How often do statins have side effects?

Q: My doctor has told me to start taking a statin — atorvastatin — but I’ve heard muscle pain and dementia are possible side effects. Do you know how risky it is? — Katylin F., Franklin, Tennessee

A: People’s reactions to medications are often complex and hard to unravel. Statins are a good example of that. Nationally, up to 50 percent of patients prescribed statins either take reduced doses or go off the meds completely because they feel they’re having a negative reaction to the drug. Complaints include muscle pain, headache, dizziness and nausea. That’s a shame, because statins are proven to reduce the risk of cardiovascular disease .

Now, a meta-study published in the European Heart Journal has figured out how many folks worldwide are really intolerant of statins: 9 percent. However, the international group of researchers who looked at 176 studies that included more than 4 million patients did find that some sub-groups of people have elevated risks for statin intolerance: They are people who are older, female, Black or Asian, obese, abuse alcohol or have diabetes, an under-active thyroid gland or chronic liver or kidney failure.

Certain medications, including drugs to control arrhythmia and calcium channel blockers, also up the risk of statin intolerance.

So talk with your doctor about your risk factors and ask what the lowest dose you can take might be.

Q: My dermatologist and primary care and diabetes doctors are all pushing me to use telehealth visits for routine check-ins and some check-ups. Do you think this is good medicine? — Steve R., Austin, Texas

A: Telemedicine has arrived. According to the Department of Health and Human Services, community health centers report a 6,000 percent increase in the number of virtual visits — up from 478,333 in 2019 to 28,550,608 in 2020. Now, the trick is for you to learn how to make these tele-visits work for you. HHS provides these guidelines:

■ Just like you get ready for an in-person visit, write down your questions.

■ Write out a list of your current medications (or gather the actual bottles).

■ If your doctor has requested information like your temperature, glucose levels, blood pressure or weight, have this information ready.

■ Take notes about what your doctor says during the e-visit or record the conversation on your computer or phone.

Email questions for Mehmet Oz and Mike Roizen to youdocsdaily@sharecare.com.