- Researchers studied the effects of vitamin D supplementation on muscle soreness associated with the use of cholesterol-lowering statins.
- They found that vitamin D supplementation worked no better than a placebo in reducing muscle pain.
- They concluded that vitamin D supplementation does not reduce SAMS.
High cholesterol does not produce any symptoms. However, it increases the risk of cardiovascular diseases such as heart attacks and strokes.
Statins are the most common treatment for high cholesterol. However several
Observational studies have found a link between vitamin D deficiency and SAMS. Studies have also shown that those who took vitamin D supplements after stopping statin use due to SAMS could tolerate further statin use.
Further study of how vitamin D affects SAMS could help improve treatment options for hypercholesterolemia.
Recently, researchers conducted a randomized, placebo-controlled trial of vitamin D supplements to treat SAMS.
They found that vitamin D was as effective as a placebo in treating SAMS.
Dr Mark A Hlatky, professor of health policy and medicine at Stanford University, one of the study’s authors, said Medical News Today:
“The study shows that vitamin D is very unlikely to prevent muscle symptoms associated with statins and that previous reports of a beneficial effect are likely due to a placebo effect of a doctor’s recommendation of the vitamin D as a way to treat muscle symptoms.”
The study was published in
The researchers used data from the VITAL (Vitamin D and Omega-3 trial) study, which investigated the effects of vitamin D and omega-3 supplements on the development of cardiovascular disease and cancer.
The study recruited men aged 50 and older and women aged 55 and older with no history of cardiovascular disease or cancer.
For this study, researchers analyzed data from a subset of 2,083 participants who started taking statins during the study period. While 1033 received 2000 international units of cholecalciferol vitamin D supplement per day at the start of the study, 1050 received a placebo.
They further noted that the number of participants stopping statin treatment due to SAMS did not differ between the groups: 13% of those in the vitamin D group and 13% in the placebo group stopped taking statins.
Further analyzes revealed that people who were vitamin D deficient were just as likely to develop SAMS whether or not they received vitamin D supplements.
When asked what could cause SAMS, Dr Hlatky said: “Most of the muscle symptoms that patients experience while taking statins are non-specific, so it is unclear why they occur. .”
Professor Kausik Ray, professor of public health at Imperial College London in the UK, not involved in the study, also said DTM that it is uncertain how statins can cause muscle pain. However, he noted that “statins can be taken up into muscle by anion transporters – [proteins that control the movement of metabolites, toxins, and drugs between cells].”
“It is possible that they may have adverse effects on mitochondrial energy balance in genetically predisposed people,” Prof Ray said.
When asked how to treat SAMS, Dr. Hlatky noted that there is no specific treatment for the condition. However, he said the
“If the approach of reassessment, rediscussion (net clinical benefit), and rechallenge is used, a majority of patients will be able to be successfully treated with at least one or more statins,” he added.
Professor Ray added that since SAMS does not damage the muscles, stopping the medication usually resolves the symptoms. He added that in rare cases of inflammation-related pain, steroids and immunosuppressive therapy may also be used.
In a press release, lead author Dr. Neil Stone, a medical professor of cardiology and preventive medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine cardiologist, said the analysis of the drugs patients are taking alongside to statins, determines whether they have metabolic or inflammatory conditions can help treat SAMS.
He further noted that counseling patients on their ability to hydrate properly and discussing “pill anxiety” can also be helpful.
The researchers concluded that while statin therapy caused an increase in mild muscle pain, more than 90% of all reports of muscle symptoms in people on statins were not due to statin use.
They further noted that most reports of SAMS occur during the first year of statin therapy, with higher doses of statins causing an 8% increase in SAMS during the first year and regimens of low to moderate intensity statins resulting in a 3% increase.
The researchers noted that their findings indicate that the known cardiovascular benefits of statins outweigh their lower risk of muscle symptoms. Professor Sir Nilesh Samani, Medical Director of the British Heart Foundation, which co-funded the study, said:
“[This study shows] the frequency of symptoms of muscle pain. Almost a quarter of the patients who took part in the trials reported such symptoms whether they were taking statins or a placebo.
“It is essential that the real concerns of people with muscle symptoms are not ignored and that doctors continue to consult with these patients to ensure that their medications are tailored to best suit them.”
Dr. Hlatky noted several limitations to his study, the most important being that patients started using statins after vitamin D supplements and SAMS was not specifically treated.
Dr Ray noted that although the sample size was relatively small, the study was nevertheless “well done” and shows that vitamin D should not be used in routine practice to prevent SAMS.
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