Creatine Supplementation Prevents Statin-Induced Muscle Toxicity
Authors: David A. Shewmon, John M. Craig
Journal: Annals of Internal Medicine (2010)

Letters16 November 2010Creatine Supplementation Prevents Statin-Induced Muscle ToxicityDavid A. Shewmon, MD and John M. Craig, BADavid A. Shewmon, MDFrom Cleveland Clinic Foundation, Wooster, OH 44691; and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205. and John M. Craig, BAFrom Cleveland Clinic Foundation, Wooster, OH 44691; and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-10-201011160-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Muscle toxicity is the most important adverse effect of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). The incidence of statin-induced myopathy is debated, depending in part on whether the milder and more common symptoms of muscle ache, weakness, and cramping are part of a continuum that also includes rhabdomyolysis, renal failure, and death. Although creatine kinase (CK) elevation is a marker of injury often used clinically to follow the severity of statin-induced myopathy, it has limited usefulness for defining statin-induced myopathy. For example, muscle-toxicity symptoms and biopsy evidence of mitochondrial dysfunction without CK elevation have been documented during statin therapy ...References1. Phillips PS, Haas RH, Bannykh S, Hathaway S, Gray NL, Kimura BJ, et al; Scripps Mercy Clinical Research Center. Statin-associated myopathy with normal creatine kinase levels. Ann Intern Med. 2002;137:581-5. [PMID: 12353945] LinkGoogle Scholar2. Askari A, Vignos PJ, Moskowitz RW. Steroid myopathy in connective tissue disease. Am J Med. 1976;61:485-92. [PMID: 973643] CrossrefMedlineGoogle Scholar3. Meyer RA. A linear model of muscle respiration explains monoexponential phosphocreatine changes. Am J Physiol. 1988;254:C548-53. [PMID: 3354652] CrossrefMedlineGoogle Scholar4. De Pinieux G, Chariot P, Ammi-Saïd M, Louarn F, Lejonc JL, Astier A, et al. Lipid-lowering drugs and mitochondrial function: effects of HMG-CoA reductase inhibitors on serum ubiquinone and blood lactate/pyruvate ratio. Br J Clin Pharmacol. 1996;42:333-7. [PMID: 8877024] CrossrefMedlineGoogle Scholar5. Tran TT, Dai W, Sarkar HK. Cyclosporin A inhibits creatine uptake by altering surface expression of the creatine transporter. J Biol Chem. 2000;275:35708-14. [PMID: 10964923] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Cleveland Clinic Foundation, Wooster, OH 44691; and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoStatin-Associated Myopathy with Normal Creatine Kinase Levels Paul S. Phillips , Richard H. Haas , Sergei Bannykh , Stephanie Hathaway , Nancy L. Gray , Bruce J. Kimura , Georgirene D. Vladutiu , John D.F. England , and Metrics Cited byCreatine, guanidinoacetate and homoarginine in statin-induced myopathyPresence of guanidinoacetate may compensate creatine absence and account for less statin-induced muscle damage in GAMT-deficient compared to AGAT-deficient miceMuscle phenotype of AGAT- and GAMT-deficient mice after simvastatin exposureBeyond sports: Efficacy and safety of creatine supplementation in pathological or paraphysiological conditions of brain and muscleCreatine as a Candidate to Prevent Statin MyopathyCreatine supplementation does not alter the creatine kinase response to eccentric exercise in healthy adults on atorvastatinStatin-induced myopathy prevented by creatine administrationS.A.M. and Breast Cancer—Focus on Statins, Red Yeast Rice, Sterols, and Other Integrative Cholesterol Medicines: The Real "Natural" OptionsThe Effects of Statin Medications on Aerobic Exercise Capacity and Training AdaptationsDoes Reduced Creatine Synthesis Protect against Statin Myopathy? 16 November 2010Volume 153, Issue 10Page: 690-692KeywordsCreatineCreatine kinaseMusclesMyalgiaPainRespirationStatinsToxicityVisual analog scaleVital signs ePublished: 16 November 2010 Issue Published: 16 November 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...