Muscle/Joint Pain with Statins?
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Theoldguy1
Posts: 2,476 Member
Appreciate thoughts/experiences with Statins.
At my last checkup, my new doctor talked me into starting a low dose statin. I’m mid 60s no history of heart issues, long time exerciser (weights and cardio), 6’2”, 210 lbs., 20% bodyfat (DEXA Scan performed by PhD in Kinesiology/Exercise Science).
Following are my numbers, (generally in or just out of reference ranges)
Total Cholesterol 192 (standard range less than 200)
HDL 41 (standard range greater that 40)
LDL 110 (standard range less than 130)
Triglycerides 204 (normal less than 150, borderline 150-199, high 200-499, very high over 500)
Chol/HDL Ratio 4.7 (standard range 0-4.4)
I’ve been on the drug Pravastatin for about 4 months. During that time I have experienced increased fatigue and muscle soreness Muscle soreness to the point of difficulty walking stairs to due to foot pain (thought I had plantar fasciitis) difficulty bending to tie shoes, crossing legs when sitting, getting up off the floor, not feeling strong in the weight room, more fatigue when walking, etc. To muddy things up a bit I had Covid about 3 weeks before my blood test/physical so not sure of the cause of the soreness/fatigue (medicine or long Covid). I was away from home for a few days and forgot the Statin. After about 3 days I started waking up earlier, feeling refreshed, and the muscle soreness has vastly improved. I messaged the doctor and they would like me to try a different Statin. I’m interested in the experience of others, has a different statin or another option relived side effects? My diet for all intents and purposes is pretty healthy, lean protein sources fruit, vegetables, minimal processed foods.
I wasn't real happy with the new doctor's "bedside manner" and have scheduled a an appointment with someone else. Think I'm just going to start over with him and skip trying the new prescription. Wondering with my situation if I really need the drug?
Appreciate any thoughts.
At my last checkup, my new doctor talked me into starting a low dose statin. I’m mid 60s no history of heart issues, long time exerciser (weights and cardio), 6’2”, 210 lbs., 20% bodyfat (DEXA Scan performed by PhD in Kinesiology/Exercise Science).
Following are my numbers, (generally in or just out of reference ranges)
Total Cholesterol 192 (standard range less than 200)
HDL 41 (standard range greater that 40)
LDL 110 (standard range less than 130)
Triglycerides 204 (normal less than 150, borderline 150-199, high 200-499, very high over 500)
Chol/HDL Ratio 4.7 (standard range 0-4.4)
I’ve been on the drug Pravastatin for about 4 months. During that time I have experienced increased fatigue and muscle soreness Muscle soreness to the point of difficulty walking stairs to due to foot pain (thought I had plantar fasciitis) difficulty bending to tie shoes, crossing legs when sitting, getting up off the floor, not feeling strong in the weight room, more fatigue when walking, etc. To muddy things up a bit I had Covid about 3 weeks before my blood test/physical so not sure of the cause of the soreness/fatigue (medicine or long Covid). I was away from home for a few days and forgot the Statin. After about 3 days I started waking up earlier, feeling refreshed, and the muscle soreness has vastly improved. I messaged the doctor and they would like me to try a different Statin. I’m interested in the experience of others, has a different statin or another option relived side effects? My diet for all intents and purposes is pretty healthy, lean protein sources fruit, vegetables, minimal processed foods.
I wasn't real happy with the new doctor's "bedside manner" and have scheduled a an appointment with someone else. Think I'm just going to start over with him and skip trying the new prescription. Wondering with my situation if I really need the drug?
Appreciate any thoughts.
1
Replies
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Since your numbers were within normal range, why did he think it was necessary to start statins? I don't think I would agree to do that, without a good reason.
My husband's doctor put him on statins because he is diabetic, so at higher risk of heart issues, even though his cholesterol and blood pressure are both good. But he does have family history of heart issues, so he agreed. He did change his meds for the same reason you are thinking about it. It is hard to know if muscle pain is part of aging or exercise or if it is due to the statins, but the fact that yours got better when you stopped taking them is a clue.
There was something on the news today (NBC) about a recent study that showed a different kind of drug to treat cholesterol that has fewer side effects than the statins and is very effective at reducing heart attacks. It may become common for people who have trouble with statins and muscle pain.3 -
spiriteagle99 wrote: »Since your numbers were within normal range, why did he think it was necessary to start statins? I don't think I would agree to do that, without a good reason.
