Are Statins Really Causing Side Effects? Major Study Finds Clarity
Benjamin John/Alamy
Recent investigations reveal that the numerous side effects attributed to statin medications have been significantly overstated. This emerging evidence prompts calls for modifications on drug packaging to mitigate unwarranted concerns that deter patients from essential lifesaving treatments.
“Our findings indicate that the majority of issues listed as potential statin side effects are unlikely caused by the medication,” stated Christine Reese during a press event at Oxford University on February 3rd.
Statins, known for their cholesterol-lowering capabilities, are affordable medications that robustly reduce heart attack and stroke risks. However, fears about side effects, notably muscle pain, have long plagued their use. A 2022 study confirmed that muscle pain is rarely, if ever, induced by statin use.
“Regrettably, both patients and many healthcare providers are confused about statin side effects, contributing to hesitance in initiating or continuing their use,” commented Reese.
In this study, Reese and her team scrutinized common side effects listed on statin labels—like dizziness, fatigue, and memory loss. These narratives stem largely from case reports and observational studies rather than concrete data. The investigation did not delve into muscle pain, weakness, or diabetes risks as previously analyzed in other studies.
Researchers evaluated 19 randomized controlled trials involving 120,000 participants over an average follow-up of 4.5 years, comparing the effects of five widely prescribed statins against a placebo.
Out of 66 observed side effects, most did not correlate with statin usage, and similar occurrences were noted in placebo participants, suggesting a nocebo effect—where fear or expectation of side effects leads to actual experiences. “We have seen that the risk of some side effects like elevated protein levels in urine, swelling in extremities, and liver function changes is legitimate,” mentioned Jeffrey Berger from New York University Langone Health. “However, these do not pose significant harm, allowing us to assert confidently that the benefits of statins overshadow their risks,” Reese concluded.
Drug regulators advocate for updates to statin labels as suggested by Karol Watson at UCLA, indicating clearer differentiation of actual side effects versus those equally occurring in placebo users.
Updating these labels can be a lengthy endeavor. Remarkably, the UK’s Medicines and Healthcare products Regulatory Agency only recommended in January 2026 the inclusion of muscle weakness and pain as possible side effects on statin labels.
In the interim, clinicians can utilize this research to reassure current and prospective statin users. “It’s essential to educate patients to adjust their expectations rather than dismissing their concerns,” emphasized Berger.
Watson hopes the findings will definitively settle the debates surrounding statins. “Future studies should pivot from whether statins typically induce these symptoms—we already know they do not. Instead, research should focus on identifying individuals who are genuinely more prone to certain statin-related side effects,” she remarked.
According to Heart UK, almost half of all adults in the UK have above-average cholesterol levels, while in the US, the Centers for Disease Control and Prevention estimate that one in 10 Americans (34 million) have cholesterol levels exceeding 240 mg/dL (milligrams per deciliter).
These individuals are at increased risk of heart attacks, often unaware of their condition.
High cholesterol typically presents no noticeable symptoms. Unless you’ve had a recent blood test or experienced medical issues, your cholesterol levels may remain a mystery.
If you have concerns about your cholesterol, it’s advisable to consult your doctor. If necessary, cholesterol-lowering medications like statins may be prescribed.
In the UK, around 8 million individuals are reported to take a statin daily, with nearly 40 million in the US.
However, it’s important to note that not everyone requires statins. If your levels are significantly high or there’s a specific medical reason for taking them, there are numerous natural methods to lower cholesterol levels.
To start, exercise is vital. A 2013 study shows that aerobic activities, like running and cycling, can decrease “bad” cholesterol and raise “good” cholesterol by approximately 5%.
Quitting smoking is also recommended. It’s well-known that tobacco smoke raises “bad” cholesterol and poses health risks, while a 2019 study suggested that vaping could have a similar impact.
However, the most effective way to improve cholesterol levels is by adjusting our diet, as recommended by NHS doctors and academics from University College London, including Dr. Riyaz Patel.
You may already know some of the major food culprits. An increasing body of research points to common offenders like pastries, processed meats, and lard. It’s best to eliminate these from your shopping cart for healthier cholesterol levels.
On the other hand, some suggested food swaps may surprise you.
The good and bad of cholesterol
Before we delve deeper into dietary changes, it’s essential to clarify that cholesterol isn’t inherently harmful. It is a vital substance required for survival.
This waxy substance is present throughout the body and serves as a crucial component of cell membranes, as well as aiding in the production of hormones like testosterone and estrogen. It also plays a key role in the synthesis of vitamin D and bile acids, which are necessary for digesting food.
Issues arise when specific types of cholesterol, namely low-density lipoprotein (LDL), become excessively high; this is often referred to as “bad” cholesterol.
“Understanding which cholesterol levels are elevated is essential,” notes Patel. “Cholesterol, like fat, cannot circulate freely in the blood. It requires packaging into particles known as cholesterol lipoproteins.”
These lipoproteins can be visualized as small delivery vehicles transporting cholesterol from the liver into the bloodstream, with high-density lipoproteins (HDL) serving as the “good” type.
