Q.  Several years ago my doctor prescribed 20 mg of Lipitor. Since then doctors have gradually raised the dose till I am now on 80 mg of generic atorvastatin.

Initially I experienced calf cramps that I could eventually stretch out. But more recently I’ve started having unbearable cramps in the backs of my thighs that literally make me scream in pain. I don’t mean groaning, I mean screaming like I’m being attacked with a sharp knife by a crazed killer!

They generally occur at night, but I’ve experienced them during the day too. NOTHING makes the cramp go away. I cannot move. I cannot stand. I grab my leg(s) [sometimes it’s both at the same time] and can literally feel the muscles roiling and twitching under my skin.

Sometimes just lifting or bending my leg the wrong way triggers an attack that can last up to 15 minutes.

My doctor scoffed at me when I mentioned my cramps. I suspect the atorvastatin because of something my pharmacist said about Lipitor and leg cramps, but my doctor doesn’t seem to believe me.  Can medication really cause leg cramps? Would quinine help control my pain?

A. Your physician has not been paying attention to the prescribing information or the scientific literature. Muscle pain is one of the most common complaints we hear from people taking statins. It can manifest as neck pain, back pain, leg pain, muscle fatigue and leg cramps.

An article in the Archives of Internal Medicine (online, Dec. 12, 2011) titled “Nocturnal Leg Cramps and Prescription Use That Precedes Them” noted that:

“The use of diuretics, statins, and inhaled long-acting beta-agonists (LABAs) is linked to muscle cramps but largely by anecdotal evidence. This study sought population-level data to better evaluate these associations.”

The authors report that their analysis “suggest that the use of diuretics, statins, and LABAs promotes muscle cramping in older adults.” Although statins were less likely to cause such problems compared to diuretics or inhaled bronchodilators, they were linked to this problem. This may just be the tip of the iceberg. As the authors point out, older people, who are most susceptible to leg cramps, are “poorly represented in most clinical trials.”

Other visitors to this website have shared similar experiences with a variety of statins:

“I know at least four people in my immediate environment who have had the ever-so-common reaction to statins of other-worldly painful muscle cramps at all hours of the day or night. In addition to myself, they include not only a relative (my father), but also my stepmother and a close friend.

“All of them had intense and painful muscle cramping that is hard to stop. The higher the doses of statin, the greater the extent of muscle cramping. I learned the hard way of this connection after a year’s worth of taking a wide variety of different statins, and altering the dosages to try to eliminate the severe and debilitating cramping.

“The problem got so bad that I could ultimately no longer open a jar lid because of cramping in the muscle at the crook of my elbow.  The most common problem came in muscles I couldn’t avoid using, e.g., knotting up of the muscles in the soles of my feet while sleeping.

“You should get this message out because doctors who deny muscle cramps are caused by statins have a total lack of understanding of how these side effects ruin the quality of your life.

“There are non-statin alternatives for bringing down cholesterol numbers. They may not be as easy or effective as statins, but they do work adequately to bring the cholesterol numbers to appropriate levels.

I feel that doctors should warn people about muscle cramps as a side effect when they prescribe any statin.” Randy G.


We agree with Randy that people should be alerted to muscle pains and cramping when they receive a statin prescription. But as noted above, diuretics that are often included in medications for hypertension can also cause cramps. So can the inhaled medicines used for asthma and COPD [chronic obstructive lung disease].

In many cases the drugs cannot be eliminated. That’s why people need a variety of treatments for leg cramps and restless legs. Even if you are not taking such medications, you may find the section on Muscle and Leg Cramps of interest in our book, The People’s Pharmacy Quick & Handy Home Remedies: Q&As for Your Common Ailments.

You will learn why you may need to avoid Earl Grey tea and why blackstrap molasses might be beneficial. Find out about massaging with castor oil. Why would a gluten-free diet help? Then there are the details about the benefits of minerals like magnesium and potassium. You will also be amazed by soap stories, turmeric tales, and reports of pickle juice and yellow mustard success, to name just a few of our favorite approaches to easing nighttime leg cramps.

Quinine poses a potential problem for some people. Side effects can include ringing in the ears and serious blood disorders. If you are not susceptible to such complications, a glass of tonic water might help prevent cramps. You may want to consider CoEnzyme Q-10 if you absoultely must continue on atorvastatin.

