Cholesterol Medication 'Statins' and Rhabdomyolysis | What You Should Know Before Taking Medication

It is said that about one in three Japanese people has high cholesterol, and many are taking statins (cholesterol-lowering drugs).

While these drugs are highly effective in preventing myocardial infarction and cerebral infarction, they can very rarely cause serious side effects.

The most representative of these is rhabdomyolysis.

This is a side effect that the Ministry of Health, Labour and Welfare also warns about, and if its discovery is delayed, it can be life-threatening.

Cholesterol is not a villain

There is an image that 'cholesterol = bad,' but that is not accurate.

Cholesterol has important functions.

* Makes cell membranes
* Becomes the raw material for hormones
* Becomes the raw material for vitamin D
* Necessary to maintain a healthy body

In other words, it is an essential substance for the body.

Therefore, how much it should be lowered depends on age and the presence or absence of disease.

It is important to consult with your primary care physician regarding treatment goals.

How do statins work?

Statins inhibit the enzyme that produces cholesterol in the liver.

As a result, the liver becomes more likely to take up cholesterol from the blood, and consequently, LDL cholesterol (so-called bad cholesterol) in the blood decreases.

The scary side effect 'rhabdomyolysis'

Although very rare, it is a side effect where muscle cells are destroyed.

A substance called myoglobin flows from the destroyed muscles into the blood, placing a heavy burden on the kidneys.

In severe cases,

* Acute kidney injury
* Need for dialysis
* Life-threatening

situations can occur.

Initial symptoms

It can occur within about one month of starting medication.

Symptoms to be particularly careful about include

* Severe muscle pain
* Pain in the thighs, shoulders, or lower back
* Leg cramps
* Difficulty applying strength
* Muscle weakness

and so on.

With statins, some people may experience muscle pain or muscle symptoms even without progressing to rhabdomyolysis.

Also pay attention to urine color

When muscles are destroyed, myoglobin is excreted in the urine.

As a result,

* Reddish-brown
* Cola-colored
* Reddish-black urine

may occur.

This is a sign that requires urgent medical attention.

It also affects the kidneys

Because myoglobin places a burden on the kidneys,

* Decreased urine output
* Swelling of the legs
* Decreased kidney function

can occur.

If left untreated, there are cases where dialysis becomes necessary.

Factors that increase risk

Factors known to increase the risk of rhabdomyolysis include

* Dehydration
* Intense exercise
* Kidney disease
* Advanced age
* Certain antibiotics
* Concomitant use with fibrate drugs that lower triglycerides
* Certain psychiatric drugs or Parkinson's disease medications

and so on.

Can be confirmed with a blood test

When muscles are destroyed,

CK (creatine kinase)

a muscle enzyme, rises significantly.

In severe cases, it can reach extremely high values of several thousand to tens of thousands.

If an abnormality is suspected, it is important to discontinue the causative drug and receive prompt treatment.

Lifestyle habits that do not rely solely on medication are also important

Reviewing lifestyle habits is also important for improving cholesterol.

Recommended foods include

* Foods containing phytosterols (soybeans, sesame, rapeseed, nuts, avocado, etc.)
* Water-soluble dietary fiber (seaweed, okra, natto, Japanese yam, mekabu, mozuku, etc.)
* Blue-backed fish (EPA/DHA)
* Flaxseed oil

and so on.

Furthermore,

* Moderate exercise
* Weight management
* Smoking cessation
* Adequate hydration

are also important.

Summary

Statins are drugs with well-proven efficacy in preventing myocardial infarction and cerebral infarction, and they offer significant benefits for many people. On the other hand, because serious side effects such as rhabdomyolysis can occur in very rare cases, if you notice any abnormalities such as muscle pain, reddish-brown urine, or decreased urine output, it is important not to continue the medication based on your own judgment, but to consult a medical institution promptly.

Always consult with your doctor before deciding to stop or reduce medication. Furthermore, maintaining lifestyle habits such as diet and exercise is essential for cholesterol management.

※Note: Statins are highly effective in preventing myocardial infarction and cerebral infarction and are beneficial for many people. If you stop taking them based on your own judgment out of excessive fear of side effects, the risk of cardiovascular events may actually increase. If you have any concerns about taking medication, please be sure to consult your primary care physician or pharmacist.

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