Supplements: Caffeine and creatine pills linked to rhabdomyolysis

Recent commentary by medical researchers stated that dietary supplements are probably a waste of time and money, yet their popularity prevails. There is an understanding that some supplements can benefit overall well-being with little to no risk. Others, however, have been linked to life-threatening complications like rhabdomyolysis, when taken at high doses.

Rhabdomyolysis is a known complication of taking certain herbal supplements alongside medications, like niacin and statins.

This is worrisome because pills are often taken together under the false belief that the cholesterol-lowering effects of one will boost those of the other.

Other herbal supplements, however, can also pave the way for severe complications like rhabdomyolysis when taken alone.

The Centers for Disease Control and Prevention says: “Rhabdomyolysis is a serious medical condition that can be fatal or result in permanent disability.

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“[It] occurs when damaged muscle tissue releases its proteins and electrolytes into the blood.

“These substances can damage the heart and kidneys and cause permanent disability or even death.”

The condition is often characterised by a triad of symptoms, consisting of muscle pain, dark urine and weakness.

A great number of patients experience self-limited illness only, but a smaller portion of people will go on to suffer a dangerous build-up of potassium in the blood.


“Even creatine manufacturers recommend a healthy fluid intake while on creatine supplements,” noted the authors of a report published in the Journal of the American Board of Family Medicine.

Sometimes rhabdomyolysis occurs in athletes who have sustained a muscle injury or suffer from impaired blood flow in damaged tissues and infections, according to the MSD Manual.

It is therefore important to recognise that although reports of rhabdomyolysis have been made by athletes taking creatine supplements, a causative effect is hard to prove.

What’s more, research published in the journal Sports Medicine in 2017 refuted claims that creatine has any involvement in rhabdomyolysis on the grounds that there is no rational evidence implicating creatine use in extreme cases of death after excessive exercise and/or dehydration. 

The journal states: “Given that all of the cases […] with a reported link to creatine occurs in young men performing the most common known factor to induce rhabdomyolysis and some were taking other drugs accepted by the FDA as being linked to adverse cardiovascular events (ephedrine), the link with creatine is highly tenuous, circumstantial, and the likely reason why rational scientific evaluations have not implicated use even in extreme cases of after excessive exercise and/or dehydration.”

A good rule of thumb for avoiding such complications is to consult a qualified health provider before taking any of the above supplements.