Something very similar happened to my father, so I looked into this at the time. There are some case reports associating PMR with statin use, but nothing conclusive. I do believe statins can make it more difficult to diagnose PMR because of the association with muscle pain.

It’s my personal opinion it’s so hard to get PMR diagnosed because it mainly strikes older people. Other than the lack of awareness with many providers, I feel they dismiss it as “normal aches and pains” and fatigue due to aging. And if you’re unfortunate enough to have a PCP who is either super busy or just dismissive, it takes a lot of wherewithal to advocate for yourself. But…that’s a whole other soapbox.

The thing is, there are many confounding factors because the very people most at risk of developing PMR are also very likely to be prescribed statins.

I did find this article that discusses statins prompting a different type of autoimmune muscle disease: https://www.hopkinsmedicine.org/news/media/releases/statin_use_linked_to_rare_autoimmune_muscle_disease_study_finds

What I found most interesting is they wrote about how it’s possible that a statin in a small number of people can prompt autoimmunity—so I figured, if this is possible for the disease referenced in this article, why couldn’t it be possible with PMR? No proof of course, but if viruses, psychological trauma, and other chronic stress are known to affect the immune system, I don’t see why a medication couldn’t do it. And as risky as high cholesterol is, the body also needs cholesterol; we can’t completely understand what’s happening with medications.

In the end, I’ll never know if statin use caused my dad’s PMR, but I believe it did. Until he started a statin, he took no other chronic medication and never had any significant health problems (though he certainly had risk factors for stroke and heart disease—we don’t deny that), and his PCP put him on the highest dose possible for statins even though he had good cholesterol.

For someone who had no prior health problems except mild back pain and a rotator cuff injury, he developed a severe case of PMR within less than a year of starting atorvastatin (Lipitor). It took over a month to get a diagnosis, mostly because his PCP was first clueless and then didn’t believe us when we brought up PMR. Eventually, he came around and prescribed prednisone with no other guidance so we had to find a rheumatologist ourselves.

He was never evaluated for GCA, and two weeks later he had a severe stroke. His condescending neurologist tried to jam statins down my dad’s throat (not literally) because it’s “standard of care.” We refused.

Is it connected? We’ll never know. Do I acknowledge that dangerously high cholesterol also must be treated? Yes.

But am I suspicious? Definitely. One year post stroke and my dad is still not taking a statin. We will exhaust every other possible option before going that route. Between the stroke, the PMR flares, the prednisone taper, we just don’t want to rock the boat too much.

And I find it really interesting that both his new neurologist (who has more of a whole health and integrative approach) and cardiologist were both aware of the “association” between arthralgias and statins—they brought it up before we did.

It is tough to weigh the pros/cons. It could also be the red yeast rice or statin can cause muscle pain that worsens the experience of PMR and vice versa. But you ask an important question.