Creatine is a naturally occurring compound derived from amino acids that helps supply energy to your muscles during high-intensity exercise. Its effectiveness has made it a staple in the fitness world for decades, but misinformation about its safety persists. This article delves into the science behind the most commonly cited adverse effects of creatine, sorting through the evidence to provide clarity.
The Real (Minor) Side Effects of Creatine
For the majority of healthy individuals, creatine is well-tolerated when used at recommended doses. The most common and scientifically supported side effects are minor and often temporary.
Water Retention and Bloating
One of the most widely acknowledged effects of creatine is an increase in intracellular water retention. This happens because creatine pulls water into the muscle cells, which is part of how it improves performance and muscle growth.
- Temporary weight gain: An initial weight gain of 1 to 3 kilograms (2.2 to 6.6 pounds) is common during the first week of a loading phase (20–25g/day for 5–7 days) due to this water retention. This is water weight, not fat, and typically subsides after the loading period.
- Bloating: The increased water in muscle cells can lead to a feeling of puffiness or bloating in some individuals, particularly during a high-dose loading phase.
Gastrointestinal Discomfort
While creatine is well-absorbed by most people, excessive single doses can lead to stomach upset.
- Diarrhea and nausea: Studies show that a single dose of 10 grams or more can significantly increase the risk of diarrhea. This is why the standard loading protocol is to split doses into four 5g servings throughout the day.
- Stomach cramps: Some individuals report stomach cramps, though this is often linked to dehydration or taking large doses at once rather than the creatine itself.
Debunking Common Creatine Myths
Many fears surrounding creatine are based on anecdotal evidence or misunderstandings of how it works. Decades of research have thoroughly debunked the following claims.
Creatine and Kidney Damage
This is perhaps the most persistent myth. The concern stems from creatine's natural byproduct, creatinine, which is excreted by the kidneys. Creatine supplementation causes a slight, benign rise in blood creatinine levels, which can be misinterpreted as a sign of kidney disease. Multiple long-term studies have shown no negative effect on kidney function in healthy individuals.
Important Caveat: Those with pre-existing kidney disease should avoid creatine or consult a doctor before use, as their kidneys may not process it efficiently. There have been isolated case reports of acute kidney problems, though a direct causal link is rare and often associated with high doses or underlying issues.
Creatine Causes Dehydration and Muscle Cramps
Contrary to popular belief, creatine does not cause dehydration. Because it pulls water into muscle cells, it can actually enhance overall hydration, especially during exercise in hot environments. The myth likely arose from reports of muscle cramps, but a 3-year study on college athletes found that those taking creatine actually had fewer cases of dehydration, muscle cramps, and muscle injuries. As with any exercise, staying well-hydrated is always recommended.
Creatine and Hair Loss
This claim is based on one small 2009 study on rugby players that found an increase in the hormone DHT (linked to hair loss) after creatine loading. However, the DHT levels remained within the normal physiological range, and the study did not measure actual hair loss. Subsequent research has not supported a link between creatine and baldness.
Creatine Is a Steroid
Creatine is not an anabolic steroid. It is a naturally occurring compound derived from amino acids (glycine, L-arginine, and L-methionine) that the body produces in the liver, kidneys, and pancreas. It is also found in foods like meat and fish. Creatine provides an energy source for your muscles, whereas steroids are synthetic hormones.
Creatine Side Effects: Reality vs. Myth
| Alleged Side Effect | Scientific Evidence | Commentary |
|---|---|---|
| Bloating/Water Weight | Fact, especially during loading phase. | Caused by water being pulled into muscle cells. Temporary and dose-dependent. |
| Gastrointestinal Issues (Diarrhea) | Fact, with high single doses. | Primarily occurs with large, infrequent doses. Often solved by splitting doses. |
| Kidney Damage | Myth (for healthy individuals). | Numerous studies show no negative effect on healthy kidneys. Benign creatinine rise is misinterpreted. |
| Dehydration/Cramps | Myth. | Research shows creatine can improve hydration and may reduce cramps. Proper hydration is always important. |
| Hair Loss | Myth (lacking evidence). | Based on one limited study. No consistent scientific link established. |
| Steroid Usage | Myth. | Creatine is a natural compound, not a synthetic hormone like a steroid. |
Minimizing Potential Side Effects
To avoid or manage the minor side effects associated with creatine, follow these best practices:
- Skip the loading phase: High-dose loading (20-25g/day) is most likely to cause water retention and stomach upset. A lower, consistent daily maintenance dose of 3-5 grams will achieve the same results over time with fewer side effects.
- Stay well-hydrated: Proper hydration is critical for anyone exercising, but especially when taking creatine. Drinking plenty of water aids in creatine absorption and helps prevent any perceived issues with dehydration.
- Take it with food: Consuming creatine with a meal can improve absorption and reduce the risk of gastrointestinal discomfort.
- Choose a quality product: Opt for high-quality, third-party tested creatine monohydrate to ensure purity and avoid contaminants that may cause issues.
- Consult a professional: If you have pre-existing health conditions, especially related to the kidneys, liver, or bipolar disorder, or are on medication, speak with a healthcare provider before starting supplementation.
Conclusion
In summary, what are bad side effects from creatine are mostly temporary, mild, and often exaggerated myths. While some individuals may experience minor gastrointestinal distress or temporary water weight gain, these issues are typically dose-dependent and can be managed effectively. The more serious concerns, such as kidney damage or dehydration, are not supported by the vast body of scientific evidence in healthy individuals using recommended dosages. As with any supplement, understanding your body and consulting with a healthcare provider is the best approach to ensuring safe and effective use. For most, creatine remains a reliable and safe tool for enhancing athletic performance. For more information on creatine and its overall safety, including long-term use and broader health implications, you can read more here.
