Can rhabdo kill you? Rhabdomyolysis (rhabdo) is a serious medical disorder I've been teaching about for over 10 years. It can occur when you exercise so much. When you do this, your muscles die, releasing toxins in your blood which can have health grave consequences. While more people know about rhabdomyolysis than when I first started talking about it, one thing I've noticed is many people don't take rhabdo seriously. Because of this, I need you to know, yes people can die from rhabdo. People have died from rhabdo. I tell you this, not to scare you but so that you know sometimes it can happen. In this review, I want to share with you some of the proof, but the risk in perspective and also give you some ideas on other things that can raise your risk.
Rhabdomyolysis Is Serious
When I go on social media – especially Instagram – I see many people tagging their workout pictures with #rhabdo.” They don't have the condition; they are using #rhabdo to give people an idea of how hard their workouts were. It's like a badge of honor I suppose.
In my opinion, their use of #rhabdo -when they do not have the condition- water-downs the significance of this health disorder. I really think it makes people believe rhabdomyolysis is not a big deal.
Rhabdo IS a big deal to all the other people on Instagram posting pictures of themselves in the hospital. It's a big deal to me too because I talk to them – sometimes from their hospital rooms. I know how serious this condition is.
So for everybody out there who uses #rhabdo, on Instagram and elsewhere, stop it. Your workout wasn't that bad. If it was, you'd have rhabdomyolysis and you'd quickly realize how serious this is.
Other Rhabdomyolysis Reviews
For more insights, here are other reviews on rhabdo I have written:
- Rhabdo and Personal Training
- Is It Rhabdo or DOMS
- 5 Reasons Gyms Are Causing Rhabdo
- Mild Case of Rhabdo?
- Can Spinning Cause Rhabdo? Yes!
- Interview: She got rhabdo from spinning class
- Interview: Rhabdomyolysis with non-typical side effects
- My interview on SuperHuman Radio
- My interview on the GymWits Podcast
As you can tell, I have a lot to say about this condition. I did, after all, write the first book -EVER 0n rhabdomyolysis and exercise.
Video Review: Can You Die From Rhabdo?
Here's a video I created to help you understand this. This video covers some information not found in the written review.
Proof Rhabdo Can Kill You
Few websites discuss this possibility but people have died from this disorder. Here are a few cases which highlight this possibility.
In July 2018 a seemingly healthy Ohio police officer died while taking part in a police training exercise. He was 50, fit by outward appearances, and showed no health problems prior to the incident.
The autopsy report stated the police officer died from “multi-system organ failure” caused by “muscle breakdown” which released toxins into the blood which was harmful to the kidneys. That toxin is called myoglobin. Basically this is muscle -hemoglobin. It's toxic to the kidneys in high concentrations.
As reported by Fox 8 in Cleveland, the physical fitness test he was doing consisted of:
- 21 push-ups in 1 minute
- 31 sit-ups in 1 minute
- Run 1.5 miles in under 13 minutes
- Going through an obstacle course
The officer was also doing this test in very hot conditions (92-degree temperatures) which likely contributed to rhabdomyolysis.
To be fair, the autopsy also stated the officer suffered from some heart disease, which I expect to see in someone who is 50. But there was no indication he ever suffered from heart problems.
I am not sure if he trained for this event or not. One thing to remember about rhabdo is it's more common when we do activities we are not used to. See the spinning and rhabdo review for more insights on this.
The report also mentioned his use of a dietary supplement but they do not tell what this supplement was. I have my suspicions. See the supplement section below.
In another report, in march 2018, a young man had to be placed in a medically induced coma after collapsing from a heart attack after completing the Shamrock Half Marathon in Virginia Beach. His heart stopped beating for 9 minutes. This was a fit, healthy young man who had just completed his first half marathon. Fortunately, this man survived because he received prompt medical attention.
In 2015,a 40-year-old triathlete from Virginia died from rhabdomyolysis and dehydration following an Ironman race in Colorado.
In a report by CBS news it was stated that between 2000-2011, 21 college football players have collapsed and died from rhabdo complications during football practice. These were fit, young people. Rhabdo does not discriminate. Both fit and unfit people can get this condition.
It is because of these deaths, many colleges now conduct genetic testing on athletes. Some genetic traits can raise the risk of getting rhabdo. See below for more on this.
I'm the first to admit, rhabdo carries a low risk of death (thank goodness). But, death is the most serious side effect you can get from something. I don't think this message gets out to the public as much as should.
What Increases Rhabdo Risk?
