For most patients, statins are linked to a lower risk of having a heart attack or stroke, according to the American Heart Association. But statins come with their own risks and benefits.

  1. A little goes a long way. At low doses, statins have their strongest effect. A patient taking 20 milligrams might see a 25 percent drop in their cholesterol level, says Paul Thompson, MD, director of cardiology for the Hartford Hospital division of cardiology in Connecticut and a member of the American College of Cardiology’s Sport and Exercise Council.
  2. Higher doses of statins have diminishing returns. If you have higher cholesterol levels, you may need higher doses. But giving a higher dose won’t have that same boost in lowering cholesterol, says Dr. Thompson. Doubling the dose, he says, might only reduce cholesterol levels another 6 percent. So a patient brought from a cholesterol level of 200 to 150 initially, would only see a further reduction to 138 with the higher dose. The problem? “When you double the dose you double the side effects,” says Thompson.
  3. Statins are often for the healthy. While most patients with cardiovascular disease may take statins, you may be advised to take a statin based on family history or other factors, such as smoking, that put you at risk for heart disease later, even though you are otherwise healthy. Doctors admit that convincing people who may benefit from a statin can be tricky, as otherwise healthy people may be reluctant to start a drug with possible side effects. “When you’re taking the statin, you can’t tell that it’s helping you. We’re treating an asymptomatic person,” says Robert Centor, MD, an internal medicine physician at the University of Alabama at Birmingham and chair of the Board of Regents of the American College of Physicians. When it comes to taking a daily medication despite feeling healthy, “a lot of people don’t want to do that,” he says. Dr. Centor notes that, for many patients, a primary care physician rather than a heart specialist may be managing their statins because, as a healthy adult, the patient doesn’t have a cardiologist.
  4. There is little evidence of mental decline while on statins. Some patients taking statins have reported fuzzy thinking. And Centor says that for many in their sixties who are asked to consider a statin, cognitive decline may be their biggest fear. While more research is being done, significant evidence linking statins to overall cognitive changes is lacking. “There are not controlled, double-blind studies that show cognitive effects,” says Thompson. “The danger of statins has been overreported and overhyped,” said Arthur Agatston, MD, cardiologist and medical director of Wellness and Prevention for Baptist Health South Florida in Miami, and clinical professor of medicine at Florida International University Herbert Wertheim College of Medicine, in a recent OpEd column.
  5. Statins can cause muscle weakness. Muscle weakness is perhaps the most common complaint of statin users, and a reason why some may opt not to take the medication. While you may not experience this effect, and most do not, it can be a reason patients opt to stop taking statins. If you experience muscle weakness or other side effects after taking a statin, be sure to bring it up with your doctor.
  6. Supplements don’t help. Because of the muscle weakness complaints, some studies have been done to find a way to alleviate that problem using supplements. Unfortunately, Thompson says, a study he conducted with colleagues on the dietary supplement known as coenzyme Q-10 had negative results. Taking coenzyme Q10 isn’t currently advised to prevent statin side effects, the Mayo Clinic notes.
  7. Statins generally don’t damage your liver or kidneys. Perhaps because cholesterol is produced in the liver, some patients express concern about their liver when starting a statin. However, liver problems are rare, according to the Mayo Clinic. Doctors may choose to monitor liver function in some patients, and although in rare cases they may need to stop, this typically isn’t an issue.
  8. Side effects go away when the drug is stopped. Healthy people may not want to take a drug without seeing a benefit, but even many who have cardiovascular disease opt not to take a statin. If you are concerned, some reassurance may come from the fact that side effects aren’t permanent and go away once the drug is stopped. “I’m amazed the number of people who could really benefit from statins but are afraid of them,” says Thompson. RELATED: Know the Cholesterol Level That’s Right for You — And Stick to It 
  9. The best way to use statins is still under debate. A long-term study conducted in Scotland showed that patients who took a statin were less likely to have a heart attack — even five years after they stopped taking the drug. People who had taken statins had fewer hospital admissions for stroke and heart failure as well. However, there is still a great deal of debate among physicians as to how widely to prescribe the drugs, especially when it means convincing healthy people to be on medication indefinitely.
  10. Statins do more than lower your cholesterol. While statins are known as cholesterol-lowering drugs, it appears they may have further benefits in preventing heart attacks, known as pleiotropic effects. Some of these include preventing plaques in the arteries from rupturing and causing a blockage of blood flow. This is one reason statins may be given even after a heart attack. “The fact that you’re on a statin predicts that you’re less likely to have another heart attack,” says Centor. “It’s not just lowering the cholesterol.” Learn more: Managing High Cholesterol