"Taking a new medicine is the start of a new experiment." Nowhere is this truer than with the statin class of drugs.

Although the majority of statin users appear to do well, the collateral damage of this class of drug is such that diverse symptoms, reflecting multiple metabolic pathways, can be expected. Glial cell inhibition of cholesterol synthesis appears to be the cause for such cognitive manifestations as amnesia, confusion, disorientation and forgetfulness.

Dolichol inhibition is directly tied to altered neuropeptide synthesis and many behavioral side effects such as aggressiveness, depression and irritability. CoQ10 inhibition seems directly tied to statin associated myopathies, neuropathies and rhabdomyolysis.

Now it is suspected that some patients may have a genetic susceptibility to statin-induced problems. Special genetic susceptibility may explain not only much of the statin associated rhabdomyolysis but also the curious pattern of persistent myopathy, often following only a short course of Statins. Since susceptibility testing of this type is not yet available, there is no way to identify those who are susceptible until the damage is done.

Such concerns document the validity of the opening statement. Every statin user is the start of an experiment. One can hardly justify this class of drugs for wide-scale use as in primary prevention and over the counter distribution (as in England) when the completely unpredictable end-point may be rhabdomyolysis death or permanent myopathic debility.

One of these genetic determined enzymatic conditions is carnitine palmitoyl transferase (CPT) deficiency. The enzymes involved are found on different membranes of the mitochondria, those busy factories within each of our cells responsible for the production of (ATP) energy.

Produced in each of our body's million's of cells, mitochondrial ATP is our body's sole source of energy. CPT enzymes work together with Coenzyme Q10 in the process of transport of fatty acids into our mitochondria and their ultimate conversion into fuel. Deficiency of this class of enzymes is characterized by unusual muscle pain and stiffness after exercise or work.

Certain types of muscle cells are especially dependant upon carnitine for fatty acid transport. CoQ10 also helps in this complex metabolic interplay. When these substances are insufficient, myopathy may result. This is particularly true in those having unusual CPT molecular mutations. Especially under conditions of CoQ10 deficiency such as from the use of statin drugs, a persistent type of myopathy may result.

Georgirene Vladutiu PhD, of the Robert Guthrie Biochemical Genetics Laboratory, reports that, "A study is underway at the University at Buffalo to pursue the possible role genetic factors may play in increasing susceptibility to statin myopathies. There is preliminary evidence that certain underlying muscle disorders may play a role in conferring increased susceptibility to statin-induced myopathies."

Volunteers Taking Cholesterol-Lowering Drugs Needed for Research Study

The Robert Guthrie Biochemical Genetics Laboratory at the Women's and Children's Hospital of Buffalo, Kaleida Health System and University at Buffalo is currently looking for individuals who are taking cholesterol-lowering drugs known as ‘Statins'. They are particularly interested in individuals who are about to begin taking statins, however, they will gladly welcome anyone who is on statin therapy to lower their cholesterol or has taken statins in the past.
Some of the common cholesterol-lowering drugs, known as Statins, include: Zocor, Lipitor, Pravachol, Crestor, Mevacor, Lescol and others.

There is no cost or payment to you for participation in this study. The benefits to you will be the provision of risk factor information about possible side effects from these medications that may help with your future medical care.
If you would like more information, please call Christine Barden at 716-829-2695 on Wednesday or Thursday or leave a message for a call back.

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor