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Statins leaving people exhausted

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The energy-sapping effect of taking statins is greater than previously thought, scientists said last night.

Women taking the anti-cholesterol drugs are particularly at risk of fatigue, they warned.

Two in five women patients had less energy than before, with one in ten saying they felt ‘much worse’.

Overall, around a fifth of those taking the drug reported they had less energy, fatigue upon exertion or both compared with non-users.

Researchers say the side-effects are greater than expected, and some people at low risk of heart disease may be better off not taking them.

More than eight million adults at risk of heart attacks and strokes are already taking statins and some experts believe the benefits mean all healthy adults over 50 should be taking them.

At present statins are restricted to people with a 20 per cent risk or more of having a heart attack or stroke during the next ten years.

Although some patients had already reported fatigue or exercise intolerance when placed on statins, previous trials had not looked at exertion fatigue or impaired energy in patients on statins compared with placebo treatments.

In a study of more than 1,000 adults, a third of whom were women, researchers at the University of California, San Diego, looked at the side-effects of the drugs on energy levels and exercise capacity.

Statins

Statins

In the trial headed by Beatrice Golomb, associate professor of medicine at UC San Diego School of Medicine, participants, were randomly given identical capsules containing either a placebo or one of two statins at relatively low potencies: Pravastatin at 40mg or simvastatin at 20mg. People with heart disease and diabetes were excluded.

Those taking part rated their energy and fatigue with exertion relative to a resting base line, on a five-point scale, from ‘much worse’ to ‘much better.’


The ones taking statins were significantly more likely than those on the placebo to report worsening energy levels, fatigue after exertion, or both, says a report in the journal Archives of Internal Medicine.

Both statins contributed to the finding, though the effect appeared to be stronger among those on simvastatin.

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

Although the study found overall a worsening of fatigue for one in five people, four in ten women on simvastatin cited worsened energy or exertional fatigue, two in ten cited worsening in both, or rated either one as ‘much worse’.

But one in ten women rated both energy and exertional fatigue as ‘much worse’.

Professor Golomb said: ‘Energy is central to quality of life. It also predicts interest in activity.

‘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.’

She said doctors should take account of these side-effects before prescribing statins for groups where there is little evidence they save life.

Professor Golomb said this included most patients without heart disease, women and those over 70, even if heart disease was present.

Are statins the new wonder drug

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Last year, the ubiquitous blood-thinning painkiller aspirin — which protects people from heart attacks and strokes by reducing the clumping action of platelets that clot and block blood flow to the heart and brain —was shown to also protect against bowel cancer, breast cancer and stop prostate cancer spreading to the bones, along with lowering death from it.

The latest drug inching up the ‘Wonderdrug Hall of Fame’ is the statin, the cholesterol-buster that makes bad cholesterol plummet enough to lower heart attacks by 60% and stroke by 17%. This week, it was reported to be effective in treating breast cancer, write US researchers in the journal Cell.

Benefiting most from statins were women with breast cancer who carry mutations of the p53 gene, which normally suppresses cancerous cells. The mutation, however, promotes cancer growth, causing rapid, invasive growth of tumours, found researchers from Columbia University. Treating breast cells carrying mutant p53 genes with statins — such as simvastatin, atorvastatin, lovastatin and pravastatin — reduced their invasive growth.

More than half of all cancers carry p53 gene mutations, which make statins a potential cure for most cancers.

Studies in the past have shown statins could be an arsenal in the clutch of treatments — chemotherapy, radiation, immunotherapy, among others — used to fight cancer. Last year, a study in the journal Cancer said that men on statins had lowered risk of prostate cancer returning by 30%. A 2005 trial showed that patients taking statins for over 5 years lowered their risk of colorectal cancer by almost half.

statins-lancastria

Statins have been hailed as a “wonder drug”

At any given time, 28 lakh people have cancer in India, which is the fourth largest killer after heart disease, respiratory diseases and childhood diarrhoea. Ten lakh (one million) people develop cancer in the country each year, with the disease projected to rise five-fold — 2.8 times because of tobacco use and 2.2 due to ageing — by 2025.


Traditionally, statins are prescribed to lower bad cholesterol after changes in lifestyle — lowering weight, exercising, dietary changes, quitting smoking — fail to meet the cholesterol-lowering targets. The indications for its use, however, have broadened over the past decade. Cancers apart, statins have a favorable effect on inflammation, chronic high blood pressure, dementia, lung disease and cataracts.

The Heart Protection Study, the world’s largest trial of cholesterol-lowering treatment, showed preventative effects of statin use in diabetics. The ASTEROID trial (2006), using only a statin in high doses, lowered bad cholesterol dramatically and showed disease regression in the arteries.

This, of course, does not mean you pop statins like a multivitamin (which incidentally, has been shown to be inadequate in meeting nutrient deficiencies). It can cause muscle pain and cramps, and rarely, neuromuscular degeneration and loss of muscle function similar to symptoms of multiple sclerosis. Like any other medicine, it works best under prescription, which also explains why sales cross several billion dollars a year.