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Statin Drugs Can Cause Significant Energy Drain, Exercise Intolerance for Many – UC San Diego

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In a placebo-controlled study involving more than 700 men and 300 women, researchers at the University of California – San Diego found that many individuals given low dose cholesterol-lowering statin drugs experienced decreased energy, fatigue upon exertion, or both.

This potential energy drain (reported June 11 as a research letter by the Archives of Internal Medicine) should be a consideration in physician decisions on the risk-benefits of statin drug prescription, the researchers suggest.

Statin Drugs – a Physician Favorite

Statin drugs are among the best selling and most widely used prescription drugs on the market. Recently, increasing attention has focused on statins’ side effects, particularly their effect on exercise.

• Some patients have reported fatigue or exercise intolerance when placed on statins,

• But until now no randomized trials had addressed the occurrence of fatigue-with-exertion or impaired energy in patients on statins relative to placebo.

Significant Effect Even at Modest Doses

The UCSD study found that the energy-reducing effects of even low doses of statin drugs could be significant – indeed “surprising, despite the fact that we had previous reports indicating there was a problem,” says Dr. Golomb.

Specifically the 1,000 study subjects (all afe 21 or older with elevated LDL or ‘bad’ cholesterol but no history of heart disease or diabetes) were randomly allocated to receive, in identical capsules, either a placebo or one of two statins at relatively low potencies: pravastatin (Pravachol) at 40mg, or simvastatin (Zocor) at 20mg.

These two drugs were 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.

Neither the subjects nor the investigators knew which agent the subject had received. During the study, the 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 placebo 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," Dr. Golomb says. "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 research findings.  For example:

• 40% of treated women on simvastatin cited worsened energy or exertional fatigue;

• 20% cited worsening in both, or rated either one as “much worse”;

• And 10% rated energy and exertional fatigue as “much worse.”

Low Energy Reduces Interest in Physical Activity

"Energy is central to quality of life. It also predicts interest in activity," says Dr. 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.

This is particularly true, Dr. Golomb says, 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 heart disease is present.

Source: Based on University of California – San Diego news release, Jun 11, 2012

Note: This information has not been reviewed by the FDA and must not be taken as medical advice. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

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5 thoughts on “Statin Drugs Can Cause Significant Energy Drain, Exercise Intolerance for Many – UC San Diego”

  1. IanH says:


    “We conclude that statin therapy can be associated with high blood lactate/pyruvate ratio suggestive of mitochondrial dysfunction. It is uncertain to what extent low serum levels of ubiquinone could explain the mitochondrial dysfunction”.