My husband's doctor put him on statins because he is diabetic, so at higher risk of heart issues, even though his cholesterol and blood pressure are both good. But he does have family history of heart issues, so he agreed. He did change his meds for the same reason you are thinking about it. It is hard to know if muscle pain is part of aging or exercise or if it is due to the statins, but the fact that yours got better when you stopped taking them is a clue.
There was something on the news today (NBC) about a recent study that showed a different kind of drug to treat cholesterol that has fewer side effects than the statins and is very effective at reducing heart attacks. It may become common for people who have trouble with statins and muscle pain.
He gave the reason as my age, pure and simple when I asked.1 -
Many times doctors are to quick to prescribe with no real reason. No need to put things like that in your body if you don’t need to.Theoldguy1 wrote: »spiriteagle99 wrote: »Since your numbers were within normal range, why did he think it was necessary to start statins? I don't think I would agree to do that, without a good reason.
My husband's doctor put him on statins because he is diabetic, so at higher risk of heart issues, even though his cholesterol and blood pressure are both good. But he does have family history of heart issues, so he agreed. He did change his meds for the same reason you are thinking about it. It is hard to know if muscle pain is part of aging or exercise or if it is due to the statins, but the fact that yours got better when you stopped taking them is a clue.
There was something on the news today (NBC) about a recent study that showed a different kind of drug to treat cholesterol that has fewer side effects than the statins and is very effective at reducing heart attacks. It may become common for people who have trouble with statins and muscle pain.
He gave the reason as my age, pure and simple when I asked.
3 -
Theoldguy1 wrote: »spiriteagle99 wrote: »Since your numbers were within normal range, why did he think it was necessary to start statins? I don't think I would agree to do that, without a good reason.
My husband's doctor put him on statins because he is diabetic, so at higher risk of heart issues, even though his cholesterol and blood pressure are both good. But he does have family history of heart issues, so he agreed. He did change his meds for the same reason you are thinking about it. It is hard to know if muscle pain is part of aging or exercise or if it is due to the statins, but the fact that yours got better when you stopped taking them is a clue.
There was something on the news today (NBC) about a recent study that showed a different kind of drug to treat cholesterol that has fewer side effects than the statins and is very effective at reducing heart attacks. It may become common for people who have trouble with statins and muscle pain.
He gave the reason as my age, pure and simple when I asked.
That seems weird to me. My doctor was on me for years to take a statin, but never brought up age as a variable, FWIW. (I was in late 50s by the end of that.) My numbers were much worse than yours, until I lost weight. Since you don't need to lose, that's obviously not a solution for you.
I wonder if, in part, he's over-reacting to your BMI (27, mid overweight) and not taking on board your BF% (low for that BMI). Second opinion sounds like a good plan.
How is your diet? High triglycerides might respond to dietary interventions, if there's room for them. I'm not usually much in favor of dietary religions, but this is one scenario where reducing sugars and refined carbohydrate sources does seem to have the potential to help, if there's much of that in your diet; ditto for reducing sat fats in favor of MUFA/PUFA sources or things like fatty fish for O-3s. Maybe you've already done that, though. Alcohol can be a factor, but it seems like you've mentioned elsewhere not being much into that.
1 -
I'm not a doctor but I'm getting the same push from my new heart doctor. My numbers are worse than yours for sure. My prior cardiologist said if you're not experiencing any blockage then there is really no reason for the statins. Unfortunately he was older and is gone on medical leave. He was definitely old enough to retire but worked because he loves it. So now comes the new guy and one of the first things he said was your cholesterol is high (I think it was 230 or 250) it's been over 200 since I was 20 years old. I'm now 65. I said yes but I have no blockage and my previous doctor (in the same group) said I don't need them. Said I need to reduce my ldl which is caused by red meat - I only eat maybe every two weeks when I go to my son in law's, then he said fried foods - I said nope I'm gluten intolerant so I don't eat fried foods for the most part. Then he continued to push and said well eventually you're going to have blockage. I said yes and eventually I'm going to die so I really don't want to do them right now. Sorry for the book - my suggestion is to have them do a cardiac score test - that will show if you have any blockage and then you can take it from there. Good luck and don't let them push things on you unless absolutely necessary!3
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that seems OTT to me too OP
if you are in your mid 60's (or older for that matter) and your blood levels are within range and you have no medical circumstances like history of heart attack - then I would not be expecting you to be prescribed statins or any sort of cholesterol lowering medication.