You will also learn how to follow Randy’s advice above about getting cholesterol (and other blood lipids) under control naturally with Certo and grape juice, cinnamon, red yeast rice and apple cider vinegar, to name just a few approaches. The book will provide practical details about implementing a low-carb Mediterranean diet. If you love natural approaches to what ails you, you will find Quick & Handy Home Remedies a powerful resource. And if you would still like to take advantage of our 50% savings on Recipes & Remedies from The People’s Pharmacy, here is an offer that is too good to miss.

 

 

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  1. Bill C.
    Texas
    Reply

    Recently I had a hammer toe operated on and my doctor put me on Keflex antibiotics. I took it twice a day for 8 days and in that time I went to having hand, leg and foot cramps to the point I could not even sleep in the bed at night. I am up and down ever 45 minutes or so and it is easier to stay in the living room on the couch in a sitting up position than it is trying to get up when a cramp hits. Have you ever heard of this problem with Keflex? I am allergic to penicillin.

  2. Kristin
    Reply

    I was on 10 mg. of the statin Crestor for 8 months, and repeatedly complained to my doctor about severe leg cramps. They finally got so bad that he ‘let’ me stop the Crestor.
    With two weeks, all muscle cramps were gone. But what really amazed me was the other things that also changed, all within 2 weeks: 1) my balance improved, 2) my tinnitus improved, 3) my vertigo disappeared, 4) my energy increased, 5) my depression disappeared. That was seven months ago, and NONE of the side effects of the Crestor have returned.
    I have changed my diet, mostly following the Mediterranean except that I hate fish, and avoid all sugar, which has dropped my cholesterol to perfect levels. I’m horrified that doctors are so unwilling to warn (or listen to) their patients as to the multiple unpleasant, dangerous, and life-style destroying side effects of statins. I will never, ever take any statin again.

  3. Charlotte M
    Reply

    After I began cycling more often, I started experiencing severe leg cramps that often woke me in the middle of the night or made it difficult to walk during the day. I tried mustard and pickle juice, each of which decreased the pain but didn’t eliminate it. Eventually I tried a pair of calf compression sleeves. I wore them every day for a week (had a couple of pairs!), and then dropped back to wearing them for my spin classes and a couple of hours afterward. Voila — no more cramps!
    I don’t know if calf compression sleeves would help cramping caused by medication, but just wanted to suggest it as a possibility. I suspect you could also try compression stockings, but the calf sleeves were easy for me to buy and comfortable to wear even in our warmer Southern weather.

  4. paulbyr
    Reply

    Evsav,
    Yes, you really DO need to know when you are talking about cholesterol “numbers” if it is total or LDL (bad) cholesterol. If the red rice decreases your HDL too, then it’s probably a bad choice. I went to two 500 mg pills of Niacin when I reduced statin from 40 mg to 20mg and it boosted my HDL to a good level (58, as I recall). Note, 1000 mg of niacin a day is a lot and needs your doctor’s consultation!

  5. hjl
    Reply

    You say your cholesterol is 136. You don’t say if that is total cholesterol or LDL. Find out exactly what the 136 is and then do some more research since it may be dangerously low.

  6. Evsav
    Reply

    Please, please read the material offered with your prescription. A side effect from statins are leg/foot cramps. To combat them, take a teaspoon of mustard (yes, from the jar) before bedtime. I take honey mustard since it tastes better.
    Also investigate taking Red Yeast Rice supplements 1000 mg daily & reduce your statin dosage. I went from 40 mg of simstatin to 20 mg and my cholesterol is now 136.

  7. paulbyr
    Reply

    WLC’s comment on Jan 21,2014 made me wonder if the sea salt content of minerals, other than sodium chloride, were the beneficial agent. I have no idea of the wide range of elements and compounds which must be in sea salt. I assume, however, that there must be wide variation in content depending on location in the world. (Mediterranean diet effect anyone?)
    Just a cartoonish light bulb going off above my head :>)

  8. hjl
    Reply

    These comments are similar to many posts on this site. I have a question for the Graedons. I just read w/o a citation that muscle problems with statin use is increased in those who are physically active. Restated, if you are active you are more likely to have muscle problems with statin use.
    Is this correct and is there a study on this.
    Thank you.