However, LDL cholesterol is akin to a reckless driver, frequently colliding with the endothelium—the inner lining of arteries.
While this shouldn’t obstruct healthy arteries, if they are compromised by factors like high blood pressure, smoking, pollution, aging, inflammation, or others, LDL can become trapped within.
When that occurs, plaque begins to develop. “A heart attack can happen when this plaque undergoes a slight rupture, leading to a blood clot that blocks the artery,” explains Patel. “Thus, the presence of plaque poses a serious problem.”
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Foods to include in your diet
Now that you understand the fundamentals of cholesterol (and why having LDL cholesterol in the driver’s seat is a bad idea), which foods can help keep cholesterol levels in check?
“Oats are an excellent way to naturally lower cholesterol,” advises Patel. “This is largely due to their fiber content, as oats contain soluble fiber that effectively reduces cholesterol.”
Soluble fiber is also found in whole grains, lentils, beans, vegetables, fruits, nuts, and seeds, and it binds to dietary cholesterol in the small intestine, preventing its absorption into the bloodstream.
Fatty cholesterol (yellow) is packaged in lipoproteins for transport in the bloodstream – Image credit: Getty Images
“Another effective option is sterols and stanols,” adds Patel. These plant-based compounds are found in fortified yogurts and spreads, or as supplements, and they mimic cholesterol in our bodies.
When you consume foods that contain cholesterol, receptors in your intestines recognize and absorb them into the bloodstream.
Sterols and stanols can deceive these receptors, allowing them to be absorbed in place of cholesterol, leading to increased excretion of cholesterol from the body and less absorption into the bloodstream.
“They are likely the best non-medicinal method to reduce cholesterol, usually by about 10%,” Patel asserts. “They are highly effective.”
Foods to eliminate
While there are beneficial foods to include in your diet, what about those “bad” foods that raise cholesterol? Should they be eradicated from your meals?
There was a time when egg yolks were feared for their cholesterol content. While it’s true that eggs contain a significant amount of dietary cholesterol, you don’t need to panic if you enjoy them with toast.
“Dietary cholesterol doesn’t equate to circulating cholesterol, which is crucial to understand,” says Patel. “In the past, foods high in cholesterol were thought to automatically increase cholesterol levels, but that notion is outdated.”
In reality, about 80% of cholesterol in the body is produced by the liver, not directly ingested from food.
That said, food can still indirectly influence your LDL cholesterol. For instance, certain foods can hinder the liver’s ability to manage cholesterol levels in the blood.
Much like statins, specific foods can act similarly to medications that alter the liver’s functions.
For example, increased saturated fat intake has been linked to higher levels of LDL cholesterol in the bloodstream. Saturated fats are commonly found in fatty or processed meats, butter, cheese, pastries, deep-fried items, and coconut oil.
“If you consume many pastries rich in saturated fat,” explains Patel, “the absorption of these fats can lead to increased LDL levels because they disrupt the liver’s ability to eliminate LDL cholesterol.”
Sugar can similarly affect cholesterol levels by prompting the liver to produce more LDL and less HDL.
So, should we forsake pastries and sugar forever, restricting ourselves to oats for every meal? Absolutely not. Extreme dietary shifts can yield unpredictable health consequences.
Patel suggests that the best approach is to maintain a healthy, balanced diet.
“When advising patients, we recommend a mixed, balanced diet. Aim for moderation in carbohydrates and saturated fats while keeping ultra-processed foods to a minimum.”
Ultra-processed foods, along with saturated fats and sugar, can lead to inflammation in the arteries and raise the risk of developing metabolic disorders like type 2 diabetes.
“Moderation in everything is likely the best advice,” concludes Patel.
“A balanced diet is partly guided by your body’s signals regarding hunger. Your body is adept at understanding its needs.”
About our experts
Dr. Riyaz Patel is an academic scholar and NHS Physician at the University of London, UK. He has contributed to numerous medical journals, including the European Heart Journal, Natural Genetics, and European Heart Journal – Quality and Clinical Results of Care.
Statin usage is on the rise, with the National Institute of Excellence in Health and Care (Nice) reporting that in October 2024, around 5.3 million people in the UK were using statins or cholesterol-lowering medications in the previous year.
This figure has nearly tripled since 2015/2016, now reflecting almost 10% of the nation’s population. Likewise, statin usage is also increasing worldwide.
Doctors prescribe statins primarily to prevent heart disease, the leading cause of death globally. These medications lower low-density lipoprotein (LDL) cholesterol—the “bad” cholesterol that contributes to artery clogging—by aiding the liver in cholesterol production and blood extraction.
While statins effectively prevent heart attacks and strokes, there are still questions individuals have before commencing treatment.
Consider inquiries like: If my cholesterol is high, should I take statins? Could I improve my condition through diet and exercise first? What side effects might I experience when I start taking statins?
The answers to the first two questions are ultimately the same: the decision rests with you.
How to Determine if Statins are Right for You
The choice to begin statin therapy should be made alongside a healthcare provider, considering not just cholesterol levels, but the overall risk of heart disease.
This involves evaluating other risk factors such as blood pressure, family history, and even geographic location.
