What is the relationship between statins and Myalgia?

Myalgia or joint muscle pain, is one of the most common side effects of statin therapy, occurring in about 5% of all patients. The increasing use of statins by Western society has led to a growing awareness within the medical community of this connection between statins and myalgia, although both the nature of the connection and its prevention are less clear. Myalgia is most often caused by some kind of trauma, such as stretching or over-use of a muscle or individual group. When the trauma is not easily identifiable, viral infections can be the cause. For example, muscle pain is one of the symptoms of the flu.

Since the discovery of mevastatin by a Japanese researcher in the 1970s, the group of drugs called statins have been favorably received by the western medical community. These medications have been primarily used to lower cholesterol levels in human blood, which leads to a dramatic reduction in cardiovascular disease. Atorvastatin, the most popular statin, is sold under the brand name Lipitor. Research also indicates that statin therapy may be useful in reducing the incidence of certain types of cancer in some patients. These actual and potential benefits of statin therapy can be considered to outweigh the disadvantages of a potential link between statins and myalgia.

In a significant subset of cases, it was found that the connection between statins and myalgia was expressed in some statin therapy patients who were deficient in vitamin D, a condition that is practically endemic in Western culture. Correction of vitamin D deficiency has resulted in a satisfactory resolution of myalgia. Vitamin D deficiency, however, does not explain all cases of myalgia in patients undergoing statin therapy; Similarly, there is no relationship between statins and myalgia in most patients with vitamin deficiency.

There is no mechanism by which prescribing physicians can determine which of the many statins causes myalgia in any particular patient. Similarly, if a patient experiences disorder, there is no way of knowing what the difference will be if the therapy is altered to one of the other statins. Some statins, such as pravastatin and fluvastatin, are more hydrophilic than other statins; In other words, they dissolve more easily in water, while other statins are lipophilic, which means they dissolve more easily in fats and oils. It has been suggested that it is easier for lipophilic statins to penetrate cell membranes and cause damage, leading to myalgia, but insufficient research has been carried out along these lines.

Exploring the relationship between statins and myalgia leads to the discovery that the other statins, lovastatin, leads to the expression of a gene thought to promote damage in the muscle fibers. The actual incidence of myalgia in lovastatin users, however, does not support the existence of a causal relationship.

• Those taking statins should check with their doctor to see if it is safe to drink grapefruit juice, which can interact with medications.
• A woman with myalgia in her neck due to muscle fatigue.