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Statin Interactions With Supplements -- close-up of statin medication box and tablets

Answer:

Atorvastatin (Lipitor), rosuvastatin (Crestor), and other cholesterol-lowering statin drugs can be affected by taking supplements and can affect your ability to absorb certain vitamins and minerals. Certain herbal supplements, such as St. John's wort, may decrease blood levels of some statin drugs, and when taken with atorvastatin, may actually result in increased cholesterol levels. Certain forms of magnesium may also decrease blood levels of statin drugs -- particularly Crestor. Red yeast rice, which contains a naturally occurring statin, should not be combined with prescription statin drugs without medical supervision.

Berberine should be avoided or used with caution when taking certain statin drugs, such as atorvastatin (Lipitor), lovastatin (Mevacor) and rosuvastatin (Crestor).

While high doses of niacin may help to lower cholesterol, studies show that if you already take a statin drug, adding high-dose niacin does not appear to provide additional benefit and may carry serious risks. Nevertheless, some physicians believe taking niacin in addition to statin medication may be helpful for certain people; however do not try this combination without consulting your physician.

Some fruit juices can also be a problem, particularly grapefruit juice, which impairs the body's normal breakdown of certain statins, allowing them to build up to potentially excessive levels in the blood. Since the effects of grapefruit juice may last as long as 3 days, it should be avoided if you are taking atorvastatin (Lipitor), lovastatin (Mevacor, Altoprev) or simvastatin (Zocor). However, some other statins do not seem to be affected by grapefruit juice, including pravastatin (Pravachol), fluvastatin (Lescol) and rosuvastatin (Crestor). 

Soy isoflavones were found to reduce the bioavailability of simvastatin by an average of 48% in people carrying a common form of the SLCO1B1 521 gene. (Note: Another form of this gene is known to increase the activity of simvastatin as well as atorvastatin).

Although green tea can help lower cholesterol, it can also decrease absorption of some, but not all, statin drugs. To play it safe, it may be best to take statins at least a couple of hours before consuming a green tea supplement or beverage.

In general, CoQ10 supplementation does not appear to reduce statin-related muscle pain, although there is evidence it may help people considered statin-intolerant due to muscle-related side effects when combined with a reduction in statin dose.

Vitamin D supplementation does not seem to reduce the risk of statin-related muscle pain, but there is preliminary evidence that it may reduce the intensity of such pain in people with low vitamin D blood levels.

Fish oil may also offer benefits to certain people on statin drugs.

For more details about these interactions, use the links above, which take you to articles on ConsumerLab with extensive information about each supplement.

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