Does atorvastatin deplete B12? Unpacking the research

January 6, 2026 •

4 min read

While some medications are known to affect nutrient levels, a 2006 study published in PubMed found that vitamin B12 levels actually increased significantly in patients treated with atorvastatin. This directly addresses the common question: does atorvastatin deplete B12?

Quick Summary

Current evidence suggests atorvastatin does not cause B12 depletion, with some studies showing an increase in B12 levels. Confusion may arise from other medications, like metformin, which do affect B12.

Key Points

No Evidence of Depletion: Multiple studies have shown that atorvastatin does not deplete vitamin B12; some research even indicates a potential increase in B12 levels.
Source of Confusion: The myth likely originates from confusion with other drugs, particularly the diabetes medication metformin, which is known to lower B12.
Other Statin Side Effects: Common statin side effects like muscle pain and fatigue are often caused by CoQ10 depletion, not B12 deficiency.
Address Symptoms with a Doctor: If you experience fatigue or weakness while on atorvastatin, consult your healthcare provider for an accurate diagnosis instead of assuming a B12 deficiency.
High-Dose Niacin Interaction: It is important to note that high doses of niacin (Vitamin B3) can interact with atorvastatin and increase muscle-related side effects.
Rule Out Other Causes: A suspected B12 deficiency may be due to diet, age, or other medical conditions, so it's crucial to investigate the real cause with a doctor.

Debunking the Myth: Atorvastatin and B12 Levels

Concerns about statin medications and nutrient deficiencies are widespread, with many patients asking, “Does atorvastatin deplete B12?” The simple and evidence-based answer is no; current research indicates that atorvastatin does not cause a depletion of vitamin B12. This misconception often stems from confusion with other medications and a misunderstanding of how statins function. Unlike drugs such as metformin, which is known to lower vitamin B12 levels in patients with diabetes, atorvastatin's mechanism of action does not directly interfere with B12 absorption or metabolism.

The Research Behind Atorvastatin's Effect on B12

Several clinical studies have investigated the relationship between atorvastatin and B12 levels, providing clear results. A notable study from 2006 involving patients with hypercholesterolemia demonstrated that after 24 weeks of receiving atorvastatin, vitamin B12 levels actually increased significantly. The researchers monitored various parameters and found positive changes in lipid profiles without negative effects on hematological markers, including B12. Similarly, a separate study focused on renal transplant recipients also found no evidence of B12 depletion linked to atorvastatin administration. These findings provide strong evidence that atorvastatin does not pose a risk for vitamin B12 deficiency.

Why the Confusion About Atorvastatin and B12?

Several factors contribute to the misconception that atorvastatin depletes B12. These include:

General Statin Concerns: The class of drugs known as statins (of which atorvastatin is one) is widely known to deplete other nutrients, most notably coenzyme Q10 (CoQ10). This can cause side effects like fatigue and muscle weakness, which are sometimes mistakenly associated with B12 deficiency.
Other Medications: Some high-profile medications, such as the diabetes drug metformin, are well-established causes of B12 depletion. This can lead to a mistaken association with other common long-term medications like statins, especially since many patients taking atorvastatin may also have diabetes.
Similarity in Symptoms: The general symptoms of fatigue and muscle weakness can occur both as side effects of some statins (due to CoQ10 effects) and as symptoms of a B12 deficiency. Without a proper diagnosis, it is easy to assume one is causing the other.
Misinformation Online: The widespread availability of health information online can sometimes lead to conflated facts and inaccurate conclusions. Claims that atorvastatin depletes B12 often circulate without being supported by credible research.

