Study suggests vitamin D deficiency can be the cause of muscle pain in statin-treated individuals

Statin drugs are the most commonly-used medications for reducing cholesterol levels. They do seem to help prevent cardiovascular disease, though whether they do this through their cholesterol reducing effects is a moot point. And despite them being billed as the wonder-drugs of the age, I think it’s worth bearing in mind that these drugs are not particularly useful. See here for more on this.

Of course the other things about statins is that they are not free from side effects. They are well known to have the ability to induce muscle pain (myalgia) and this appears to have at least some relationship with the fact that they deplete the body of the nutrient known as coenzyme Q10 (CoQ10). In fact, as you can read about here, CoQ10 therapy has been found to be quite an effective treatment for reversing the side-effects of statin drugs.

Another cause of muscular pain is vitamin D deficiency, and I was interested to read about a recent study which looked at the relationship between vitamin D levels and myalgia in more than 600 individuals taking statins [1]. Some of the study subjects had myalgia, while some did not. In those with myalgia, blood vitamin D levels were generally lower (28.6 v 34.2 ng/mL). Also low blood levels of vitamin D were found in 64 per cent of patients with myalgia, compared to 43 per cent of symptom-free individuals.

After this, some of the myalgic patients with vitamin D deficiency were treated with vitamin D at a dose of 50,000 IU each week for 12 weeks. Vitamin D levels rose from an average of about 20 ng/ml to an average of 48 ng/ml. But perhaps most importantly of all, this led to a resolution of myalgia in more than 92 per cent of the individuals treated.

This research, I think, suggests that vitamin D deficiency may be an underlying factor in myalgia in statin-treated individuals. It is perhaps an argument for individuals having their vitamin D levels assessed, particularly if, say, they did not respond to CoQ10 therapy for their myalgic symptoms.

References:

Ahmed W, et al. Low serum 25 (OH) vitamin D levels (<32 ng/mL) are associated with reversible myositis-myalgia in statin-treated patients. Transl Res 2009; 153(1): 11-6.

16 Responses to Study suggests vitamin D deficiency can be the cause of muscle pain in statin-treated individuals

  1. Alan 7 April 2009 at 4:35 am #

    I had my vitamin D levels checked recently via the grassrootshealth project and my levels came back as 15 ng/ml (got the result this morning). It is a bit of a shock to see this article refer to 28.6ng/ml as being low!

    What is the level at which my Dr would likely consider to be deficient? I am now taking 5000IU a day and am hoping to get a test at my GP’s in 3 months. Do you think he would give me such a test?

  2. Trinkwasser 7 April 2009 at 7:23 am #

    Fascinating, I had a half formed theory that maybe statins might be one of the seemingly many factors in reducing vitamin D levels in the first place. The name cholecalciferol suggests a connection.

    Know anything about the metabolic pathways involved?

  3. Todd Hargrove 7 April 2009 at 12:57 pm #

    Very interesting. Do you think its possible that other forms of muscle pain are caused by vitamin D deficiency? Do you think that vit D supplementation could help with muscle pain unrelated to statin drugs?

  4. Ted Hutchinson 8 April 2009 at 3:59 am #

    UK doctors consider below 30ng ~ 75nmnol/l insufficient.
    The vitamin D experts in the video’s at Grassrootshealth conclude 60ng ~ 150nmol/l the natural level associated with <a href=”http://www.grassrootshealth.org/_download/disease_incidence_prev_chart_101608.pdf”least chronic disease incidence and vitamin d3 flowing in breast milk is optimum while levels below 40ng ~ 100nmol/l are insufficient.

  5. Ted Hutchinson 8 April 2009 at 4:02 am #

    UK doctors consider below 30ng ~ 75nmnol/l insufficient.
    The vitamin D experts in the video’s at Grassrootshealth conclude 60ng ~ 150nmol/l the natural level associated with least chronic disease incidence and vitamin d3 flowing in breast milk is optimum while levels below 40ng ~ 100nmol/l are insufficient.
    Sorry I forget to close the link can someone delete message 4?

  6. Bendigedig 11 April 2009 at 5:03 pm #

    I find this very interesting. Up to the end of last year, I had been taking statins for 10 years. I suddenly developed severe leg pains. In consultation with my GP, I stopped the statins. I saw the article on CoQ10, so have been taking those for a few weeks. I can’t say whether or not they have made a difference. I recently saw my GP. My cholesterol has risen again, as expected. The pain isn’t as bad but is still there. My GP thinks it might be referred pain from my hip. I’m not convinced.
    Quite a long time ago but maybe only a year, I decided to stop using margarine and now only use unsalted butter for spreading/cooking etc.. I don’t eat breakfast cereals, except porridge with no salt or sugar. I eat organic yogurt and use organic semi skimmed milk.
    I have also stopped eating liver, not certain why and have gone off fish. I eat eggs but not as many as I used to.
    I will follow the Vit D subject with interest.

