statin-induced myopathy and thyroid

Q: Which of the following is more prone to statin-induced myopathy? (select one)

A) Hyperthyroidism

B) Hypothyroidism

Answer: B

It is a common practice to check liver enzymes prior to starting statin, but ideally, thyroid-stimulating hormone (TSH) level should also be checked prior to initiating statin therapy, as hypothyroidism itself is a potential cause of dyslipidemia, and may predispose to statin-induced myopathy. 

This suggests that the use of statins may "unmask" the underlying subclinical hypothyroid myopathy.

#endocrinology

#pharmacology

References:

1. Bar SL, Holmes DT, Frohlich J. Asymptomatic hypothyroidism and statin-induced myopathy. Can Fam Physician 2007; 53:428.

2. Lando HM, Burman KD. Two cases of statin-induced myopathy caused by induced hypothyroidism. Endocr Pract 2008; 14:726.

3. al-Jubouri MA, Briston PG, Sinclair D, et al. Myxoedema revealed by simvastatin induced myopathy. BMJ 1994; 308:588.

4.Scalvini T, Marocolo D, Cerudelli B, et al. Pravastatin-associated myopathy. Report of a case. Recenti Prog Med 1995; 86:198.