What Should I Know About Statins and the Liver?

Statins and the liver are closely related, because statins are drugs that keep bad cholesterol from being produced by the liver. While serious side effects do not always occur with statins, at times they will cause a person’s liver enzymes to rise. For this reason, those who have had liver problems in the past may be advised by their doctor not to take cholesterol-lowering statins.

Certain enzymes in the liver produce a type of cholesterol that is bad for the body. This cholesterol can lead to heart attacks and other problems. Statin drugs have been developed to keep the liver from being able to produce cholesterol. When the liver is unable to produce bad cholesterol, it reduces the amount found in the blood.

There are benefits, but there also can be serious problems between statins and the liver — some that affect the liver's function. It can increase the amount of liver enzymes a person has and, if the problem is left untreated, can result in serious and permanent damage to the liver. Many times, doctors will monitor a person’s liver enzymes closely, running blood tests on a regular basis to check the amount of enzymes present. If the level of enzymes goes up a little bit because of how the statins and the liver interact, the statin drug may still be prescribed, but the liver enzyme level of the person may be more closely watched.

Higher increases in enzyme levels — typically thought to be at least three times what is considered the normal level for liver enzymes — resulting from how statins and the liver get along may result in a person being taken off the cholesterol-lowering drug. The specific enzyme in the liver that increases is called transaminase. When this enzyme becomes elevated, it signals that damage is being done to the liver. People who have liver problems such as liver disease may need to discuss their situation with their doctor before taking any kind of statins medication. They may be more at risk for increased levels of liver enzymes and liver damage.

Most often, people who take statins and have increased level of liver enzymes do not have any symptoms. This is usually because doctors take such great care in making sure that blood tests are done on a regular basis. If treatment must be stopped because of a rise in enzymes, no long-term damage is usually found. Many times the enzyme levels will return to normal after the drug has been stopped.