Each year, tens of millions of Americans take statins to lower their cholesterol. Statins prevent your body from producing cholesterol. They may also help your body to reduce the plaque or buildup from cholesterol inside your arteries. Plaque that remains in your arteries may eventually partially or fully clog your arteries. This can lead to a heart attack or stroke.

Not everyone with high cholesterol needs to be treated with statin medication. Whether you need to be treated with a statin largely depends on your risk for developing heart disease. The American College of Cardiology and American Heart Association created a to estimate this risk. Your individual score is calculated using several different health factors, one of which is your cholesterol level. Other health factors include your age, other health problems, and whether you smoke. The single greatest determining factor is your cholesterol level.

Know your numbers: What does healthy cholesterol look like?
Total cholesterol levelBelow 200 mg/dL
LDL (bad) cholesterolBelow 100 mg/dL

If you’re at risk for any cardiovascular diseases or have a history of heart attack or heart problems, you may be a better candidate for statin medication than a person who doesn’t have as many pre-existing conditions or potential complicating factors.

Beyond those simple principles, the have identified four groups of people who should consider taking statins:

  1. People who have been diagnosed with cardiovascular disease
  2. People who have high levels of LDL (greater than 190 mg/dL)
  3. Diabetics between the ages of 40 and 75 who have elevated LDL levels (70 to 189 mg/dL) but have not yet been diagnosed with cardiovascular disease
  4. People with an elevated LDL level (over 100 mg/dL) and an increased risk of developing cardiovascular disease or having a heart attack in the next 10 years

The use of statins isn’t without its controversies or issues. In recent years, researchers discovered that people taking statins reported increased levels of general fatigue and tiredness, especially after exertion.

A study from the found that people taking statins experienced lower levels of energy than people who took a placebo. These side effects increased as the dosage of the statin increased. The levels of statins used in the study were relatively low. It’s not uncommon for doctors to prescribe higher doses.

Women are at particular risk. The same from UCSD found that 4 in 10 women experienced fatigue and loss of energy after activity. Also, people between the ages of 70 and 75, especially if they had been diagnosed with heart disease, were more likely to experience these side effects.

Why does this occur? suggests that statins may cause you to feel tired because they play a role in decreasing the amount of energy provided to the cells in your muscles. However, the exact reason why this happens is still being studied.

Fatigue isn’t the only unwanted side effect related to the use of statins. Before you begin taking the medication, consider these additional side effects.

Digestive problems

The most common side effect of statins is digestive problems. Diarrhea, nausea, gas, and heartburn are not uncommon problems associated with the use of statins. These may improve after a few weeks of treatment.

Muscle pain and damage

You may experience muscle pain when taking a statin. This may include soreness, tiredness, or even weakness in your muscles. The pain may be mild, or it may become severe enough to greatly impact your daily routine. If you have any new or unusual muscle pain or fatigue after starting a statin, talk to your doctor right away. Ignoring muscle pain can make it worse. There’s also a risk that the pain can progress to serious muscle damage called rhabdomyolysis.

Rhabdomyolysis

This life-threatening type of muscle damage is very rare. In addition to pain, people who develop rhabdomyolysis may experience darkened urine, reduced kidney function, and even kidney failure. It can progress to liver damage, and may result in death without proper treatment.

Liver damage

Using statins may cause your liver to produce more enzymes than needed. If your liver enzyme levels are low, you may be okay to continue taking statins. If they’re too high, you may need to stop. To check your liver enzyme levels, your doctor will order a blood test soon after you begin taking the medication.

Rash or flushing

You may develop a skin rash or flushing after you begin taking statins. Talk with your doctor about ways to prevent this.

Increased risk for type 2 diabetes

Some people taking a statin will develop increased blood sugar levels. This may lead to the development of type 2 diabetes if not managed properly. If you’re at risk for diabetes, your doctor may check your blood sugar a few weeks after you start the drug.

Memory loss or confusion

Neurological side effects from statin use are uncommon, but not unheard of. Stopping the use of statin medications typically reverses memory problems.

If your doctor suggests that you may benefit from the use of statins to control your cholesterol or to reduce your risk of heart attack, have a discussion. By now, your doctor should be aware of the potential fatigue and energy issues related to the use of statins. If these side effects are of concern to you or may interfere with your lifestyle, discuss alternatives or solutions to the fatigue you might experience.

Request the lowest dose to test possible side effects first. Ask about lifestyle changes that might reduce your need for statins. If you maximize your effort to improve your diet and exercise, you may need less treatment for cholesterol. Lastly, don’t be afraid to get a second opinion about the use of statins and any alternative measures you can take to reduce your need for the cholesterol-lowering medicines. Ultimately, living a healthier life can drive down your risk for high cholesterol and cardiovascular disease. You and your doctor can work to find a balance that is right and healthy for you.

Q:

What are some safe, healthy ways I can boost my energy when on statins?

A:

Eat a healthy, balanced diet, exercise regularly, and keep regular sleep patterns. Start your exercise routine slowly and build your stamina gradually. Avoid smoking cigarettes and drinking caffeine late in the day. Limit alcohol intake to less than two drinks a day for men and one drink a day for women. There’s no magic pill or drink that provides anything more than a temporary boost of energy. Since the boost is only temporary, you may feel even more drained when the effect wears off. 

Dr.China Medical TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.