After investigating this condition for over a decade, I've seen several factors linked to increasing the risk of exercise-induced rhabdomyolysis. Some of these factors include:
- Performing new/unusual exercises or activities
- Returning to strenuous exercise after a long hiatus from training
- Exercise in hot temperatures
- Lack of fluids (dehydration does not stop rhabdo but can reduce kidney failure)
- Having the sickle cell anemia trait (a genetic trait)
- Having McArdle's disease (a genetic trait)
- Thyroid problems
- Diabetes
- Recent viral illness
- Drug abuse (that includes marijuana)
- Having liver problems
- Taking some medicines like statin drugs or even acne medications
- Lack of education by fitness professionals
There are additional factors too. Please know I listed the medical conditions not to scare you but to just mention they can elevate the risk, especially if you are at a low fitness level and take part in strenuous exercise. I cannot tell you the odds of getting rhabdomyolysis if you have these medical conditions though. It's complicated and statistics are not available.
Of all of these factors, I believe the biggest reasons for getting rhabdo are:
- the newness of the exercise (have you ever done it before or done it recently?)
- exercising in hot temperatures
- lack of education about rhabdo
Supplements And Rhabdo
As stated above, the Ohio police officer who passed away from rhabdomyolysis was also said to be taking a dietary supplement. Could the supplement have played a role? While they did not give the name of the supplement, over the years, I've noticed reports of some dietary supplements being linked to rhabdomyolysis.
While there are hundreds of thousands of supplements, the ones I think which might elevate your risk of rhabdo the most are those containing stimulants like:
- caffeine
- ephedra
- bitter orange
- higenamine
Supplements which might contain ingredients can include:
- pre-workout supplements
- Energy drinks
- weight loss supplements
Obviously, the risk increases when you use more than is recommended and engaging exercises that are:
- intense
- long-lasting
- activities you have not done before or recently
What about creatine supplements? Do they also raise the risk? In some circles, this is a bit controversial. While there have been reports of individuals getting rhabdo after taking creatine supplements, in every report I've seen, the people had other factors too (sickle cell trait, just started training, etc.) which I believed was more likely the reason why they developed this condition. Could creatine have played role? Sure, it's possible, but I have not seen any damming proof it does this.
My rhabdomyolysis book
In my rhabdo book, I stated I did not believe creatine causes rhabdo in healthy people. I am very happy to now see other researchers agreeing with me.
The risk of rhabdo occurring from dietary supplement use is not known. Most of what we know comes from reports of individuals who were admitted to hospitals.
So Can Rhabdo Kill You?
The short answer is yes, people have died from rhabdo complications. The risk is low, however. Please know most people do not die from rhabdomyolysis. I know some of you are reading this because you think you have rhabdo and are scared. I don't want to scare you. I wrote this so people would take this rare medical condition seriously and help them get medical attention if needed.
Because each case is different, if you think you have rhabdomyolysis, do not look for answers on the internet. For example, despite what so-called experts often say about looking for dark-colored urine, your pee can look normal and you can still have the disorder. The only way to know for sure if you have rhabdo is to go to the hospital. Doctors can quickly figure out if you have it by doing some simple blood and urine tests.
I truly hope this has helped you.
Hey joe I’m 16 and I just got rhabdo for the first time I went to the gym Monday night and woke up Tuesday morning with very sore arms barely able to move them I pushed myself pretty hard it was my first time in the gym in a while here it is Thursday night and my urine is dark and still barely able to move arms without pain should I go to the hospital? Do I need to drink more or less water ? Can I stay home and rest? What else can I do to make a recovery
Joel, if I were you, I’d go to the hospital. You are showing classic rhabdo symptoms. Let me know what happens.
Hey I didn’t realize you responded thank u for getting back to me I drunk ton of electrolytes and recovered after like a week and a half my arms aren’t like they used to I struggle with things like push ups and pulls up a bit when I used to do them with ease I hope my muscles recover completely 😂
Joel, give your body time to recover. Since you said you are struggling with those exercises says to me you are still recovering. Most people do recover but it will take time. Don’t be in a rush to go back. See my other reviews including on recovering from rhabdo.
I feel like I will never recover. I am in PT for the muscle weakness. I was never warned of this even though I had recently discontinued all medications including extremely high doses of psychotropic and seizure medications. I was in good shape until I suffered a trunk muscle trauma that went untreated because the doctor said, “oh that doesn’t happen”.
So I continued to do light workouts that lead to a hernia that was also untreated because I soon suffered a TBI and that is when I moved to a remote farm during the quarantine.
I am now trying to recover but just getting out of bed is a struggle. It definitely affects my self-esteem and I get terribly depressed. This will be a process and I would love to be able to get into the ring before I am too old, at least once.
