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Statin myopathy and nutrition

Published online by Cambridge University Press:  11 September 2013

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In a nutshell

Statin drugs can be associated with myopathy of various degrees from mild to severe. Mild symptoms are not uncommon.

Coenzyme Q10, vitamin D, vitamin E, carnitine and creatine have all been mentioned as being nutrients that may be involved in this myopathy and potentially therapeutic.

Whilst deficiencies of some of these nutrients have been found with statin and/or in statin myopathy cases, only CoQ10 has any degree of RCT evidence, and only a little at that.

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Brief Report
Copyright
Copyright © Cambridge University Press 2011

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References

References:

1. Harper, CR. et al. Evidence-based management of statin myopathy. Curr Atheroscler Rep. 2010 Sep;12(5):322–30.CrossRefGoogle ScholarPubMed
2. Phillips, PS. et al. Statin-associated myopathy with normal creatine kinase levels. Ann Intern Med. 2002 Oct 1;137(7):581–5.CrossRefGoogle ScholarPubMed
3. Mastaglia, FL. Iatrogenic myopathies. Curr Opin Neurol. 2010 Oct;23(5):445–9.CrossRefGoogle ScholarPubMed
4. Baker, SK. et al. A neuromuscular approach to statin-related myotoxicity. Can J Neurol Sci. 2008 Mar;35(1):821.CrossRefGoogle ScholarPubMed
5. Hennekens, CH. Statin-induced myopathy: hypothesis about randomized evidence and clinical impressions. Am J Med. 2009 Jan;122(1):45.CrossRefGoogle ScholarPubMed
6. Abel, T. et al. Statin therapy and skeletal muscle. CEMED. 2009;3(1):913.Google Scholar
7. Ballantyne, CM. et al. Risk for myopathy with statin therapy in high-risk patients. Arch Intern Med. 2003 Mar 10;163(5):553–64.CrossRefGoogle ScholarPubMed
8. Silva, M. et al. Meta-analysis of drug-induced adverse events associated with intensive-dose statin therapy. Clin Ther. 2007 Feb;29(2):253–60.CrossRefGoogle ScholarPubMed
9. Hansen, KE. et al. Outcomes in 45 patients with statin-associated myopathy. Arch Intern Med. 2005 Dec 12-26;165(22):2671–6.CrossRefGoogle ScholarPubMed
10. Phillips, PS. et al. Observations from a statin myopathy clinic. Arch Intern Med. 2006 Jun 12;166(11):1232–3.CrossRefGoogle ScholarPubMed
11. Phillips, PS. et al. Statin myotoxicity is associated with changes in the cardiopulmonary function. Atherosclerosis. 2004 Nov;177(1):183–8.CrossRefGoogle ScholarPubMed
12. Carlsen, SM. et al. [Statin therapy, Q10 and heart failure. Is there any difference between statins?]. Tidsskr Nor Laegeforen. 1994 Apr 30;114(11):1345.Google ScholarPubMed
13. Al-Sulaiman, AA. et al. Statin-induced myopathy: a clinical perspective. Bahrain Med Bull. 2009 Jun; 31(2): 14.Google Scholar
14. Antons, KA. et al. Clinical perspectives of statin-induced rhabdomyolysis. Am J Med. 2006 May;119(5):400–9.CrossRefGoogle ScholarPubMed
15. Chapman, MJ. et al. Mechanisms of statin-induced myopathy: a role for the ubiquitin-proteasome pathway? Arterioscler Thromb Vasc Biol. 2005 Dec;25(12):2441–4.CrossRefGoogle ScholarPubMed