Muscle soreness is a known side effect of statins for some people.1 -
Maybe a statin is justified for someone at high risk for a heart attack or have hypercholesterolemia but for most, it's just pure nonsense and it's just big pharma doing what it does best. I suspect and it looks like it's going to happen in the near future (soon) which is, they will lower once more the acceptable level of LDL to 70 where most children and quite frankly, most of the world will then be eligible. Besides the muscle problems there's other concerns as well, mostly liver and kidney and mucks with blood sugar levels and I would suggest people do more research and I don't mean documentaries. Look at cholesterol, particle sizes of lipoproteins as it relates to cholesterol etc. Knowledge is king and could save you a lot of pain, and in this context it's your muscle. As far as muscle aches go from statins take a look at CoQ10. Not medical advice just an opinion. Cheers
https://sciencedirect.com/science/article/abs/pii/S1567724907000591?via%3Dihub
https://healthline.com/health/coq10-and-statins
2 -
Theoldguy1 wrote: »spiriteagle99 wrote: »Since your numbers were within normal range, why did he think it was necessary to start statins? I don't think I would agree to do that, without a good reason.
My husband's doctor put him on statins because he is diabetic, so at higher risk of heart issues, even though his cholesterol and blood pressure are both good. But he does have family history of heart issues, so he agreed. He did change his meds for the same reason you are thinking about it. It is hard to know if muscle pain is part of aging or exercise or if it is due to the statins, but the fact that yours got better when you stopped taking them is a clue.
There was something on the news today (NBC) about a recent study that showed a different kind of drug to treat cholesterol that has fewer side effects than the statins and is very effective at reducing heart attacks. It may become common for people who have trouble with statins and muscle pain.
He gave the reason as my age, pure and simple when I asked.
That seems weird to me. My doctor was on me for years to take a statin, but never brought up age as a variable, FWIW. (I was in late 50s by the end of that.) My numbers were much worse than yours, until I lost weight. Since you don't need to lose, that's obviously not a solution for you.
I wonder if, in part, he's over-reacting to your BMI (27, mid overweight) and not taking on board your BF% (low for that BMI). Second opinion sounds like a good plan.
How is your diet? High triglycerides might respond to dietary interventions, if there's room for them. I'm not usually much in favor of dietary religions, but this is one scenario where reducing sugars and refined carbohydrate sources does seem to have the potential to help, if there's much of that in your diet; ditto for reducing sat fats in favor of MUFA/PUFA sources or things like fatty fish for O-3s. Maybe you've already done that, though. Alcohol can be a factor, but it seems like you've mentioned elsewhere not being much into that.
Thanks.
My triglycerides have generally been in the okay range looking back at 10 years of blood tests. Our church has a couple of nurses who volunteer once a month to take BP and answer questions so I talked to one of them (30 yr ER RN). She said the triglycerides can swing pretty widely with temporary diet changes. She said she is typically in range but one test she was over 400. She thought about it a bit and realized she had 4 glasses wine at a party 5 days before the test. She took it again and was fine.
I don't each much added sugars and refined carbs but do occasionally have a few beers on a weekend. May have spiked the reading a bit.1 -
munecasmom wrote: »I'm not a doctor but I'm getting the same push from my new heart doctor. My numbers are worse than yours for sure. My prior cardiologist said if you're not experiencing any blockage then there is really no reason for the statins. Unfortunately he was older and is gone on medical leave. He was definitely old enough to retire but worked because he loves it. So now comes the new guy and one of the first things he said was your cholesterol is high (I think it was 230 or 250) it's been over 200 since I was 20 years old. I'm now 65. I said yes but I have no blockage and my previous doctor (in the same group) said I don't need them. Said I need to reduce my ldl which is caused by red meat - I only eat maybe every two weeks when I go to my son in law's, then he said fried foods - I said nope I'm gluten intolerant so I don't eat fried foods for the most part. Then he continued to push and said well eventually you're going to have blockage. I said yes and eventually I'm going to die so I really don't want to do them right now. Sorry for the book - my suggestion is to have them do a cardiac score test - that will show if you have any blockage and then you can take it from there. Good luck and don't let them push things on you unless absolutely necessary!
