Statin-induced myalgia and neuralgia (CASE REPORT and MECHANISMS)

INTRODUCTION: This is a case of a private patient that I have treated. I am reviewing this case and providing some explanations, so that it can provide a clinical guide/tool for practising doctors and statin-sceptics who want to do better for their patients. In my experience, most doctors have been brainwashed by the medical 'education' system long enough will not question the efficacy of statins, and they genuinely believe that it is a life-saving drug. I re-iterate that this is nothing but a BELIEF - there is no legitimate evidence suggesting that these drugs are useful. I acknowledge that most doctors and practising physicians do not know how to read ''scientific'' papers, analyse statistics from clinical trials, or draw conclusions - this is deliberate so that Big Pharma can produce whatever 'evidence' they want to market their drugs. 

CASE REPORT:
65 year old male patient had a Myocardial Infarction (Heart Attack) in 2021, had a stent and was on DAPT (Aspirin + Clopidogrel) and Rosuvastatin 10 mg. This MI was triggered by a stressful event in the family, of his daughter being unwell. His diet was a typical vegetarian Indian diet that is rich in carbohydrates. Poor sleep. Virtually zero protein in his diet. 

Patient complains of neurological back pain on both sides, and intermittent muscle cramps - both of these stopped after stopping the statin, and patients quality of life has improved significantly.

The only problem is that his cardiologist said that if he stops the statin, he could drop dead of a heart attack at any moment.

MECHANISMS:

As you can see in this image, muscle cells undergo 'cell death' when exposed to a statin. This is why many patients report cramps and muscle issues. This is because statins destroy your muscles. It also destroys your heart muscles, causing heart failure in the long term. This is especially the case if you're taking Atorvastatin 80 mg.

ALL cells in the body are lined by cholesterol, but nerve cells are particularly cholesterol rich. Reduced cholesterol in nerve cells will cause nerve damage. In the brain, it can cause dementia and psychiatric symptoms.
Source: Statin Neuropathy: Can Statins Cause Nerve Damage?

OTHER EXAMPLES OF STATIN-INDUCED DAMAGE FROM MY OWN CLINICAL EXPERIENCE:

• Patients have been unable to walk because of statins - especially older ones. I have seen many patients come in with falls after being prescribed an 80 mg statin. Mobility and deconditioning is a consequence of muscle destruction. This is a VERY concerning side effect, because a lot of symptoms considered to be due to 'old age' might be due to statin usage. 

• Heart Failure - I have seen heart failure and NT-proBNP levels improve with statin stoppage. There is also evidence of statin-induced heart failure, and chest pain. Obviously - the heart is the most important muscle in the body!

• Dementia, Confusion, Epilepsy and neurological problems have been implicated with statins. I have seen patients dementia improve with stopping statin. There are studies confirming the same [3] 

•  Liver damage.

DO STATINS REDUCE RISK OF HEART ATTACK?
Not by a significant amount. [1]

ARE STATINS LIFESAVING? No, the opposite - it increases your risk of dying. [1]

IF I STOP A STATIN WILL I IMMEDIATELY DROP DEAD OF A HEART ATTACK OR STROKE?
There is only ONE study done on stopping a statin. It would be very difficult to do further such studies, because it would threaten the pharmaceutical industry. All hail capitalism.[2] This study shows that ZERO people died from heart attack or stroke within 3 years of stopping the medicine.

DO THE SCIENTIFIC TRIALS ON STATINS SHOW BENEFIT?
The short answer to this is no. Studies on statins that are free of pharmaceutical industry bias show virtually no benefit, and most of the studies show increased death in the treatment group. Please see my article reviewing all the evidence [1]

NEUROPATHY/MYOPATHY SYMPTOMS TO WATCH OUT FOR:
- Numbness or tingling in the feet, legs, hands, or arms — often starting in the toes
- Burning or prickling sensations, particularly at night
- Increased sensitivity to touch (even bedsheets may feel painful)
- Muscle weakness, especially in the lower legs
- Loss of balance or coordination
- Sharp, stabbing, or electric-shock-like pains

SAFER ALTERNATIVES:

A low dose rosuvastatin of 5 mg is the safest and best tolerated. Avoid atorvastatin, especially at high doses such as 80 mg. Higher doses provide NO clinical benefits for heart attacks. 80 mg statin increases risk of death as per SPARCL trial.

HOW TO REVERSE STATIN-INDUCED HEART, MUSCLE AND NERVE DAMAGE:

1. Stop the medication, or switch to a low dose rosuvastatin (5 mg) or another cholesterol-lowering medication such as ezetemibe.

2. Take COQ10 300 mg daily, for atleast 3-4 months.

[1] STATINS - A review of the Evidence and Side Effects
Statin Research | DR HANNAH MATHEW

[2] Statin-Associated Cardiomyopathy Responds to Statin Withdrawal and Administration of Coenzyme Q10 | The Permanente Journal

[3] The Effect of HMG-CoA Reductase Inhibitors on Cognition in Patients With Alzheimer's Dementia: A Prospective Withdrawal and Rechallenge Pilot Study - ScienceDirect

[4] Clinical outcomes of high‐intensity doses of atorvastatin in patients with acute coronary syndrome: A retrospective cohort study using real‐world data - Rahhal - 2021 - British Journal of Clinical Pharmacology - Wiley Online Library

[5]High-Dose Atorvastatin after Stroke or Transient Ischemic Attack | New England Journal of Medicine