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Which statin medication has the least amount of side effects?

Which statin medication has the least amount of side effects?

According to the Center for Disease Control and Prevention (CDC), an estimated 95 million American adults currently suffer from high cholesterol (total cholesterol levels of 200 mg/dL or higher), while 29 million American adults suffer from very high cholesterol (total cholesterol level of 240 mg/dL or higher). Although many people in the United States could benefit from medication to manage their high cholesterol, only about 55 percent of those patients are currently taking the medication. Concern about the side effects of statin medications, which are commonly used to treat high cholesterol, is widespread. No one wants to experience unpleasant side effects as a result of their medication, but statins have a particularly high rate of intolerance. Unfortunately, high cholesterol levels can be life threatening because they increase your risk of experiencing heart disease, heart attack, and stroke due to the buildup of plaque in the blood vessels of the body. So, which statin medication has the least amount of side effects, and can statin medication side effects be mitigated?

What are statin medications?

Statin medications are among the most commonly prescribed medications in the world. Although the medications belong to a class of prescription drugs called HMG CoA reductase inhibitors, they are more commonly referred to as statins due to the names of the medications. Statin medications are commonly used to lower levels of low-density lipoprotein, or LDL, cholesterol, which is the type of cholesterol that can cause damage to the blood vessels and cardiovascular system. Statin medications work by decreasing the amount of cholesterol produced by the liver. As a result of lower levels of cholesterol, the substance is less likely to cause the buildup of plaque along the walls of the blood vessels, which allows blood to flow freely from the heart to the brain, extremities, and organs.  

What are statin medications used to treat?

Statin medications are used to treat high levels of cholesterol in the blood. Statins primarily work to reduce cholesterol by acting on the levels of LDL, or “bad” cholesterol in the blood. In addition to reducing the production of cholesterol overall, statin medications also help to increase the level of “good” cholesterol, called high-density lipoprotein or HDL, in conjunction with lifestyle changes. Statin medications can also help to reduce the levels of triglycerides, a type of fat that is found in the blood. Lower levels of LDL cholesterol and triglycerides are associated with a lower risk of heart attack, stroke, and other cardiovascular events in patients with type 2 diabetes, coronary heart disease, and other risk factors.  

The body contains two types of cholesterol, both of which are impacted by the use of statin medications. LDL cholesterol, also known as bad cholesterol, and HDL cholesterol, also known as good cholesterol, impact the total cholesterol level in the body. Most people have more LDL in their bodies than HDL, which can cause plaque to build up on the walls of the blood vessels when the imbalance gets too large. Plaque buildup along the walls of the blood vessels causes the blood vessels to narrow, reducing blood flow to and from the heart, organs, brain, and extremities. Reduced blood flow is associated with a higher risk of experiencing heart disease, heart attack, and stroke, so it’s important to keep cholesterol levels in check. However, good cholesterol, or HDL, is actually a good thing to have high levels of, as this type of cholesterol helps absorb LDL and transport it to the liver, which removes it from the body. Although you want to keep levels of HDL high, it’s better to have low levels of LDL, since LDL is the substance that contributes to the development of plaque buildup in the blood vessels. Statin medications help reduce the total cholesterol level in patients, which is calculated by adding together the LDL and HDL levels and combining them with 20 percent of the triglyceride level.

What side effects are commonly associated with statin medications?

Statins are a group of medications that have the same mechanism of action of lowering cholesterol through inhibiting its production in the liver. There are two classes of statins: 1) Hydrophobic (non-water soluble) and 2) Hydrophilic (water soluble). The side effect profiles of statins are very similar with more severity of symptoms common in hydrophilic forms of statins due to more medication penetrating the muscle tissue.

