Statins shown to cause fatigue

In a study of more than 1,000 adults, researchers at the University of California, San Diego, found that individuals taking cholesterol-lowering statin drugs are more likely than non-users to experience decreased energy, fatigue upon exertion, or both. The researchers suggest that these findings should be taken into account by doctors when weighing risk versus benefit in prescribing statins.

Statin drugs are among the best selling and most widely used on the market. Recently, increasing attention has focused on statins' side effects, particularly their effect on exercise. While some patients have reported or exercise intolerance when placed on statins, had not previously addressed occurrence of fatigue-with-exertion or impaired energy in patients on statins relative to placebo.

In the June 11 issue of Beatrice Golomb, MD, PhD, associate professor of medicine at UC San Diego School of Medicine, and colleagues present randomized trial data which show that these side effects were significantly greater in persons placed on statins than those on a placebo.

More than 1,000 adults from San Diego were randomly allocated to identical capsules with placebo, or one of two statins at relatively low potencies: pravastatin (Pravachol) at 40mg, or simvastatin () at 20mg – chosen as the most water-soluble and most fat-soluble of the statins, at doses expected to produce similar LDL ("bad cholesterol") reduction. According to the researchers, the cholesterol reduction would be similar to that expected with atorvastatin (Lipitor) at 10mg, or rosuvastatin (Crestor) at 2.5-5mg.

Persons with heart disease and diabetes were excluded. Neither subjects nor investigators knew which agent the subject had received. Subjects rated their energy and fatigue with exertion relative to baseline, on a five-point scale, from "much worse" to "much better."

Those placed on statins were significantly more likely than those on to report worsening in energy, fatigue-with-exertion, or both. Both statins contributed to the finding, though the effect appeared to be stronger in those on simvastatin. (Simvastatin led to significantly greater cholesterol reduction.)

"Side effects of statins generally rise with increasing dose, and these doses were modest by current standards," said Golomb. "Yet occurrence of this problem was not rare – even at these doses, and particularly in women."

The magnitude of the effect observed can be seen in the study findings; for example, 4 of 10 treated women on cited worsened energy or exertional fatigue; 2 in 10 cited worsening in both, or rated either one as "much worse"; and 1 in 10 study participants rated energy and exertional fatigue as "much worse."

"Energy is central to quality of life. It also predicts interest in activity," said Golomb. "Exertional fatigue not only predicts actual participation in exercise, but both lower energy and greater exertional fatigue may signal triggering of mechanisms by which statins may adversely affect cell health."

For these reasons, the researchers state that decreases in energy, and increases in exertional fatigue on statins represent important findings which should be taken into account in risk-benefit determinations for statins. According to Golomb, this is particularly true for groups for whom evidence does not support mortality benefit on statins – such as most patients without heart disease, and women and those over 70 or 75, even if is present.

Related Stories

Statins shown to lower blood pressure

Apr 14, 2008

A large, randomized drug trial has shown for the first time that statin drugs result in a modest, but significant, reduction in blood pressure. These effects may contribute to the reduced risk of stroke and cardiovascular ...

FDA adds new safety information to statin drugs

Feb 28, 2012

(AP) -- Federal health officials are adding new safety warnings about risks of memory loss and elevated blood sugar to statins, a widely prescribed group of cholesterol-lowering medications.

Recommended for you

Novartis Japan admits concealing drug side effects

Sep 01, 2014

The Japanese unit of Swiss pharma giant Novartis has admitted it did not report more than 2,500 cases of serious side effects in patients using its leukaemia and other cancer drugs, reportedly including some fatalities.

Most US babies get their vaccines, CDC says

Aug 28, 2014

(HealthDay)—The vast majority of American babies are getting the vaccines they need to protect them from serious illnesses, federal health officials said Thursday.

Expression of privilege in vaccine refusal

Aug 27, 2014

Not all students returning to school this month will be up to date on their vaccinations. A new study conducted by Jennifer Reich, a researcher at the University of Colorado Denver, shows that the reasons why children may ...

User comments