16. Mohaupt, MG. et al. Association between statin-associated myopathy and skeletal muscle damage. CMAJ. 2009 Jul 7;181(1–2):E118.CrossRefGoogle ScholarPubMed
17. Dreier, JP. et al. Statin-associated rhabdomyolysis triggered by grapefruit consumption. Neurology. 2004 Feb 24;62(4):670.CrossRefGoogle ScholarPubMed
18. Sorokin, AV. et al. Rhabdomyolysis associated with pomegranate juice consumption. Am J Cardiol. 2006 Sep 1;98(5):705–6.CrossRefGoogle ScholarPubMed
19. Lilja, JJ. et al. Grapefruit juice-simvastatin interaction: effect on serum concentrations of simvastatin, simvastatin acid, and HMG-CoA reductase inhibitors. Clin Pharmacol Ther. 1998 Nov;64(5):477–83.CrossRefGoogle ScholarPubMed
20. Vaquero, MP. et al. Major diet-drug interactions affecting the kinetic characteristics and hypolipidaemic properties of statins. Nutr Hosp. 2010 Mar-Apr;25(2):193206.Google ScholarPubMed
21. Wyman, M. et al. Coenzyme Q10: a therapy for hypertension and statin-induced myalgia? Cleve Clin J Med. 2010 Jul;77(7):435–42.CrossRefGoogle ScholarPubMed
22. Marcoff, L. et al. The role of coenzyme Q10 in statin-associated myopathy: a systematic review. J Am Coll Cardiol. 2007 Jun 12;49(23):2231–7.CrossRefGoogle ScholarPubMed
23. Littarru, GP. et al. Coenzyme Q10 and statins: biochemical and clinical implications. Mitochondrion. 2007 Jun;7 Suppl:S16874.CrossRefGoogle ScholarPubMed
24. Sacconi, S. et al. Coenzyme Q10 is frequently reduced in muscle of patients with mitochondrial myopathy. Neuromuscul Disord. 2010 Jan;20(1):44–8.CrossRefGoogle ScholarPubMed
25. Levy, HB. et al. Considerations for supplementing with coenzyme Q10 during statin therapy. Ann Pharmacother. 2006 Feb;40(2):290–4.CrossRefGoogle ScholarPubMed
26. Mas, E. et al. Coenzyme Q10 and statin myalgia: what is the evidence?. Curr Atheroscler Rep. 2010 Nov;12(6):407–13.CrossRefGoogle ScholarPubMed
27. Duncan, AJ. et al. Decreased ubiquinone availability and impaired mitochondrial cytochrome oxidase activity associated with statin treatment. Toxicol Mech Methods. 2009 Jan;19(1):4450.CrossRefGoogle ScholarPubMed
28. Villalba, JM. et al. Therapeutic use of coenzyme Q10 and coenzyme Q10-related compounds and formulations. Expert Opin Investig Drugs. 2010 Apr;19(4):535–54.CrossRefGoogle ScholarPubMed
29. Colquhoun, DM. et al. Effects of simvastatin on blood lipids, vitamin E, coenzyme Q10 levels and left ventricular function in humans. Eur J Clin Invest. 2005 Apr;35(4):251–8.CrossRefGoogle ScholarPubMed
30. Passi, S. et al. Statins lower plasma and lymphocyte ubiquinol/ubiquinone without affecting other antioxidants and PUFA. Biofactors. 2003;18(1–4):113–24.CrossRefGoogle ScholarPubMed
31. Lamperti, C. et al. Muscle coenzyme Q10 level in statin-related myopathy. Arch Neurol. 2005 Nov;62(11):1709–12.CrossRefGoogle ScholarPubMed
32. De Pinieux, G. et al. Lipid-lowering drugs and mitochondrial function: effects of HMG-CoA reductase inhibitors on serum ubiquinone and blood lactate/pyruvate ratio. Br J Clin Pharmacol. 1996 Sep;42(3):333–7.CrossRefGoogle ScholarPubMed
33. Bargossi, AM. et al. Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med. 1994;15 Suppl:s18793.CrossRefGoogle ScholarPubMed
