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Atorvastatin Side Effects: What They Are and What You Can Do About Them

Atorvastatin Side Effects: What They Are and What You Can Do About Them

Heart disease kills one person every 36 seconds in the United States, and it is the leading cause of death for both men and women. About one in every four people dies as a result of heart disease. Heart disease has many contributing factors, including high blood pressure and high blood cholesterol. High cholesterol is an epidemic in the United States, with an estimated 95 million American adults suffering from high cholesterol (total cholesterol levels of 200 mg/dL or higher) and 29 million American adults suffering from very high cholesterol (total cholesterol level of 240 mg/dL or higher), according to the Centers for Disease Control and Prevention (CDC). Some people have high cholesterol levels due to genetic factors, but lifestyle factors such as unhealthy diets, sedentary lifestyles, and carrying around extra weight are usually the cause. High cholesterol levels are dangerous and increase your risk of experiencing heart disease, heart attack, and stroke as a result of a narrowing of the blood vessels that occurs when plaque builds up in the body, so many people take medication in order to control their high cholesterol. The most popular medication for the treatment of high cholesterol is atorvastatin, but the medication also can cause unpleasant side effects. Many side effects may be explained by nutrient depletions. Fortunately, there is a solution to address the nutrient needs of atorvastatin users to reduce the side effects caused by atorvastatin and continue this important therapy with confidence. 

Overview

Atorvastatin, also sold under the brand name Lipitor, belongs to a class of drugs called HMG CoA reductase inhibitors (more commonly referred to as “statins”). Atorvastatin is a prescription medication that is available in both brand name and generic forms. Atorvastatin was the most commonly prescribed drug in the United States in 2017, when more than 104 million prescriptions were written for the medication. The high rate of prescriptions not only reflects the medication’s popularity, but also the epidemic level of high cholesterol facing Americans. 

Conditions Treated by Atorvastatin

Atorvastatin and other drugs like it, known as statins, are not only used to treat high cholesterol but also used to reduce the risk of cardiovascular disease and stroke, even in individuals with normal cholesterol levels.

The understanding of heart disease has advanced tremendously over the last decade. Doctors now use multiple points of assessment to understand if a patient is a good fit for a statin. 

These heart health factors:

  • Blood Pressure
  • Cholesterol panel
  • Family history
  • Body Mass Index 
  • Blood glucose and A1C
  • Inflammatory markers like C Reactive Protein (CRP)
  • Coronary calcium score 

Statins are a powerful tool in the fight against heart disease and stroke, as they have been found to reduce the risk of cardiovascular events and lower mortality rates among people with the above risk factors.  

Statins work by lowering levels of “bad” cholesterol, known as LDL, in the blood and increasing the levels of “good” cholesterol, known as HDL, when used with lifestyle changes made by the patient. Triglycerides, a type of fat that is found in the blood, can also be reduced using medications like atorvastatin. By reducing the levels of bad cholesterol and triglycerides in the blood, atorvastatin helps lower the risk of stroke, heart attack, and other complications in people with coronary heart disease, type 2 diabetes, and other risk factors.

So, what exactly are the different types of cholesterol? It can be easy to mix up the two. Humans have two types of cholesterol in their bodies: “bad” cholesterol, which is known as LDL or low-density lipoprotein, and “good cholesterol, which is called HDL or high-density lipoprotein. Most people have more LDL in their bodies than HDL, and when quantities of LDL in the body become too high, the substance can start to form plaque on the walls of the blood vessels. As plaque builds up along the walls of the blood vessels, the blood vessels become more narrow. This in turn slows or even blocks the flow of blood from the heart and other organs, which causes a higher risk of experiencing heart disease, heart attack, and stroke. Good cholesterol, or HDL, plays an important role in the body, as it helps absorb LDL and transport it to the liver, which flushes it from the body. Low levels of LDL are ideal because that means that you are at a lower risk of developing plaque buildup in your lungs, but it’s better to have high levels of HDL, since this type of cholesterol lowers your risk of experiencing heart disease,  heart attack, and stroke. Your total cholesterol level is calculated by adding together the LDL and HDL levels and combining them with 20 percent of your triglyceride level. If you have high cholesterol or are at risk for experiencing high cholesterol, it’s important to get your cholesterol levels tested regularly. Your doctors will use your total cholesterol numbers and the specific levels of HDL, LDL, and triglycerides in the body in order to formulate a treatment plan that will help you lower your cholesterol safely.

How Atorvastatin Lowers Cholesterol Levels (works)

For a long time statins have been thought of as purely cholesterol-lowering medications used to treat high cholesterol.  Statins like atorvastatin work by inhibiting an enzyme called HMG-CoA used to make cholesterol in the liver. But as time has gone on, statins are now viewed as risk-reducing medications that benefit individuals at high risk of heart disease or stroke but may not necessarily have high cholesterol.

Why this shift in thinking? Because we have learned more. Statins provide several  benefit  beyond lowering cholesterol.

These are called pleotrophic effects. Think about it as the bonus benefits.

