statins and brain fog
September 4, 2020 12:14 PM   Subscribe

Have you experienced brain fog while taking statins?

It seems that there is anecdotal evidence that people on statins may experience brain fog, but there is also science showing no relation between statins and memory loss or cognitive function. My mom has problems with brain fog and is taking a statin for cholesterol (which is working, along with diet, and her cholesterol is at a safe level now). Her doctor is quite clear that there is no connection between the brain fog and the statin. I don't doubt the doctor or the science, but it is sooo tempting to think that a simple change in medication could clear up this issue. We are tempted to push him to reduce the dose, just so we could see if it makes a difference, but we know he will not agree to this. The brain fog is pretty annoying for her, but not dangerously debilitating. Not sure how hard to push. I am curious to know if anyone has direct experience with statins and brain fog... did you stop taking the drug and did the brain fog go away?
posted by aunt_winnifred to Health & Fitness (9 answers total) 3 users marked this as a favorite
Has she decreased her consumption of red meat as a part of this change in her diet? I had brain fog/memory loss when first diagnosed with anemia (my ferritin levels were in the very low single digits) and once I got those increased even a little bit it cleared up. I'm wondering if her diet change might be the cause rather than the statin (assuming that this brain fog occurred when she started taking the statin).
posted by jabes at 12:22 PM on September 4, 2020

Yes 100% causal link for me. I took in statins in my 30s, as well for my mother (60s).
posted by gryphonlover at 12:37 PM on September 4, 2020 [1 favorite]

I'm reading Invisible Women: Exposing Data Bias in a World Designed for Men right now and not more than an hour ago finished the chapter on drug research, where statins were specifically mentioned as having exceedingly poor clinical data for their side effects on women.

So, you know, probably. It's probably related but how could we ever know. The doctor sounds like a great guy, so certain, how nice for him.

I would push.
posted by phunniemee at 12:54 PM on September 4, 2020 [4 favorites]

If you search for "statin antidepressant", statins do share a certain amount of similar mental effects as antidepressants -- I, for one, had a very significant reduction in anxiety when I went on statins.

So -- amateur anecdotal thoughts here, IANAD, but given that statins can have affects on humans in the same area as other drugs which can cause brain fog, it would seem to indicate that you may be correct.
posted by AzraelBrown at 2:16 PM on September 4, 2020 [1 favorite]

I'm a 50-year-old woman, and I take rosuvastatin 20 mg/day and I have not experienced brain fog on it, FWIW.
posted by pH Indicating Socks at 7:32 PM on September 4, 2020 [1 favorite]

Please get a second opinion. So much depends on your mom's individual biology, and her age. Selections from the link in your question, about an Australian observational study published in 2019, Effects of Statins on Memory, Cognition, and Brain Volume in the Elderly:

- This study tested the memory and overall cognitive function of 1,037 people aged 70 to 90 at several points over a 6-year period.

- Of the people in the study, 395 had never used statins and 642 had used statins, for an average of 9 years before the start of the study. 99 people started taking statins during the study.

- There are a few limitations with the study. Complete data was only available for 55% of the people who started the study, and those who dropped out were older and had lower cognitive scores. The type of study also means we are limited in how we can interpret the results.

From a large observational study published this past April, The Cognitive Effects of Statins are Modified by Age:

To reveal new insights into statin cognitive effects, we performed an observational study on a population-based sample of 245,731 control and 55,114 statin-taking individuals from the UK Biobank. Cognitive performance in terms of reaction time, working memory and fluid intelligence was analysed at baseline and two follow-ups (within 5-10 years). Subjects were classified depending on age (up to 65 and over 65 years) and treatment duration (1-4 years, 5-10 years and over 10 years). Data were adjusted for health- and cognition-related covariates. Subjects generally improved in test performance with repeated assessment and middle-aged persons performed better than older persons. The effect of statin use differed considerably between the two age groups, with a beneficial effect on reaction time in older persons and fluid intelligence in both age groups, and a negative effect on working memory in younger subjects.

Our analysis suggests a modulatory impact of age on the cognitive side effects of statins, revealing a possible reason for profoundly inconsistent findings on statin-related cognitive effects in the literature. The study highlights the importance of characterising modifiers of statin effects to improve knowledge and shape guidelines for clinicians when prescribing statins and evaluating their side effects in patients.
posted by Iris Gambol at 9:11 PM on September 4, 2020 [3 favorites]

Crud, closing out tabs, and there's this other 2020 study which doesn't have as many details available, but may be of interest if your mom carries the APOE4 allele: Effects of LDL Cholesterol and Statin Use on Verbal Learning and Memory in Older Adults at Genetic Risk for Alzheimer's Disease:

The apolipoprotein epsilon 4 (APOE4) allele is a well-established genetic risk factor for Alzheimer's disease (AD). However, there are mixed findings as to how the APOE4 allele modifies the effects of both higher low-density lipoprotein cholesterol (LDL) and statin use on cognitive functioning.[...] This study sought to examine the effects of LDL levels and statin use on verbal learning and memory, as modified by the presence of the APOE4 allele, in a sample of cognitively unimpaired, older adults at risk for AD. [...] Conclusion: LDL and statin use may have differential effects on verbal learning and/or memory depending on genetic risk for AD. Women appear to be particularly vulnerable to statin use depending on their APOE4 status.
posted by Iris Gambol at 9:28 PM on September 4, 2020 [1 favorite]

Sounds like your mom needs a new doctor, if at all possible.
posted by k8lin at 3:12 AM on September 5, 2020 [1 favorite]

It can happen. However, it is also probably reversible if it is truly drug-related. She could use Pravastatin, which penetrates the blood brain barrier less than other statins, but offers less LDL-C reduction than others. Alternatives are bempedoic acid and injectable PCSK9 inhibitors (though they are extremely expensive). Over 80% of the benefit of statins accrue at the lowest dose.
posted by metasunday at 6:37 AM on September 6, 2020 [1 favorite]

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