Medical History Summary – Persistent Chest, Abdominal and Muscle Pain Reason for consultation: Persistent/recurrent muscle pain and discomfort affecting the chest, abdomen, and neck, with worsening symptoms after starting rosuvastatin (Novostat 10 mg). 1. Symptom History - Symptoms first started around September 2025, involving the chest and abdominal areas. - Initially, the pain was mild, approximately 1/10 in severity, but it recurred intermittently. - In February 2026, after starting Novostat 10 mg, the muscle pain and cramping progressively worsened. - By May–June 2026, the pain sometimes reached 8–10/10, particularly during walking, exercise, arm swings, and movements that compressed the chest or abdominal muscles. - At its worst, the pain occurred even while standing or remaining still, causing significant discomfort and occasionally bringing tears to my eyes. - The symptoms mainly involve the chest and abdominal muscles, with occasional discomfort in the neck resembling a muscle sprain. - I continue to experience intermittent muscle pain and small, rapid muscle twitches or pulsing sensations under the skin in different parts of my body, particularly the chest, abdomen, and neck, despite stopping Novostat. - The symptoms have persisted even after stopping the statin in September 2026. 2. Medical Investigations - ECG: Reportedly normal. - Echocardiogram: Reportedly normal. - Blood tests: Previously showed elevated total cholesterol and LDL cholesterol, elevated uric acid, and elevated ESR. - Lipid profile: Improved significantly after starting rosuvastatin and exercising. - Liver enzymes: I noticed an increase in SGOT/AST or SGPT/ALT during treatment; the exact values and dates need to be reviewed. - Abdominal ultrasound: Grade 1 fatty liver. - Thyroid function: Reportedly normal on recent testing. - No definitive cause for the persistent muscle pain has been established. 3. Medication and Lifestyle Timeline - September–November 2025: Received treatment for elevated uric acid and vitamin D deficiency. - January 19, 2026: Started Novostat 10 mg (rosuvastatin), following medical consultation for elevated cholesterol. - January–September 2026: Exercised almost daily, including approximately 30 minutes of walking. My weight decreased from approximately 86 kg to 73 kg. - February–June 2026: Muscle pain progressively worsened while taking Novostat, especially with movement and exercise. - Early September 2026: Reduced Novostat 10 mg to alternate-day dosing. - September 15, 2026: Completely stopped Novostat. - I also started homeopathic medicines for cholesterol and uric acid around this period and have continued to experience muscle symptoms. 4. Current Concerns I would appreciate an assessment to determine: 1. Whether my symptoms could be related to statin-associated muscle symptoms or another muscle condition. 2. Whether persistent symptoms after stopping rosuvastatin require further investigation. 3. Whether electrolyte abnormalities, vitamin deficiencies, or another neurological or musculoskeletal condition could explain the twitching and pain. 4. Whether my liver enzyme changes are related to fatty liver, medication, or another cause. 5. What investigations and treatment are appropriate before restarting or changing cholesterol-lowering medication. 5. Tests for the Doctor to Consider Depending on clinical assessment: - Creatine kinase (CK) - Liver function tests (AST/SGOT, ALT/SGPT) - Kidney function and electrolytes, including potassium, calcium, and magnesium - Thyroid function - Vitamin D and vitamin B12, if indicated - Repeat lipid profile - Further cardiac or musculoskeletal evaluation if indicated by the current symptoms Important: My chest and abdominal pain began before starting rosuvastatin but became significantly worse during treatment. The symptoms have not completely resolved since stopping it. I would like to identify the underlying cause rather than simply treating the symptoms.