Exercise and statins

The most common statin toxicity is liver inflammation. Most patients with the problem don't even know they have it, but some develop abdominal distress, loss of appetite, or other symptoms. Even without these complaints, liver enzyme abnormalities, such as high aminotransferase levels, show up in the blood tests of 1%–2% of people taking a statin drug. The other major side effect is muscle inflammation, which can be silent or cause cramps, fatigue, or heavy, aching muscles. Like liver inflammation, muscle damage can often be detected with a simple blood test; in this case, it's an abnormally high level of creatine phosphokinase (CPK). 

Lifestyle therapy: The first step

With so many people in need and so many medications available, it's understandable that both doctors and their patients are tempted to rely on medications to improve unhealthy cholesterol levels. That's a mistake. Instead, lifestyle therapy is the place to start. That means avoiding tobacco in all its forms. It also means choosing foods low in saturated fat, trans-fatty acids, and cholesterol while favoring foods that provide heart-healthy omega-3 and monounsaturated fats and large amounts of dietary fiber. It also requires regular exercise, which can be as simple as walking at a moderate pace for at least 30 minutes nearly every day. And the combination of a good diet and regular exercise should help men achieve another important goal, weight control.

Lifestyle therapy can improve cholesterol levels, and certain foods can provide extra help (see "Foods that lower cholesterol" below). But even with clean living, many people need medication to achieve optimal cholesterol levels, particularly when they have to reduce their LDL levels to 100 mg/dL or less. It's important to keep up a good diet and exercise program even if you take medication. And if you can't take a statin, here is a rundown of other medications that can help; Table 3 (see below) summarizes their effects on blood lipids and compares them to the statins.

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