Lifestyle modifications in the form of smoking cessation, improved dietary intake and exercise therapy should be the primary intervention tool. ULN, upper limit of normal.
Arthritis Rheum ; By countering HMG-CoA synthase, statins block the formation of mevalonic acid, which is a precursor to all steroids, including cholesterol. In this regard, it is interesting to note that in the PRIMO study, the most hydrophilic statins pravastatin and fluvastatin were least likely to cause myalgia, whereas simvastatin, the most lipophilic one, was most likely to be associated with muscular adverse effects 4.
Its success is due in part to its effectiveness in addressing cardiovascular disease CVD. Sorry you don't agree with this statement, but it is true.
Additionally, randomized, controlled trials evaluating the use of CoQ 10 as prevention have yielded equivocal results. The incidence of myopathy was highest for rosuvastatin and lowest for fluvastatin. Rhabdomyolysis is a serious condition in which skeletal muscle tissue breaks down rapidly and is released into the bloodstream.
While supporting the previously mentioned definitions, the task force recommended further clarification.
Medications included eprex, levothyroxine sodium and fluoxetine for non-specified durations and 80mg atorvastatin daily for seven years. Some experience a gradual improvement over the course of a year or more. Hansen KE, et al.
In the event that patients are not responding as expected, or if symptoms are progressing, differential diagnoses must be explored.
Preliminary evidence suggests that statin-intolerant patients demonstrate increased fatty acid oxidation FAO in response to lovastatin, implicating an intrinsic FAO abnormality [ 10 ]. Approach to the patient with myalgia Clinical manifestations and diagnosis of fibromyalgia in adults Clinical manifestations and diagnosis of rhabdomyolysis Differential diagnosis of fibromyalgia Hypothyroid myopathy Lipid lowering with diet or dietary supplements Management of elevated low density lipoprotein-cholesterol LDL-C in primary prevention of cardiovascular disease Muscle enzymes in the evaluation of neuromuscular diseases Overview of soft tissue rheumatic disorders Pathogenesis of inflammatory myopathies Prevention and treatment of heme pigment-induced acute kidney injury Statins: Table 1 Selected properties of various statins.
While scientists have not concluded what may cause this, the general hypothesis is that cholesterol may somehow be important to cell-wall integrity — in other words, low levels may increase the risk of blood-vessel rupture. Sensory testing of the lower limbs was normal with the exception of a subjective decrease in sharp and dull discrimination on the right medial malleolus.
Health care professionals usually prescribe another statin. These opinions do not represent the opinions of WebMD.
While rare, side-effects of statin therapy exist in the form of renal disease, hepatopathology, neuropathy and death. How do we manage the patient who develops myalgia while on statin therapy? You are not alone in this. Your privacy is important to us.
Statins increase the expression of mitochondrial carnitine acylcarnitine translocase and this effect may contribute to the alteration in FAO [ 11 ].