Creatine Side Effects, Interactions, and What You Should Know (2024)

Creatine is the top sports performance supplement available. Despite its research backed benefits, some people avoid creatine because they worry it’s bad for their health.

Creatine is the top sports performance supplement available. Yet despite its research-backed benefits, some people avoid creatine because they worry it’s bad for their health.

Some claim it causes weight gain, cramping, and issues with digestion, the liver, or the kidneys. But hundreds of studies support its safety and effectiveness.

This article provides an evidence-based review of creatine’s safety and side effects.

Depending on who you ask, the suggested side effects of creatine may include:

  • kidney damage
  • liver damage
  • kidney stones
  • weight gain
  • bloating
  • dehydration
  • muscle cramps
  • digestive concerns
  • compartment syndrome
  • rhabdomyolysis

Is creatine a steroid?

Some people wrongly claim that creatine is an anabolic steroid, that it’s unsuitable for women or teenagers, or that it should be used only by professional athletes or bodybuilders (1).

Despite this negative press, the International Society of Sports Nutrition regards creatine as extremely safe, concluding that it is one of the most beneficial sports supplements available (2).

One study examined 69 health markers after participants took creatine supplements for 21 months. It found no adverse effects (3).

Creatine has also been used to treat various diseases and health concerns, including neuromuscular disorders, concussions, diabetes, and muscle loss (2, 4, 5, 6).

Is creatine safe to take every day?

Research has shown that it is safe to consume creatine supplements daily, even over several years.

There is no evidence to support any significantly detrimental side effects in people who consume high doses of creatine (30 grams/day) for up to 5 years (2).

In fact, research has shown positive health benefits in athletes who took daily supplements of creatine for long periods of time (2).

Summary

Although some people make false claims about creatine’s side effects and safety issues, none of them are supported by research.

Creatine is found throughout your body, with 95% of it stored in your muscles (2).

It is obtained from meat and fish and can also be produced naturally in your body from amino acids (2).

Your diet and natural creatine levels do not typically maximize muscle stores of this compound.

The average stores are about 120 mmol/kg in someone who weighs 154 pounds (70 kg), but creatine supplements can elevate these stores to around 160 mmol/kg (2).

During high intensity exercise, the stored creatine helps your muscles produce more energy. This is the main reason that creatine enhances exercise performance (2).

Once you fill your muscle’s creatine stores, any extra is broken down into creatinine, which is metabolized by your liver and released in your urine (2).

Summary

Around 95% of the creatine in your body is stored in your muscles. There, it provides increased energy for high intensity exercise.

Creatine alters your body’s stored water content, driving additional water into your muscle cells (1).

This fact may be behind the theory that creatine causes dehydration. However, this shift in cellular water content is minor, and no research supports the claims about dehydration.

A 3-year study of college athletes found that those taking creatine had fewer cases of dehydration, muscle cramps, or muscle injuries than those not taking it. They also missed fewer sessions due to illness or injury (7).

One study examined creatine use during exercise in hot weather, which can accelerate cramping and dehydration. During a 35-minute cycling session at 99°F (37°C), creatine had no adverse effects on cyclists, compared with o a placebo (8).

Further examination via blood tests also confirmed no difference in hydration or electrolyte levels, which play a key role in muscle cramps (8).

The most conclusive research has been conducted in individuals undergoing hemodialysis, a medical treatment that may cause muscle cramps. Researchers noted that the group taking creatine experienced a 60% reduction in cramping (9).

Based on the current evidence, creatine does not cause dehydration or cramping. If anything, it may protect against these conditions.

Summary

Contrary to popular belief, creatine does not increase your risk of cramps and dehydration. In fact, may reduce your risk of these conditions.

Research has thoroughly documented that creatine supplements cause a quick increase in body weight.

In a study, 1 week of high dose loading of creatine supplementation (20 grams/day) increased participants’ body weight by around 2–6 pounds (1–3 kg) (10).

Over the long term, studies show that body weight may continue to increase to a greater extent in creatine users than in people who do not take creatine. This weight gain is due to increased muscle growth — not increased body fat (11, 12).

Increased muscle may also have benefits for older adults, individuals with obesity, and those with certain diseases (4, 13).

Summary

Weight gain from creatine is not due to gaining fat but increased water content in your muscles.

Creatine can slightly raise levels of creatinine in your blood. Creatinine is commonly measured to diagnose kidney or liver conditions (14).

However, the fact that creatine raises creatinine levels does not mean that it is harming your liver or kidneys (15).

To date, no study of creatine use in healthy individuals has provided evidence of harm to these organs (2).

