What Is the Best Alternative to Statins?

Statins are a group of medications that lower a specific type of cholesterol level in your blood. The best alternatives to statins are PCSK9 inhibitors, fibric acid derivatives or fibrates, bile acid sequestrants, selective absorption inhibitors, nicotinic acid or niacin, and omega-3 fatty acids and fatty-acid esters.

Statins are a group of medications that lower a specific type of cholesterol level in your blood. You will be prescribed statins if your arteries are narrowed or you have cardiovascular disease. While these medications are highly effective in lowering your cholesterol, they often come with serious side effects that may lead you to look for alternatives. 

Often, people are resistant to taking statins because of their intense side effects and the fact that you will have to take them for the rest of your life. A more rare subset of the population—around 4% of all people—may also look to alternatives because statins simply do not work on them.

The side effects of statins include:

• Muscle pain and damage
• Liver damage
• Increased blood sugar
• Type 2 diabetes
• Memory loss
• Confusion
• Constipation
• Headaches
• Colds
• Sore muscles

However, not everyone who takes statins will experience these side effects. Some of the risk factors for side effects of statins could be:

• Taking many cholesterol medications
• Being a woman
• Having a more petite body
• Being at an advanced age
• Experiencing kidney or liver disease
• Heavily consuming alcohol
• Having neuromuscular disorders

Additionally, the following drugs may also interact poorly with statins:

• Amiodarone. This is a medication that helps to regulate your heartbeat.
• Gemfibrozil. Often, your doctor will prescribe you this medication for high cholesterol in combination with statins.
• Saquinavir and ritonavir. Both of these medications are used in the treatment of HIV.
• Antibiotics or antifungal medications. Medications such as clarithromycin or itraconazole can often interact poorly with statins.
• Immunosuppressants. Cyclosporine and other similar medications can also interact poorly with statins.

You should determine the best medication alternative for you, depending on your unique health situation and lifestyle. No one medication is the best. Some of the alternative medications to statins are:

• PCSK9 inhibitors. Usually, these medications are used in combination with statins to treat high cholesterol, but they can also be taken independently. They work by attaching to liver proteins. Side effects of these medications are back pain, muscle pain, and cold symptoms. These are typically given through injection and can be pretty expensive.
• Fibric acid derivatives or fibrates. These drugs focus on reducing your blood fat levels. They lessen the wrong type of cholesterol and increase the good type of it. They are not recommended, though, for people with pre-existing conditions in their kidneys or liver. Side effects of these medications can be constipation, weight loss, bloating, vomiting, stomachaches, headaches, backaches, or muscle pain.
• Bile acid sequestrants. Bile is a green fluid made of cholesterol that helps your liver digest food. Sequestrant drugs work inside of your intestine and attach themselves to your bile. Having these drugs bound to your bile decreases your body's levels of cholesterol. Side effects of these medications could be sore throats, disruption to your digestion, weight loss, bloating, nausea, vomiting, or stomach pain.
• Selective absorption inhibitors. Often combined with statins, these drugs help your body to stop absorbing cholesterol.
• Nicotinic acid or niacin. This is a B-complex vitamin. You can often get these over the counter, but some types are only available with a prescription. Niacin decreases the amount of bad cholesterol in your body. You should not take it if you have underlying conditions in your liver, though. You can experience skin issues, headaches, stomach issues, increased blood sugars, and coughing while taking these medications.
• Omega-3 fatty acids and fatty-acid esters. These medicines contain oils called fish oils. You can find many of them as over-the-counter options; however, they are not appropriate to take if you are allergic to fish or shellfish. Possible side effects of omega-3 fatty acids include belching, skin issues, gas, and increased bleeding.

The goal of taking statins is to lower your cholesterol. There are many ways to try and lower your cholesterol naturally. However, while many of these have no adverse side effects, their exact impact on cholesterol is still uncertain. These nutritional remedies could be:

• Red yeast rice
• Omega-3 fatty acids
• Spirulina
• Soy proteins
• Green tea
• Lupin
• Garlic
• Bergamot
• Berberine

Typically, using natural remedies is recommended in combination with statins for higher-risk patients, as they are not well understood, and their power to lower cholesterol is not known.