The side effects of statins include:

  • Muscle pain and weakness (myalgia)
  • Fatigue
  • Digestive distress
  • Nausea
  • Headaches 
  • Trouble sleeping 
  • Joint pain 
  • Cognitive changes 
  • Increased blood sugars
  • Vision changes 

Muscle pain is the most common complaint among patients taking statins, and statin intolerance is most commonly related to myalgia, or muscle pain. Muscle pain is commonly experienced as soreness, weakness, or fatigue of the muscles, and while some people experience only mild effects, others experience muscle pain that is severe enough to interfere with their daily activities. The actual risk of experiencing muscle pain as a result of taking statin medications is about five percent, though some researchers and physicians agree this is underreported. While muscle pain caused by statins is usually just uncomfortable, it can also be dangerous if you experience any of the following symptoms:

  • Unusual muscle pain or cramps
  • Fever
  • Diarrhea
  • Tiredness
  • Dark urine

The above symptoms can be a sign of rhabdomyolysis, which is a condition causing the breakdown of the muscles and kidney problems.

Rare side effects associated with statin medications include:

  • Liver damage or inflammation
  • Increased blood sugar or development of type 2 diabetes 
  • Neurological side effects, including memory loss or confusion

What statin medication has the least amount of side effects?

While all statin medications cause side effects, some are associated with a lower incidence of side effects than others. Lovastatin is considered the statin medication with the least amount of side effects. Common side effects of lovastatin include digestive discomfort, infection symptoms, and muscle pain and weakness; taking the medication with a meal can help reduce the incidence of digestive distress. Lovastatin is associated with a lower risk of side effects compared to other statins because it is not as strong of a medication as some of the other drugs, including rosuvastatin, which has the highest rates of reported side effects. Other statin medications include fluvastatin, which is generally well tolerated, atorvastatin, pravastatin, and simvastatin. Statin medications can be either hydrophobic or hydrophilic, which influences how they deliver the medication to tissues in the body; these differences can also contribute to side effects. There are many factors that influence how patients experience side effects of statin medications, including the dose of the statin medication they are taking,health of their liver, age, and other medications that they might be taking.

Is it possible to prevent or avoid statin medication side effects?

High cholesterol is a major risk factor for serious cardiovascular conditions like heart attack and stroke, and many people rely on statin medications to keep their cholesterol at a healthy level. Unfortunately, unpleasant side effects of the drugs can lead to intolerance of statin medications and cause some people to stop taking their medications. If you are experiencing negative side effects while taking a statin medication, the first step is to talk to your cardiologist about the side effects you are struggling with. Your doctor can order blood tests to test the levels of different nutrients in your system, including vitamin D and B vitamins, to measure how statins impact your nutrient absorption. Side effects associated with statins increase as the dose a patient is taking increases, so taking a lower dose may help to avoid many side effects. Unfortunately, some patients need high doses of their medication in order to keep their cholesterol under control. If you are one of these patients, you may be able to minimize the side effects experienced while taking statins by addressing nutritional deficiencies. 

Fortunately, it may be possible to mitigate or avoid some of the side effects associated with statin medications. Researchers believe that some of the side effects of statin medications are caused by the depletion of coenzyme Q-10, or CoQ10, in the body. The human body naturally produces CoQ10, an important antioxidant, as a byproduct of the cellular respiration process, which is the process by which the mitochondria of the cells create the energy we need to function. CoQ10 is an antioxidant that helps prevent damage to cells and DNA caused by free radicals, which are another byproduct of cellular respiration. Statin medications can cause a decline in CoQ10 levels, contributing to a rise in side effects like muscle pain and damage. Patients may be able to prevent or diminish some side effects of statin medications by taking dietary supplements that are specifically designed to provide bioavailable CoQ10, vitamin K2, chelated minerals and mitochondrial antioxidants that help support biochemical balance in the body and boost levels of CoQ10. Statins are important medications that can help save your life, so finding the right medication, dose, and supportive nutrients are critical to improving your heart health over the long term. 

Sources:

https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013 

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

https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statins/art-20045772 

https://www.lipidjournal.com/article/S1933-2874(14)00158-5/fulltext#sec3