Thanks for your comments.
I checked myself into the ER 4 years ago. Didn't remember that I did. Turned out I had Transient Global Amusia. It's very rare an if you have it even more rare to have it again. You basically forget many details of your life but everything comes back in less than 24 hours and no ill effects. Here's a description of what it if interested
https://www.mayoclinic.org/diseases-conditions/transient-global-amnesia/symptoms-causes/syc-20378531#:~:text=Transient global amnesia is an,such as epilepsy or stroke.
Given the way I was acting the ER thought I was having a stroke or some other heart issue. After I started remembering things they checked with a neurologist and decided I had TGA. Still they ran a full battery of cardiac/brain related tests (to the tune of $25k for the ER time, overnight in the hospital and testing) didn't find any issues. I would have thought that if there was even a bit of blockage at that time they would have said something. But I would be happy to do some tests again.1 -
paperpudding wrote: »that seems OTT to me too OP
if you are in your mid 60's (or older for that matter) and your blood levels are within range and you have no medical circumstances like history of heart attack - then I would not be expecting you to be prescribed statins or any sort of cholesterol lowering medication.
Muscle soreness is a known side effect of statins for some people.
Yeah, no known heart issues, BP 118/78 without meds, resting HR 58.0 -
neanderthin wrote: »Maybe a statin is justified for someone at high risk for a heart attack or have hypercholesterolemia but for most, it's just pure nonsense and it's just big pharma doing what it does best. I suspect and it looks like it's going to happen in the near future (soon) which is, they will lower once more the acceptable level of LDL to 70 where most children and quite frankly, most of the world will then be eligible. Besides the muscle problems there's other concerns as well, mostly liver and kidney and mucks with blood sugar levels and I would suggest people do more research and I don't mean documentaries. Look at cholesterol, particle sizes of lipoproteins as it relates to cholesterol etc. Knowledge is king and could save you a lot of pain, and in this context it's your muscle. As far as muscle aches go from statins take a look at CoQ10. Not medical advice just an opinion. Cheers
https://sciencedirect.com/science/article/abs/pii/S1567724907000591?via%3Dihub
https://healthline.com/health/coq10-and-statins
Thanks much. I was taking a CoQ10 supplement before the statin for general health. If it helped the muscle pain, I couldn't imagine what it would have been without it.0 -
I’d fire my doctor. 118/78 is perfect.Theoldguy1 wrote: »paperpudding wrote: »that seems OTT to me too OP
if you are in your mid 60's (or older for that matter) and your blood levels are within range and you have no medical circumstances like history of heart attack - then I would not be expecting you to be prescribed statins or any sort of cholesterol lowering medication.
Muscle soreness is a known side effect of statins for some people.
Yeah, no known heart issues, BP 118/78 without meds, resting HR 58.
In many cases there are financial incentives for prescriptions
3 -
Theoldguy1 wrote: »Theoldguy1 wrote: »spiriteagle99 wrote: »Since your numbers were within normal range, why did he think it was necessary to start statins? I don't think I would agree to do that, without a good reason.
My husband's doctor put him on statins because he is diabetic, so at higher risk of heart issues, even though his cholesterol and blood pressure are both good. But he does have family history of heart issues, so he agreed. He did change his meds for the same reason you are thinking about it. It is hard to know if muscle pain is part of aging or exercise or if it is due to the statins, but the fact that yours got better when you stopped taking them is a clue.
There was something on the news today (NBC) about a recent study that showed a different kind of drug to treat cholesterol that has fewer side effects than the statins and is very effective at reducing heart attacks. It may become common for people who have trouble with statins and muscle pain.
He gave the reason as my age, pure and simple when I asked.
That seems weird to me. My doctor was on me for years to take a statin, but never brought up age as a variable, FWIW. (I was in late 50s by the end of that.) My numbers were much worse than yours, until I lost weight. Since you don't need to lose, that's obviously not a solution for you.
I wonder if, in part, he's over-reacting to your BMI (27, mid overweight) and not taking on board your BF% (low for that BMI). Second opinion sounds like a good plan.
