Statin Intolerance? Here’s What a Cleveland Clinic Doctor Says You Can Do

Updated: May 12, 2023

Do you take statins to manage your cholesterol, or perhaps have a genetic predisposition to high cholesterol? You may have come across the term "statin intolerance"—but what does it mean, and how does it affect you?

Statins, a class of widely prescribed medications, are crucial in helping millions of people manage cholesterol levels and maintain a healthy heart. These effective drugs primarily focus on lowering the production of LDL (low-density lipoprotein) cholesterol, often known as the “bad” cholesterol, in the liver. However, despite these benefits, some individuals may encounter statin intolerance, which impacts their ability to continue taking these medications.

Statin intolerance sneaks up when side effects or adverse reactions make it difficult or impossible to take statins. Diagnosing it can be tricky, as symptoms might masquerade as other conditions or be mistakenly attributed to factors like age, physical activity, or stress. Furthermore, the symptoms can vary from person to person, ranging from mild discomfort to debilitating pain, making it even more challenging to pin down and identify.

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Statin intolerance symptoms

The most common symptom of statin intolerance are muscle issues, also known as myalgia. But there’s more. According to the American Heart Association, some potential signs of statin intolerance include fatigue, abdominal pain, type 2 diabetes, liver problems, and memory loss or confusion.

If any of these symptoms sound familiar, it’s time to chat with your healthcare provider. They’ll help determine if it’s statin intolerance or something else.

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Discovering alternative cholesterol-busting options

If you have difficulty tolerating statins, don’t worry—there may be some other options to help manage your cholesterol levels. An April 2023 study published in the New England Journal of Medicine highlights bempedoic acid as a potential treatment for those who struggle with statin intolerance. Stephen Nissen, MD, the study’s chair and chief academic officer at the Heart Vascular & Thoracic Institute at the Cleveland Clinic, explains that this study is the first to directly address statin-intolerant patients, yielding highly favorable results for this population.

The study’s findings were impressive: Heart-related complications decreased by 13% to 15%, heart attack risk was reduced by 23%, and stent or bypass surgery risk dropped by 19%. Although Dr. Nissen stresses that statins are effective for most patients, bempedoic acid may offer an alternative treatment with minimal side effects.

In addition, the American College of Cardiology lists alternatives such as ezetimibe, PCSK9 inhibitors, and Inclisiran. Each medication works differently to help lower cholesterol levels, and their suitability varies depending on individual needs. Work closely with your healthcare provider, monitor side effects, and be aware of potential medication interactions.

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Lifestyle changes that make a difference

A healthy lifestyle is the best way to combat high cholesterol. Eat a balanced diet with many fruits, vegetables, whole grains, lean proteins, and healthy fats while avoiding too many saturated and trans fats, cholesterol, and added sugars. Exercise regularly, aiming for 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic exercise per week, plus strength training at least twice a week.

Maintaining a healthy weight is essential for cholesterol control. Keep an eye on your weight and, if needed, consult a healthcare provider or registered dietitian to develop a safe, long-term weight loss plan. Additionally, quitting smoking greatly benefits your heart and cholesterol levels.

Statin intolerance doesn’t need to be a roadblock on the path to better heart health. With alternative treatments and the support of a healthcare provider, individuals can navigate their cholesterol management journey confidently. By embracing a healthy lifestyle and exploring innovative options, those facing statin intolerance can continue to strive for improved cardiovascular health.