PMR & Statins
Recently, I’ve been trying to research out the possible connection of PMR and the use of statin drugs. Does anyone have any information they would like to share regarding this subject matter. Apparently there is now some concern that statins “might” cause PMR however, it is hard to sort out what is PMR pain and what is the muscular weakness/pain caused by the statins. I have been on statins, most recently Crestor, for a total of 20 years. I decided to take a statin “vacation”10 days ago. I recently had my cholesterol checked…. my results were all within range.
In November 2023 I was diagnosed with giant cell arteritis (GCA) & polymyalgia. I am told that both of these often go hand-in-hand. I was put on 60 mg of prednisone to control the inflammation in my head. (42 days of headaches). Once the GCA was under control and polymyalgia pain was diminished. I was able to start a prednisone taper per my rheumatologist. April of 2024 I was down to 3 mg. The month of May I dropped down to 2 mg when I hit the wall and the polymyalgia returned. In June. I upped my prednisone to 3 mg. With “minimal” pain relief. I have experienced many side effects while on the prednisone. Currently I have taken myself off of the statins and the prednisone to see if I can manage my pain. I have also been following an anti-inflammatory diet for several months and I am now trying to add in some physical therapy exercises geared to help with PMR. I have been off prednisone for almost a week and I do not see that much of a difference in the pain level from 3 mg to zero. We shall see what happens.
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I had a statin reaction 20 yrs ago. I have Familial Hypercholesterolemia. But I discontinued and was just living with high numbers(250). The weakness in the muscles of legs is very similar. I could see where it would be possible to link the two. Since no one has found the link for what causes PMR, it does seem many things can trigger our already sensitive immune systems. I developed what they initially diagnosed as Crohn's disease. After discontinuing the liptor and it all disappeared they changed it to statin allergy. I cant take any medication with a statin. Although it left me with a little IBS, I would say great your off the prednisone if you can manage the pain. Painkillers may help. But you need to be very careful just stopping prednisone. It can have serious other concerns. Your body requires cortisol and after two weeks of prednisone your pituitary shuts down. I would read up on adrenal insufficiency, The AI can also restart your PMR.
There are some case reports and reviews associating statins with PMR and other autoimmune diseases if you search the two terms together online. I tried to find an article I referenced before as an example, but couldn’t find it.
We believe my dad got statin-induced PMR because of the sequence and timing of the events, but there’s no way to prove this. He was on a statin for a much shorter time.
The trouble is the population that experiences PMR is age 50 and older, and that’s the same population that has a higher likelihood of taking statins. And as you said, what makes it difficult to diagnose is the known muscle pain/myalgia side effect. My dad’s PMR was blamed on that, but it didn’t get better and only got worse when he stopped the statins.
It’s sort of like how others have shared they believe a vaccine triggered PMR. It’s not impossible, but if one is older and already has a risk of developing PMR, it’s hard to say if it was for example, the shingles vaccine that caused it. The same group that gets PMR is far more likely to get a shingles vaccine, so it’s not a surprise than many people with PMR also had a shingles vaccine.
I’m not trying to minimize what you’re saying. I’m agreeing it’s really hard to figure out. In my family’s case, we do believe it was the statins.
You possibly need to consider that your high dosage of steroids did have a side effect of depressing your adrenal grands long term. This can cause systemic pain when titrating down off the prednisone that could be confused with PMR pain. Waking up your adrenal glands is a major portion of the steroid triturating process. If they do not wake properly you could have what is known as adrenal insufficiency. This can be identified/eliminated via blood tests. This test must be drawn at the proper time of day, it is a sensitive test, but properly done it will reveal if there is an adrenal problem. Talk with your PCP or Endochronogist about eliminating this as a contributing cause for the steroid titrating pain.
Here is a short Mayo Clinic article on Adrenal Insufficiency https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-adrenal-insufficiency/
Thank you so very much for bringing this to my attention. I’m going to keep a close watch on this possibility of adrenal insufficiency. I have a rheumatologist, as well as an endocrinologist that I can consult with.