Lipitor and leg pain

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Was wondering if any other practitioners have noticed any links between lipitor and leg pain in their clientele. I've seen a lady today who has had 'achilles tendonitis' diagnosed 4 years ago - has seen various health professionals for this including some intensive physiotherapy. She was told by a pharmacy assistant that she might try stopping the lipitor for a short while and as if by magic her leg pain, arm pain and memory problems have disappeared. Most of my diabetes clients are on Lipitor or Zocor - so a huge number might be affected by this! Info on internet seems to agree with her case. Another differential diagnosis to consider!

 

Not sure if it was lipotor, but I do recall see a report about an increased incidence of peripheral neuropathy from one of the lipid modifiying drugs.

 

According to the BNF all of the statins have a potential side effect of peripheral neuropathy. When you look at the other side effects that they can bring as well (and I have experienced some of them with 2 different statins), they are not the nicest things in the world.
i.e
day and night sweats
loss of memory (not good as a student)
mood swings
puffing and panting up hills after a short distance (not good if you live on hills!!)

Have a friend who is an optician who runs 1/2 marathons etc (50 yrs old) on statins for 1 month and thought she would die as she couldn't breath, walk yet alone run and muscle tone went in her legs.

I always ask patients who are on simvastatin and others how they get on with them. Lots have reported side effects, but sometimes its difficult to sort out what might causing it from the cocktail they take. Those new diabetics who are diet controlled and just on statins are good bets for some interesting side effects sometimes.....with no auto suggestion during conversation.

 

Statin drugs inhibit the enzyme HMG-CoA reductase. This stops the formation of Cholesterol and also Coenzyme Q 10. As a result, a myopathy may develop. In my office, I see muscle soreness as a result of statins much more frequently than expected.
Some of my patients tell me that they have taken CoQ10 supplementation to prevent this and it works in about 50% of my patients that take it.
Also, statin drugs increase VEGF (vascular endothelial growth factor) which is implicated in malignancy of neoplasms.

 

Interestingly, VEGF is also upregulated in patients with Achilles tendinosis. Didn't this patient present with Achilles 'tendinitis'?

Cheers,
Kent

 

The patient sure did. Intractable over 3+ years and seen by a host of other health professionals including physio, chiropractic and general practitioners. Where is the information regarding upregulation of VEGF and Achilles Tendinosis??

 

I think it's in: Alfredson, H. (2005) The chronic painful Achilles and patellar tendon: research on basic biology and treatment. Scand J Med Sci Sports, 15: 252-259.

Cheers,
Kent

 

Hi there all,

jus wondering, HMG Co-A reducatase inhibitors donot have any influence on collagen properties so iam wondering how wud these medications cause tendinoses or musculoskeletal pain.

regards

Dav

 

Dav,

Have a look at this link for Science Daily

Stanley pointed out that statins increase VEGF which has also been found to be upregulated in patients with tendinosis.

Kent

 

Arthur Vinik in a talk at the 2007 Diabetic Foot Conference in the US (available here)cited some researchers who found lipitor and other statins reduced blood flow to rat epididymis with the exception of rosuvastatin (Crestor) which caused vasodilation, and that he was going to present some research at the American Diabetes Association later in 2007 showing improved blood flow and neuropathy scores with rosuvastatin. I haven't hunted down the research of which he speaks, but if so it could have some implications for prescribers?