Statins and ALS: What the Latest Science Really Shows

For over 30 years, statins have been one of the most prescribed drugs in the world. Millions take them daily to lower cholesterol and reduce the risk of heart attacks and strokes. But since 2007, a quiet but persistent concern has crept into medical discussions: could these common pills be linked to ALS - a devastating, untreatable neurodegenerative disease also known as Lou Gehrig’s disease?

The fear isn’t baseless. The FDA started getting reports. Patients on statins were being diagnosed with ALS. Doctors noticed muscle weakness - a symptom of both early ALS and a known side effect of statins - and wondered if the two were connected. But here’s the thing: correlation doesn’t mean causation. And the science, as it stands in 2025, tells a much more complicated story.

What the FDA Found - and Why It Still Matters

In 2008, the FDA looked at data from 41 large clinical trials involving thousands of people. These weren’t just anecdotal reports. These were controlled studies, the gold standard in medical research. The result? No increase in ALS cases among statin users compared to those taking a placebo.

The FDA’s conclusion was clear: statins don’t cause ALS. They told doctors to keep prescribing them. They told patients to keep taking them. That message hasn’t changed. Even today, the FDA still stands by that position, monitoring reports through its Adverse Event Reporting System (FAERS), which has logged over 1,200 cases of ALS in statin users since 2004. But the agency emphasizes: without knowing how many people are on statins overall, those numbers mean nothing. It’s like saying more ice cream sales are linked to drowning deaths - both go up in summer, but one doesn’t cause the other.

The Conflicting Studies - And Why They Don’t Agree

Since 2008, dozens of studies have tried to settle the question. And they’ve come to wildly different conclusions. That’s not because scientists are confused - it’s because they’re asking different questions with different tools.

One 2024 study used a method called Mendelian Randomization. It looked at genetic data to try to prove statins cause ALS. It claimed atorvastatin increased ALS risk by nearly 17 times. Simvastatin? Five times higher. Rosuvastatin? A jaw-dropping 693,000 times higher. These numbers are so extreme they’ve been widely criticized. Experts say the method likely picked up noise, not truth. Genetic links can be misleading when they’re influenced by other health factors - a problem called pleiotropy. Most neurologists dismiss this study’s conclusions.

Then there’s the Norwegian study - one of the most rigorous ever done. Researchers tracked over 500 ALS patients using national health registries that record every prescription, hospital visit, and death. They found no link between statin use and ALS survival. The difference in life expectancy between those who took statins and those who didn’t? Less than three weeks. Statistically meaningless. The researchers concluded: stopping statins won’t help ALS patients live longer.

But here’s the twist: another 2024 study in Neurology found something surprising. Short-term statin use - less than a year - was linked to a higher ALS risk. But long-term use - over three years - was linked to a lower risk, especially in men. Why? The answer might be reverse causality. People in the early, undiagnosed stages of ALS often feel muscle pain and weakness. They go to the doctor. The doctor, seeing high cholesterol, prescribes a statin. The statin didn’t cause ALS. ALS was already there, and the statin was just a side effect of seeking care.

Could Statins Actually Help?

It sounds counterintuitive, but some lab studies suggest statins might protect nerve cells. In mice bred to develop ALS, lovastatin and atorvastatin reduced motor neuron loss by up to 30%. These drugs appear to calm inflammation in the brain and spinal cord - a key driver of ALS progression. One 2018 study showed simvastatin reduced harmful immune cells in brain tissue. Another 2022 study by Harvard researchers found people who took statins for more than three years had a lower chance of developing ALS.

This isn’t proof statins prevent ALS. But it does suggest they might not be the enemy. In fact, they could be quietly helping. The same anti-inflammatory effects that protect arteries might also protect nerves.

Why So Many ALS Patients Stop Taking Statins - And Why That’s Dangerous

Here’s the real-world problem: patients are scared. When someone is diagnosed with ALS, they start looking for answers. They Google. They hear stories. They see forums where people say, “I stopped statins and felt better.”

That’s not surprising. Early ALS symptoms - muscle cramps, fatigue, weakness - feel just like statin side effects. A 2024 study found that 21% of ALS patients stopped their statins in the year before diagnosis. They thought the drug was making them worse.

But here’s what those patients didn’t know: stopping statins didn’t help their ALS. In fact, those who stopped had worse outcomes - not because the statin hurt them, but because they lost the heart protection statins provide. Many ALS patients already have high cholesterol, high blood pressure, or a history of heart disease. Stopping statins puts them at higher risk for heart attacks and strokes - conditions that can kill faster than ALS itself.

Neurologists report that about 35% of ALS patients ask about stopping statins. Twelve percent actually do. Dr. Merit Cudkowicz of Massachusetts General Hospital says this is a preventable danger. “We’ve seen patients have heart attacks after stopping statins,” she told ALS News Today. “That’s not ALS. That’s avoidable.”

What Doctors Are Telling Patients Today

The American Academy of Neurology, the Mayo Clinic, the European Medicines Agency, and the FDA all agree: statins should not be stopped because of ALS concerns.

The Mayo Clinic’s official website, updated in January 2024, says plainly: “There’s no good evidence that statins cause or trigger ALS.”

Guidelines from the European ALS Consortium say the same: “Discontinuing statins solely because of an ALS diagnosis may deprive patients of their cardiovascular benefits.”

So what’s the rule? If you have heart disease, high cholesterol, or a high risk of heart attack - and you’re on a statin - keep taking it. If you’ve been on statins for years and are now diagnosed with ALS, don’t stop unless your doctor says so. If you’re experiencing muscle pain, talk to your doctor. But don’t assume it’s the statin. It could be ALS. Or it could be something else. Only a professional can tell the difference.

The only time to stop a statin is if you’re having severe muscle damage - a rare condition called rhabdomyolysis - or if your doctor determines the symptoms are clearly from the drug and not the disease. Even then, it’s a decision made case by case, not a blanket rule.

The Bigger Picture: Statins vs. ALS - Numbers That Matter

Let’s put this in perspective. In the U.S., about 39 million people take statins every year. About 5,000 to 6,000 people are diagnosed with ALS each year. That’s one ALS case for every 6,500 to 7,800 statin users. If statins caused ALS, you’d see clusters. You’d see spikes. You’d see clear patterns. You don’t.

The CDC is spending $2.3 million in 2025 on new research to dig deeper - studying lipid metabolism, inflammation, and long-term outcomes in statin users. But even if future studies find a tiny link, experts agree: the cardiovascular benefits of statins vastly outweigh any unproven risk to the nervous system.

Statins save lives. They prevent heart attacks. They reduce strokes. They’re one of the most studied drugs in history. And while ALS is terrifying and mysterious, the evidence doesn’t support blaming statins for it.

What we know now is this: if you’re on statins, keep taking them. If you’re worried, talk to your doctor. But don’t stop because of fear. Stop only because your doctor says it’s safe to do so.