How is your diet? High triglycerides might respond to dietary interventions, if there's room for them. I'm not usually much in favor of dietary religions, but this is one scenario where reducing sugars and refined carbohydrate sources does seem to have the potential to help, if there's much of that in your diet; ditto for reducing sat fats in favor of MUFA/PUFA sources or things like fatty fish for O-3s. Maybe you've already done that, though. Alcohol can be a factor, but it seems like you've mentioned elsewhere not being much into that.
Thanks.
My triglycerides have generally been in the okay range looking back at 10 years of blood tests. Our church has a couple of nurses who volunteer once a month to take BP and answer questions so I talked to one of them (30 yr ER RN). She said the triglycerides can swing pretty widely with temporary diet changes. She said she is typically in range but one test she was over 400. She thought about it a bit and realized she had 4 glasses wine at a party 5 days before the test. She took it again and was fine.
I don't each much added sugars and refined carbs but do occasionally have a few beers on a weekend. May have spiked the reading a bit.
Yeah, that's part of why dietary interventions can work so well for triglycerides IMU. I had one test where mine hit over 400. I realized that pizza (lots) and beer a few days before the test - in unusual amounts for me - had probably thrown things off. On later tests, I'd make it a point to stick with normal eating/drinking routine for around a week before a blood test.
One of my friends was outraged that I was "gaming the test". That would be dumb. In my mind, I wasn't doing that . . . I was just making it a point not to do something unusual for me that would distort the test.
1 -
I learn so much reading these forums. Thanks everyone!2
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Theoldguy1 wrote: »paperpudding wrote: »that seems OTT to me too OP
if you are in your mid 60's (or older for that matter) and your blood levels are within range and you have no medical circumstances like history of heart attack - then I would not be expecting you to be prescribed statins or any sort of cholesterol lowering medication.
Muscle soreness is a known side effect of statins for some people.
Yeah, no known heart issues, BP 118/78 without meds, resting HR 58.
so healthy range BP, healthy range weight, no history of heart diseases, non diabetic, within range or borderline cholesterol blood levels - I cant see the justification for cholesterol lowering meds, regardless of your age.
2 -
tomcustombuilder wrote: »
I’d fire my doctor. 118/78 is perfect.Theoldguy1 wrote: »paperpudding wrote: »that seems OTT to me too OP
if you are in your mid 60's (or older for that matter) and your blood levels are within range and you have no medical circumstances like history of heart attack - then I would not be expecting you to be prescribed statins or any sort of cholesterol lowering medication.
Muscle soreness is a known side effect of statins for some people.
Yeah, no known heart issues, BP 118/78 without meds, resting HR 58.
In many cases there are financial incentives for prescriptions
most of the poor doctors i've gone to overprescribe not for money but because they tend to genericize their patients and their symptoms, and those doctors tend to recommend the done thing rather than tailor treatments to their patients. many people never know they were misdiagnosed or received inappropriate treatment because they feel you should always do what the doctor says.2 -
Theoldguy1 wrote: »Theoldguy1 wrote: »spiriteagle99 wrote: »Since your numbers were within normal range, why did he think it was necessary to start statins? I don't think I would agree to do that, without a good reason.
My husband's doctor put him on statins because he is diabetic, so at higher risk of heart issues, even though his cholesterol and blood pressure are both good. But he does have family history of heart issues, so he agreed. He did change his meds for the same reason you are thinking about it. It is hard to know if muscle pain is part of aging or exercise or if it is due to the statins, but the fact that yours got better when you stopped taking them is a clue.
There was something on the news today (NBC) about a recent study that showed a different kind of drug to treat cholesterol that has fewer side effects than the statins and is very effective at reducing heart attacks. It may become common for people who have trouble with statins and muscle pain.
He gave the reason as my age, pure and simple when I asked.
That seems weird to me. My doctor was on me for years to take a statin, but never brought up age as a variable, FWIW. (I was in late 50s by the end of that.) My numbers were much worse than yours, until I lost weight. Since you don't need to lose, that's obviously not a solution for you.
I wonder if, in part, he's over-reacting to your BMI (27, mid overweight) and not taking on board your BF% (low for that BMI). Second opinion sounds like a good plan.
How is your diet? High triglycerides might respond to dietary interventions, if there's room for them. I'm not usually much in favor of dietary religions, but this is one scenario where reducing sugars and refined carbohydrate sources does seem to have the potential to help, if there's much of that in your diet; ditto for reducing sat fats in favor of MUFA/PUFA sources or things like fatty fish for O-3s. Maybe you've already done that, though. Alcohol can be a factor, but it seems like you've mentioned elsewhere not being much into that.
