I've heard that taking statin drugs to lower cholesterol can cause memory loss? Is there any truth to this?

I've read anecdotal reports associating statins with memory loss, and I'm aware of an ongoing study at the University of California, San Diego (UCSD), that is investigating the effects of these drugs on thinking, mood, behavior, and quality of life. The same researchers have also been collecting reports about other side effects that patients attribute to statins, including peripheral neuropathy (tingling and numbness or burning pain), headaches, joint pains, and abdominal pain, problems with sleep and with sexual function, fatigue, dizziness, a sense of detachment, swelling, shortness of breath, changes in vision, temperature regulation, blood sugar, blood pressure, weight, as well as hunger, breast enlargement, dry skin, rashes, nausea, upset stomach, bleeding, and ringing in ears or other noises. Based on some 5,000 reports accumulated by early 2008, memory problems were the second most common side effect reported. (Muscle aches were first.) Memory returned to normal when affected patients discontinued the statins.

Statins are known to cause muscle aches and liver dysfunction; warnings of both possibilities are prominent in the printed instructions patients get when they pick up their prescriptions. So far, no causal link between the drugs and memory loss has been demonstrated. Worldwide, some 25 million people take these cholesterol-lowering agents. With that denominator, even a few thousand reports of memory loss represent only a tiny fraction of patients.

How statins might affect memory isn't known. But since there's lots of cholesterol in the brain, lowering levels throughout the body could impact brain function.

In general, I wouldn't worry about the effect of statins on memory. But if you're taking the drug and find that you're becoming forgetful, tell your doctor. Lowering your dose may help. Or your physician might suggest going off the drug for a few weeks to see if your memory improves. If it does, you should discuss with your physician other approaches to cholesterol control.

Remember, it is possible to lower cholesterol without medication: get at least 30 minutes a day of aerobic exercise and reduce the amount of saturated fat and trans-fats in your diet. Other beneficial measures include drinking green tea, eating one clove of garlic per day (diced or crushed in food), and consuming more soluble fiber (such as oat bran), foods rich in omega-3 fatty acids (good sources include salmon, sardines and walnuts) and plenty of leafy greens and fresh fruits.

If lifestyle changes don't help, you could try red rice yeast (Monascus purpureus), a source of naturally occurring statins, before resorting to pharmaceutical versions. Because it delivers a mix of those compounds rather than a single molecule, red rice yeast is less likely to cause side effects.

Andrew Weil, M.D.

我已听说服用司他汀药物降低胆固醇会引起记忆力丧失。这是否具有真实性呢？

我已读过司他汀与记忆力丧失相关的轶事，而且我知道在美国加州大学圣地亚哥分校（加州大学圣地亚哥分校）的一项持续的研究，换句话说就是调查这些药物对思想，情绪，行为，和基本的生活条件的影响。同时，研究人员们还一直在收集关于其他副作用的报告，患者把这些副作用都归因于司他汀，包括周围神经病变（刺痛和麻木或灼痛），头痛，关节痛，腹痛，睡眠和性功能问题，疲劳，晕眩，意识涣散，肿胀，呼吸短促，在视野，体温调节，血糖，血压，体重方面的变化无常，以及饥饿，乳腺癌的扩大，皮肤干燥，皮疹，恶心，肚子痛，大量出血，和耳鸣或其他的噪音。据2008年年初所收集的大约5000份报告显示，记忆力问题是所报导的第二个最常见的副作用。 （肌肉疼痛位居第一。 ）当受影响的患者停止了服用司他汀，记忆体恢复正常。

众所周知，司他汀会造成肌肉疼痛和肝功能异常;当患者拿到自己的药方时，在印刷的用法说明书上这两种可能性的警告显而易见。到目前为止，这些药物和记忆力丧失之间没有因果关系得已证明。世界各地大约2500万人服用了胆固醇降低作用剂。相对于那分母而言，即使几千份有关记忆力丧失的报道也仅代表了一极小部分的患者。

司他汀如何可能影响记忆就不为人知。但是由于有大量的胆固醇在大脑中，降低整个身体的胆固醇量是可能影响脑功能的。

总的来说，我不会担心司他汀对记忆力的影响。但如果您正在服药，并发现您正变得健忘的话，请告诉您的医生。降低您的剂量可能有益。或者您的医生可能建议停用药物几个星期，看看您的记忆力是否有所改善。若确实如此，您应该与您的医生讨论其他控制胆固醇方法。

请记住，无药物降低胆固醇是有可能的：每天至少30分钟有氧运动且在您的饮食中减少饱和脂肪和反型脂肪的摄入量。其他有益的措施，包括每天喝绿茶，吃大蒜（切成丁或粉碎在食物中） ，以及摄取更多的可溶性纤维（如燕麦麸）和富含欧米加- 3脂肪酸的食物（良好的来源包括鲑鱼，沙丁鱼和胡桃）以及大量的绿叶菜类和新鲜水果。

如果生活方式的改变不起作用，您可以尝试红米酵母（红紫色） ，来源于天然的司他汀，在诉诸制药版本之前。因为它提出了那些化合物的组合，而不是单一的分子，红米酵母是不太可能产生副作用的。