  9. wlc
    Reply

    I too have taken simvastatin for several years and also suffered severe leg, calf, ankle, feet and toe cramps.
    Finally a doctor told me it could be the statin causing them and suggested I try SEA SALT. Trust me I was shocked at the results. Immediate relief. I could feel the pain subside instantly. Just 1tsp of salt per a glass of water, more if needed. Buy at any store next to the regular salt.
    PEOPLE’S PHARMACY RESPONSE:
    Of course most cardiologists would be horrified with this antidote, since the public health advisories from the FDA and the CDC all say to limit sodium consumption. We find it interesting that a doctor actually recommended salt/sodium to counteract the complications of the statin.

  10. crandreww
    Reply

    @ Everyone…if you are being prescribed a Statin…remember this, I was 34 and on the lowest dose when I became permanently disabled… Neuronal Apoptosis (Holes in my brain) Mitochondrial Encephalomypathy with Stroke Like Episodes (MELAS) Peripheral Neuropathy. Hey I used to be a Critical Care RN, and pushed these poisons just like any doctor, as I was educated just like our doctors, by the drug company who SELLS the drug. If you take a Statin…you may decrease your risk of a coronary event by LESS THAN 1/2 of 1 percent…HARDLY WORTH THE RISKS! RUN AWAY, Find a new doctor if yours is insistant. Or ask him/her if they will personally guarantee no permanent side effects, Mine hit me very suddenly, and at 35 years old am PERMANENTLY and TOTALLY DISABLED. Pain every day, 24/7. I need to WARN everyone, your prescribers are not knowlegeable if they are prescribing these POISONS!

  11. JBG
    Reply

    Here’s an example of absolute risk reduction vs relative risk reduction.
    Doc said I was at risk for a condition that (I found out later) might affect 3% of people like me. A drug my doc wanted me to take would have reduced the risk to 1 1/2%.
    The drug trumpets that using it makes a person TWICE AS LIKELY to avoid the condition — the relative risk reduction.
    But of course, a person chosen at random from the population at risk has only a smidgeon of a chance (3%) of getting the condition. Having that reduced to half a smidgeon (1 1/2%), the absolute risk reduction, at the cost of some serious side effects, and usually some serious money, doesn’t seem nearly as impressive.
    With a drug like that one, you’d have to treat 200 people (exposing them to the expense and side effects of the drug) in order to actually help three people. This is the NNT — number needed to treat — factor. It raises the question, at the end of the day will more people be well off if 200 people take the drug, or not?

  12. B.J.
    Reply

    I am on statins too and have the very same pain in my thighs. They are different and much more painful than mere Charlie horses in the toes, arches and calves of my legs. The only thing that I have found to help with the severe pain in the thighs is to apply a very cold wet wash cloth to that area, but I need help in getting it because when it happens I can’t get up out of bed.
    My son who is NOT on any statins has the same pain in his thighs so I know it has to be something other than just statins. I believe magnesium is needed but haven’t tried it yet.

  13. Noni S
    Reply

    Having extreme muscle problems after taking a variety of statins, I am wondering about the use of magnesium to help with this. How much should one take? I have tried physical therapy, chiropractor. While the problem has eased some, I am still left at times with inability to walk without pain, and continued muscle problems.
    My Dr. seems to understand, but still prescribed “one more” type of drug. That sent me over the edge. Doctors do not want to recognize the pain these drugs cause. I now take NONE and will never take again. The interesting part is that I took pravachol and lipitor for six years with no problems. Somehow, either these drugs changed, or I did. Please advise about the magnesium. Thanks.

  14. CS
    Reply

    After experiencing alarming symptoms from Lipitor, I refused my physician’s attempts to prescribe statins. When I had my genome sequenced, the results supported an intolerance to statin drugs. Instead I take a high dose prescription strength fish oil plus fenofibrate.
    My elevated cholesterol and triglycerides have come down and I avoided the problems with statins. If your physician does not listen to you, get another doctor.

  15. Don
    Reply

    If your doctor scoffs at a report of cramps so severe that you are screaming in pain, I would contend you need a new doctor. While you are searching for a new doctor, please research the statin articles on this website. There must be a reason your doctor has you at a maximum dose of a statin, but what benefit is 80 mg. achieving that 40 mg. (or 20 mg.) could not?

