Low-Dose Creatine Supplementation May Be Effective in Early-Stage Statin Myopathy: A Preliminary Study

<b>Background.</b> Statins are the main cholesterol-lowering treatments, but often they are stopped because of statin myopathy. Expensive second-line treatments are then prescribed, causing a burden on the health system. Previous research showed that creatine supplementation may be a relatively inexpensive, safe, and effective way to mitigate statin toxicity to the muscle. <b>Methods.</b> We thus investigated the tolerability and effectiveness of creatine supplementation in consecutive patients with statin myopathy, as observed at our Cardiology or Neurology outpatient services for previous cardiac or cerebral ischemic disease. <b>Results.</b> We confirmed previous findings showing that creatine supplementation is safe and well tolerated even in this elderly population. Eleven of the thirteen enrolled patients completed the study, and only one patient interrupted the study because of a creatine-related issue (elevation of serum creatinine). Creatine supplementation significantly reduced the Shewmon and Craig's "myopathy score", while it did not reduce serum creatine kinase (CK), a marker of muscle structural damage. Notably, creatine supplementation was effective at a dose of 1 g. t.i.d., lower than usually prescribed in the international literature and within the recommendations of health agencies like the Italian Ministry of Health. <b>Conclusion.</b> Creatine supplementation may improve statin myopathy in its milder and/or earlier form when serum CK is not elevated. Since creatine is relatively inexpensive, its supplementation may be used instead of switching from statins to the very expensive second-line anti-cholesterol treatments.