I was still in practice, over twenty years ago, when lovastatin, the first statin drug, became available for use by primary care physicians.
By Duane Graveline, MD, MPH
We learned to expect liver inflammation and occasional muscle aches and pains. With the dosages used at that time and with a relatively small number of patients on the early statins, the side effect issue impressed me as being acceptable.
This is no longer true. Today, with more potent drugs, millions of people taking them and at doses triple and quadruple those of the past, the side effect profile has radically changed. Now, cognitive damage, emotional and behavioral change, neuropathies and even neuro-degenerative damage are increasingly recognized as associated with statin drug use. But there is something even more perverse - the element of permanence of some of these consequences.
Yes, within the past six years, after my own cognitive reactions to statins in the prevailing climate of complete physician denial, drug companies have belatedly added cognitive damage but not one word about permanent cognitive damage. And the same for neuromuscular - yes, most of the drug companies now admit that peripheral neuropathy may be a consequence of statin use but have never mentioned it might be disabling, crippling or permanent.
On the basis of my repository of several thousand reports from statin "victims", the first evidence of permanence came from reports of cognitive problems associated with statin use. Michael Hope was one of the first to receive widespread media attention - a former CEO reduced to unemployable status due to persistent loss of short-term memory. Today, four years after the onset, Michael is still grossly impaired. He is one of many hundreds who have persistent cognitive deficits long after stopping their statin.
Next came reports of muscle aches and pains brought on by statin drugs that persisted and even worsened despite promptly stopping the statin. Two astronaut friends of mine, having no history of muscle problems, experienced muscle pains shortly after their statin was started for mild hypercholesterolemia. Much to their dismay these pains have persisted years after they stopped the offending drug. They are but two of thousands of people in this growing subgroup with persistent and apparently permanent muscle symptoms seemingly triggered by statin drug use. Current research indicates that many of these have an unsuspected genetic predisposition. Some of these cases respond to CoQ10, many do not.
Another growing reality is that of peripheral neuropathy, particularly unresponsive to treatment, coming on soon after statin therapy is initiated. Once this occurs, not only does it seems to be permanent but tends to worsen in many patients. Hundreds of victims are incapacitated, even crippled by this unfortunate side effect, seemingly related to alterations in CoQ10 availability brought on by statin drug interference with the mevalonate pathway.
On hearing hundreds of complaints about doctor rebuff on this subject of statin side effects, I well recall the words of Doctor Ellsworth Amidon, my professor of medicine at Vermont College of Medicine, way too many years ago: "Listen well to the words of the patient, my young doctors, for they are telling you the diagnosis."
Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor