By Gabe Mirkin, M.D.
Statins can cause muscle pain that leads many people to stop exercising. They also raise blood sugar levels and increase diabetes risk. If this is a problem for you, check with your doctor. Sometimes you are better off stopping the statins and continuing your exercise program.
Beta blockers for high blood pressure and irregular heartbeats can slow your heart rate so much that you will tire much earlier when you exercise. They can also raise blood sugar levels. Serious cyclists who take beta blockers should ask their doctors if they can switch to other drugs that will not slow their heart so much.
ACE inhibitors lower high blood pressure by interfering with the production of a protein that causes muscles around arteries to constrict. If you get into an accident and lose a lot of blood, the muscles around blood vessels may not be able to constrict, so your blood pressure can drop too low and send you into shock. ACE inhibitors also increase risk for dizziness during and after exercising.
Diuretics make you urinate more, lower blood volume, can make you tire earlier during exercise and increase risk for heat stroke.
Medications to lower blood sugar can sometimes cause blood sugar levels to drop too low. Since more than 98 percent of the energy for your brain comes from circulating blood sugar, low blood sugar can make you dizzy and cause you to pass out. Diabetics should always carry a sugar source with them when they ride.
Aspirin and other anti-clotting medicines can be dangerous if you crash. If you hit your head, you can bleed into your brain and die.
My Recommendations
If you ride regularly and take any of these medications, I recommend that you let your companions know about any issues you may have. Do not ride alone if you take drugs that increase risk for bleeding or shock in the event of an accident. Medic-alert identification can help in emergencies. By all means, keep on exercising! Your body will thank you. Some people are able to get off their medications after they make major lifestyle changes.
Gabe Mirkin, M.D., is a sports medicine doctor and fitness guru. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin has run more than 40 marathons and is now a serious tandem bike rider with his wife, Diana. His website is http://drmirkin.com/. Click to read Gabe’s full bio.
Nice overview. Expanding on your comments-
1-All should ask their doctor for the names and possible side-effects of EVERY drug they are taking. I am amazed at the number of local riders who have no idea what the meds they take actually do to their bodies 🙁
2- ARB’s, angiotensin II receptor blocking drugs, deserve mention as having exercise-related effects similar to the ACE inhibitors. Both can make folks more sensitive to dehydration with exercise.
3- The risks of all anti-clotting drugs are not the same. For example, full-dose warfarin (Coumadin) poses a MUCH greater bleeding risk after injury than low-dose (baby) aspirin.
4- Low blood sugar (hypoglycemia) symptoms can also affect non-diabetic folks, especially on long rides. I am not diabetic but always carry an energy gel on my bike.
5- Do NOT stop taking prescribed medications without discussing with your doctor. The internet is NOT a substitute for proper individualized medication advice.
I’ve had a two year running battle with statins. I’m a 69-year old male, normal blood pressure and not diabetic, but couldn’t keep my cholesterol levels down despite a reasonably healthy diet. Started on a statin and after a couple of weeks my legs continually felt fatigued. I had no stamina on rides and didn’t improve with training even with assistance of a coach. Also recovery after a hard effort took at least a week rather than one to two days that I was accustomed to. With doctor’s approval, I went off the statin to train for a week long event and after about a month I started to notice a difference. I was able to train for and ride my week long, nearly 500 mile event without any trouble at all. A few months later, checked cholesterol again and level was high (around 250). Tried a different statin. Same story. I went off that statin and redoubled my efforts on diet and tried over-the-counter cholesterol-lowering medications (cholestoff and berberine). This got my cholesterol level down to 205, but doctor felt this was still too high given other factors. I started another low-dose statin plus low-dose ezetimibe. Numbers for cholesterol and all the other “lipid-related” things that doctor looks at are now “fantastic” (doctors words). I haven’t noticed the muscle fatigue and other issues that I couldn’t tolerate with other statins, so I think I’m good. Doctor said that issues like mine with statins are not uncommon, but he has found with various types of adjustments about 95% of patients find a regimen that will work for them.
Thank you for sharing. I, too, began using a statin and had the dead/painful leg issues and some others. Would you kindly share your current statin medication so I may explore this with my cardiologist? Thank you.
I am taking ezetimibe (10 mg) and rosuvastatin (5 mg).
Thank you for sharing. I, too, began using a statin and had the dead/painful leg issues and some others. Would you kindly share your current statin medication so I may explore this with my cardiologist? Thank you.
I apologize for the double request. The email address I used to add the reply is incorrect so I had to direct it to the proper one.
Check out the book “The Great Cholesterol Myth” by Jonny Bowden and Stephan Sinatra. I’m 70 and have had total cholesterol in the mid 230 range for years. A few years ago my PCP convinced me to try a statin. I spent 1 1/2 years with a lot of pain in my legs, feet, and ankles. It got so bad that I could hardly stand up and walk in the morning. My legs always felt dead when I rode and took a long time to recover. I read this book and stopped taking the statin. It took about a month for the pain in my legs to go away and 3 months for the pain in my feet and ankles to leave. When I told my PCP and explained my reasons for stopping his reply was “HMMM, makes sense.” Early this year I underwent a heart cath. (That’s a long story and I don’t recommend it) The cardiologist told me afterward that “everything looks clean and healthy, keep doing what you’re doing. I see no reason for you to be on a statin.” That was the best thing that came out of the ordeal. Sometimes you need to do your own research and do what is best for yourself.
All the best to you.