A South Carolina woman had been taking the same cholesterol-lowering drug for a year, until suffering a life-threatening reaction that kills up to six in 10 patients.
The unnamed 63-year-old had been taking rosuvastatin, the same statin taken by President Donald Trump, and it had been managing her cholesterol well.
But one day, with virtually no preceding symptoms, her legs began to swell from her hip to ankle. They became sore and weak. The weakness got so bad she suffered a fall in her bathroom.
At the hospital, doctors ran a series of blood tests and scans. They revealed severe muscle damage, which prompted a massive immune response, including a rush of fluid and white blood cells to her legs, causing the swelling.
Her kidneys were also starting to feel the strain from filtering all the debris from the broken-down muscles and were becoming overworked and stressed.
Doctors determined that her statin was wasting away her muscles, a condition called rhabdomyolysis.
The condition is rare. It is estimated to affect roughly 26,000 Americans per year. When caught early, the survival rate is approximately 90 percent. But severe cases kill about 59 percent of patients.
Statins are not a common cause of rhabdomyolysis for the majority of the 40 million people in the US who take them. However, when rhabdomyolysis does occur in someone taking a statin, the medication is very often the culprit.
Rosuvastatin, the medication marketed as Crestor, is among the most prescribed drugs in the United States, with about 11.8 million patients in 2023. Former President Donald Trump is one of them
For the average person taking a statin, the risk of developing rhabdomyolysis is very low. Studies have shown the annual incidence to be about one in a million.
And while the percentage of people affected is small, the absolute number of cases means it is a side effect that doctors have been trained to recognize and manage.
The benefits of statins in preventing heart attacks and strokes are considered to outweigh this minimal risk for most patients.
But in some cases, statins can cause severe muscle breakdown not through external force, but by disrupting the internal chemistry of muscle cells.
This biochemical damage depletes cellular energy and compromises the cells’ structural integrity, leading to the dangerous release of toxins as a physical muscle injury.
The unidentified woman’s medical history was significant for Coronary Artery Disease (CAD), according to her case in the American Journal of Case Reports.
CAD occurs when the arteries that supply blood to the heart muscle become narrowed or blocked by a buildup of cholesterol and other substances called plaque. She also had a history of high cholesterol in her blood.
Doctors measured an extremely high level of creatine kinase (CK) in her blood, a protein that leaks out from damaged muscles. This was confirmed by an MRI, which revealed extensive inflammation and swelling within the muscle groups themselves.
The unnamed 63-year-old had been taking rosuvastatin, the same statin taken by President Donald Trump , and it had been managing her cholesterol well (stock image)
On the third day of her hospitalization, photographs documented significant and unusual swelling in both of the patient’s legs. A shows the swelling in both legs. B is a close-up view of the right thigh and leg. C is a close-up view of the left thigh and leg
Then, doctors measured her creatinine levels, a waste product the kidneys should filter out. As her muscles broke down, they released a toxic load of cellular debris that overwhelmed the kidneys’ filtering capacity.
Clinicians immediately discontinued the statin, aiming to halt further muscle damage at its source.
She received aggressive IV fluids to flush toxins from her system and protect her kidneys. Her blood levels improved steadily, confirming the treatment’s success, and she was discharged after 12 days.
Severe muscle breakdown, or rhabdomyolysis, is typically caused by direct trauma, certain metabolic disorders or direct physical damage to muscle cells.
A statin causes that kind of damage through a biochemical disruption inside the muscle cells themselves.
Statins are thought to do this primarily by blocking the production of a vital substance called CoQ10, which muscles need to generate energy. Without it, muscle cells starve, making them fragile and prone to breakdown.
They also disrupt the delicate composition of the muscle cell membranes themselves, making them leaky and unstable. The combined stress of energy depletion and structural instability can trigger the muscle cells to self-destruct.
This internal breakdown releases the same toxic cellular contents into the bloodstream as a physical crush injury, leading to rhabdomyolysis.
An MRI scan of the patient’s right thigh revealed widespread muscle swelling. The images, marked with arrows, pinpointed this fluid buildup in the inner thigh muscles (the adductor group) and, in a different view, showed similar swelling affecting the muscles at the back of the thigh
The patient’s muscle breakdown peaked with a creatine kinase (CK) level of 31,080 U/L, dramatically higher than the normal range (30-135). Her kidney function was also stressed, shown by a mildly elevated creatinine level (1.3 mg/dL versus a normal 0.5-1.1). Both levels returned to normal within about ten days after stopping the statin medication
Rosuvastatin, sold under the brand name Crestor, is one of the most widely prescribed medications in the US. Approximately 11.8 million patients were given prescriptions for rosuvastatin in the US in 2023 alone.
One of those patients is Donald Trump.
In 2018, his cholesterol levels were considered borderline high, with a total cholesterol of 223 and an LDL of 143, despite taking a 10 mg dose of rosuvastatin.
His physician, Dr Ronny Jackson, indicated that he planned to increase the medication dosage to manage these numbers better.
By 2025, Trump’s cholesterol showed significant improvement. His total cholesterol fell to 140, and his LDL dropped dramatically to 51.
A recent medical report did not specify his current rosuvastatin dosage. Still, it did reveal he is now taking a second cholesterol drug called ezetimibe, which blocks the absorption of cholesterol in the gut, providing a dual approach to managing his levels.
High cholesterol can lead to a range of severe conditions if unmanaged, including heart attack, stroke, a buildup of plaque in the arteries, chest pain caused by reduced blood flow to the heart and chronic kidney disease.
