Do statins cause muscle pain?

Great news! All those aches and pains you’ve been suffering while taking a cholesterol-lowering statin had nothing to do with the drug after all. No, it was because you’re getting older and researchers have verified that the elderly suffer from—yes, you guessed it—aches and pains.

Then there are always those difficult patients who blame the drug when there’s nothing wrong with them at all, but frankly they are troubled souls, and we should move swiftly on.

“There’s no doubt that aging does increase your risk of experiencing pain,” explains Prof. Colin Baigent at the University of Oxford. He’s director of the Medical Research Council Population Health Research Unit, so he should know.

Colin wears many a hat, and he is also the lead researcher of the study that has concluded statins aren’t causing muscle aches. The sheer scale of the study has been described as “monumental,” admittedly by Colin himself, but, again, he should know.

He’s not alone in praising the study. “This is the definitive study; this is really gold standard evidence,” said Prof. Sir Nilesh Samani, medical director at the British Heart Foundation. Admittedly, the foundation paid for Colin’s study, but it should know.1

Colin and his team from the Cholesterol Treatment Trialists’ Collaboration analyzed data from 23 studies involving around 155,000 people and concluded that nobody was really suffering muscle aches at all, and if anybody was, it wasn’t due to statins.2

All of this comes as a bit of a surprise to everyone else. The UK’s National Health Service website lists muscle aches as a common side effect and advises that if the aches become unbearable, the patient should have a blood test for levels of creatine kinase (CK), a substance released into the blood when muscles become inflamed or damaged.

The problem even has a name: statin-associated muscle symptoms (SAMS). Another group, the European Atherosclerosis Society Consensus Panel (don’t think Colin’s on that one) says that muscle pains are one of the biggest reasons people stop taking the drugs. The panel has come up with its own theory as to what’s going on: statins reduce mitochondrial activity (mitochondria are the body’s “power cells”), which reduces energy levels and causes muscle proteins to degrade. Strange—not a word about getting old.3

It’s a common problem with the drugs, affecting up to 30 percent of users, say Israeli researchers. Interestingly, patients often suffer aches and pains when they begin taking a statin, but they are usually pain-free within a month after stopping the drug.4 Again, doesn’t sound as if that has much to do with old age, but still.

Colin and his team saw a different picture. They estimate that 11 out of 1,000 statin users suffer aches and pains—that’s just 1 percent, a world away from 30 percent. But why the enormous disparity? One reason could be that they’re looking at studies that have been, in the main, funded by the statin manufacturer. It’s well known that at least 70 percent of drug trials are fraudulent—in other words, the conclusions don’t match the data but produce a result that favors the study’s sponsor.

In an oft-cited blog, former BMJ editor Richard Smith argued that it’s safer to assume all medical research is fraudulent until it’s proven otherwise.5

Colin has been on a mission for years to get more people onto statins. He describes all the talk about muscle pains as “fake news” stopping people from taking statins that could save their lives.

Industry watchers think the latest study could finally turn the tide and provide reassurance to doctors and patients that statins are safe to use. In the UK, 18 million people have reached the age when they could be taking the drug as a heart disease preventative, but just 8 million do so right now—so that could be very good news for the statin manufacturers.

Sadly for Colin and his team, you can’t wish the truth away. Many studies have reported on the debilitating pains suffered by statin users, which are sometimes so excruciating, they have to stop taking them.

Perhaps Colin’s team could have spent the foundation’s money on exploring other remedies that can be better tolerated, but he should know.