34. Mabuchi, H. et al. Effects of CoQ10 supplementation on plasma lipoprotein lipid, CoQ10 and liver and muscle enzyme levels in hypercholesterolemic patients treated with atorvastatin: a randomized double-blind study. Atherosclerosis. 2007 Dec;195(2):e1829.CrossRefGoogle ScholarPubMed
35. Thibault, A. et al. Phase I study of lovastatin, an inhibitor of the mevalonate pathway, in patients with cancer. Clin Cancer Res. 1996 Mar;2(3):483–91.Google ScholarPubMed
36. Kim, WS. et al. Phase II study of high-dose lovastatin in patients with advanced gastric adenocarcinoma. Invest New Drugs. 2001;19(1):81–3.CrossRefGoogle ScholarPubMed
37. Rott, D. Does coenzyme Q 10 supplementation reduce muscle pain caused by statins? (cholesterol lowering medications) (cosmic). Registered with clinicaltrials.gov as: NCT00716612Google Scholar
38. Galli, F. et al. Do statins cause myopathy by lowering vitamin E levels? Med Hypotheses. 2010 Apr;74(4):707–9.CrossRefGoogle ScholarPubMed
39. Cangemi, R. et al. Statins enhance circulating vitamin E. Int J Cardiol. 2008 Jan 11;123(2):172–4.CrossRefGoogle ScholarPubMed
40. Hill, KE. et al. Combined selenium and vitamin E deficiency causes fatal myopathy in guinea pigs. J Nutr. 2001;131:1798–802.CrossRefGoogle ScholarPubMed
41. Beltowski, J. Statins and modulation of oxidative stress. Toxicol Mech Methods. 2005;15(2):6192.CrossRefGoogle ScholarPubMed
42. Ceglia, L. Vitamin D and its role in skeletal muscle. Curr Opin Clin Nutr Metab Care. 2009 Nov;12(6):628–33.CrossRefGoogle ScholarPubMed
43. Helman, A. Vitamin D and falls in the elderly. Arb Clin Nutr Upd. 2005 Jan;197:13.Google Scholar
44. Goldstein, MR. et al. Statin therapy, muscle function and vitamin D. QJM. 2009 Dec;102(12):890–1.CrossRefGoogle ScholarPubMed
45. Wilczek, H. et al. [Monitoring plasma levels of vitamin D metabolites in simvastatin (Zocor) therapy in patients with familial hypercholesterolemia]. Cas Lek Cesk. 1994 Dec 5;133(23):727–9.Google ScholarPubMed
46. Wilczek, H. et al. [Iatropathogenic effect of Mevacor on vitamin D metabolism]. Cas Lek Cesk. 1989 Sep 29;128(40):1254–6.Google ScholarPubMed
47. Gupta, A. et al. The relationship of vitamin D deficiency to statin myopathy. Atherosclerosis. 2010 Dec 5.Google Scholar
48. Dobs, AS. et al. Effects of pravastatin, a new HMG-CoA reductase inhibitor, on vitamin D synthesis in man. Metabolism. 1991 May;40(5):524–8.CrossRefGoogle ScholarPubMed
49. Rejnmark, L. et al. Simvastatin does not affect vitamin d status, but low vitamin d levels are associated with dyslipidemia: results from a randomised, controlled trial. Int J Endocrinol. 2010;2010:957174.Google Scholar
50. Ismail, F. et al. Effects of pravastatin and cholestyramine on circulating levels of parathyroid hormone and vitamin D metabolites. Clin Ther. 1990 Sep-Oct;12(5):427–30.Google ScholarPubMed
51. Montagnani, M. et al. Effects of pravastatin treatment on vitamin D metabolites. Clin Ther. 1994 Sep-Oct;16(5):824–9.Google ScholarPubMed
52. Ertugrul, DT. et al. STATIN-D Study: Comparison of the Influences of Rosuvastatin and Fluvastatin Treatment on the Levels of 25 Hydroxyvitamin D. Cardiovasc Ther. 2010 Mar 27.Google Scholar
