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What Is Statin Intolerance?

Medically Reviewed by Dan Brennan, MD on June 01, 2021

Statins are one of the most prescribed medications. They help prevent cardiovascular disease so that patients live longer and healthier lives. Yet, some people develop a statin intolerance that makes the medication ineffective. Learn about statin intolerance and how to address it.

The Purpose of Statins

Statins are on the market under brand names like Lipitor, Crestor, and Zocor. They are prescribed by doctors to lower cholesterol levels in your liver and bloodstream.‌

Understanding cholesterol. Your body has two different types of cholesterol. One is good, and the other is bad. Good cholesterol is HDL cholesterol. When you maintain healthy HDL cholesterol levels, you protect yourself from heart attack and stroke.

If you have high blood triglycerides, you usually have lower HDL levels. Health and lifestyle impacts that lower your levels of good cholesterol include:

Bad cholesterol is called LDL cholesterol. It is important to maintain low levels of LDL cholesterol to stay healthy. High levels of LDL increase your risk for heart attack and stroke. If your diet is high in saturated and trans fat, you likely have higher levels of bad cholesterol.‌

How statins work. If you are unable to maintain proper cholesterol levels on your own, your doctor may prescribe a statin. By lowering your LDL cholesterol levels, you decrease your risk for heart attack and stroke. In fact, studies so that patients who take statins live longer than those with high cholesterol who don’t address it.

Understanding Statin Intolerance

‌A statin intolerance occurs when you have an allergy to the medication or develop a negative side effect that outweighs its benefits. When you have a statin intolerance, you’re no longer able to continue taking the medicine to lower your LDL cholesterol levels.‌

Most commonly, a test will reveal that you have decreased liver or muscle function. In some cases, you may be able to tolerate statins in low doses. In other cases, you cannot tolerate statins at all.‌

Signs of a statin intolerance. If your doctor prescribes you a statin for lowering your cholesterol levels, pay close attention to any changes you notice. The more common signs of a statin intolerance include: 

  • Muscle aches
  • Pains
  • Weakness‌
  • Cramps

If you experience any of these symptoms, talk to your doctor right away. Once you stop taking a statin, these symptoms usually resolve themselves. However, if you continue to take a statin after noticing signs of an intolerance, it may lead to permanent muscle damage.

Statin Intolerance Risk Factors

There are factors that increase your risk of a statin intolerance. These include: 

  • Being older than 80
  • Being female
  • Descending from an Asian ethnicity
  • Having a pre-existing neuromuscular condition
  • Having a personal or family history of myopathy, or disease of the muscles
  • Having pre-existing liver disease
  • Having pre-existing kidney disease
  • Having a pre-existing untreated hypothyroidism

While these factors can’t necessarily be fixed or changed, other factors can be addressed such as:

  • High-dose statin therapy
  • Drinking too much alcohol
  • Drug interactions with other medications
  • Exercising too much
  • Drinking too much grapefruit juice

Diagnosing Statin Intolerance

Your doctor can ask questions about your symptoms and complete a cardiovascular exam. Through this, they will look for indications that your symptoms are from a statin intolerance or other condition. If your doctor suspects another condition, you may need additional tests, including: 

  • Blood tests to rule out other conditions
  • Genetic tests to see if you are more prone to statin intolerance
  • Muscle biopsy to check for creatine production
  • Symptoms questionnaire to provide more in-depth information about your symptoms, medications, and family medical history ‌
  • Muscle tests to see if you are experiencing any losses in strength 

Treating Statin Intolerance

In the case of a severe intolerance, you may need to stop taking statins and pursue more stringent lifestyle changes to address high levels of cholesterol. Your doctor may also lower your dose and monitor changes in your symptoms to see if there is any improvement. If your cholesterol levels are still too high, there are non-statin medication options that lower your cholesterol levels.‌‌

Lifestyle changes include maintaining a healthy diet, increasing your physical activity, and cutting out bad habits like drinking too much and smoking. These changes may also have positive effects on your overall health, improving both your cholesterol and negative side effects to statins.‌

If testing determines that there are no dangerous health implications aside from muscle pain, they may suggest supplements. Taking vitamin D or Q10 supplements may improve your muscle health and alleviate the pain you feel from taking statins.

WebMD Medical Reference

Sources

SOURCES:

American Heart Association: “Understanding your cholesterol levels.”

Journal of Atheroscler Thrombosis: “Diagnosis and Management of Statin Intolerance.”

Journal of Circulation: “Statin Intolerance."

Mayo Clinic: “Statin Intolerance Service.”

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