Substances to Avoid or Use with Caution
Caffeine and Stimulants
While a cup of coffee likely won't cancel out creatine's benefits, consistent and high doses of caffeine taken simultaneously with creatine may interfere with its benefits. Some studies suggest that caffeine's opposing effects on muscle relaxation time could theoretically counteract creatine's positive effects on muscle energy production. Additionally, combining these two can exacerbate gastrointestinal discomfort and increase the risk of dehydration. Herbal stimulants like ephedra or ma huang should also be strictly avoided due to serious health risks.
Alcohol
Consuming alcohol while on a creatine regimen is not advisable for several reasons. Alcohol is a diuretic, which increases urination and can lead to dehydration. This directly counters creatine’s function of pulling water into the muscle cells for improved performance. Furthermore, both creatine and alcohol are processed by the liver and kidneys. Excessive alcohol consumption can overwork these organs and negatively impact their function, especially if a pre-existing condition is present. Alcohol also impairs nutrient absorption and muscle protein synthesis, undermining creatine's muscle-building properties.
Certain Medications
Particular care should be taken with medications that affect kidney function. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can potentially increase the risk of kidney damage, especially when combined with creatine. Diuretics, or 'water pills,' are also problematic because they increase fluid excretion, elevating the risk of dehydration and electrolyte imbalance. Individuals with diabetes should also consult a doctor, as creatine can affect blood sugar levels.
Other Supplements
While creatine is generally compatible with most supplements, always read labels. Some pre-workout formulas already contain creatine, and accidentally doubling up on your dose could lead to an upset stomach or other side effects. For individuals with a sensitive stomach, staggering the timing of your supplements may be beneficial.
Practices to Avoid
Inadequate Hydration
Creatine's primary mechanism involves drawing water into your muscle cells. Failing to drink enough water while taking creatine can lead to several problems, including reduced effectiveness, dehydration, and muscle cramps. While creatine itself doesn’t cause dehydration, it significantly increases your body’s fluid requirements. Most experts recommend aiming for at least 3-4 liters of water daily, especially on training days.
Mixing with Hot or Excessively Acidic Liquids
Mixing creatine with very hot or highly acidic beverages for extended periods can accelerate its breakdown into creatinine. Creatinine is a metabolically inactive waste product, so this process reduces the creatine's effectiveness. While a quick stir in orange juice is unlikely to do much harm, it is best to mix your creatine powder with cool or room-temperature water or another non-acidic liquid right before consumption.
Unsupervised High Dosing (Loading Phase)
The 'creatine loading' phase, where high doses (e.g., 20g/day) are taken for a short period, can increase the risk of gastrointestinal issues like diarrhea and bloating. For many people, a simple, consistent daily maintenance dose of 3-5g is just as effective over the long term and minimizes side effects. If you choose to load, it is crucial to stay well-hydrated and space out your doses to avoid stomach upset.
Comparison of Things to Avoid vs. Recommended Practice
| Aspect | Avoid Doing | Recommended Practice |
|---|---|---|
| Caffeine | Regularly combining high-dose caffeine with creatine. | Space out caffeine and creatine intake by several hours to maximize benefits and reduce digestive upset. |
| Alcohol | Consuming excessive alcohol, especially regularly. | Limit alcohol consumption significantly or abstain, ensuring you stay extra hydrated. |
| Medications | Taking creatine with NSAIDs, diuretics, or kidney-affecting drugs without a doctor's supervision. | Consult a healthcare provider if you take medications that impact kidney or liver function. |
| Hydration | Drinking less than the recommended amount of daily water. | Consume at least 3-4 liters of water daily to support creatine's cellular function and prevent dehydration. |
| Mixing | Mixing and leaving creatine in hot or highly acidic liquids. | Mix creatine with cool or room-temperature water or juice and drink immediately. |
| Dosing | Taking excessively high doses, especially during a loading phase without proper hydration. | Stick to the recommended 3-5g maintenance dose or space out a loading phase to minimize GI issues. |
High-Risk Groups and Underlying Health Conditions
Individuals with certain health conditions should be particularly cautious or avoid creatine entirely. Those with pre-existing kidney disease, liver disease, or diabetes should not use creatine without a doctor’s approval. This is because creatine and its byproduct, creatinine, are processed by these organs, and supplementation could add unnecessary stress. Similarly, individuals with a history of heart disease or high blood pressure should be monitored by a healthcare professional. For people with bipolar disorder, creatine has been linked to increased manic episodes, and it should be avoided. Pregnant and nursing women, and children under 18, should also avoid creatine due to insufficient safety data.
Conclusion
For most healthy adults, creatine is a safe and effective supplement for improving athletic performance. However, what you should avoid while taking creatine is just as important as the intake itself. By prioritizing proper hydration, being mindful of your intake of caffeine and alcohol, checking for potential drug interactions, and consulting a healthcare professional if you have pre-existing health conditions, you can safely maximize its benefits while minimizing risks. The key is to be consistent with a moderate dosage and support your body's increased fluid needs. For more information on creatine and other supplements, consult reliable medical sources like the National Institutes of Health.(https://www.msdmanuals.com/home/special-subjects/dietary-supplements-and-vitamins/creatine)
