From the Guidelines
Statins are not commonly associated with causing paresthesias, and there is limited evidence to suggest a direct link between statin use and paresthesias. The provided evidence does not specifically mention paresthesias as a common side effect of statins. According to the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol 1, the most common side effects of statins include muscle symptoms, liver enzyme elevation, and new-onset diabetes mellitus. Some studies suggest that statins may be associated with a rare risk of polyneuropathy, but this is not the same as paresthesias 1. The 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults also does not mention paresthesias as a common side effect of statins 1. Therefore, based on the available evidence, it is unlikely that statins are a common cause of paresthesias. If a patient experiences paresthesias while taking a statin, it is essential to consult with a healthcare provider to determine the cause and appropriate management. The healthcare provider may recommend evaluating the patient for other conditions that could be causing the paresthesias, such as vitamin deficiencies or other medications. In some cases, adjusting the statin dose or switching to a different statin may be necessary. However, it is crucial to prioritize the patient's cardiovascular health and not discontinue statin therapy without consulting a healthcare provider.
From the FDA Drug Label
Nervous System Disorders: dizziness, peripheral neuropathy. The FDA drug label mentions peripheral neuropathy as a nervous system disorder associated with atorvastatin calcium, which can be related to paresthesias. Paresthesias are a symptom of peripheral neuropathy. Therefore, statins, specifically atorvastatin, may cause paresthesias indirectly through peripheral neuropathy 2.
From the Research
Statins and Parasthesias
- Statins are known to have various side effects, including musculoskeletal symptoms and increased risk of diabetes, but the frequency of adverse effects is extremely low 3.
- Peripheral neuropathy is a potential side effect of statin use, with a study showing that 66% of patients taking atorvastatin or rosuvastatin for hypercholesterolemia developed polyneuropathy, compared to none in the control group 4.
- The study also found that the severity of polyneuropathy increased with the duration of treatment, and that early detection and changing hypercholesterolemia treatment may prevent permanent nerve damage 4.
- Another study discussed statin-associated muscle pain, but found that the evidence in support of muscle pain caused by statins is equivocal and not particularly strong, and that reported symptoms are difficult to quantify 5.
- A review of the safety of statins found that myalgia is the most common side effect of statin use, with documented rates from 1-10%, but that rhabdomyolysis is the most serious adverse effect, though it occurs quite rarely (less than 0.1%) 6.
- A meta-analysis of large-scale, randomised, double-blind trials of statin therapy found that statin therapy yielded a small, clinically insignificant increase in median creatine kinase values, and that most (>90%) of all reports of muscle symptoms by participants allocated statin therapy were not due to the statin 7.
Specific Findings on Parasthesias
- A study found that neuropathy was observed in a neurological examination performed within the first year in 50% of rosuvastatin users and 18% of those taking atorvastatin, with symptoms including tingling, numbness, pain, and tremor in the hands and feet, and unsteadiness during walking 4.
- The same study found that electrodiagnostic changes have been detected in motor and sensory nerves in nerve conduction studies of patients on long-term statin treatment, indicating an increased risk of peripheral neuropathy with long-term statin use (>1 year) 4.