Statins are risk-reducing medications by:

  • Decrease oxidative stress and inflammation. An important component to heart disease. 
  • Improve endothelial function. A thin membrane that lines the inside of blood vessels that releases substances that control blood pressure, clotting, immune function and more. 
  • Improve Nitric Oxide. This molecule dilates blood vessels and improves blood flow, an important aspect of cardiovascular health.
  • Stabilize atherosclerotic plaque. Statins stabilize plaque by pulling cholesterol out of the waxy substance called plaque. Plaque can build up and cause blockage of blood flow to the heart or brain. 

Atorvastatin Side Effects

Both common and uncommon side effects are associated with atorvastatin. Common side effects associated with atorvastatin that usually do not need medical attention include:

  • Confusion
  • Gas
  • Diarrhea
  • Joint pain
  • Forgetfulness or memory loss
  • Heartburn

The common side effects listed above are typically mild and usually do not last for more than a few days or weeks. However, if these common side effects persist or you have an allergic reaction, talk to your doctor about your use of atorvastatin or consider taking a statin support supplement.

Other side effects of atorvastatin are less common but can be more serious and do require medical attention. Make sure to speak to your doctor right away if you experience any of the following uncommon but serious side effects while taking atorvastatin:

  • Muscle pain, tenderness, or weakness
  • Extreme tiredness
  • Unusual bleeding or bruising
  • Fever
  • Nausea
  • Loss of appetite
  • Flu-like symptoms
  • Lack of energy
  • Pain in the upper right part of the stomach
  • Dark-colored urine
  • Weakness
  • Hoarseness
  • Itching
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • Yellowing of the skin or eyes
  • Chest pain
  • Rash
  • Hives
  • Difficulty breathing or swallowing

How to Reduce Atorvastatin Side Effects

Atorvastatin is an important medication that many people rely on to keep their cholesterol levels in check. However, the side effects of the medication can be unpleasant and cause people to resist taking their medications because they do not want to experience uncomfortable side effects. It is believed that some side effects of statins like atorvastatin are caused by the depletion of coenzyme Q-10, or CoQ10, in the body. CoQ10 is an important antioxidant that is naturally produced by the human body as a byproduct of the cellular respiration process, which is the process by which cells create the energy we need to function. CoQ10 is responsible for preventing the cellular and DNA damage caused by free radicals, which are another byproduct of cellular respiration. Atorvastatin and other statins contribute to lower levels of CoQ10 in the body, which can cause higher levels of inflammation and damage to the cells and mitochondria. Therefore, it may be possible to reduce atorvastatin side effects by boosting CoQ10 levels in the body through dietary supplements

Dietary supplements designed to support statin use, such as Statin Support by Even, provide vitamins B1, B2, and B3, vitamin K2, sulforaphane, selenium, vitamin D3, and Resveratrol in addition to CoQ10. Vitamins B1, B2, and B3 have been found to support mitochondrial health by helping to reduce the levels of lactic acid that may contribute to muscle symptoms. Vitamin K2 can help prevent arterial calcification that is caused by cholesterol, while selenium provides selenoproteins that contribute to redox balance. Resveratrol is an antioxidant that can help reduce muscle pain from statins by supporting the health of the mitochondria, while sulforaphane helps mitigate the risk of insulin resistance that some patients experience. Dietary supplements  that are specifically designed to provide bioavailable CoQ10, vitamins B1, B2, and B3, vitamin K2, and chelated minerals and mitochondrial antioxidants that help support biochemical balance in the body can help minimize the experience of side effects resulting from atorvastatin. 

Groups That Should Avoid Atorvastatin

While nutritional support can help reduce side effects associated with atorvastatin, the medication can be dangerous for certain groups of people. Atorvastatin should not be taken by people who are allergic to it or to other statins. People who meet some or all of the following criteria should not take the medication without consulting with their healthcare professional:

  • People who have had any of the following conditions should exercise caution:
    • Diabetes
    • Muscle pain, muscle aches, muscle problems, or weakness
    • Kidney disease or kidney problems
    • Thyroid disorder
  • People experiencing any of the following conditions may need to briefly stop taking atorvastatin:
    • Surgery or medical emergency
    • Uncontrolled seizures
    • Severely low blood pressure
    • Electrolyte imbalance, such as high or low levels of potassium
    • Severe infection of illness
  • People with liver disease
  • Women taking birth control pills should talk to their doctors about hormone interactions. 
  • People who drink more than two alcoholic beverages per day
  • Women who are pregnant or planning to become pregnant.
  • Women who breast-feed should not take atorvastatin.

Sources:

https://medlineplus.gov/druginfo/meds/a600045.html#side-effects 

https://clincalc.com/DrugStats/Drugs/Atorvastatin 

https://www.healthline.com/health/high-cholesterol/statins-list-of-common-types 

https://www.healthline.com/health/high-cholesterol/why-statin-drugs-may-be-bad-for-you 

https://www.healthline.com/health/coq10-and-statins#benefits 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096178/ 

https://www.cdc.gov/heartdisease/facts.htm 

https://ipccs.org/2019/02/20/inverse-association-between-long-term-statin-adherence-and-all-cause-mortality-in-ascvd/ 

https://www.ahajournals.org/doi/full/10.1161/01.cir.0000131517.20177.5a