Dialysis, Anxiety and the Pull of 'Natural' Remedies
When the Body Is Tied to a Machine, the Mind Goes Looking for Control
Three or four hours in a dialysis chair, several times a week, leaves a lot of room for thinking. Some of that thinking is practical. Much of it is not. People living with advanced chronic kidney disease describe worry about lab results, grief over a body that no longer does a basic job on its own, and a restless wish to do something, anything, that feels like their own choice.
That emotional weight is well documented. The National Kidney Foundation cites research finding that about 1 in 5 people on dialysis experience depression. It describes mental health conditions in kidney care as common, often overlooked and treatable.
Key Points
About 1 in 5 people on dialysis experience depression, and anxiety often sits alongside it.
The pull toward herbs during chronic illness is usually a wish for control and hope, not a medical need.
Failed kidneys cannot clear many substances, so a "natural" supplement can carry real risk at stage 5.
Meditation and slow breathing meet the same need for agency and are generally considered low risk.
Any supplement should be reviewed by the kidney care team before it is taken.
Why Herbs Feel So Appealing During Chronic Illness
From a psychological point of view, the draw makes sense. Chronic illness strips away autonomy. Appointments, fluid limits, diet rules and medication schedules are all set by someone else. Choosing a herb is a decision the patient makes alone, and that alone can feel like relief.
There is also the comfort of the word "natural," which many of us quietly translate as "gentle." And there is hope. When a product is described as cleansing or balancing, it speaks directly to the wish that something might undo the damage.
These are ordinary human responses to loss of control. The trouble is that healthy kidneys clear many substances from the body. A person whose kidneys have failed is exactly the person for whom a "gentle" supplement may not be gentle at all.
A Real Question, and a Clear Answer
A good illustration comes from Ask Ayurveda, an online Ayurvedic consultation service. Someone at stage 5 of chronic kidney disease, also dealing with hypertension, raised uric acid and restless legs, wrote in hoping a traditional herb would support both the body and a meditation practice carried out during dialysis. The practicing Ayurvedic doctor who replied took up the question of whether haritaki is safe with kidney disease and said plainly that, in this case, it should not be taken.
The reasoning was specific. Haritaki (Terminalia chebula) is used in Ayurveda as a laxative. The doctor warned that its laxative and drying action could:
worsen electrolyte imbalance
add stress in someone dependent on dialysis
lower blood pressure unpredictably alongside blood pressure medicines
aggravate muscle cramps and restless legs
The doctor added that Ayurveda itself treats advanced kidney disease and dialysis as situations where this herb is avoided.
What stands out is the second half of the reply. Rather than leaving the person with a flat "no," the doctor redirected the wish behind the question. Deeper meditation, the doctor wrote, does not require herbs, detox or stimulation, and mental practices are the safer route.
What Health Agencies Say About Supplements and Kidneys
That caution matches mainstream guidance. The National Kidney Foundation's page on herbal supplements and kidney disease warns that these products can make kidney disease worse, interact with prescription medicines or raise the risk of complications. It notes that some contain potassium or phosphorus, minerals that people on dialysis often have to limit, and that contaminants such as heavy metals are a concern.
The U.S. Food and Drug Administration, for its part, says it is not authorized to approve dietary supplements for safety and effectiveness before they are sold. In practice, the label on a bottle is not proof that a product has been tested in people with failing kidneys.
Meditation Is the Part You Can Safely Keep
The mental health side of the original question deserves a serious answer too. The National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health, summarizes research suggesting that meditation and mindfulness may help with symptoms of anxiety and depression. One 2019 meta-analysis it cites, covering 862 participants, found meditation slightly more effective than relaxation therapy for anxiety.
NCCIH also says these practices are usually considered to have few risks, while noting that a minority of people report unpleasant experiences such as increased anxiety. Meditation is a complement to established care such as therapy or medication, not a replacement. Our guide to CBT vs. pharmacotherapy for depression compares those options.
