Statins are among the most widely used medicines in the world. For decades, these drugs have helped millions of people lower their cholesterol levels and reduce their risk of heart attacks and strokes.
Doctors often prescribe statins to people with heart disease or those at high risk of developing it. Because heart disease remains one of the leading causes of death worldwide, statins have become a cornerstone of modern medicine.
Although statins are highly effective, they are not perfect. Many people who take these medications experience muscle-related side effects. Some develop muscle aches, soreness, weakness, or tiredness.
In rare cases, the muscle damage can become severe and even lead to kidney failure. These side effects can be worrying and sometimes cause patients to stop taking their medication, even though the drugs are protecting their hearts.
Now, researchers at the University of British Columbia and the University of Wisconsin-Madison believe they have discovered why these muscle problems occur. Their findings were published in the journal Nature Communications and could eventually lead to a new generation of statins that are less likely to cause muscle pain.
To make this discovery, the scientists used an advanced imaging technology called cryo-electron microscopy. This method allows researchers to create extremely detailed pictures of molecules and proteins inside cells.
By freezing biological materials at very low temperatures, scientists can examine structures almost down to the level of individual atoms. In recent years, this technology has transformed medical research because it lets researchers see exactly how drugs interact with the body.
The research team focused on a protein called RyR1, which is found in muscle cells. This protein plays an essential role in controlling muscle movement. Muscles need calcium to contract and relax properly, and RyR1 acts like a gate that releases calcium only when it is needed.
Normally, the protein opens briefly and then closes again, allowing muscles to function normally. However, the researchers discovered that statins can interfere with this process.
Lead author Dr. Steven Molinarolo explained that the researchers were able to observe exactly how statins attach to the RyR1 protein. They found that once the statins bind to the protein, they make it remain open longer than it should. This causes calcium to leak continuously from its storage areas inside muscle cells.
Too much calcium leaking into the cell can be harmful. Over time, the constant leak places stress on muscle cells and may damage them. This damage could explain why many people taking statins experience muscle pain, weakness, or fatigue.
The researchers closely examined one of the most commonly prescribed statins, atorvastatin. However, they believe that the same process probably occurs with many other statins as well.
One of the most surprising discoveries was how the statin molecules behaved inside the protein. The scientists found that three statin molecules gather in one area of the RyR1 protein. The first molecule attaches while the protein is closed and makes it more likely to open.
Then two more statin molecules fit into the same area, forcing the protein to open completely and stay open. This unusual chain of events appears to trigger the harmful calcium leak.
Senior researcher Dr. Filip Van Petegem said the findings provide scientists with a detailed map for designing improved statins. Researchers may now be able to develop drugs that keep their cholesterol-lowering benefits but avoid interacting with muscle proteins in this damaging way.
In other words, scientists hope to keep the part of the medicine that protects the heart while removing the part that causes muscle problems.
Although severe muscle damage affects only a small percentage of the more than 200 million people worldwide who take statins, mild muscle symptoms are much more common.
Even relatively minor symptoms can have important consequences because many patients stop taking their medicine when they feel muscle discomfort. This means they may lose the powerful protection that statins provide against heart attacks and strokes.
The researchers believe that safer statins could encourage more people to continue their treatment and enjoy better long-term health. Their work also highlights the growing importance of advanced imaging technologies such as cryo-electron microscopy.
By revealing the smallest details of how medicines work inside the body, these tools are helping scientists develop more effective and safer treatments.
Dr. Van Petegem said that statins have been one of the foundations of heart disease treatment for many years. The goal now is to make them even safer so that patients can continue benefiting from these life-saving drugs without worrying about muscle pain or weakness.
For millions of people around the world, this discovery may one day lead to cholesterol medicines that protect the heart while causing far fewer unwanted side effects.
If you care about muscle, please read studies about factors that can cause muscle weakness in older people, and scientists find a way to reverse high blood sugar and muscle loss.
For more health information, please see recent studies about an easy, cheap way to maintain muscles, and results showing these vegetables essential for your muscle strength.
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