Why statins cause muscle pain

Many who take cholesterol-lowering statins complain about bad muscle pains that can be so severe that they stop taking the drug—and now scientists have figured out why this happens.

The drugs jam open a critical muscle protein, causing a toxic calcium leak that affects the muscles.  Sometimes, a dangerous breakdown of muscle tissue can lead to kidney failure, say scientists at the University of British Columbia.

Those who don’t suffer such extreme reactions still report stiffness and fatigue, which are milder reactions to the same problem.

Using cryo-electron microscopy, an advanced imaging method that sees proteins in near-atomic detail, the researchers discovered how statins interact with a key muscle protein known as the ryanodine receptor (RyR1).  The protein regulates the flow of calcium inside muscle cells, acting as a gate that opens only when muscles need to contract.

Statins bind to RyR1 and force the channel into an open position. This causes calcium to leak continuously, which can be toxic to muscle tissue and damage it.

Although the researchers used atorvastatin, one of the most commonly prescribed statins, for their tests, they believe the same mechanism would probably be seen in other statins, too.

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