Thanks.
My triglycerides have generally been in the okay range looking back at 10 years of blood tests. Our church has a couple of nurses who volunteer once a month to take BP and answer questions so I talked to one of them (30 yr ER RN). She said the triglycerides can swing pretty widely with temporary diet changes. She said she is typically in range but one test she was over 400. She thought about it a bit and realized she had 4 glasses wine at a party 5 days before the test. She took it again and was fine.
I don't each much added sugars and refined carbs but do occasionally have a few beers on a weekend. May have spiked the reading a bit.
Yeah, that's part of why dietary interventions can work so well for triglycerides IMU. I had one test where mine hit over 400. I realized that pizza (lots) and beer a few days before the test - in unusual amounts for me - had probably thrown things off. On later tests, I'd make it a point to stick with normal eating/drinking routine for around a week before a blood test.
One of my friends was outraged that I was "gaming the test". That would be dumb. In my mind, I wasn't doing that . . . I was just making it a point not to do something unusual for me that would distort the test.
If pizza and beer was a daily habit and one cut it out for a few weeks on purpose I could see that as "gaming the test". If not a normal part of your lifestyle, avoiding it a bit before the test actually gives a more realistic reading.1 -
Having muscle pain with statins is a serious issue. There are specific genetic mutations that cause this. Unfortunately, traditional medicine doesn't pay attention to genetic reports. However, if you are having pain, your doctor is following the guidelines that suggest you try another type of statin. If that statin also causes you pain, then the doctor can appeal to your insurance company to put you on a PCKS9 inhibitor.
I also had statin caused muscular pain and had a Next Generation Sequence genetic report detailing my specific mutations that indicated that the specific statin was da m aging to me. Unfortunately, my cardiologist (from the best hearr hospital in the US), let me know that the genetic evidence was not enough to allow him to change medications. Instead he pointedly asked me "Have you quit taking these statins and why?" And when I replied "yes, because I have so much pain", he said "Bingo!" And now we will put you on another statin and I will ask you the same questions. He did just that..I had the same problem and told him so and within 1 week I had my PCKS9 inhibitor (which showed up on a mutated PCSK9 gene in many areas on my genetic report). I had a massive drop in LdL and TC and TG after taking the drug .....so....statin prescribing to everyone with high cholesterol numbers is just an insurance driven " tail wagging the dog" game to try to reduce costs. Pcsk9 inhibitor was phenomenal for me.2 -
Having muscle pain with statins is a serious issue. There are specific genetic mutations that cause this. Unfortunately, traditional medicine doesn't pay attention to genetic reports. However, if you are having pain, your doctor is following the guidelines that suggest you try another type of statin. If that statin also causes you pain, then the doctor can appeal to your insurance company to put you on a PCKS9 inhibitor.
I also had statin caused muscular pain and had a Next Generation Sequence genetic report detailing my specific mutations that indicated that the specific statin was da m aging to me. Unfortunately, my cardiologist (from the best hearr hospital in the US), let me know that the genetic evidence was not enough to allow him to change medications. Instead he pointedly asked me "Have you quit taking these statins and why?" And when I replied "yes, because I have so much pain", he said "Bingo!" And now we will put you on another statin and I will ask you the same questions. He did just that..I had the same problem and told him so and within 1 week I had my PCKS9 inhibitor (which showed up on a mutated PCSK9 gene in many areas on my genetic report). I had a massive drop in LdL and TC and TG after taking the drug .....so....statin prescribing to everyone with high cholesterol numbers is just an insurance driven " tail wagging the dog" game to try to reduce costs. Pcsk9 inhibitor was phenomenal for me.
Thanks for sharing your experiences. I took myself off the drugs and have an appointment with a different doctor in May. I was not happy with several things the original doctor did, such as not explaining possible side effects, ordering follow up blood work 2-3 months after starting, etc.2 -
I am new here and all these questions and comments are very useful. My doctor has prescribed statins to me but my liver numbers were high. I don’t know all the details but they took me off statins for a couple years. Although I am officially back on statins my doctor appointments are irregular so I rarely get that prescription. I suffer from fatigue even without that medication.2
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