Are Statins Truly Safe — And When Should You Take Them?

So your doctor has told you that you should be taking a statin. But you’ve heard that the medication can cause harmful side effects — and might not even be necessary in the first place. Is it worth the risk?

Let’s make two things clear: First, the unwarranted fears around statins are nothing new, though social media has helped spread them. And second, statins are not even close to being the nightmare drugs random people on the Internet would have you believe.  

What statins do and how they work

There are seven main types of statins that doctors have been prescribing for decades, and they’re all very similar; which one you should take depends on your cholesterol level as well as other medical conditions and medications.  

Statins are used to lower LDL or “bad” cholesterol and can slightly increase HDL or “good” cholesterol. In doing this, they also help prevent stroke as well as heart problems like atherosclerosis and heart attack — which is a big deal, because heart disease and stroke are two of the leading causes of death in the United States and the world.

Statins work by inhibiting your liver from making an enzyme it needs to create cholesterol. While some of your cholesterol comes from what you eat and absorb, most cholesterol in your blood comes from your liver.  

Are statins safe? Can they cause dementia or diabetes?  

There are lots of claims out there that statins cause certain diseases — dementia and diabetes are the more prevalent ones. But is there any truth to them?  

“Statins actually decrease the risk of dementia,” says Kelley Branch, MD, a cardiologist at the UW Medicine Heart Institute. “Mini-strokes are a contributor to developing vascular dementia, and statins lower your risk for mini as well as major strokes. The other type of dementia is Alzheimer's disease and the risk may be reduced by statins, but importantly, there is no evidence that statins increase Alzheimer's.”

So, the dementia claim is unfounded, but what about diabetes? It’s true that statins can contribute to the development of diabetes in people who are already pre-diabetic or at risk for diabetes, but in everyone else, no, statins won’t cause diabetes.  

If you’re at risk for diabetes and your doctor recommends a statin, it’s worth discussing the pros and cons of taking the medication. It is often more beneficial for you to take the statins if your risk for heart disease is high since pre-diabetes and diabetes are risk factors for heart attack and stroke, and statins lower that risk further.  

But don’t statins have tons of side effects?  

“Just like any other FDA-approved drug, there’s a long list of side effects that people had during the research and evaluation period, and many of those events also occurred in people who took a placebo as well,” says Branch. “Statins are actually a pretty well tolerated medication compared to many others we need to prescribe.”

That means that some symptoms, like brain fog, may occur in people who take statins, but research hasn’t proven that the drugs actually cause those symptoms.

One proven symptom that statins can cause is muscle pain, particularly in people with something called statin intolerance.  

“Statin intolerance happens in around 1% to 3% of my patients, and it’s usually a genetic predisposition,” Branch says. “The muscle aches make people feel like they have the flu.”  

However, intolerance to a certain statin doesn’t mean you shouldn’t take any statins; it may be just that one medication that your body doesn’t like.  

“About half of the time, people can still be on a statin by changing to another statin or decreasing the dose, even if they have statin intolerance,” Branch says.

So muscle aches aren’t a reason to stop taking a statin completely. Instead, tell your doctor what’s going on so they can try you on a different medication.  

But statins aren’t natural  

Another common reason Branch hears from patients who don’t want to take statins is that the medications aren’t natural. While some statins are made from synthetic ingredients, all statins are actually derived from natural ingredients.

Statins were originally discovered in natural sources, such as red rice yeast and mushrooms, where they occur naturally. The yeast yielded the first statin, called lovastatin, although the current imported red yeast rice has variable to no statin. The drugs you take now aren’t derived from those same sources, but that doesn’t change the fact that the compounds are naturally occurring.  

Why statins might be your best option  

If you turn out not to tolerate any statin, there are newer oral and injectable drugs that lower cholesterol. They may be a good option for some people, but they are much more expensive.

There are some tried-and-true lifestyle modifications that can help lower your cholesterol, including: 

• Eating a wide variety of fruits and vegetables, whole grains, and low-fat sources of proteins such as beans, nuts, fish and lean meats
• Avoiding saturated fats and processed foods
• Exercising regularly
• Maintaining a healthy weight

“If your cholesterol is at a certain level, you are making too much cholesterol and there’s nothing you can do to get it to go down to goal levels other than going on medications,” Branch says. “Just like statin intolerance, this is typically genetically determined, and you can blame your parents for something. ”  

This may not seem like an ideal situation, but at the end of the day, statins are life-saving, and they can lengthen your life as well as improve its quality. Before writing them off completely, make a plan to talk with your doctor about them and see if they could help improve your health.