53. Pérez-Castrillón, JL. et al. Vitamin d levels and lipid response to atorvastatin. Int J Endocrinol. 2010;2010:320721.Google Scholar
54. Yavuz, B. et al. Increased levels of 25 hydroxyvitamin D and 1,25-dihydroxyvitamin D after rosuvastatin treatment: a novel pleiotropic effect of statins? Cardiovasc Drugs Ther. 2009 Aug;23(4):295–9.CrossRefGoogle ScholarPubMed
55. Pérez-Castrillón, JL. et al. Effects of Atorvastatin on vitamin D levels in patients with acute ischemic heart disease. Am J Cardiol. 2007 Apr 1;99(7):903–5.CrossRefGoogle ScholarPubMed
56. Aloia, JF. et al. A randomized controlled trial of vitamin D3 supplementation in African American women. Arch Intern Med 2005;165:16181623.CrossRefGoogle ScholarPubMed
57. Grimes, DS. Statins and vitamin D: editorial to: “increased levels of 25 hydroxyvitamin D and 1,25-dihydroxyvitamin D after rosuvastatin treatment: a novel pleiotropic effect of statins?” by Yavuz, Bunyamin et al. Cardiovasc Drugs Ther. 2009 Aug;23(4):261–2.CrossRefGoogle Scholar
58. Lee, P. et al. Vitamin D insufficiency--a neglected cause of statin-induced myalgia? BMJ. rapid response published 6 April 2010.Google Scholar
59. Bell, DS. Resolution of statin-induced myalgias by correcting vitamin D deficiency. South Med J. 2010 Jul;103(7):690–2.CrossRefGoogle ScholarPubMed
60. Duell, PB. et al. Abstract 3701: Vitamin D Deficiency is Associated With Myalgias in Hyperlipidemic Subjects Taking Statins. Circulation. 2008;118:S_470.CrossRefGoogle Scholar
61. Bittner, V. et al. Vitamin D levels are not related to myalgias in statin-treated patients with stable coronary disease. J. Am. Coll. Cardiol. 2010 Mar;55:A167.E1570.Google Scholar
62. Grimes, DS. Are statins analogues of vitamin D? Lancet. 2006 Jul 1;368(9529):83–6.CrossRefGoogle ScholarPubMed
63. Helman, A. Muscle cramps. Arb Clin Nutr Upd. 2011 Jan;;328:14.Google Scholar
64. Arduini, A. et al. Improvement of statin-associated myotoxicity by L-carnitine. J Thromb Haemost. 2004 Dec;2(12):2270–1.CrossRefGoogle ScholarPubMed
66. Naba, H. et al. Improving effect of ethyl eicosapentanoate on statin-induced rhabdomyolysis in Eisai hyperbilirubinemic rats. Biochem Biophys Res Commun. 2006 Feb 3;340(1):215–20.CrossRefGoogle ScholarPubMed
67. Kobayashi, M. et al. Bicarbonate supplementation as a preventive way in statins-induced muscle damage. J Pharm Pharm Sci. 2008;11(1):18.CrossRefGoogle ScholarPubMed
65. Bhuiyan, J. et al. The effects of 3-hydroxy-3-methylglutaryl-CoA reductase inhibition on tissue levels of carnitine and carnitine acyltransferase activity in the rabbit. Lipids. 1996 Aug;31(8):867–70.CrossRefGoogle Scholar
68. Gupta, EK. et al. Lovastatin and extended-release niacin combination product: the first drug combination for the management of hyperlipidemia. Heart Dis. 2002 Mar-Apr;4(2):124–37.CrossRefGoogle ScholarPubMed
69. Reaven, P. et al. Lovastatin, nicotinic acid, and rhabdomyolysis. Ann Intern Med. 1988 Oct 1;109(7):597–8.CrossRefGoogle ScholarPubMed
70. Guyton, JR. et al. Safety considerations with niacin therapy. Am J Cardiol. 2007 Mar 19;99(6A):22C31C.CrossRefGoogle ScholarPubMed