Can statins make you tired?

In this article:

• Do statins make you tired?
• Why do statins make you tired?
• Distinguishing statin fatigue
• Managing statins fatigue
• Balancing benefits

In this article

• Do statins make you tired?
• Why do statins make you tired?
• Distinguishing statin fatigue
• Managing statins fatigue
• Balancing benefits

Statins are a class of medications used to treat high cholesterol. There are many prescription statins available, including Lipitor (atorvastatin), Crestor (rosuvastatin), Mevacor (lovastatin), Zocor (simvastatin), and Pravachol (pravastatin). They all lower cholesterol in the same way, by blocking the production of a liver enzyme that makes cholesterol. One side effect of statins is fatigue, or feeling tired. 

Do statins make you tired?

Yes, statins can make you tired. Research shows that some, but not all, people on statins experience low energy and a “lack of pep”: 20%–40% of users, particularly women, reported reduced energy levels and increased exertional fatigue compared with placebo. So you’re not alone if you feel like you need more sleep while taking statins. Fortunately, going to sleep after taking statins is not dangerous. It may even improve the medicine’s cholesterol-lowering abilities. 

Why might statins cause fatigue?

There are two reasons you might feel tired on statins: First, the exact mechanism of action that lowers cholesterol production also reduces the production of ubiquinone (CoQ10), an antioxidant involved in energy production. Second, statins can interfere with sleep by causing muscle pains, restlessness, and even vivid dreams, says Anthea Nwandu, MD, a double board-certified internist and lifestyle medicine provider in Maryland. “Poor sleep then adds to the feeling of daytime fatigue,” Dr. Nwandu adds. 

Statins like atorvastatin work quickly, reaching peak blood concentrations within an hour or two. This could mean that statin-related fatigue is at its worst within the first few hours of administration. “It’s not dangerous, but it can feel like your energy tank is running lower than usual,” Dr. Nwandu says. Given this, taking a statin before bedtime rather than in the morning could help reduce the impact of statin fatigue on daily activities. 

In general, medication side effects also lessen as your body adjusts to a new medication. If tiredness from statins has not gone away after a few weeks of being on the medication, seek personalized medical advice from a healthcare provider.

Distinguishing statin-related fatigue from other causes

One of the best ways to tell statin-related fatigue apart from other forms of exhaustion is to pay attention to timing. “If the fatigue starts soon after beginning a statin and improves when the dose is adjusted or stopped, that’s a clue it may be medication-related,” Dr. Nwandu says. 

Other clues to help determine the cause of your fatigue include:

• When you feel tired: Research suggests that statin-related fatigue is often worsened with exertion. In other words, feeling more tired during or after a workout or strenuous physical activity can be a sign of statin-related fatigue.
• Specific symptoms: While statin-related fatigue may feel like general low energy, it can also involve burning muscle aches. That’s because statins increase the body’s production of lactic acid, according to Troy Alexander-EL, MD, a board-certified internal medicine provider based in Portland, Oregon. “You may have heard of lactate or lactic acid as the cause of that burning sensation in your muscles you experience after a hard workout or run,” she explains.  
• How long it lasts: “Statin-related fatigue usually resolves in a few weeks,” Dr. Nwandu says. “Fatigue that is sudden, severe, worsening, or comes with symptoms like chest pain, shortness of breath, or weight loss should always be checked right away.”

Strategies for managing statin-related fatigue

Managing statin-induced tiredness often involves small lifestyle or dosage adjustments. One of the simplest strategies is adjusting medication timing. “Taking statins at night can help, since cholesterol production is highest during sleep and fatigue may be less noticeable,” Dr. Nwandu says.

Here are some practical strategies for reducing the feelings of fatigue related to statins:

1. Take statins in the evening. Again, taking statins at night can help support the drug’s cholesterol-lowering capabilities while also working with feelings of fatigue rather than against them.
2. Ask your provider about CoQ10 supplements. Dr. Alexander-EL says taking daily coenzyme Q10 supplements can help with statin-related fatigue by replenishing ubiquinone, which plays a role in energy production.
3. Limit alcohol. It’s generally safe to consume alcohol on statins, but it’s also important to remember that alcohol causes drowsiness. If you’re struggling with fatigue from statins, consider limiting or eliminating alcohol until the side effect goes away.
4. Prioritize protein. Eating heart-healthy protein, such as lean meats and legumes, can fuel your muscles and boost energy levels while also supporting healthy cholesterol levels.
5. Be patient. “Some patients feel better after a few weeks as the body adjusts, so mild fatigue may improve with time,” Dr. Nwandu says. This is the case with many medications.
6. Ask about a dose reduction. “A drug holiday or dose reduction can decrease symptoms,” Dr. Alexander-EL says. However, it’s essential to consult with your prescriber before changing your statin dose or discontinuing the medication.
7. Ask about switching medications. If fatigue persists, Dr. Nwandu recommends talking to your provider about trying a different statin or “adding on a non-statin agent” to alleviate exhaustion. 

Extreme fatigue or sleep disturbances from statins should be reported to a healthcare professional. It’s important to talk to a provider rather than abruptly quitting the medication since stopping statins can increase the risk of cardiovascular problems.

Serious side effects and rare side effects that warrant consulting a healthcare professional include:

• High blood sugar, especially in people with Type 2 diabetes
• Memory problems
• Confusion
• Worsening muscle weakness (myopathy)
• Rhabdomyolysis (rapid muscle damage characterized by severe muscle pain and weakness, along with dark-colored urine)
• Signs of an allergic reaction, such as a skin rash, itching, hives, or angioedema (swelling of the face, lips, tongue, or throat)

As always, it’s also important to consult with a healthcare provider about possible drug interactions that may exacerbate or cause fatigue. Provide your prescriber with a complete list of prescription and over-the-counter medications, including supplements, before starting statins.

Balancing benefits and side effects

Statin drugs can significantly improve cardiovascular health. The benefits of statin use include lowering LDL cholesterol and triglyceride levels. Cholesterol-lowering medications like these also improve heart health by preventing heart disease and heart attack. Of course, statin drugs also have several common side effects, including muscle aches and fatigue. There are many statins available, and some possible side effects may vary by dose and type of statin. As with all medications, it’s important to weigh the benefits and side effects of statins.

Ultimately, only a healthcare provider familiar with your medical history, health conditions, and other medications can determine the best statin therapy for you. It’s important to report concerning or worsening adverse effects to your prescriber. Sometimes, a lower dose may be needed. In other cases, a healthcare professional may recommend switching to a different cholesterol-lowering medication. Never skip or discontinue statin doses without first checking with your provider. Self-adjusting your statin therapy can be detrimental to your cardiovascular health.