Hi, I’ve been on AIs for 2 years, firstly letrozole for 1 year and then switched to exemestane as I wasn’t tolerating letrozole well. My recent blood tests show that my cholesterol levels have gone through the roof since before I started the AIs and I’m now looking at statins 
Has anyone else had similar? On the whole I have a pretty good diet and although I’m still overweight I do exercise regularly. I guess I’m going to have to try the statins, last thing I wanted was another medication!
Yes, that happened to me. The truth is, I have congenitally high LDL - my mother also had it and she was 5 feet nothing and 7.5 stones her entire adult life. I was on a low statin to control it prior to the cancer dx but three years on Letrozole sent cholesterol through the roof, meaning I was put on a much higher dose of Atorvastatin. Both Letrozole and Atorvastatin cross the blood/brain barrier so have caused me quite a lot of cognitive issues. A few weeks ago I discussed this with my oncologist and she agreed that I could stop taking Letrozole so that I could stop taking Atorvastatin. I have yet to get an appointment with a senior GP in the practice to discuss either stopping the statin completely or, more likely, trying out a hydrophilic statin which will not cross the blood/brain barrier. I have a very high percentage chance of being alive in 15 years according to Predict without taking an AI. It is a risk but one I am willing to take aged 70.
My advice, having discussed it with the oncologist is, IF you have to have a statin, ask for one that is hydrophilic otherwise they will undoubtedly start you on Atorvastatin which is lipophilic so can (not necessarily will) cause muscle aches and cognitive issues. I also had permanent cold-like symptoms on it which is a known rare side effect.
Yes, I thin Letrozole putting your cholesterol up is a known side effect. Certainly that is what happened to me and as a Type 1 Diabetic had no choice but to go on statins. This has then caused different side effects and made them reduce the dose of statins to the lowest level. I tried to get them to prescribe me a different type of statin to the standard but couldn’t get them to budge. I think as others have already noted here, it is worth discussing with your Oncologist to consider the pros and cons and be able to make a choice that works best for you.
I have above target cholesterol before my cancer was diagnosed. I started to take plant sterols because I didn’t want to go on statins. I have been on Letrozole for 2 weeks now and last week I asked my GP whether it was ok to take plant sterols with Letrozole. He has asked the question to the hospital pharmacy and will get back to me. May take 2 weeks. Happy to keep you posted. Plant sterols are a natural solution with no side effects.
I’ve been on anastrozole for 5 years, due to be on it another 5. My cholesterol went up a bit- not too much but above the preferred level. Followed GP’s advice to go on statins. I take it at night, no side effects, and my cholesterol is right down.
I know about feeling, oh not another pill, but science has saved my life, and long may it continue to do so.
Good luck with whatever you decide.
Yes I have high cholesterol now and also high blood pressure so I am on Atorvastatin for cholesterol and amlodopine for high blood pressure
Thank you all for replying, it’s really helpful to know how others have managed this new (to me) issue!
I have spoken to my oncologist and it looks like coming off the AI would not be sensible so I’m going to have to give the statins a go. Have taken on board your comments about type of statin and plant sterols so will see what the GP says when I see her on Tuesday.
Thanks again. I really appreciate having this space to ‘talk to‘ people who get it!
Lisax
I’d love to know what they say, I am on Letrozole and been using benecol drinks and butter didn’t even think about the Letrozole and I do have high cholesterol too.
Thanks xx
Dear @ AMWG, Fellow type 1 diabetic here. I also cannot take a statin so take Bezafibrate. I also managed to get a Diabetes team referral to the hospital lipid clinic. The clinic has up to date info re several alternative treatments for high cholesterol including injections. Don’t give up. Enlist the help of PALS if necessary. Love Tulip x
Thank you, this is really helpful
After three years of Letrozole and Ribociclib for SBC with bone mets, I’ve been switched to Elacestrant. This involved blood tests (amongst other things) before I started the new drug and that revealed my LDL level is 5.2. I then realised that not only had the Letrozole raised it, but also the anti-depressant I take! I was all prepared to take statins - what’s another tablet after all? However, the Elacestrant has given me indigestion and my oncologist has said statins would make it worse. So I bought some Benecol drinks - bleugh! Too sweet! So where do I go from here? I don’t want to get hung up on my diet - I don’t know how many years I’ve got left and I want to enjoy them! So whatever you learn would be really helpful.
My cholesterol also raised a little from taking Letrozole. 5.1 which I do not consider overly high so am avoiding Statins for now. I also take a daily Benecol drink - original non-sweetened. If you find that still too sweet - it doesn’t take long to drink it down - worth it . Also changed from Lurpak butter to Benecol spread. Will try anything to avoid Statins
2.5 years into Letrozole for my Breast Cancer. I also am progressing to medication with my Chronic Lymhphatic Leukaemia in a few months (following bone marrow biopsies) too.
I have now developed Diabetes (likely Type 3C due to enlarged pancreas followin* medication) and have high cholesterol following BC meds……
tomorrow Fri 9 Jan 2026 - appointment for formal diagnosis if the diabetes and to need to use insulin (1st time in my life) and discuss how to attack the high cholesterol- I have read/seen that you can use other tactics to lower this without statins as below
Has anyone used other things other than statins? I’m only 49 so don’t fancy going on statins yet
what a bummer. I am now on statins but I am 70. I don’t seem to get any side effects from them unlike the letrozole which has given me osteoporosis so that annoys me a lot.
I would find some really pleasurable things to do and live as well as you can. get support from your friends at home and in this Forum.
Take up knitting, jigsaws, embroidery or listening to podcasts, or whatever floats your boat.
Keep swimming against the tide, or with it, you choose…
Seagulls
Hi @vixster11, I have type 1 diabetes and high cholesterol. After reacting badly to statins ( could not walk) I now take Bezafibrate. I did try exetemibe first but experienced loss of taste. There are also other options including injections. I was referred to a lipid clinic by my diabetes team and they have knowledge and access to all the latest treatments on the nhs. Wishing you well. Love Tulip x