Creatine is a naturally occurring compound derived from amino acids that helps muscles produce energy during high-intensity exercise. It has become one of the most widely researched and used dietary supplements in the world of sports and fitness. Yet, persistent myths and anecdotal claims continue to raise questions about its safety.
Debunking the biggest creatine myths
Many of the common fears associated with creatine are not supported by science. Here is a closer look at some of the most prominent misconceptions.
The kidney damage myth
This is perhaps the most widespread and persistent myth surrounding creatine use. The concern stems from the fact that creatine is broken down into creatinine, a waste product filtered by the kidneys. When supplementing with creatine, blood creatinine levels naturally increase. An elevated reading on a lab test can be mistakenly interpreted as a sign of kidney problems.
What the science says: Numerous long-term studies, including one lasting up to 5 years, have consistently shown that creatine supplementation does not harm kidney function in healthy individuals. However, those with pre-existing kidney disease should avoid it and always consult a doctor.
The dehydration and cramping myth
Another common concern is that creatine causes dehydration and muscle cramps by drawing water into the muscles. Anecdotal reports are often used to fuel this fear, but clinical evidence suggests the opposite.
What the science says: Research by the International Society of Sports Nutrition (ISSN) and others indicates that creatine may have a hyper-hydrating effect, increasing total body water. Studies on athletes have shown that those who supplement with creatine experienced fewer instances of cramping and heat-related illness. Adequate hydration is always important, especially during intense training, but creatine itself is not the cause of dehydration.
The hair loss myth
The claim that creatine leads to hair loss is also a common fear. This idea arose from a single small study in 2009 involving rugby players, which showed an increase in dihydrotestosterone (DHT), a hormone linked to male pattern baldness.
What the science says: Later, more comprehensive reviews found no significant effect of creatine on DHT levels or any link to hair loss. Male pattern baldness is primarily determined by genetics, and the increase in DHT observed in the initial study remained within normal clinical limits.
Potential side effects of creatine and what to do
While the serious dangers are mostly myths, creatine can cause some minor side effects, especially at higher doses. These are generally a source of temporary discomfort and not a serious health risk.
- Gastrointestinal distress: Bloating, diarrhea, or an upset stomach can occur, especially during the loading phase (e.g., 20 grams/day) or when taking a large single dose. Splitting the dose throughout the day and taking it with meals can help.
- Temporary weight gain: Creatine draws water into the muscle cells, which can cause an initial increase in body weight, typically 2-5 pounds during the first week. This is water weight, not fat gain, and is a sign that the creatine is effectively saturating your muscles. Long-term weight gain is attributed to increased muscle mass from enhanced training.
Comparison: Creatine myths vs. facts
| Feature | Myth | Fact |
|---|---|---|
| Kidney Damage | Creatine harms the kidneys, especially long-term | Long-term studies show no adverse effect on kidney function in healthy individuals |
| Dehydration | Creatine causes dehydration and muscle cramps | Studies show creatine may improve total body water and reduce the incidence of cramping |
| Hair Loss | Creatine causes or accelerates hair loss | No conclusive scientific evidence links creatine supplementation to hair loss |
| High Doses | More creatine leads to better results | Muscle creatine stores become saturated; excess creatine is simply excreted, and high doses increase risk of side effects like stomach upset |
| Safety in General | Creatine is an unregulated, dangerous substance | It is one of the most researched and safest supplements for healthy adults |
Who should be cautious with creatine?
Although creatine is safe for most people, certain populations should consult a healthcare professional before use or avoid it altogether.
- Individuals with pre-existing kidney or liver disease
- People with diabetes, as creatine may affect blood sugar levels
- Those with bipolar disorder, as it may worsen mania symptoms
- Adolescents and children, due to insufficient long-term safety data in this population
- Pregnant or breastfeeding women, as safety is not well established
- Anyone taking medication that affects the kidneys
How to use creatine safely
To minimize potential discomfort and maximize benefits, follow these best practices for creatine supplementation:
- Use recommended doses: For healthy adults, a daily maintenance dose of 3–5 grams is typically sufficient to keep muscle stores saturated.
- Stay hydrated: Drink plenty of water throughout the day to support the increased water retention in your muscles and maintain overall hydration.
- Choose a quality product: Opt for third-party tested products (e.g., NSF Certified) to ensure purity and avoid contamination.
- Avoid a large loading dose: If you experience gastrointestinal distress during a loading phase (20g/day), skip it. A consistent, lower daily dose will achieve the same results over a few weeks.
- Be consistent: The most important factor for success is taking creatine every day, even on rest days, to keep muscle saturation high.
Conclusion
For most healthy adults, the research is clear: creatine is a safe and effective supplement with a minimal risk of side effects. Most of the 'dangers' associated with it are unfounded myths perpetuated by misinformation. By following recommended dosages, staying hydrated, and choosing a reputable product, individuals can safely benefit from creatine's performance-enhancing effects. However, those with pre-existing health conditions or specific concerns should always consult a medical professional before starting supplementation. For more information, read the position stand on the safety and efficacy of creatine by the International Society of Sports Nutrition.