  16. raw
    Reply

    I’ve only been on 40 MG Atorvastatin for 7 months and had some leg and foot cramps before starting this prescription. At 82 my walking is pretty much limited to Walmart— which I do 2 or 3 times a week just for the exercise. But, Gatorade sound easy and probably good for me anyhow. Thanks, I’ll give it a try. PS: I’ve have been taking tart cherry juice for a month and think it helps some of my bedtime pains.

  17. RML
    Reply

    I and my husband are always suffering from cramps on our legs, but because I also suffer from FBS, it is doubly painful. But Doctor does not believe either.

  18. paul43
    Reply

    Norma, I too was on simvastatin and started to develop leg cramps and MEMORY LOSS.
    I stopped taking the simvastatin the minute I realized about a severe memory loss and the muscle cramps went away and hopefully my memory is back to normal.

  19. HRC
    Reply

    Have same cramp problems with statins. Doctor said a small percentage of population develop cramping as an allergic reaction. At the first sing of cramps I discontinue the statin for 3-5 says and then have my doctor prescribe a different one. Works every time. (Also follow your lead and place soap chips in a sock and place under sheets)

  20. Norma C.
    Reply

    I too was on simvastatin for several yrs. I used to be able to walk 3 miles or so about every day. But the pain in my legs got so bad, I hurt just to walk in a store. Above my left knee, it aches. I quit taking the med after my heart doctor said I was ok to quit. But still after 3 wks, I still hurt.

  21. ecn
    Reply

    I had taken Pravachol and other statins for 20 years. I was a hiker, about 8 mi/day 3000 ft climb, and I gradually lost strength in my thighs until one day I had to stop a 6 mile hike and go back.
    Today I can barely do 3 miles with a little climbing. I stopped the statin drugs 10 years ago.

  22. crandreww
    Reply

    Indeed your medicine could be causing your leg cramps. According to the BMJ, Doctors are not very well informed as to the ABSOLUTE RISK REDUCTION of statins…which should be the only reason a person would be placed on a statin “therapy”..http://www.bmj.com/content/345/bmj.e8357/rr/620972 The author, Freudenthal1 is right to point out that, even in high risk groups, it remains a fact that the majority of patients taking a statin will derive no meaningful benefit from it.
    Dr Dougal Jeffries, GP notes in another letter to the BMJ, “how disappointing to see a News item in the BMJ that reports relative risk reductions alone, instead of absolute risk reductions and/or NNT figures. The more so because it is precisely because of the low ARR that widespread use of statins in primary prevention is of dubious value, though there was no way of evaluating this from the article. When is the BMJ going to consistently follow its own advice to authors?”
    Statin Studies done by Pharmaceutical companies boast a Relative Risk Reduction, versus the more Accurate Absolute Risk Reduction. When they publish these data, this is what the prescribers are relying on, and often are not made aware of the Absolute Risk Reductions…which is a fraction of the often touted Relative Risk Reduction.

  23. SWG
    Reply

    My husband, too, has been on statin drugs for quite some time and suffers horrific cramps in this legs and hands.
    I take a diuretic and also have minor leg cramping.
    We have found that plain old prepared yellow mustard stops the cramping in minutes. It has been amazing!
    Another recent find is ‘Smart Water’ which, like Gatorade, helps to balance our body’s electrolytes. It seems to be enormously helpful for us as well as our 43-old-daughter. We each drink a bottle daily and have found much less tendency toward cramping.

  24. LLE
    Reply

    The comments above almost look like I wrote them. For the past several months, I think every muscle in my body, from my toes to my fingers, has cramped at one time or another. A few days ago, I picked up a pencil to write a note. I cuold not put the pencil down. I had to physically pull it out of my hand, then bend my hand and wrist back into position. I didn’t know my toes could curl as far as they do when they cramp. They also try to go straight up at times.
    I am now down to 10mg of Atorvastatin, from 40, and hope to be off completely very soon.
    Lynn

  25. paulbyr
    Reply

    I wanted to say that it is very important and helpful when The Peoples Pharmacy publishes an actual medical journal citation backing up the problems people have with prescription medicines.
    Without these cites, too many doctors can just blow off their patients complaints and prescribe another drug (like Advil) to combat the pains.
    If a doctor still refuses to honor their patient’s pain, it is time to change doctors!

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