Statins and liver ALT

Posted by raylo32 @raylo32, Jan 5, 2025

I am one of the folks with very high CAC score and have been on statins for 5 or 6 years. The doc wanted my target LDL below 70 and the only way to get there was 40mg rosuvastatin along with Zetia, but then my liver ALT climbed up to 62. We adjusted the meds down to 20 mg rosuvastatin and liver ALT is back down to ~50, still slightly above normal. All other liver enzymes are normal. So, we are considering switching me to Repatha, depending on insurance coverage, but not sure my situation is qualifying.

My question is have any of you here had similar liver response to a statin? And is a stable ALT of ~60 really a problem or a no nevermind?

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caroline58 | @caroline58 | Nov 15, 2025

After a TIA 2.5 years ago I was given Atorvastatin, severe muscle pain at 40 mg, stopped completely for a month, then escalated to 20 mg which I had until October this year, got 3 times as high liver values which is not unusual according to the pharmaceutical company. The muscle pain was severe again, changed doctors. Now 5 mg Rosuvastatin for 8 weeks and then supplemented with Ezetimibe (blocks cholesterol absorption in the liver) 5 mg and feel good after 2 months. New liver test in December but expect higher liver values but are okay to a certain level. Im also a nurse and have fibromuscular dysplasia in the arteries of the brain and mildly in the carotid arteries.

caroline58 | @caroline58 | Nov 17, 2025

In reply to @unmanageable "I was given Artovastatin 10mag My arms hurt,my mouth was tingly,i would feel weak and shaky..." + (show)

@unmanageable
After 2 years of Atorvastatin, I have switched to a newer statin that is different from other statins, Rosuvastatin and Ezetimibe. For 2 months I had 5 mg Rosvastatin but my blood lipids increased so then I was given 10 mg Ezetimibe which blocks the absorption of cholesterol in the liver, had it for a month. Had Tia and have an artery disease that means I have to have low blood lipids.
No muscle pain or elevated liver values so far, had severe muscle pain with Atorvastatin.

jdebusk | @jdebusk | May 27 2:59pm

In reply to @tdm1 "I was on Rosuvastatin 5mg, they raised it to 10 mg, my ALT rose to 119,..." + (show)

@tdm1
I was started on Rosuvastatin 20 mg 2 months ago and recently started having abdominal pain. My labs came back with a sightly elevated AST, ALT, and creatinine. I have an appt. with my GI doc soon, but I wonder now if the elevated results and abd pain are due to the statin. Thoughts?

tdm1 | @tdm1 | May 27 3:40pm

In reply to @jdebusk "@tdm1 I was started on Rosuvastatin 20 mg 2 months ago and recently started having abdominal..." + (show)

Honestly I don't know, but in my case after the PA had me reduce back down
to 5mg it came down. I switch my primary doctor, after he did baseline
blood work and an Advanced Lipid Test, he took me off statins and started
me on Repatha. My Advanced Lipid Test came back high for Lpa and ApoB. Now
my bloodork is good less the Lpa, seeing this is hereditary, and as of this
moment there isn't a drug, exercise or diet that will reduce Lpa number. So
waiting on the FDA to approve medication that's in the pipeline. But
reducing all my other numbers has helped bring down my risk category. Hope
you get the answers your looking for.

gently | @gently | May 27 4:08pm

In reply to @jdebusk "@tdm1 I was started on Rosuvastatin 20 mg 2 months ago and recently started having abdominal..." + (show)

@jdebusk slightly higher AST and AST can be expected. You do need the consultation that you've wisely scheduled. Mild abdominal pain can be a common side effect. If the pain is upper right and sharp, you may have to abandon the rouvastatin. Stopping any statin can cause a rapid, unhealthful rebound of cholesterol levels, so you need guidance. I'd be trying to get a response by phone or a my chart portal depending on how soon is soon,

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