Quiz, oh I am SO sorry to hear about what you are dealing with. How long have you been in physical therapy for your muscle weakness? Muscles take time to gain strength so don’t be discouraged if it has been just a few weeks. I understand what you say about self-esteem problems. I don’t think you are alone in this.
Hi I just tried to complete an Ironman a week ago. I had been training for 8 months for this. I do overheat easily and the temp was around 78. I was on around mile 100 of the bike and my muscles just gave out. I was pumping up a hill. My legs would not work anymore (could not unclip from my peddles) I became confused and just toppled over.
I knew things were not right and waited for some assistance. They took me to the hospital where I was diagnosed with Rhabdo (which I had never heard of before). I was admitted and put on IV’s. My #’s were really off and they scared me.
The next morning they tested my blood 2 times and everything was back to normal. They released me at 2:00 p.m. I traveled back home and had my blood work tested again and all looked good.
My question is: Is it ok to compete in just a sprint triathlon (which would only take about 1:30) 2-1/2 weeks after? I’m a female, 68 yrs old and have been doing triathlons for about 15 years now but only my 2nd attempt at an Ironman.
Completing an Ironman was on my bucket list but after this scare I am redirecting my goals to another endeavor. It’s hard to find a race that is in the cold. Oh, and I was also on Atorvastatin which they said to lay off of for a while. I felt I had been drinking plenty of my hydration drink (Drip Drop). Thank you for your help. Your site is very informative.
Hi Gail, I generally suggest to give yourself at least a month of rest and having no lingering symptoms before returning to exercise. It’s possible the cholesterol lowering medicine you were taking – combined with the exercise could have contributed to rhabdo (rhabdo is a side effect of statin meds) so that makes sense. While hydration can help reduce rhabdo, I believe its not the only factor to consider.
Activities that are new to us and repetitive play a role too. Training for an Ironman and actually doing it are not the same thing. Also running the race in a different environment / terrain and being under the pressure to beat the clock are factors to consider as well.
All that said, I see no reason why you can’t go back to doing triathlons eventually. I would just make sure your properly recovered.
Do keep me posted on how you are doing Gail. I enjoyed reading your website too 🙂
Makes you feel like dying and yes, Kidney failure will kill you. It almost killed me. BP 60/40, pulse 31. CK-7, GFR-8….1 year later, I am on SSI and Disability, not how I planned to spend my retirement. Caused by Simvastatin.
Tom, I am SO sorry to hear what you went though! It’s ironic that they often refer to rhabdo as a rare side effect of statin meds when Ive met many people who have had issues with them. Not as much as you did though. There is a new class of injectable cholesterol meds like Repatha being promoted on TV. I’m not sure sure they are safe either.
Here’s my Repatha and muscle pain review
I had no idea rhabdo could kill you! I recently found your site after searching for why my friends urine was dark colored 2 days after we worked out. Thanks to you we got him to the hospital. As weird as this condition was, this post about dying from rhabdomyolysis shocked the crap out of me. I am so glad we got him to the hospital when we did.
Hi Sam, I’m so glad you found my rhabdo reviews and got your friend to the hospital when you did! Again, I do feel the risk of death from rhabdo is low but I don’t want that to lull people into not seeking medical attention. I’m happy to hear your friend is doing well now. If you or your friend has any other questions, just ask 🙂
Hey Joe, I never heard of rhabdo until I read your book. I’ve been stalking (following) you ever since. 🙂
I read your book after I developed rhabdo 3 years ago after doing a tough mudder. I thought I was in shape before and so I did not prepare for it. Since reading your book I learned that was my big mistake.
Fortunately, I have been rhabdo-free ever since. The pain was unbearable. I thought I was going to die. I was sorry to learn about the cases you mentioned in your review.
Anyways, just wanted to share.
Your stalker 🙂
Hi Jane, sorry to hear you got rhabdo. From talking with countless others, I know how stressful this can be. I am so glad you found my book helpful too.
Keep stalking me – I am single too 🙂
Joe, thanks for posting this! I’ve had rhabdo 2x and have also seen people on Instagram bragging about their workouts using #rhabdo. It makes me mad to no end. They have NO IDEA the pain I went through when I got rhabdo. That 1 workout cost me $20K in medical bills.
I was one of the lucky ones. I have heard stores of much worse.
Richard, thanks for saying that. I’m glad I’m not the only person who gets angry at #rhabdo posted by people who don’t have the condition. wow 20K in medical bills. I am so sorry. I hope your insurance can pay for some of that? If you have trouble paying this – most would – do reach out to the hospital. I’m sure they would work with you. The good news is I dont think medical bills impact our credit scores like they used to. Double check that to make sure.
How did you get rhabdo?
The important thing is you made it through rhabdo OK. I am very glad of that.