David Leonardi, M.D. ABAAM, CNS

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Statins and Headache

David Leonardi, M.D., ABAAM, CNS

Headache is a known potential side effect of statin therapy, although fairly unusual. Studies evaluating headache occurrence with statins are few. In a small study of 200 patients taking statins, of those who did experience side effects, 16.5% complained of headache1. That doesn’t mean that 16.5% of statin-takers got headaches, just 16.5% of those who had side effects – quite different. In the early days of Lipitor, 1996, a study on just a single dose found headache to be the most common side effect2. Another small, placebo-controlled study examined statin tolerability in patients concurrently being treated for hypertension. Of 24 such subjects taking simvastatin at an average dose of 40 mg daily, only one had to stop the medication due to headache3. On his first visit at the Leonardi Institute in Lakewood, CO, a 60 year-old man gave a history of having stopped Lipitor due to repeated headaches4. His previous physician did not offer any suggestions. He was placed on Statin Sidekick™, 2 caps twice a day for a week prior to resuming atorvastatin 10mg daily. While continuing the Statin Sidekick, 2 caps twice daily, he was able to continue the atorvastatin without further headaches. How might this be explained? Muscle pain is a common side effect of statins and muscle-contraction is a common cause of headache called “tension headache” or more accurately, “muscle contraction headache”. It is quite possible that the atorvastatin was creating muscle pain about the cranium that was relieved by the Statin Sidekick™. We do know that two Statin Sidekick ingredients, CoQ10 and buffered creatine, are effective in relieving muscle symptoms. It is not clear what other mechanism might have been responsible for the resolution of the headaches. For details on the effects of statins on muscle and the solution to this problem, click here.

For one experiencing headache from a statin, other possible solutions might be to reduce the dose, change the statin, or take the statin every other day. Any of these three maneuvers can also be tried in conjunction with Statin Sidekick™ for a greater likelihood of success. If undertaking any of these maneuvers, one must reassess the lipoprotein levels to determine if the new statin regimen is adequately effective. As you might expect, it’s been well demonstrated in clinical trials that reducing the dose or frequency of a statin does reduce the lipid-lowering effectiveness5. However, the reduction in effectiveness seems to be less than would be expected from the reduction in dose. That is, at lower doses there seems to be a greater benefit on a “per mg” basis.

 

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1East Mediterr Health J. 2011 May;17(5):460-4. Patients’ report of statins use and side-effects in a sample of hospitalized cardiac patients in the Islamic Republic of Iran.

 

2J Clin Pharmacol. 1996 Aug;36(8):728-31. Tolerance and pharmacokinetics of single-dose atorvastatin, a potent inhibitor of HMG-CoA reductase, in healthy subjects.

 

3J Hypertens Suppl. 1990 Mar;8(1):S25-30; discussion S30-2. Simvastatin in the treatment of hypercholesterolaemia in patients with essential hypertension.

 

4Unpublished clinical experience-case report. Leonardi Institute, Lakewood, CO. February, 2013.

 

5Curr Med Res Opin. 2012 Mar;28(3):371-8. Epub 2012 Feb 7. Daily and intermittent rosuvastatin 5 mg therapy in statin intolerant patients: an observational study.

 

 

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