A long-term study of college athletes found no side effects related to liver or kidney function. Other studies measuring biological markers in the urine found no difference after creatine ingestion (16, 17, 18).

One of the longest studies to date — lasting for 4 years — similarly concluded that creatine has no negative side effects (19).

Another popular study often cited in the media reported kidney disease in a male weightlifter who supplemented with creatine (20).

But this single case study is insufficient evidence. Numerous other factors, including additional supplements, were also involved (20).

That said, use caution when it comes to taking creatine supplements if you have a history of liver or kidney concerns. A healthcare professional can help you decide whether taking creatine is right for you.

Summary

Current research suggests that creatine does not cause liver or kidney issues.

As with many supplements or medications, excessive doses may cause digestive issues.

In a 2008 study, a 5-gram dose (taken twice per day) caused diarrhea in 29% of participants, which was not significantly different than the placebo. However, a 10-gram dose (taken once per day) increased diarrhea risk by 56% (21).

For this reason, the recommended serving is set at 3–5 grams. The 20-gram loading protocol is also split into 4 servings of 5 grams each over a day (2).

Despite anecdotal reports, there is no evidence that creatine causes digestive concerns when taken at recommended doses (22).

It is possible that additives, ingredients, or contaminants generated during the industrial production of creatine can lead to issues (23).

It is recommended that you purchase a trusted, high quality product.

Summary

Creatine does not increase digestive issues when the recommended dosages and loading guidelines are followed.

There is no evidence that creatine causes acne. Creatine may enhance your ability to exercise harder and longer, leading to increased sweat. While sweating can lead to acne, creatine itself does not.

Some research has demonstrated that creatine may help your skin by improving skin wrinkles, aging, and damage when used topically (4).

Summary

There is no current research to suggest creatine directly causes acne. In fact, some studies show that it can help with wrinkles, aging, and skin damage.

As with any diet or supplement regimen, it is best to discuss your creatine plans with a doctor or other healthcare professional before you start.

You may also wish to avoid creatine supplements if you take any medications that affect liver or kidney function.

Creatine may interact with certain medications, so check with your doctor before starting supplementation.

Creatine can help improve blood sugar management, so if you are using medication known to affect blood sugar, you should discuss creatine use with a doctor (24).

You should also consult a healthcare professional if you are pregnant or nursing or if you have a serious condition, such as heart disease or cancer.

Summary

Creatine may cause concerns if you take certain types of medications, including medications that affect blood sugar.

Some people suggest that creatine can lead to compartment syndrome, a condition that occurs when excessive pressure builds inside an enclosed space — usually within arm or leg muscles.

Although one study found increased muscle pressure during 2 hours of heat training, this resulted mainly from heat and exercise-induced dehydration — not from creatine (25).

Researchers also concluded the pressure was short-lived and insignificant.

Some claim that creatine supplements increase your risk of rhabdomyolysis, a condition in which muscle breaks down and leaks proteins into your bloodstream. However, this idea is not supported by any evidence.

The myth originated because a marker in your blood called creatine kinase increases with creatine supplements (26).

This slight increase is quite different from the large amounts of creatine kinase associated with rhabdomyolysis. Interestingly, some experts even suggest creatine may protect against this condition (26).

Some people also confuse creatine with anabolic steroids, but this is yet another myth. Creatine is a completely natural and legal substance found in your body and in foods — such as meat — with no link to steroids (15).

Finally, there is a misconception that creatine is suitable only for male athletes. Yet no research suggests that it is unsuitable in recommended doses for women or older adults (15).

Unlike most supplements, creatine has been given to children as a medical intervention for certain conditions, such as neuromuscular disorders or muscle loss.

Studies lasting as long as 3 years have found no negative effects of creatine in children (15, 27).

Summary

Research has consistently confirmed creatine’s excellent safety profile. There is no evidence that it causes adverse conditions like rhabdomyolysis or compartment syndrome.

Creatine has been used for more than a century, and hundreds of studies support its safety and effectiveness.

It also provides many benefits for muscle and performance, may improve markers of health, and is being used in medical settings to help treat various diseases.

Creatine is one of the cheapest, most effective, and safest supplements available.

Creatine Side Effects, Interactions, and What You Should Know (2024)

FAQs

Creatine Side Effects, Interactions, and What You Should Know? ›

Creatine is possibly safe when taken long-term. Doses up to 10 grams daily for up to 5 years have been safely used. Side effects might include dehydration, upset stomach, and muscle cramps. When applied to the skin: There isn't enough reliable information to know if creatine is safe.

What are the effects and side effects of creatine? ›

Creatine is possibly safe when taken long-term. Doses up to 10 grams daily for up to 5 years have been safely used. Side effects might include dehydration, upset stomach, and muscle cramps. When applied to the skin: There isn't enough reliable information to know if creatine is safe.