As Julie Ward, a senior cardiac nurse at the British Heart Foundation, explains, your physician will use all available information to calculate your individual cardiovascular risk score.
“Once we have that cardiovascular risk score, we can initiate a discussion on measures to reduce that risk,” Ward states. “It’s about individuals [doctors] or pharmacists communicating, ‘This is your cardiovascular risk. We recommend starting you on a statin.’
The initial conversation may focus on lifestyle modifications, such as healthier eating habits and smoking cessation. You can assess your risk with an online calculator like this one. A higher 10-year risk score indicates a greater likelihood of needing to discuss statin therapy.
After a few months, you may visit the calculator again to see if your risk has changed, and perhaps determine that your risk is low enough to pursue dietary changes and exercise instead. But what if the recommendation for statins remains strong?
Statins are Safe and Effective
It’s natural to feel apprehensive about starting a potentially lifelong medication.
However, scientific research may provide reassurance; ample evidence highlights the effectiveness of statins in preventing heart disease, says Professor James Shepherd, a Health Data Scientist at the University of Oxford.
“Statins are arguably the most studied medication in medical history,” he points out. “Numerous clinical trials have examined their effects.”
Additionally, researchers have compiled the results of numerous trials to bolster the evidence surrounding statins.
For instance, in 2015, researchers from Cochrane, a distinguished medical review publisher, synthesized data from nearly 39,000 individuals who participated in 296 trials assessing Atorvastatin, the most commonly prescribed statin.
Their comprehensive review revealed that taking atorvastatin for up to 12 weeks reduced LDL cholesterol by 37-52%, depending on the dosage.
What’s the impact of statins on the risk of death from heart attacks and other cardiovascular issues? The answer largely depends on individual circumstances.
A recent review from early 2025 indicated a risk reduction ranging from 20% to 62%, with higher percentages for individuals in high-risk groups. This represents significant savings for medications costing less than £2 (around $2.50) per 28 tablets.
However, it’s essential to understand how to interpret numbers for your own decision-making.
In large-scale trials, efficacy is often expressed in relative terms, indicating the difference compared to those not taking statins.
As Shepherd emphasizes, “For real-world treatment decisions, the absolute risk is what matters most.”
For example, if a statin reduces the risk of a heart attack by 20%, a patient with a 1% absolute risk (or cardiovascular risk score) sees their risk drop from 1% to 0.8%.
In contrast, those with risk scores above 10% can realize significantly greater benefits.
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Side Effects Vary
While we know statins are effective, what about the negative aspects related to side effects?
“Previous reporting has skewed public perception,” reveals Ward. “Yet, research demonstrates that side effects are minimal, and statins are well-tolerated by most patients.”
This is supported by findings from Shepherd and his team, detailed in a 2021 study that reviewed side effects across 62 trials involving over 120,000 participants, revealing only “a small number” reported issues.
Approximately 15 out of every 10,000 individuals experienced muscle pain and related symptoms, while liver, kidney, and eye abnormalities were even less prevalent.
When patients discontinue statin use, it is often linked to side effects. So, what’s behind this?
A different 2021 study suggests that the perceived side effects may be associated with the act of taking medication rather than their actual occurrence.
In that research, 60 participants received a month’s supply of different medications—some statins, some placebos—without knowing which was which. A year later, researchers noted more symptoms as patients were taking medication compared to nothing at all, with 90% of those experiencing side effects from statins also reporting symptoms while on the placebo.
Adjusting Dosage or Medication
If you encounter side effects, it’s essential to communicate these with your doctor instead of just enduring them.
For instance, atorvastatin can be prescribed in doses ranging from 10 to 80 mg per day. Side effects are often dose-dependent; hence, 80 mg is more likely to induce issues than 10 mg, though a lower long-term dose is usually possible.
“If someone has high cholesterol, they may start at 80 mg,” explains Ward. “If they’re managing well in a few months, we might lower it to 40 mg, and potentially down to 20 or 10 mg later on, transitioning to a maintenance dose.”
Alternatively, switching medications can also be effective. In the UK, five different statins are available, all functioning similarly, though atorvastatin is often regarded as the most effective.
“If someone previously took a higher dose of a different statin, a doctor could prescribe atorvastatin at a lower dosage that could achieve similar cholesterol-lowering effects with fewer side effects,” Shepherd adds.
In rare cases, taking statins may lead to more serious issues affecting the liver and kidneys, which is why regular blood tests are crucial for monitoring.
Individuals with diabetes might be concerned regarding findings suggesting that statins can elevate blood sugar levels.
Nevertheless, the cholesterol-lowering benefits are believed to outweigh the minimal increases in blood glucose.
In conclusion, taking statins is a personal choice. If you have concerns, consider discussing them with a cardiac nurse at the British Heart Foundation or explore resources on cholesterol at Heart UK.
About Our Experts
Julie Ward is a senior heart nurse at the British Heart Foundation.
Professor James Shepherd is a health data scientist at the University of Oxford, focusing on cardiovascular disease prevention. His work has been featured in General UK magazines, BMC Medical Research Methodology, and BMJ Open.
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