  2. CWB says:

    “Increases in exertional fatigue on statins represent important findings which should be taken into account in risk-benefit determinations for statins,” says the conclusion of this article, but for those who follow articles on Prohealth about ME/CFS there are more risks to take into consideration, such as the connection between statins immune dysfunction reported here at Prohealth in March, 2010: “Statin drug appears to weaken body’s immune defenses.” As I commented at that time, statin drugs kick started my descent into ME/CFS in 2003. Though I stopped taking statin drugs a year later, the insult to my immune system remains. Since that time, my research has bumped into the immune dysfunction caused by statins in a number of areas that might seem unrelated, which I summarize here in case it will be of help to others on their own statin/immune path. I’ve had to do a lot of research because of on-going, atypical, disseminated shingles (or herpes zoster, like EBV, in the herpes family of viruses), including in my eyes, and compounds that work on the same immune pathways as statins have been implicated in causing and protracting them. My acupuncturist got me on this helpful trail after she saw an article in an arthritis newsletter with a reference to “Anti-TNF-? Agents in the Treatment of Immune-mediated Inflammatory Diseases: Mechanisms of Action and Pitfalls” (Immunotherapy. 2010;2(6):817-833.) There I learned that reports link TNF-blocking substances to reactivating viruses, particularly in the herpes family. Along that trail I’ve found many links between immunity and cholesterol. While statins, as a pharmaceutical, deliver an Atomic bomb’s worth of TNF-blocking action, many natural compounds taken for lowering cholesterol or other primary goals work on the same immune pathways and may also lead to reactivating viruses. In a nutshell, they are anti-inflammatories, often also noted as immune modulators, even some anti-virals oddly enough. Indeed they may all those things, but whether they will help or harm you is important to find out, preferably before you try them. Research the Th1/Th2 balance, and if you find that you present on the Th2 side as many of us with viral illnesses do, the TNF blockers including statins may stir up your viruses. If you are on Th1 dominant, as are those with RA, Hashimoto’s, and many autoimmune conditions, statins and the anti-inflammatory, TNF-blocking supplements or other drugs may be indeed quite helpful. As it turns out, my protocols included a preponderance of TNF-blocking drugs and supplements taken by mouth as well as applied to the skin. Individually they may or may not have been enough to re-awaken the herpes viruses in my system, but together, and with a probably genetic tendency, they certainly did push me over the edge into this period of shingles dominance in my longer struggle with ME/CFS (which includes a cocktail of reactivated viruses including the other herpes family viruses EBV and HHV6, as measured by my infection disease doctor). Circling back to the current article, “Statin Drugs Can Cause Significant Energy Drain, Exercise Intolerance for Many,” I would guess that these substances then may also create an energy drain or exercise intolerance. Other people may be able to use some or all of these substances or ingredients with no problem or even great help–certainly one size does not fit all, so I write for those that may be suffering as I have. TNF-blockers include the corticosteroid drugs like Prednisone, sinus sprays like Flonase and Nazonex, anti-aging Rx and OTC retinoid and retinol creams, cortisone creams, and most sunscreens (though aside from the natural ingredients listed below I can’t pin-point the exact chemical ingredients; it takes a while to research each ingredient in those long lists of tiny type on packaging, but I do). Supplements and foods that are powerful TNF-blockers include turmeric/cur cumin, green tea, grape seed extract, olive leaf extract, Oxymatrine, resveratrol, sillymarin/milk thistle, isatis, jiaogulan, eucalyptus, cat’s claw, red yeast rice, SAMe, NAC, fish oil, flax seed oil, Vit. D, Vit E, sesame seed oil, coconut oil. Knowing your Th1/Th2 proclivity, look up individual substances by name in a PubMed search along with “TNF” and you can learn quickly enough if it may help or harm you. The authors of the Immunotherapy article say “data regarding the effect of TNF inhibitors on the course of viral infections are mostly limited to case reports, thus further studies are warranted.” I heartily agree! If this speaks to your experience, please follow up with research beyond my synopsis. Additionally, look into the lysine-arginine ratio, and avoid anti-aging lotions with arginine-based cosmeceuticals (usually with “peptide” in their title), which also will turn on viruses, as well can progesterone. Getting these substances out of my protocols, lotions and cosmetics has helped me to curb the break-through flare-ups of shingles that were so painful, debilitating, and unsightly the first two years, though I still remain at the highest, acute dose of Acyclovir (800 mg, 5/day). I have not been able to cut down without a major flare for three years. My hope is that in the short term I will be able to cut down on Acyclovir and then heal from shingles, and in the long term heal from EBV and HHV6 as well, which may just cure my ME/CFS.

  3. CWB says:

    While I want to share important cautions about statin drugs and other powerful TNF-blockers, I do not mean to suggest that a person who has been prescribed them should go off them without research and sharing your findings with your doctor(s) to come to a conclusion together. I went off of statins in 2005 after much research and seeing several specialists each assessing my cardiac risk. While the study that this comments on gives me hope that more studies will reveal more of the inter-complexities of our body’s many systems, I suspect that the mainstream advice to cardiologists will focus on the mechanics they are already accustomed to and for which statins are targeted, that they will not necessarily be open to this information. A rheumatologist, holistic endocrinologist, or infectious disease specialist, may be more responsive, especially if you come to your appointment with an outline linked to abstracts from PubMed.

  4. pfreiman says:

    It is nice to know what has been wrong with me for the past 2 years (that my sports med doctor couldn’t diagnose). It all started when I hiked 1000 miles of the Pacific Crest Trail in 2010, and lasted 2 years. Instead of 20 miles a day and feeling great, I felt exhausted after 5 miles. I look forward to feeling good again.

  5. jenunsa says:

    I’ve been doing a lot of reading about cholesterol levels and mood problems…I end up finding a lot of articles on statins and their side-effects. But there are some studies that show that low total cholesterol (below 160) is unhealthy and can cause symptoms (hormone problems, mood problems) so I think that a lot of these side-effects attributed to statins could really just be the effects of lowering one’s total cholesterol.

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