Atorvastatin vs. Other Medications: A Comparison

To clarify the difference between atorvastatin and other drugs, consider the following comparison table:


Feature	Atorvastatin (Lipitor)	Metformin	Niacin (High-Dose)	Statins (General)
Effect on B12	No depletion; may increase levels	Known to cause depletion	No significant interaction	Generally not linked to B12 depletion
Associated Deficiencies	Coenzyme Q10 (CoQ10)	Vitamin B12	None (at therapeutic dose)	Coenzyme Q10 (CoQ10)
Key Interaction	High-dose niacin, Grapefruit juice	None listed with B12	Atorvastatin (at high doses)	Grapefruit, certain antibiotics
Primary Use	Lowering cholesterol	Managing type 2 diabetes	Lowering cholesterol (at high doses)	Lowering cholesterol
Common Side Effects	Muscle pain, digestive issues	Digestive upset, B12 deficiency	Flushing, digestive issues	Muscle pain, fatigue

Potential Causes of B12 Deficiency

If you are taking atorvastatin but suspect a B12 deficiency, it is important to consider other potential causes. B12 deficiency is common and can be caused by various factors unrelated to your statin medication. These can include:

Dietary Factors: A strict vegetarian or vegan diet that is not supplemented with B12 can lead to deficiency, as the vitamin is primarily found in animal products.
Medical Conditions: Conditions like pernicious anemia, Crohn's disease, or celiac disease can impair B12 absorption.
Age: The body's ability to absorb vitamin B12 from food can decrease with age.
Other Medications: As mentioned, drugs like metformin and proton pump inhibitors (PPIs) can interfere with B12 levels.
Lifestyle Choices: Heavy alcohol use is a known risk factor for vitamin deficiencies.

What to Do If You Experience Symptoms

If you are taking atorvastatin and experiencing symptoms like fatigue, weakness, or nerve issues (such as tingling in the extremities), do not assume it is a B12 deficiency or stop your medication. You should:

Consult Your Doctor: Discuss your symptoms with your healthcare provider. They can order a blood test to check your B12 levels and determine the true cause.
Report Side Effects: Keep a record of your symptoms and mention them to your doctor during your next appointment. The symptoms may be related to another known side effect of atorvastatin, such as CoQ10 depletion, and not B12.
Do Not Self-Medicate: Avoid taking high doses of supplements without medical advice, especially since some, like high-dose niacin, can have significant interactions with atorvastatin.

Conclusion: Atorvastatin and B12—The Final Word

Contrary to a persistent health myth, atorvastatin does not deplete vitamin B12. Research has consistently shown that B12 levels are either unaffected or, in some cases, may even see a small increase in patients on this medication. The misconception likely arises from associating atorvastatin with other medications known to cause B12 deficiency, or confusing B12-related symptoms with other common statin side effects. For those concerned about their B12 levels, a consultation with a healthcare provider is the best course of action to identify the true cause and get appropriate guidance. The available evidence affirms that atorvastatin's benefits in managing cholesterol are not undermined by this particular concern.

For more information on the study showing increased B12 levels, you can review the research here: Effects of atorvastatin on coagulation parameters and homocysteine levels in patients with primary hypercholesterolemia.

Frequently Asked Questions

No, current medical research indicates that atorvastatin does not cause vitamin B12 depletion. In fact, one study found that B12 levels significantly increased in patients taking atorvastatin.

There is no strong evidence to suggest that you should be concerned about B12 depletion specifically due to atorvastatin. Regular check-ups and open communication with your doctor are the best way to monitor your overall health.

While the statin drug class has been associated with other nutrient depletions like CoQ10, they are not specifically known to cause B12 deficiency. The confusion often arises from other medications, such as metformin, which does impact B12 levels.

The misconception can arise from confusion with other medications (like metformin) or from attributing general statin side effects, such as fatigue, to a B12 issue, even though these are often linked to other deficiencies like CoQ10.

Common side effects include diarrhea, gas, heartburn, joint pain, and muscle weakness or pain. More serious side effects can occur, so it's important to report any new or unusual symptoms to your doctor.

Yes, standard vitamin B12 supplements are not known to interact negatively with atorvastatin. However, always inform your doctor about any supplements you take, especially high doses of other B vitamins like niacin.

Taking high doses of niacin (vitamin B3), typically 1 gram or more per day, can increase the risk of muscle problems when combined with atorvastatin. Lower, over-the-counter doses are not typically a concern.

Yes, fatigue is a non-specific symptom. It could be a side effect related to CoQ10 depletion, another underlying condition, or the normal aging process. A doctor's evaluation is the most reliable way to determine the cause.