When it comes to heart health, cholesterol is a big problem. While not all cholesterol is bad, some types, particularly Low Density Lipoprotein (LDL) or ‘bad’ cholesterol, can prove harmful for your heart. High cholesterol can occur due to various factors, including an unhealthy diet, sedentary lifestyle, smoking, genetics, and obesity. While lifestyle changes can often help manage cholesterol levels, some individuals may require cholesterol-lowering medications like statins in severe cases. However, the critical question remains: is statin use safe for everyone?

What Are Statins And Its Uses?

In an interaction with the OnlyMyHealth team, Dr P. Praneeth, Consultant Cardiologist, CARE Hospitals, Banjara Hills, Hyderabad, describes statins as medications commonly used to lower cholesterol levels, especially LDL cholesterol.

"By reducing LDL, statins help prevent plaque buildup in the arteries, which lowers the risk of heart attacks, strokes, and other cardiovascular issues," he explains, adding that they are often prescribed for people with high cholesterol, those with a history of heart problems, and individuals at risk of heart disease due to conditions like diabetes or high blood pressure.

Can Some People Be Intolerant Towards Statin Use?

The short answer is yes. Some people can have statin intolerance.

Explaining the same, Dr Praneeth says, “Statin intolerance refers to the inability to tolerate the side effects of statins at the necessary dose to achieve the desired cholesterol-lowering effect. This can occur in a minority of patients and varies in severity. It does not necessarily mean a person is allergic to the medication, but rather that they experience symptoms that make continued use difficult.”

Common symptoms associated with statin intolerance include:

• Muscle pain or weakness (myalgia)
• Fatigue, feeling unusually tired or lethargic
• Digestive issues, such as nausea, diarrhoea, or constipation
• In rare cases, statins may cause increased liver enzymes, which could indicate liver irritation.

Dr Praneeth shares that while some mild side effects may resolve over time, true statin intolerance is typically persistent and cannot be tolerated at any dose of the medication. To distinguish between typical side effects and true intolerance, doctors may temporarily stop statin therapy to see if symptoms resolve or try a different statin to check if the side effects persist.

Blood tests and careful monitoring can also help determine whether the symptoms are due to statins or other underlying issues.

What Are The Alternatives?

For those intolerant to statins or seeking non-pharmaceutical options, several alternatives and lifestyle changes may be helpful.

Non-statin cholesterol-lowering drugs, such as ezetimibe, bile acid sequestrants, fibrates, and PCSK9 inhibitors, can effectively lower cholesterol without using statins, according to Dr Praneeth, who adds that a heart-healthy diet rich in fruits, vegetables, whole grains, and healthy fats, like omega-3s, can also naturally reduce cholesterol levels.

Furthermore, the doctor recommends the Mediterranean diet, which includes foods like olive oil, fish, nuts, and legumes and is said to be particularly effective for cardiovascular health. 

Additionally, regular physical activity, including aerobic exercise and resistance training, can also raise High-Density Lipoprotein (HDL) cholesterol while lowering LDL cholesterol.

Reference Link

https://www.onlymyhealth.com/signs-of-statin-intolerance-and-alternatives-for-cholesterol-management-1728382993