Statin Side Effects: Neurological side effects of statins. In this system. We are talking about the side effects of statin medication use. So we’re going to talk about what statins are and some of the mild and severe side effects of statins. What are Statins? Statins are medications used to lower or reduce blood cholesterol levels.
So they all have the suffix statin in their name. One example is atorvastatin, another is symphostatin, and another is rosuvastatin. Now, the statin medications inhibit cholesterol synthesis via inhibition of the HMG COA reductase enzyme. So they inhibit the activity of the HMG COA reductase enzyme, which is involved in producing cholesterol. So there are many different enzymatic steps between HMG COA reductase and cholesterol.
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Statin Side Effects: Neurological side effects of statins
But this is the rate-limiting step in cholesterol synthesis. So if statins bind to this enzyme, they prevent cholesterol production or synthesis. But the problem is statins may cause a variety of mild and or severe side effects. We will talk about the side effects in the next upcoming slides. Certain patient characteristics increase the risk of having side effects.
These include being female. Older age patients, especially greater than 80 years of age, are also at an increased risk. Having certain medical conditions increases your risk of having side effects of statin medications. These include kidney disease, liver disease, hypothyroidism, or a low functioning thyroid. Being a heavy alcohol consumer is another risk factor for having statin side effects. Then, using multiple cholesterol-lowering medications can also increase your risk of statins’ side effects.
Now let’s talk about the side effects of statins. One of the main side effects of statin medications is myalgia or myopathy. Myalgia is muscle pain, and myopathy is a muscle disease. That’s what those words mean. So the symptoms that patients experience with myalgia and myopathy include muscle aches, pains, and tenderness, so they can have places where their muscles feel very tender or have aches and pains.
atorvastatin adverse effects
And in some cases, if your pain, we’re going to talk about that at the moment. This is relatively common. It can affect upwards of 50% of patients, so the range is quoted as 20% to 50% of patients will experience issues with muscle aches and pains. This is a dose-dependent effect. So the higher the dose of statin, the more likely and more severe these myalgia symptoms will be.
Most of the time, it’s mild symptoms, but there may be more severe symptoms with rhabdomyolysis occurring. But this is a rare outcome of statin use. So rhabdomyolysis is muscle breakdown. We can see this in blood work and increased creatine kinase levels. So rhabdomyolysis is when the muscles start to break down, which can have severe pain in the affected muscles.
And if this is not treated properly, this can lead to kidney issues. And another very important significant side effect of statin use is hepatitis. So hepatitis. The word hepatitis means inflammation of the liver. Hepat means liver, IDIS means inflammation.
cholesterol side effects
And we can see this in blood work. We increased liver transaminases. So as the liver becomes damaged, the liver releases enzymes into the blood, and we can detect these enzymes. What is noted in patients that are affected with hepatitis from statins is that there’s right upper quadrant pain or tenderness. So right upper Quadrant is in this area here.
So if we’re looking straight at the patient, this is the patient’s right side, the patient’s left side, and the right upper Quadrant. So this is where the liver is located, and this is where the patient will experience pain and tenderness. And in some cases, if the hepatitis is severe, there can be significant liver damage leading to some jaundice. So jaundice is yellowing the skin and yellowing the whites of the eyes. If there is yellow in the whites of the eyes, that is known as sclero Citrus.
And there can be some other signs and symptoms of liver disease. If you want more information on the signs and symptoms of liver disease, please check out my lesson on that topic. But this is more of a rare side effect of statin use, although it can occur. So myalgia and myopathy are very common and very important to recognize with statins, and then hepatitis may occur. Some other side effects of statins include headaches.
atorvastatin adverse effects
Statin Side Effects: Neurological side effects of statins This may be the most common side effect of statin use, and there may be some migraine headaches, especially in patients who are more susceptible to migraine headaches. So statins may trigger migraine headaches. But paradoxically, there’s also some evidence demonstrating that statins, if used with vitamin D supplementation, may reduce the risk of severe headaches and migraines. So some evidence shows that statins perhaps cause headaches or migraine headaches. But in some cases, if they are combined with vitamin D supplementation, they may reduce some severe headaches and migraines symptoms.
So this is very interesting. There may be some differences in side effect profiles depending on vitamin D levels in certain patients. So very interesting. But there is some contradicting evidence here. Another side effect of statin use is fatigue.
This is again one of the most common side effects of statins, which may be related to muscle weakness. So because of myalgia and myopathy, there can be some muscle weakness that may lead to a feeling of fatigue. So this can also be another side effect of statin use. Another side effect of statin use is memory issues. This is an uncommon side effect, and there can be some reduced memory or memory loss with statin use.
atorvastatin adverse effects
Statin Side Effects: Neurological side effects of statins So there can be some issues with cognition with statins. However, this appears to reverse when statins are discontinued. Some patients may have issues with retaining certain memories or loss of certain memories. But when they are stopped when they have discontinued statins, these memory issues are resolved. So this is another very important side effect that can occur in some patients. Another possible side effect of statin use is sleep disturbances.
Statins may cause issues with insomnia, although unlikely. So there has been some evidence that may suggest that statins cause insomnia, but this doesn’t seem to be very strong evidence if it does occur. If statins do cause issues with insomnia, the statins that are more likely to do that are simvastatin and atorvastatin. The reason being is that they are more fat-soluble. So the theory is that perhaps they can cross the blood-brain barrier easier and cause issues with sleep.
So this can be a possible reason. But again, sleep disturbances may occur with statin use, although again, it is unlikely. Another side effect of statins is the precinct. This is a sensation of lightheadedness or dizziness, which can occur with statin use. And there can also be issues with bowel habit changes.
atorvastatin withdrawal symptoms
Bowel habit changes meaning constipation and or diarrhea. So there can be a change in normal bowel habits, and patients can alternate between constipation and diarrhea so they can have either one or the other or alternate between the two. Important to note here is that when looking at the evidence, when statins are compared to placebos in trials, the placebos cause these side effects as well. So it may not be the statins themselves. It may simply be taking the statin leading to these types of side effects. Some of these side effects are very common with other medications, but I do want to mention them here as they are possibly related to statin use, although again, placebos can also cause these types of side effects.
But some other side effects that statins can cause that are caused by statins include increased blood sugars. This has been observed in patients with type two diabetes, and there is some evidence to suggest that it may also increase the risk of developing type two diabetes. So statins can lead to increased blood sugars, but there’s not much research done to look at the outcomes of this. So there is some change in blood sugars. There are some increased blood sugar levels with statins, but the outcome of this effect has not been fully studied.
withdrawal symptoms of stopping statins
It does seem to be due to statin-mediated immune responses that depress insulin functioning. So this is the reason why statins can lead to increased blood sugar. It’s very important, and then statins can also lead to thrombocytopenia. So thrombocytopenia is a low platelet count. This seems to be a very rare side effect.
There have been some case reports of severe thrombocytopenia occurring with atorvastatin use, but again this is likely a very rare side effect. And then another possible side effect of statin use is hair loss. This is a very rare side effect affecting only 1% of patients who use statins, and it likely occurs with all statins. So this is a possible side effect that can happen with other medications, but this is a possible side effect that can occur with statin use if you want to learn more about other medications and their side effects.
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In conclusion
statins are effective medications that can help to lower cholesterol levels and reduce the risk of heart attack and stroke. However, statins can also cause a number of side effects, such as muscle pain, weakness, and difficulty breathing. It is important to discuss the risks and benefits of statin therapy with your doctor before starting treatment.
