Could statins be the reason I’m now too stiff to run?

QI was a long-distance runner until about two years ago, when suddenly my leg muscles tightened so much I could hardly walk. Vascular disease was ruled out and tests on my lumbar area, heart and lungs found nothing, although I was recently diagnosed with mild asthma. Could my daily statin, which I have been taking for a decade, cause my muscle problems? My GP says there is no alternative treatment.

AMuscle pain, caused by inflammation, is known to be a side-effect of statins, though it is actually quite rare. So it is possible that your statins are to blame.

A test for the blood level of the chemical creatine kinase can be helpful, as this is often raised in statin-induced muscle pain.

However, even if this level is normal, the best way to find out if your statins are to blame is to stop them for a short time.

Statins work by reducing the level of harmful cholesterol and are used to help prevent heart disease.

However, unlike other treatments, such as those for high blood pressure or heart failure, it is usually safe to stop them for a brief time – though you should tell your GP beforehand.

Muscle pain caused by statins usually goes away within a week or two of stopping them. If this happens, then you’ll know the cause.

If the drug is to blame, it can be worth trying a different statin.

You haven’t said which you are on, but the most common are atorvastatin and simvastatin.

If you are on one of these then it may be helpful, muscle-wise, to switch to the more powerful rosuvastatin. This can lower cholesterol levels when given in very low doses which are not enough to cause muscle inflammation.

The only alternative medication available for lowering cholesterol is ezetimibe, but this is not as effective as statins.

High cholesterol is one of many risk factors for heart disease. If you do not have any of the others (such as diabetes, high blood pressure and obesity) and eat a healthy diet then it could be argued that staying fit and active is just as important, heart wise, as a lower cholesterol level.

In other words, being able to go for a jog without pain is better for your heart than taking a statin.

Q

I have always been very fair skinned and have lots of moles and freckles, but I found a new dark mark on my leg about a month ago. I thought it was a scab at first but it

hasn’t fallen off and looks a bit pink now. I had my moles checked in the summer – do I need to go back with this new one?

AAny new mole that appears and persists for more than a few weeks and changes colour (and well done for checking) should be looked at by your GP. Other things to watch out for are a mole with uneven borders, or that is bleeding, or starts itching.

Having fair skin and lots of freckles means you have the type of skin that makes you more at risk of a melanoma, so even though you sensibly had your skin checked last summer, you should contact your GP once again.

Hopefully your new mole will be nothing to worry about, but just because you had no suspicious moles nine months ago doesn’t mean that your skin is in the clear now.

Q

In January 2018 (long before the Covid-19 pandemic) I had a bad strain of flu, after which I lost my sense of taste and smell. I saw my GP and was referred to a consultant at our local hospital for various tests and scans, including an MRI. Nothing was diagnosed and the doctors concluded that my sense of taste and smell would never return. I can no longer enjoy meals. Is there no cure? Am I to resign myself to no longer enjoying normal pleasures of life, or has someone found a remedy, however partial?

AThough we have come to link loss of taste and smell with Covid-19, any infection that causes inflammation of the lining of the nose, such as a bad cold or flu, can lead to a loss of the sense of smell, which in turn can affect taste.

It is not known why some people lose these senses with an infection while others don’t, and also why some recover much more quickly than others. It is presumably due to the amount of damage to the cells that sense smell.

If loss of smell persists then investigations need to be done, but your examinations have apparently ruled out another underlying cause, such as nasal polyps or a problem in the brain.

Some medications can affect smell, such as beta blockers and ACE inhibitors, which are used for high blood pressure and heart conditions, along with dental problems, so check if these apply to you.

As you know, losing your sense of taste and smell can profoundly affect your quality of life, but in most people the nerve cells in the nose do slowly recover, so hopefully you will regain the senses a little.

In the meantime, specialist smell training may help you, which aims to stimulate the nerves that are still remaining.

This involves smelling four different scents for 20 seconds, twice a day for at least three months.

Essential oils can be used for this, such as lemon, eucalyptus, and oregano. After that, try the training with four new, different oils and repeat the process.

If you get any hints of smell, it will probably just be a matter of time until it returns further, but you will have to be patient.

If you have a health question for Dr Leonard, email her in confidence at yourhealth@express.co.uk. Dr Leonard regrets she cannot enter into personal correspondence or reply to everyone.