Can I Take This? Supplements, creatine, recreational drugs and Kidney Health

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The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS).

Welcome to For Kidneys’ Sake! The new name for our podcast series is previously known as The Rest Is Kidneys. In this first episode of our new 20-part series, Prof Jeremy Levy and Dr Andrew Frankel return to tackle a topic that crops up frequently in both clinic and primary care: supplements, herbal remedies, and recreational drugs and what they really mean for people with chronic kidney disease (CKD).

This episode explores everything from high-dose vitamins and gym-related creatine use to the dangers of anabolic steroids, ketamine, and certain traditional herbal medicines. With their usual clarity and clinical insight, Jeremy and Andrew offer practical advice for clinicians and thoughtful guidance on how to approach these often-overlooked areas of patient care.

Key Takeaways:

1. Ask directly about supplements, herbs, and non-prescribed products – especially in anyone with reduced kidney function or a CKD diagnosis. These are often missed unless specifically asked about.
2. Standard multivitamins are safe in CKD, but high-dose vitamin C and extra vitamin D can be harmful, especially when kidney function is already reduced.
3. Creatine, high-protein diets, and muscle mass can raise creatinine without indicating CKD. Use a urine dipstick, ACR, blood pressure, and ultrasound to assess properly.
4. Anabolic steroids and ketamine carry serious risks, including nephrotic syndrome and irreversible bladder damage. These are increasingly common but poorly understood dangers.
5. Herbal remedies are not without harm – some are directly nephrotoxic, others interact with prescribed treatments. These should be avoided in CKD, but conversations must be handled with care and cultural awareness.

This opening discussion sets the tone for the series: practical, collaborative, and focused on bridging gaps between clinical insight and everyday patient care. Supplements and herbal products are everywhere, and understanding their impact is more important than ever for improving kidney health.

References: 

Creatine and kidneys:  Nutrients 2023, 15, 1466.   doi.org/10.3390/nu15061466 

Herbal medicines and CKD; Nephrology 15 (2010) 10–17   doi:10.1111/j.1440-1797.2010.01305.x 

Herbs and more: Drug stewardship for people with chronic kidney disease; towards effective, safe, and sustainable use of medications:  Nat Rev Nephrol. 2024 June ; 20(6): 386–401. doi:10.1038/s41581-024-00823-3 

Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE

Northwest London CKD guidelines for primary care

The purpose of this podcast is to inform and educate health care professionals working in the primary care and community setting. The content is evidence based and consistent with NICE guidelines and North West Guidelines available at the time of publication.

The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement.

Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub