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Can Statins Cause Brain Fog?

Medically Reviewed by Brunilda Nazario, MD on June 21, 2021

Cholesterol is a waxy, fat-like substance that flows through your bloodstream. You’re at risk for a heart attack or stroke if your cholesterol numbers aren’t good. Statins might help. That’s a class of drugs designed to lower your body’s level of low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol.

Statins and Brain Fog

While statins have a lot of health benefits and are safe for most people to use, there are some side effects. These can include:

Brain fog is “a general level of confusion and disorientation,” says Robert Rosenson, MD, director of the Cardiometabolic Unit at Mount Sinai Hospital in New York City.

The FDA approved label changes for statins that list memory loss and confusion as a “non-serious and reversible side-effect.”

Cholesterol is an important part of your brain. In fact, 25% of the body’s cholesterol is found there. So it may seem like statins could affect how your brain works.

But experts don’t think there’s cause for concern. Several studies on the drug’s side effects suggest there’s no direct link. And the symptoms could be a sign of other problems, Rosenson says.

“They forget where they put their keys down, they may open the refrigerator, put the keys in there, [and] they forget and can’t find them. But these are often signs of Alzheimer’s. And Alzheimer’s is a disease that develops over a long term,” he says.

These types of memory issues usually happen to people who are middle-age or older and can be a sign of many conditions.

“One might need to ask the question: ‘Is it really the drug?’ Or is there something else going on here that would require formal evaluation with a neuropsychiatric specialist,” Rosenson says.

On the flip side, some research suggests statin use is linked to lowering the risk of dementia or improving brain function. A 12-year study in Taiwan looked at 57,669 people over the age of 65 and found that high statin doses were “particularly effective” in preventing dementia. More research needs to be done on this.

What to Do if You Have Brain Fog

Don’t stop taking your medication without talking to the doctor first. They may choose to:

  • Stop your statin therapy
  • Switch you to another type of statin
  • Lower your dose

Rosenson says he may switch someone to a non-statin drug like ezetimibe. It works by absorbing the cholesterol in your intestine. Or he might try a PCSK9 inhibitor. It’s a class of drugs that don’t cross the blood-brain barrier. They break down LDL receptors and clear bad cholesterol from the bloodstream.

Currently, the FDA has approved two PCSK9 inhibitors for use. They are:

  • Alirocumab (Praluent)
  • Evolocumab (Repatha)

But Rosenson stresses that when it comes to statin therapy, the side effects like brain fog are rare and usually short-term. The pros often outweigh the cons, especially for people with high cholesterol or those at risk for:

“You have to realize that there are not many drugs that can both reduce inflammation in the arteries and lower cholesterol,” he says. “So, one has to think of the big picture and the extensive data.”

Things to Be Aware of When You’re on Statins

Here are a few things to keep in mind to avoid or ease side effects:

Be careful with grapefruit. The juice contains certain chemicals that may interrupt how statins metabolize in your gut. While you don’t have to give up grapefruit, ask your doctor what amount is safe to eat or drink.

Tell your doctor about all the medications you’re on. Certain drugs can interact with statins and may cause side effects. These include:

Take it easy when you exercise. One of the common side effects of statins is muscle aches and pain. But too much exercise can raise your risk for muscle injury or make it worse. If you’re starting a new exercise routine, build up the intensity slowly.

WebMD Feature

Sources

SOURCES:

Robert S. Rosenson, MD, professor of medicine (cardiology), Icahn School of Medicine at Mount Sinai; director, Cardiometabolic Unit, Mount Sinai Hospital, New York City.

Mayo Clinic: “Statins: Are these cholesterol-lowering drugs right for you?” “Statin side effects: Weigh the benefits and risks.”

CDC: “Cholesterol.”

Canadian Pharmacists Journal: “Statins and their effect on cognition.”

Translational Neurodegeneration: “The role of statins in both cognitive impairment and protection against dementia: a tale of two mechanisms.”

Journal of Internal Medicine: “Statin use reduces the risk of dementia in elderly patients: a nationwide data survey and propensity analysis.”

FDA: “Cholesterol-lowering drugs get labeling changes.”

Mount Sinai Health System: “Attention Statin Patients: Are You Experiencing Muscle Aches, Weakness, Decreased Exercise Capacity, ‘Brain Fog,’ Impaired Clarity, or Memory Loss?”

American Diabetes Association: “Remembering Statins: Do Statins Have Adverse Cognitive Effects?”

Harvard Health: “Are statins enough? When to consider PCSK9 inhibitors.”

Medlineplus.gov: “Ezetimibe.”

American Heart Association: What is Cholesterol?

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