  7. Susan 11 April 2009 at 8:41 pm #

    Probably not relevant but Guardian today has report which mentions Vit D in relation to Multiple Sclerosis of which there is a much higher incidence in Scotland…

    “Recent research into MS has looked at whether Scots may have a genetic susceptibility to the disease, and at the role of vitamin D levels. In February a British and Canadian research team discovered that vitamin D helps to control a gene known to increase the risk of MS.” Might of course be less sun in Scotland, at least on the West side of the country! Or less hours of daylight…!!!

  8. Terry 11 April 2009 at 11:42 pm #

    Vitamin D is actually a hormone that plays a huge role in multiple areas, not least muscle health. After taking it for a couple of weeks at levels of at least 10,000 IU’s a day, those who are Vitamin D deficient (that’s below 60 ng) will experience multiple positive effects. I know because it has happened to me.

    One note of warning: do NOT take a calcium supplement when taking large doses of Vitamin D.

    I’d like to thank Dr Briffa for highlighting the critical importance of Co Q10 in combating statin effects on energy levels. Since taking Pharma Nord’s Bio-Active Co Q10 Uniqinol tablets, I have regained all of my energy levels again. I wake up bright and refreshed every morning and can keep going all day.

  9. Janet Alton MNIMH 12 April 2009 at 5:24 pm #

    Vitamin D is made from a form of cholesterol. Dehydrocholesterol migrates to the skin from the liver and is converted to Vitamin D by the action of sunlight on the skin. This is the main way in which we get our Vit D – not through diet. That’s why it’s important, despite the advice we’ve been given in recent years, to get some sun exposure during the summer months. I have wondered whether this is a reason why cholesterol builds up in the bloodstream – because people don’t go outside, and don’t get their cholesterol converted to Vit D! In the patients in the study above, presumably artificially lowering their blood cholesterol meant that there wasn’t enough available for conversion. This would compound the general low Vit D levels in the population as a whole.

  10. R Vasudevan 13 April 2009 at 6:49 pm #

    I tend to agree with Janet’s observation. I am on statins for the past few years and recently I have developed muscle pain in the arms and right lower back. Though I live in India, I have not had the benefit of direct sunlight to get enough vit D perhaps. I intend to correct the situation by taking Co Q 10 and get sufficient direct sunlight exposure too.

  11. bad NHS ON THIS SUBJECT 22 April 2009 at 3:49 pm #

    They dont recognise it in Scotland. I was told no one is low in vitamin D yet my level is 28 and i have weak muscles. I tested it myslf had to I am now taking 1 50000iu a week and will see in12 wees what my levl is then and if my muscles get stronger. Ive had that for 4 years undiagnoised

  12. Mike 7 May 2009 at 11:58 am #

    The benefits of vitamin D go way beyond muscle pains. take a look at http://www.vitaminD3UK.com for some good summaries of the data. Everyone should know about vitamin D

  13. Moe 30 April 2010 at 11:38 pm #

    I have had muscle pain from running 2 hours and more. This was done for about 4 months. I took 1,000 I U of vitamin D3 and within 2 hours my pain was gone. I took 7 days rest and continue my D3 at 2,000 per day.

  14. See Clearly 10 July 2010 at 12:58 am #

    “Cholesterol and vitamin D share the 7-dehydrocholesterol metabolic pathway.” This is from a study that was looking for why statins have some small statistical benefit. http://www.ncbi.nlm.nih.gov/pubmed/17398180

    The study proposed that Lipitor actually raised Vit D levels, thus bringing the benefits of Vit D to statin patients. Obviously, taking cod liver oil or sunshine is a better option, but this seems contrary to the idea that statin lowers Vit D and thus muscle pain results.

    Since correlation is not causation, one can hypothesize that muscle pain from statins may result in less outdoor activity, especially in Norther climates where there is only limited opportunity for sunshine.

    Since statins are known to cause liver damage, it is reasonable to think that other liver damaging agents can cause variability in study results. Alcohol use, pesticides, other medications, etc. need to be looked at too.

    BTW, the Linus Pauling Institute states that moderate alcohol use is associated with a 20-30% reductions in Coronary Heart Disease risk. Why fuss with the possible 3% reduction by statin use?

    Bottom line, get off statins!
    Have 2 drinks a day (while some is good, more is NOT better)

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