Things to Know When Starting a Statin, with Nieca Goldberg, M.D.

Statins are widely used to lower cholesterol and reduce the risk of heart attacks. In addition to lowering cholesterol, they have anti-inflammatory properties that help stabilize plaque in the arteries, preventing dangerous blood clots. However, like all medications, statins come with potential side effects. In an interview with The Educated Patient, Nieca Goldberg, M.D., a board-certified cardiologist at NYU Langone Health and an American Heart Association volunteer expert, discusses what patients need to know when initiating statin treatment.

She says for patients with arthritis or existing joint pain, statins do not necessarily worsen symptoms, but any new muscle aches should be reported to a doctor. Physicians can monitor muscle inflammation through a blood test and adjust the medication if necessary — either by changing the statin type, reducing the dose or switching to a non-statin alternative.

Another potential side effect is an increase in liver enzymes, which is why doctors commonly order liver function tests a month or so after starting the medication. If enzyme levels rise significantly, adjustments may be needed. Some patients also report cognitive side effects, but these symptoms are reversible upon stopping the medication.

Goldberg emphasizes that patients should maintain open communication with their doctors when starting a statin. Regular follow-ups and lab tests help ensure safety while benefiting from the heart-protective effects of statins.

“I’m going to encourage all people to have an open mind, to express your concerns to the doctor, listen to their responses and have a shared decision on starting statin medication,” she concludes.

4 Things to Know When Starting a Statin

• Statins lower cholesterol and reduce heart attack risk: They also have anti-inflammatory properties that help stabilize plaque in arteries.
• Muscle aches are a possible side effect: About 5% of patients report muscle pain, but studies show some may experience this even on a placebo.
• Statins may cause temporary cognitive changes: Some people report feeling foggy or forgetful, but these symptoms are reversible if the medication is stopped.
• Shared decision-making is key: Your doctor can guide you through the risks and benefits, ensuring statins are the right choice for your health.