What does creatine interact with? ›

Some drugs that may interact with this product are: drugs that may harm the kidneys (including NSAIDs such as ibuprofen/naproxen), "water pills" (diuretics such as hydrochlorothiazide). This product may interfere with certain lab tests (such as kidney function tests), possibly causing false test results.

Who should and should not take creatine? ›

Taking the stimulants caffeine and ephedra with creatine can increase the risk of side effects. Creatine isn't recommended for people with kidney disease, liver disease, or diabetes. Others who should avoid taking it are children under age 18 and women who are pregnant or nursing.

What to know before taking creatine? ›

What are the side effects of creatine ?
  • Water retention: Creatine may cause water retention, which may increase body weight.
  • Muscle cramps: Some users report muscle cramps, although scientific evidence is limited.
  • Gastrointestinal problems: High doses may cause stomach upset, diarrhea or nausea.

Are there negatives to creatine? ›

As with many supplements or medications, excessive doses of creatine may cause digestive issues. In a 2008 study , a 5-g dose taken twice daily caused diarrhea in 29% of participants, which was not significantly different from the placebo. However, a 10-g dose taken once daily increased diarrhea risk by 56%.

Can creatine cause anxiety? ›

Negative changes in mood or anxiety following supplementation with creatine have been documented in two human trials (Roitman et al., 2007; Volek et al., 2000) and one animal experiment (Allen et al., 2010).

Who Cannot drink creatine? ›

Rhabdomyolysis (breakdown of skeletal muscle tissue) and sudden kidney failure was reported in one case involving an athlete taking more than 10 grams daily of creatine for 6 weeks. People with kidney disease, high blood pressure, or liver disease should not take creatine.

What not to mix creatine with? ›

Caffeine and creatine are both independently regarded as safe and effective sports performance aids. However, the combination may lead to worsened sleep, increased risk of dehydration, and digestive discomfort in some people.

What can I not eat with creatine? ›

Creatine works best when taken with easy-to-digest carbohydrates and proteins to quickly provide muscle boost during activity. Avoid taking creatine with alcohol or caffeine, since they're both diuretics that can cause dehydration. Also, if you have kidney or liver disease, talk with your doctor before taking creatine.

Why do doctors not recommend creatine? ›

While taking creatine might not help all athletes, evidence suggests that it generally won't hurt if taken as directed. Although an older case study suggested that creatine might worsen kidney dysfunction in people with kidney disorders, creatine doesn't appear to affect kidney function in healthy people.

Is creatine safe for the heart? ›

Once a divisive topic, creatine is now one of the most effective and safe dietary supplements that gives proven results. When taken in approved dosages, creatine has been shown to increase muscle mass, strength, brain function, and potentially heart function as well. Creatine is good for you!

Is creatine a steroid? ›

Creatine is not an anabolic steroid, nor does it increase testosterone levels. Some people will retain a couple of pounds of fluid during the first week they start creatine supplementation. But this is temporary, and studies of long-term use do not show a persistent problem with holding onto extra water.

Does creatine raise blood pressure? ›

Short-term blood pressure spikes caused by creatine monohydrate may occur; these are attributed to water retention. The long-term effects are not conclusive, and different studies have shown different outcomes.

How much water should I drink when taking creatine? ›

You should take each 5-gram dose of creatine with at least 8 ounces of water. As for total daily water intake, you should aim for 3 to 4 liters, or 12 to 16 cups, per day. Remember: 1 L equals 1000 ml of water and 1 cup equals 8 ounces of fluid.

What to expect when first taking creatine? ›

Though rare, some people have reported gastrointestinal issues like nausea, vomiting, and diarrhea. Creatine may also cause temporary weight gain and bloating, as it may temporarily increase water retention in your muscles ( 1 ).

What does creatine do to the body? ›

Creatine is a compound that your body naturally makes, and you also get it from protein-rich foods. It supplies energy to your muscles and may also promote brain health. Many people take creatine supplements to increase strength, improve performance and help keep their minds sharp.

What happens when you stop creatine? ›

The simple answer is that your body will go back to producing energy the way it did before you started supplementing with creatine. However, your body's creatine stores will be depleted, especially in muscle and the brain. Creatine withdrawal can cause lethargy and tiredness, lasting anywhere from 1 to 2 weeks.

Does creatine cause weight gain? ›

Creatine can make you weigh more due to water retention, and it can also support lean muscle building, both of which can make you gain weight. However, creatine is very unlikely to contribute to fat gain - woohoo! Find out more below about weight and muscle gain from taking creatine.

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