Heartburn and Statins – Do Statins Cause Acid Reflux?

There has been a lot of talk suggesting that statins (the popular class of cholesterol-lowering drugs) can be a cause of heartburn. It is listed on numerous websites as having the side effect of heartburn and this connection is also mentioned in several popular books on acid reflux. However, is there any evidence of this? Let’s find out!

Statins – What Are They?

The term statins simply refers to the class of medications that have become very popular around the world for their ability to reduce LDL cholesterol and inflammation in the body. The most popular statins include the brands Lipitor, Zycor, and Crestor (among others). Given the ubiquity of obesity, statins are among the most prescribed medications in the United States.

Statins and Heartburn – The Research

Despite the fact that statins are linked with heartburn anecdotally as well as listed on multiple third-party websites, the official NIH (National Institute of Health) page as well as the official site for Lipitor make no mention of acid reflux being a recognized side effect of statins. Now, this does not mean they aren’t recognized – it just is not documented.

I will say that of the listed side effects, other digestive issues such as upset stomach, constipation, or diarrhea are recognized as side effects of most statins (note that there are slight differences among each type of statin – but this is beyond the scope of this article). Additionally, unusual muscle function (cramping, involuntary contractions, fatigue) are also reported.

With that in mind, given that heartburn can be caused by irregular motility of the digestive tract, and that the usage of statins seems to cause irregular muscle activity, it would stand to reason that stains may indeed have acid reflux as a side effect.

Statins and Acid Reflux – What to Do

However, just because statins may have lead to heartburn does not mean that you should disregard your doctor’s advice if he (or she) prescribes them. Now, understand that I have very negative feelings about the chronic usage of prescription medication, but the facts are the facts: statins save lives.

Statins do not just make you more comfortable; there are dozens of very large studies which have reported that statins reduce not only cholesterol but also all-cause mortality (1, 2). There are many other studies that report the same thing: people who take statins just live longer.

The results surrounding statins are so good that some doctors have been even issuing them to those with low-risk for developing cardiac disease to help prevent cardiac disease from developing. It has become so wide spread that a recent Cochrane Review stated that while statins were beneficial, they did not recommend issuing them for low-risk patients (2).

The point is this – yes, statins may have side effects, but if you are a moderate or high-risk individual, they can save your life and help you live a lot longer. In regards to the development of acid reflux – you can talk to your doctor if you develop side effects, but personally I’d rather be alive with acid reflux than die prematurely without it. Interestingly though, a recent study reported that the use of statins was actually reported to reduce the risk of developing esophageal adenocarinoma (esophageal cancer) in those with Barrett’s Esophagus (a condition present in some with esophageal damage, particularly due to GERD) (3). Perhaps due to the anti-inflammatory properties of statins they can even reduce the damage done by acid reflux and be protective rather than destructive.

There are two important takeaways that you should get from this article. The first is that although statins may or may not cause heartburn, they do save lives and have been repeatedly shown to reduce all-cause mortality. The other thing to remember is that those who need cholesterol-lowering drugs and those who have acid reflux have a few common factors: obesity, smoking, and a poor diet.

Perhaps if you are on statin medications and are developing acid reflux, this may serve as a bit of a wake-up call. If you need to lose weight, quit smoking, or start following a smart acid reflux diet, those are things should be at the top of your priority list so that you can live a healthier and more satisfying life.

As always, everyone responds to medication differently. The decision to start or stop a medication should always be done under a doctor’s supervision. Statins do have some dangerous side effects, particularly related to liver and kidney dysfunction. Talk to your doctor about your medication if you have any concerns or side effects.

References

1. Baigent C., et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010 Nov 13;376(9753):1670-81.

2. Taylor F., et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD004816.

3. Nguyen DM, Richardson P, El-Serag HB. Medications (NSAIDs, statins, proton pump inhibitors) and the risk of esophageal adenocarcinoma in patients with Barrett’s esophagus. Gastroenterology. 2010 Jun;138(7):2260-6.