The practices the Ayurvedic doctor suggested are simple and need no equipment:
Slow breathing. Watch the breath at the nostrils, inhale to a count of four and exhale to a count of six, without holding the breath.
Soft-focus gazing. Rest the eyes on a small dot or an image for a minute or two, then close them. The doctor advised checking with the treating physician first.
Silent repetition. Repeat a calming word or phrase in time with the breath.
Steady routines. Keep regular sleep and wake times and avoid heavy mental stimulation before a session.
The reply also reframed the idea of "opening the third eye" in practical terms: better focus, calmer awareness and less anxiety in the chair. That is a goal a therapist would recognize, and one that asks nothing of the kidneys.
How to Hold the Wish for a Natural Remedy
Name the need underneath
Ask what the herb is supposed to give you. If the honest answer is "a sense that I am doing something," there are other ways to meet that need. A daily practice is one. So is a support group or group therapy, a conversation with a renal social worker, or individual therapy with a counselor who understands chronic illness.
Bring it into the open
Many patients hide supplements from their care team because they expect to be dismissed. Try the opposite. Take the bottle to the nephrologist, renal dietitian or pharmacist and ask them to look at it against your labs and medication list.
Accept "not for you" without hearing "never for anyone"
A herb can have a long history of traditional use and still be the wrong choice for a person at stage 5. Both things can be true, and holding both is less painful than feeling that a whole tradition has been taken away.
When to Ask for More Support
If sadness, anxiety or hopelessness lasts longer than two weeks, the National Kidney Foundation's advice is to reach out to your healthcare team. Tell your dialysis team and ask about a referral to mental health care. Feeling this way does not mean you are coping badly. It is one of the most common parts of the illness.
Treatment helps. The foundation's guide to depression and dialysis says counseling, support groups and medication can all be used on dialysis, though some antidepressants need lower doses or extra monitoring. That is the job of careful medication management, coordinated with your nephrologist.
If you are in Massachusetts, Massachusetts Mind Center is accepting new patients for in-person and remote appointments. If a first visit feels daunting, our walkthrough of what happens at a first psychiatrist appointment for anxiety explains what to expect.
Frequently Asked Questions
Is haritaki safe for someone on dialysis?
In the case described here, a practicing Ayurvedic doctor advised a person at stage 5 not to take it, citing its laxative and drying action. The National Kidney Foundation urges caution with herbal supplements in kidney disease generally. Ask your nephrologist before taking any herb.
Are "natural" supplements safer than prescription medicines?
Not necessarily. The FDA does not approve dietary supplements for safety and effectiveness before sale. Some contain potassium, phosphorus or contaminants that failing kidneys cannot clear.
Can I meditate during dialysis?
Simple breathing and attention practices need no equipment and can be done in the chair. NCCIH describes meditation as low risk for most people, though a minority report increased anxiety. Tell your care team if a practice leaves you feeling worse.
When should someone on dialysis seek mental health support?
When sadness, anxiety or hopelessness lasts longer than two weeks, or sooner if it disrupts treatment or daily life. Start with your dialysis team. If cost is a worry, our guide to affordable mental health services in Boston lists places to start.
Related Reading
Sources
National Kidney Foundation. Your Mind Matters: Mental Health and Kidney Disease.
National Kidney Foundation. Depression and Dialysis.
National Kidney Foundation. Herbal Supplements and Kidney Disease.
U.S. Food and Drug Administration. Information for Consumers on Using Dietary Supplements.
National Center for Complementary and Integrative Health. Meditation and Mindfulness: Effectiveness and Safety.
National Center for Complementary and Integrative Health. Anxiety and Complementary Health Approaches: What the Science Says.
Please note: what you have read here is general information. It is not medical advice, and it cannot stand in for a conversation with your nephrologist or treating physician. Do not start or stop any supplement or medicine without talking to them first.
