How Safe is Creatine Use?

I receive a lot of questions from athletes and aspiring athletes in regards to how safe certain supplements are.  Let’s explore a couple of topics in regards to creatine use!

For healthy individuals are there any health risks for creatine use?

Presently, for healthy individuals cleared by a physician for regular exercise, scientific evidence supports that there are not any short or long-term detrimental effects of creatine use at the suggested consumption levels. Generally, doses less than or equal to 5 grams per day are well tolerated by the gastrointestinal tract . Several studies have dispelled any concern regarding creatine and muscle cramping, heat tolerance, and hydration status.  Creatine supplementation (up to 5 years) in athletes has not shown impairment in renal function or other clinical markers with up to 20 g/day in healthy athletes.  The only clinically significant side effect reported is weight gain and for some that may not be as much of a “side-effect “as it is a desired result.   As far as supplementation is concerned, creatine monohydrate is the most widely studied variation of creatine so there may be alternate findings involving studies other varieties of creatine such as creatine ethyl ester, creatine pyruvate, creatine with D-pinitol, or polyethylene glycosylated creatine to name a few.

What type of physical activities might benefit from creatine supplementation and what type of activities might creatine have no effect OR worsen performance?

Creatine is most beneficial for physical activities that involve high intensity, anaerobic activity and for increasing muscle mass and strength. Performance benefits include an increase of: maximal power, work performed during maximal efforts of muscle contraction, work performed during single effort sprint performance. Physical activities that may benefit from creatine may be sprinting/short-distance running events, football, wrestling, and weightlifting. Since creatine can cause an individual to gain weight, it may cause a decrease in performance with physical activities such as long-distance running, swimming, gymnastics, or dance.

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  1. Kreider, R.B., Melton, C., Rasmussen C.J., Greenwood, M., Lancaster,S., Cantler, E.C., Milnor, P., &  Almada, A.L. (2003). Long-term Creatine Supplementation Does Not Significantly Affect Clinical Markers of Health in Athletes. Molecular and Cellular Biochemistry, 244(1-2), 89-104.
  2. Ostojic, S., & Ahmetovic, Z. (2008). Gastrointestinal Distress After Creatine Supplementation in Athletes: Are Side Effects Dose Dependent? . Research in Sports Medicine: An International Journal, 16(1), 15-22.
  3. Lopez, R. M., Casa, D. J., McDermott, B. P., Ganio, M. S., Armstrong, L. E., & Maresh, C. M. (2009). Does Creatine Supplementation Hinder Exercise Heat Tolerance or Hydration Status? A Systematic Review With Meta-Analyses. Journal of Athletic Training, 44(2), 215-223.
  4. . Gill ND, et al Creatine Serum Is Not as Effective as Creatine Powder for Improving Cycle Sprint Performance in Competitive Male Team-Sport Athletes (2004) The Journal of Strength and Conditioning Research, 18(2), 272–275.
  5. Glaister, M., Lockey, R., Abraham, C., Goodwin, J., Staerick, A. (2006). Creatine Supplementation and Multiple Sprint Running Performance. Journal of Strength and Conditioning Research, 20(2); 273-277.