High cholesterol is a major risk factor for heart disease, heart attacks and strokes. Some patients are able to lower cholesterol with lifestyle changes, while others require medication. Finding the right type and dose of medication may take some experimentation, because some cholesterol medications can cause side effects such as muscle pain. If this occurs it is important to speak with a physician who can adjust the medication if needed.
Considerations
To protect against heart disease it is important to keep total cholesterol at less than 200 mg/dL and LDL, or bad cholesterol, at less then 100. HDL cholesterol, which is considered the good kind, should be kept at 60 or higher. If LDL levels are high and HDL levels are low, cholesterol may begin to build up as plaque along the blood vessel walls. This can lead to blood clots and reduced blood flow to the heart and brain. Lifestyle changes are usually required, but some patients also need medication. Various types can be used.
Statins
There are five main types of cholesterol medications and satins are the ones that tend to cause muscle pain as a side effect. Statins, which lower LDL levels, block the enzyme HMG-CoA reductase that helps the body make cholesterol. Each case is unique and each patient has a different sensitivity to the medication. Some patients on these medications experience muscle pain and others do not. If muscle pain occurs, talk with a physician as stopping the medication without medical supervision can make high cholesterol worse.
Considerations
The exact mechanisms that lead to muscle pain when you take statins is still not well understood. However, a report in the "Journal of the Federation of American Societies of Experimental Biology" in September 2009 suggests that statins may lead to an increased release of a gene called atrogin-1. Atrogin-1 is involved in making muscles break down or atrophy. Some patients who take statins, appear to have a higher amount of this gene in their body. For some this causes minor muscle pain and weakness that resolves as the body adjusts to the medication, while others suffer severe muscle pain. In rare cases the medication can cause the muscles to break down, which is called rhabdomyolysis. If muscle atrophy or rhabdomyolysis occurs, the protein myoglobin may be released into the bloodstream, which can damage the kidneys and liver and can be life threatening.
Solution
The best solution is to talk with a physician to weigh out the risks and benefits of taking statins based on personal health. It may be that a lower dose can be prescribed or a different cholesterol lowering medication can be taken. If you take statins, the higher the dose, the higher the risk of muscle pain and muscle damage. To help lower the risk of side effects, it may be necessary to take over-the-counter pain relievers. Some patients benefit from taking coenzyme Q10. You may be taking other medications that are contributing to the symptoms as well. In most cases, a solution can be found so that you can keep cholesterol levels in check without having to live with muscle pain.
References
- FamilyDoctor.org: Cholesterol: What Your Level Means
- Texas Heart Institute: Cholesterol Lowering Medicines
- "The Journal of the Federation of American Societies of Experimental Biology"; Statin-Induced Muscle Damage ...; Peirang Cao, et al.; September 2009
- MayoClinic.com: Statin Side Effects: Weigh the Benefits and Risks
