Statins are a class of drugs that lower the levels of LDL cholesterol in the bloodstream. Unhealthy LDL cholesterol is a fatty, waxy substance that builds up to the blood vessels of the heart and artery walls, making them to harden.

LDL cholesterol may also form plaques that can block the flow of blood. Moreover, if plaques form blood clots on the walls of the arteries or break away from them, you can have a stroke or heart attack.

How do statins work?

Statins work by blocking substances the body uses to manufacture LDL cholesterol. This class of medication may also help the body reabsorb the cholesterol that has accumulated in plaques on the blood vessels of the heart and walls of the arteries, preventing further blockage and heart attacks.

Statin therapy lowers the risk for heart attacks and other cardiovascular problems by as much as 48%, depending on the level of risk factors. In fact, about 32 million Americans take statins.

Research has found that statin medications do more than just lower LDL cholesterol. Increasing evidence suggests that statins can also prevent cardiovascular disease in adults aged between 40 and 75 years. However, the benefits are not entirely clear particularly for the elderly and researchers want to learn more about the benefits and side effects of statin medications.

Another promising benefit of statin drugs is their anti-inflammatory effect which stabilizes the lining of blood vessels. Statins may also help prevent venous thrombosis which is primarily characterized by deeo veins (DVT, or deep vein thrombosis) or blood clots in the lungs.

Which statin drug should you take?

Researchers have studied statins extensively  due to their wide use. Although statins are safe for most people, there are some differences between individual statin drugs. The safest statin drug for you depends on various factors.

Some statin drugs are safer for people who have specific medical conditions because there are specific known interactions between individual statin drugs and other medications. The dose or amount of a particular statin drug to be effective is also a factor. However, the risk of side effects is usually less with a lower dose of most statin medications.

What statin medications are available in the U.S.?

Individual statin drugs available for use in the U.S. include:

1. Lipitor (atorvastatin)
2. Altoprev (lovastatin)
3. Pravachol (pravastatin)
4. Zocor (simvastatin)
5. Livalo (pitavastatin)
6. Crestor (rosuvastatin)
7. Lescol XL (fluvastatin)

Sometimes, an individual statin therapy drug is combined with other heart health medications. Examples include ezetimibe/simvastatin (Vytorin) and amlodipine/atorvastatin (Caduet).

Thyroid disease and cholesterol treatments

Just as thyroid treatments may affect cholesterol levels, cholesterol medications may affect thyroid disorders and/or the efficacy of thyroid medications in various different ways:

• Absorption: Some bile acid sequestrants/resins such as colestipol (Colestid), cholestyramine (Questran) and colesevelam (Welchol) may bind to levothyroxine and completely prevent its absorption.
• Flushing and other symptoms of hyperthyroidism: Niacin can be used for people with low HDL levels. Some of its common side effects can closely mimic hyperthyroidism symptoms. This is very important for people who have hypothyroidism, as well as those who have hyperthyroidism. It is particularly important for people who wonder if their dose of levothyroxine is too high.
• Muscle pain: This is one of the most common side effects of statin drugs, such as pravastatin (Pravachol), and atorvastatin (Lipitor), as well as various PCSK9 inhibitors such as evolocumab (Repatha). If you have hypothyroidism, you are more likely to experience mild to severe muscle pain on statins. However, the incidence of muscle pain is lower with fluvastatin (Lescol) and higher with simvastatin (Zocor).
• Thyroid disease: According to a 2008 study, treating high cholesterol with statins reduces the risk of Grave’s orbitopathy, which is usually accompanied by eye symptoms such as irritation and bulging.

Consider statin medications a lifelong commitment

If statin helps you lower your LDL cholesterol levels, you’ll probably have to stay on it for the long term. If you stop taking the drug, your LDL cholesterol levels might go back up. Therefore, you shouldn’t stop taking statins simply because your cholesterol has gone down unless your doctor recommends it.

However, there’s one exception: if you lose a lot of weight or make significant changes to your diet, you may be able to control or lower your cholesterol levels without medications. However, you should not make any adjustments to your medications without consulting your physician first.

Weighing the benefits and risks of statins

You should avoid taking statins if you have liver disease or are pregnant. When considering whether you should take statin drugs for high cholesterol, it’s critical to ask yourself the following questions:

• Am I able and willing to make significant diet and lifestyle changes to lower my LDL cholesterol levels and improve my health?
• Do I have any other risk factors for heart disease?
• Am I concerned about the side effects of statins or their interactions with other medications?
• Am I worried about taking pills every day for the rest of my life

It’s always important to consider your lifestyle choices, personal values, medical reasons, and any other concerns when choosing a treatment option. You should also consult your doctor about your personal preferences and total risk of cardiovascular disease before making decisions about statin therapy.

Check this list of high-cholesterol food you should avoid!