Cholesterol Medications May Cause Fibromyalgia

Cholesterol-lowering "statin" drugs often cause severe side effects—including CFS & fibromyalgia! Unless you have had a heart attack, these medications are usually not necessary (see Lower Your Cholesterol—Naturally). We have found they can often cause or worsen fibromyalgia, and I recommend that those with CFS/FMS speak with their physician about stopping these medications for 3 months to see if the pain and fatigue decrease.

The most frequently reported side effect of these medications is fatigue, and about 9% of patients report statin-related pain. Earlier research showed that statins cause Coenzyme Q10 deficiency.

The results of a new study show that statins may also block the ability of the muscles to repair and regenerate themselves. This may then also contribute to pain.

References

Cholesterol-lowering drugs and the effect on muscle repair and regeneration, American Physiological Society

[http://www.endfatigue.com/health_articles_c/Cholesterol-medications_may_cause_fibromyalgia.html]

Lower Your Cholesterol—Naturally

It is important to recognize that even though cholesterol gets a lot of attention, it is not necessarily the most important (or even an especially significant) factor in preventing heart disease. Other factors, such as nutritional support and optimizing thyroid function (in women) and testosterone levels (in men) may also decrease the risk of heart attack.

Although the cholesterol-lowering medications in use today can be lifesaving in those who have already had a heart attack or have angina, they only decrease heart attack deaths by 1.4% in those without a previous heart attack (called "primary prevention"), and they are not without risks. Some of these include muscle pain, liver inflammation, and depletion of the nutrient coenzyme Q10. This nutritional deficiency can then contribute to fatigue and congestive heart failure, and I believe that anybody on Mevacor related cholesterol-lowering medications (most are) should take 200 mg a day of coenzyme Q10.

To put it in perspective, cholesterol medications lower the risk of heart attack death by less than 2%, while owning a cat is associated with a 30% lower risk of heart attack death, and having high vs. low normal thyroid function is associated (in women) with a 69% lower risk of dying of a heart attack.

Although cholesterol is NOT the main cause of heart disease, heart and blood vessel diseases are the number one killers in the U.S. Increasingly, heart disease is occurring because the heart muscle is not making enough energy. This can occur because of a number of changes, and is a subset of the "human energy crisis" occurring worldwide. This is why decreased heart function is a part of CFS (the heart muscle has trouble making energy just like the rest of the body), and CFS/fibromyalgia also improve (often dramatically) using the nutritional energy powerhouses discussed in Treating Heart Disease Naturally.

So why all the fuss about cholesterol?  Two main reasons:

 1. We have a test to measure it, and
  
 2. Drug companies make over 10 billion dollars a year on these meds.

The second reason is the main one.

Meanwhile, taking cholesterol medication can cause muscle pain (including fibromyalgia) and heart failure, which the physician will usually mistakenly blame on something else. Except for those with a history of heart disease, or cholesterols over at least 250, I WILL NOT USE CHOLESTEROL MEDICATIONS IN CFS OR FIBROMYALGIA! Often, when the medication is stopped, the CFS/fibromyalgia symptoms lessen over the next month or two—making it clear that the medication was a factor.

A few key points:

 1. Cholesterol can often be optimized safely and naturally without the medication. 
  
 2. If the cholesterol is high, optimizing thyroid function will often lower it (and likely protect the heart WAY more effectively that cholesterol medications)—even if the thyroid tests are "normal."
  
 3. In men, if the testosterone level is under ~ 450, using natural testosterone (not the dangerous high dose synthetics some athletes use) will often markedly lower cholesterol while also decreasing diabetes and high blood pressure—and leave you healthier overall. I aim for a testosterone level over 700.
  
 4. If taking cholesterol medication, be aware that they cause Coenzyme Q10 deficiency. I strongly recommend that you take 200 mg of Coenzyme Q10 daily as well. After you stop your cholesterol medication, I would continue the Coenzyme Q10 for 3 more months. Stopping any medication should be done with your physician's OK. See the American Board of Holistic Medicine to find a knowledgeable holistic physician if yours will not work with you.
  
 5. Cholesterol serves a critical function in your body, as it is essential for making stress hormones (e.g., cortisol and DHEA), estrogen, progesterone and testosterone. Lowering it too much is not healthy.

Let's look at safe and natural ways to lower your cholesterol.

Treatments

 1. Begin with an exercise program and, if overweight, bring your weight down.
  
 2. In men, especially if you are overweight, have high blood pressure, and have diabetes (or are prediabetic), this may ALL be coming from too low of a testosterone level. If your total testosterone is under 450 on the blood test, I would consider using prescription natural testosterone (Androgel or Testim or compounded) to bring your level up over 700. For more information, see Effect of Testosterone on Metabolic Syndrome.
  
 3. In women, consider a trial of prescription natural Armour Thyroid—even if the labs are normal. High cholesterol is often caused by low thyroid and the tests are horribly unreliable (they miss the majority of those who need thyroid hormone). Consider an exercise stress test before beginning exercise or thyroid. Both are very healthy for the heart, but could unmask heart disease in those with severe heart blockages. For more information, see Thyroid Hormone Deficiency—An Overview.
  
 4. Enjoy eating your eggs and cholesterol. Study after study shows that eating 6 eggs a day for 6 weeks has no effect on cholesterol blood levels. Yet this myth persists. Avoid saturated fats (hard fats) and margarine (butter is much healthier and tastier than margarine).
  
 5. Eat 1-3 cloves of garlic a day. Crushed into olive oil, it makes a yummy treat that may drop your cholesterol. In addition, have a cereal with oats (e.g., Life, Cheerios, Quaker Oats Squares) for breakfast. Simply adding garlic and oats to your diet can lower your cholesterol almost as much as many medications. Artichokes also lower cholesterol.
  
 6. Herbals can be quite effective as well at maintaining a healthy cholesterol level. I recommend a product called "Chol-Less" which contains inositol hexaniacinate (flush free niacin), berberine, chromium, artichoke, policosanol and deodorized garlic. 
  
 7. If triglycerides are also elevated, especially be sure to avoid sweets and add Acetyl-L-Carnitine 1,000 mg a day to the above for 3 months to see if it lowers the triglycerides.
  
 8. If on cholesterol lowering medications (statins), be sure to take Coenzyme Q10 (200 mg a day. I use the Enzymatic Therapy CHEWABLE brand as quality is an issue for Coenzyme Q10 ).

Cholesterol Lowering Medications Can Cause Coenzyme Q10 Deficiency

Holistic practitioners have known that cholesterol lowering medications called statins (most are this kind) block Coenzyme Q10 production along with cholesterol production. Coenzyme Q10 is critical for energy production and heart function, but when people go into heart failure the doctors don't know that it could be from the cholesterol medication.

I prefer natural options for lowering cholesterol. But if you are (or have been) on a cholesterol lowering medication, take Coenzyme Q10 at 200 mg a day. If you have heart disease, see Treating Heart Problems Naturally.

References

"Comparison of effects of pitavastatin and atorvastatin on plasma coenzyme Q10 in heterozygous familial hypercholesterolemia: results from a crossover study," Kawashiri MA, Nohara A, et al, Clin Pharmacol Ther, 2008; 83(5): 731-9.).

Cholesterol-lowering drugs and the effect on muscle repair and regeneration

25-Sep-2008:-  HILTON HEAD, SC—Statins are powerful drugs that reduce "bad" cholesterol and thus cut the risk of a heart attack. While these medications offer tremendous benefits to millions, they can carry side effects for some. The most frequently reported consequence is fatigue, and about nine percent of patients report statin-related pain. Both can be exacerbated when statin doses are increased, or physical activity is added. The results of a new study may offer another note of caution for high-dose statin patients. Working with primary human satellite cell cultures, researchers have found that statins at higher doses may affect the ability of the skeletal muscles–which allow the body to move–to repair and regenerate themselves.

The study is entitled "Simvastatin Reduces Human Primary Satellite Cell Proliferation in Culture." It was conducted by Anna Thalacker-Mercer, Melissa Baker, Chris Calderon and Marcas Bamman, University of Alabama at Birmingham. They will discuss their findings at the American Physiological Society (APS;  [www.The-APS.org/press] conference, The Integrative Biology of Exercise V. The meeting is being held September 24-27, 2008 in Hilton Head, SC.

The Study

Statins have been reported to have adverse effects on skeletal muscle in both human and animal models causing cramping and fatigue and potentially myopathy. Relatively little is known regarding the effect of statins on the muscle progenitor cells (i.e., satellite cells (SC)) which play a key role in skeletal muscle repair and regeneration following exercise or injury. SC remain in a quiescent state until stimulated to proliferate. Statins are known to have antiproliferative effects in other cell types and therefore may inhibit or effect this critical step in muscle repair. Thus it is important to understand the influence of statins on SC function which may further affect the overall health and physiology of human skeletal muscle..

The study examined the proliferative capacity of human satellite cells in culture, which were exposed, to a lipophilic statin: simvastatin. The aim of the study was to determine SC viability during proliferation when treated with statins which may be indicative of the ability of SCs to undergo mitosis (i.e. divide to make new cells).

The research team used primary cell lines isolated from quadriceps muscle biopsies. SC were mixed and grown for 48 hours with several concentrations of statin: 0.0, 0 plus the solvent DMSO (control), 0.05, 0.1, 1.0, 10, or 100µM. The MTS assay was utilized to measure cell viability/reproducibility.

Additionally the investigators determined the effects of varying concentrations of simvastatin on SCs in different states (i.e., undergoing differentiation or differentiated into myotubes).

Key Findings

The researchers found the following:

There was a dose dependent decrease in the viability of the satellite cells at 1.0, 10 and 100µM concentrations of simvastatin. At approximately 5.0 µM concentration the viability of the proliferating cells was reduced by 50% (equivalent to the availability of simvastatin in circulation from a 40 milligram dose per day used in some patients). Specifically, the higher end concentrations led to reduced SC proliferation, which would likely negatively affect the muscle's ability to heal and/or repair itself.

There was no change in the viability of satellite cells at concentrations of 0.05 or 0.1µM.

Cell viability was reduced by approximately half in differentiating cells and myotubes with concentrations of 1.0 and 5.0 µM, respectively.

Next Steps

According to Dr. Thalacker-Mercer, a member of the research team, "While these are preliminary data and more research is necessary, the results indicate serious adverse effects of statins that may alter the ability of skeletal muscle to repair and regenerate due to the anti-proliferative effects of statins."

Looking ahead, she added, "We are very interested in these effects in the older population. It is possible that older adults may not be able to distinguish between muscle pain related to a statin effect or an effect of aging and therefore adverse effects of statins in older adults may be under-reported. Therefore, our next step is to examine statins among older adults."

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Physiology is the study of how molecules, cells, tissues and organs function to create health or disease. The American Physiological Society (APS; [www.The-APS.org/press]  has been an integral part of this discovery process since it was established in 1887.
[http://www.eurekalert.org/pub_releases/2008-09/aps-cda092308.php]