Understanding Creatine: Are There Any Negatives to Creatine?

October 22, 2025 •

4 min read

Creatine is one of the most extensively researched dietary supplements on the market, with hundreds of studies confirming its effectiveness and safety. Despite its proven benefits, many people still ask, "Are there any negatives to creatine?" due to persistent misconceptions and anecdotal reports.

Quick Summary

This article explores the safety profile of creatine supplementation based on scientific evidence, examining common concerns like kidney damage, dehydration, and bloating. It clarifies who may experience side effects and provides best practices for safe and effective use.

Key Points

Kidney Concerns: For healthy individuals, creatine does not damage the kidneys; rising creatinine levels are a normal metabolic effect of supplementation, not a sign of dysfunction.
Hydration Status: Contrary to popular belief, creatine does not cause dehydration or muscle cramps; it may actually improve hydration within muscle cells, with studies showing a reduced risk of cramping in athletes.
Temporary Weight Gain: Initial weight gain from creatine is primarily due to water retention in the muscles and is not fat mass; this effect is short-term and can be minimized with lower doses.
Minor Digestive Issues: High doses, especially during a loading phase, can cause gastrointestinal distress like diarrhea or bloating, but these effects are rare and can be managed by splitting doses.
Exercise Caution with Pre-existing Conditions: Individuals with kidney or liver disease, diabetes, or bipolar disorder should consult a healthcare provider before using creatine.
Hair Loss Link is Unproven: The claim that creatine causes hair loss is based on a single, unreplicated study, and scientific consensus does not support this link.

Creatine Myths vs. Scientific Reality

Many supposed negatives of creatine are based on misunderstandings rather than strong scientific evidence. Research has largely disproven these fears, especially for healthy individuals using recommended amounts.

The Kidney Damage Myth

A common fear is that creatine harms the kidneys because it increases creatinine, a waste product filtered by the kidneys. While creatinine levels do rise with supplementation, multiple studies, including some lasting several years, show no evidence of kidney or liver damage in healthy individuals. Those with existing kidney disease should consult a doctor before use.

Dehydration and Muscle Cramps

Another misconception is that creatine causes dehydration and muscle cramps by drawing water from the body. Creatine does pull water into muscle cells, which is beneficial for performance. Some research even suggests it might help prevent dehydration and cramping during exercise in hot conditions. One study on college football players found fewer cramps and heat-related issues in creatine users.

Hair Loss Concerns

A single study from 2009 suggested a link between creatine and increased dihydrotestosterone (DHT), a hormone linked to hair loss. However, this finding has not been supported by other research, and most evidence doesn't connect creatine to hair loss. Genetics are the main factor for baldness.

The Weight Gain Misconception

Creatine can lead to weight gain, mainly due to water retention in the muscles during the initial loading phase, not increased body fat. This water weight is temporary and often makes muscles look fuller. Any long-term weight increase is typically due to muscle gain from improved training.

Myths vs. Facts About Creatine's Negatives


Feature	Common Myth	Scientific Fact
Kidney Damage	It harms your kidneys by increasing creatinine levels.	Does not harm healthy kidneys; elevated creatinine is an expected, harmless byproduct of supplementation.
Dehydration	Creatine causes dehydration and muscle cramps by pulling water from the body.	Pulls water into muscles (cell volumization) but does not cause dehydration; some evidence suggests it can reduce cramping.
Weight Gain	Creatine causes fat gain and bloating.	Primarily causes temporary water retention in muscles; long-term weight gain is from increased muscle mass, not fat.
Hair Loss	It accelerates baldness by increasing DHT levels.	The link is based on a single, unreplicated study and lacks broader scientific support.
Steroid Status	Creatine is a type of anabolic steroid.	Creatine is not a steroid; it is a naturally occurring compound found in meat and synthesized by the body.

Potential Side Effects and How to Manage Them

While many reported negatives are myths, some individuals might experience minor side effects, especially with higher doses. Responsible use and proper hydration can help minimize these.

Gastrointestinal Distress

Taking excessive amounts, typically over 10 grams in one dose, may lead to digestive issues like diarrhea, stomach cramps, or nausea. This is more common during a loading phase. Splitting doses or taking creatine with food can help.

Temporary Water Retention

Initial water retention is common, particularly during the loading phase, but usually disappears after a week or two. Staying well-hydrated also helps manage fluid balance.

Who Should Be Cautious?

While safe for most healthy adults, certain individuals should consult a doctor before using creatine.

Pre-existing Kidney or Liver Conditions: Those with compromised kidney or liver function should avoid creatine unless a doctor advises otherwise, as its effects haven't been well-studied in these groups.
Pregnancy and Breastfeeding: Due to limited data, it's recommended to avoid creatine during pregnancy or breastfeeding as a precaution.
Bipolar Disorder: Creatine might increase the risk of mania in people with bipolar disorder and should be used cautiously.
Diabetes: People with diabetes should consult a doctor, as creatine can potentially affect blood sugar.

Best Practices for Safe Creatine Use

To get the most benefit and reduce potential negatives:

Choose a Quality Product: Look for third-party testing (like NSF Certified for Sport) to ensure purity.
Stick to Recommended Doses: A daily dose of 3–5 grams is enough to saturate muscle stores over 3–4 weeks. An optional loading phase (20g/day for 5–7 days) may increase the chance of minor side effects.
Stay Hydrated: Drink plenty of water to support hydration and manage water retention.
Consult a Professional: Talk to a doctor or dietitian if you have health conditions, take medication, or are unsure about using creatine.

Conclusion

Scientific evidence indicates that for healthy individuals, creatine is a safe and effective supplement with minimal negative side effects when used correctly. Common concerns about kidney damage, dehydration, and hair loss are not supported by clinical studies. Minor issues like bloating or digestive upset are rare and can often be managed by adjusting dosage. By following recommended guidelines and staying hydrated, most people can use creatine to improve performance and support muscle health without major concerns.

For more detailed information on creatine's safety and benefits, consult the position stand from the International Society of Sports Nutrition.

Frequently Asked Questions

Decades of research have shown that creatine does not harm healthy kidneys when taken at recommended dosages. The myth stems from creatine's natural conversion to creatinine, a waste product that increases in the blood but does not indicate renal damage in healthy individuals.

No, scientific studies have debunked the myth that creatine causes dehydration or cramps. Creatine pulls water into muscle cells, aiding hydration. In fact, research on athletes has shown creatine supplementation is associated with a reduced incidence of cramping and other heat-related issues.

Creatine can cause an initial, temporary increase in body weight due to water retention within your muscles. This is not fat gain. Long-term weight gain is typically a result of increased muscle mass from improved training performance.

The most common, though rare, side effects of creatine are mild and typically related to digestive issues, such as bloating, diarrhea, or stomach cramps, especially at higher doses during a loading phase. These can often be mitigated by reducing the dose or splitting it throughout the day.

No, a loading phase is not necessary. While it can saturate your muscle creatine stores faster (in about a week), a consistent daily maintenance dose of 3–5 grams is just as effective over a slightly longer period (3–4 weeks) and less likely to cause digestive side effects.

Creatine is not recommended for individuals with pre-existing kidney or liver disease. It is also advised to consult a doctor if you have diabetes, bipolar disorder, or are pregnant or breastfeeding, as more research is needed for these populations.

Long-term studies lasting up to five years have shown no significant, detrimental side effects of creatine supplementation in healthy individuals at recommended doses. It is one of the most well-researched and safest supplements available.