal function for us. And some people are just plain wierd.

  11. Lori says

    Keep in mind, Beans, that the muscle problems can still happen with no pain. Besides that, there is plenty of research that speculates that we need PLENTY of cholesterol as we age to protect our brains. Lowering cholesterol for the sake of lower cholesterol may have a very negative impact on our health. I spoke with an insurance agent the other day looking to save some money on my health insurance premiums (don’t get me started on this!) and when I told him I take no medications, he said not only is that unusual for my age, but just about every client he has over the age of 50 is taking a cholesterol lowering drug. I have a friend who was put on Lipitor a few months ago and his cholesterol plummeted from 201 (which I consider safe and healthy) to 135. He feels terrible all the time but his doctor is very happy with his numbers and is telling him that the way he feels has nothing to do with the drug or lowering his levels. My friend is being lied to, and sorry, so are you.

  12. Anonymous says

    For those of you who use statins and are not hypercholesterolemia pay close attention, our bodies need cholesterol in order for our skins to absorb the sunshine vitamin, if we force our liver to reduce the cholesterol via prescription drugs to the optimal levels according to their propaganda, not only it will impair the cholesterol producing machine but at the same time by reducing the cholesterol to these levels the skin will not absorb such vital nutrient, for in this process cholesterol is needed, remember I said nutrient and every living cell needs it without it we are doomed, they know the liver will put a fight and they are counting on this but we are exposing ourselves to their dangerous games just to gain profits, and yes they will monitor the liver when given prescription, my question, do we really need to go overboard with these medications?, maybe someone with this expertise and with credential and one who is not under Big-Pharma indoctrination could enlighten us. JAM

  13. Tom CHHC says

    Statins rob the body of CoQ10. (So does Red Yeast Rice.) CoQ10 supports and protects cellular mitochondria. Mitochondria enable muscles to use oxygen, giving them energy. Impaired mitochondrial function means your muscles will not be able to use oxygen as effectively, and therefore they will tire more easily and be more prone to sustaining damage. Now think about what your most important muscle is.

  14. Digit says

    Hi Guys, I took statins and proton pump pills for around 10 -12 years, they didn’t make me feel any better. My doctor kept upping the dose of statins to the point of nerve damage, when I suggested the treatment is not working she wanted to double it yet again. Around the same time I found I was type 2 diabetic and the doc wanted me on meds for that as well. I learned when I was younger that if something is not working – do something different… no sense doing the same thing and expecting a different result, right?
    I stopped taking all meds and started reading on sites just like this one and and eventually came to the position of “If my doctor says – do this it’s good for you- I do a little study and end up doing the opposite.” I stopped eating bread which solved the proton pump issue and helped with the diabetes, I started eating a high saturated fat diet and dropped the oils so now I use coconut oil and butter, animal fat, lots of meat and home grown veggies. I’m now 54 My cholesterol is (if it does make a difference, which I don’t believe it does.) is 4.6 – lower than it has ever been, and I am healthy, still have type 2 but none of the evil things that go with it. I don’t believe doctors give out bad advice on purpose, they just use the info they have and they there is no other point of view. Keep searching folks, you will find what is right for you, when you do – run with it…

  15. silver surfer says

    I am very confused about all the above comments. Not one person has specified to which cholesterol they are referring. Are they talking about “total overall level, LDL or HDL? My LDL’s are borderline but my HDL’s are lower than normal. A healthy diet, exercise and moderation are imperative regardless whether or not you have cholesterol problems. I just hope years from now people that have been taking statin drugs, don’t find out that these drugs are the cause of other serious problems, other than the reported ones. I believe the drug companies making claims that these drugs are necessary, are only interested in their “bottomline” and are brainwashing the doctors to push them on to their patients. I take two statin drugs along with Omega 3-6-9 but I wonder if I would be o.k. with just continuing my healthy diet and worked in more exercise. My doctor says I have to be on statins for the rest of my life. She has me convinced that I would be playing Russian roulette to stop taking them. Who really knows??

  16. bluebell says

    I have had a similar experience as NO 16. I have come off all meds except for blood pressure. I eat butter, coconut oil animal fats and meats, eggs daily. cholesterol stays around 220. blood sugar has dropped from 110 to 95. I do not eat grain based foods except for family celebrations. I have had bad experiences with medicine to lower cholesterol. Foods mother nature indeded for us are much healthier.

  17. Anonymous says

    Thanjs for all the information but I feel it is too late. I now am fully disabled from taking Statin drugs for 5 years. I now walk at a snails pace . Loss all my muscels all over my body including in my joints . Spent tens of thousands of dollars with liver, heart and other specialist. After going broke and not able to work I finally went to a reumatoligist who after much blood work found my kinase level over 3,600 (normal40) put me on Predistone for 4 months. It lowered my Evelyn to 90 and now I have to stop taking it before it makes me go blind.
    My recommendation is to never take Statin Drugs period.

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