Who Cannot Drink Creatine? Critical Safety Warnings

November 18, 2025 •

4 min read

While creatine is considered one of the most well-research supplements for healthy adults, certain medical conditions and life stages mean some people should not use it. Knowing who cannot drink creatine is crucial for ensuring safe supplementation and avoiding potential health complications.

Quick Summary

Creatine is not recommended for individuals with kidney disease, liver disease, or bipolar disorder due to potential health risks. Pregnant or breastfeeding women, and those under 18, should also exercise caution or avoid creatine, as safety data is limited.

Key Points

Kidney & Liver Disease: Individuals with pre-existing kidney or liver conditions should avoid creatine due to the extra metabolic strain and potential complication of monitoring health markers.
Bipolar Disorder: Creatine may exacerbate mania in individuals with bipolar disorder and should only be considered under strict medical guidance.
Pregnancy & Breastfeeding: Due to a lack of safety data and the potential for unknown risks to the baby, creatine should be avoided by pregnant and nursing women.
Teenagers: Creatine is generally not recommended for those under 18, as the long-term effects on developing bodies are not well-studied.
Diabetes: Diabetics should exercise caution and consult a doctor before using creatine, as it can affect blood sugar levels and require close monitoring.
Dehydration Risk: Proper hydration is essential when taking creatine to counteract the supplement's water-pulling effect on muscles and prevent dehydration.
Genetic Syndromes: Those with rare genetic creatine deficiency syndromes must consult a specialist to determine if supplementation is appropriate for their specific condition.

Creatine is a popular supplement prized by athletes and fitness enthusiasts for its ability to boost strength, increase muscle mass, and improve exercise performance. However, despite its widespread use and solid safety profile for healthy individuals, it is not suitable for everyone. Certain pre-existing medical conditions, medication interactions, and specific life stages require caution or outright avoidance of this supplement. It is imperative to consult a healthcare professional before beginning any new supplement regimen, especially if you fall into one of the following high-risk categories.

Underlying Medical Conditions That Prohibit or Limit Creatine Use

Kidney Disease or Impairment

Creatine and its waste product, creatinine, are processed by the kidneys. A primary safety concern surrounds individuals with compromised kidney function. While studies show creatine does not negatively impact kidney function in healthy people, those with pre-existing kidney disease face a higher risk of complications. Increased creatinine levels in the blood, a marker for kidney function, can complicate diagnosis and monitoring in those with existing issues. Although not proven to cause kidney damage, a higher metabolic load could potentially worsen a pre-existing condition. Avoiding creatine is the safest approach for individuals with a history of kidney disease or those taking medication affecting kidney function.

Liver Disease

The liver plays a key role in creatine metabolism. Individuals with pre-existing liver disease should be cautious. While most studies on healthy individuals report no adverse effects on liver function, some research, including animal studies, suggests potential concerns, especially when combined with alcohol. Consulting a doctor before supplementing is crucial for those with liver issues due to limited and sometimes conflicting research.

Bipolar Disorder

Some individuals with bipolar disorder should avoid creatine as it may exacerbate manic episodes. This is potentially due to creatine influencing brain energy metabolism. Anyone with a history of bipolar disorder should only consider creatine under strict medical supervision.

Genetic Creatine Deficiency Syndromes

Rare genetic disorders affect the body's natural production or transport of creatine. While supplementation can treat some of these conditions, it may be ineffective or not recommended for others, like creatine transporter deficiency. A medical professional is necessary for diagnosis and appropriate treatment guidance.

High-Risk Populations and Life Stages

Pregnancy and Breastfeeding

Due to insufficient research and potential risks to the fetus and infant, health organizations recommend pregnant and breastfeeding women avoid creatine supplementation. Most studies have not included these populations. The effects of maternal supplementation on creatine levels in breast milk and on the infant are unknown. The immature kidneys of a nursing infant could theoretically be strained by excessive exposure.

Teenagers and Younger Children

Medical societies generally advise against creatine supplementation for individuals under 18. While some studies exist, the long-term effects on a developing body are not fully understood. Adolescence is a period of significant change, and the long-term impact of creatine during this stage is unclear. Research on minors is ethically complex, leading to a gap in reliable long-term data. If an older teenager is a serious athlete, any creatine use should be supervised by a healthcare provider.

Creatine and Other Health Interactions

Diabetes Management

While creatine combined with exercise may benefit glycemic control in Type 2 diabetics, supplementation requires careful management. Creatine can affect insulin sensitivity and blood sugar levels, necessitating close monitoring and potential medication adjustments. The added burden on the kidneys from creatine requires close medical supervision given the link between diabetes and kidney health.

Dehydration and Fluid Balance

Creatine pulls water into muscle cells, potentially increasing the risk of dehydration, especially during intense exercise or in hot weather if fluid intake is insufficient. Individuals taking creatine must prioritize adequate hydration to compensate for the fluid shift. Watch for signs of dehydration such as dark urine, dizziness, and fatigue.

Caffeine Interactions

Combining high doses of caffeine with creatine has been reported to increase the risk of certain side effects. Use caution and monitor your body's response.

Creatine Contraindications: A Comparison


Factor	Healthy Adults	Kidney Disease	Liver Disease	Bipolar Disorder	Pregnant/Nursing
Safety Profile	Generally safe and well-researched.	High risk; potential to worsen condition.	Exercise caution; limited human data for severe cases.	Potential for exacerbating mania.	Avoid due to lack of safety data.
Risk Factors	Minimal, if dosed appropriately.	Compromised creatinine filtration.	Impaired metabolic processing.	Mood instability and mania risk.	Fetal and infant health risks unknown.
Recommendation	Safe under most conditions.	Avoid unless directed by a doctor.	Use only under medical supervision.	Use only under medical supervision.	Avoid completely.
Primary Concern	Minor digestive issues possible with high doses.	Increased metabolic load on kidneys.	Metabolic stress and potential complications.	Psychological side effects.	Unknown effects on developing systems.

Consulting a Healthcare Professional

For anyone with a pre-existing medical condition or in a specific life stage like pregnancy, consulting a healthcare provider is the most responsible action. A doctor can evaluate your health, discuss risks and benefits, and help determine if creatine is right for you, advising on dosage and monitoring if necessary. Trustworthy medical information can be found on sites like the Mayo Clinic.

Conclusion

While beneficial for healthy individuals aiming to boost athletic performance, creatine isn't for everyone. Contraindications include kidney or liver disease, bipolar disorder, pregnancy, and breastfeeding. Teenagers should be cautious due to limited long-term data. Prioritizing safety means understanding these risks and making informed decisions, ideally with medical guidance. The benefits of creatine are only worth pursuing if they don't compromise your underlying health.

Frequently Asked Questions

No, if you have pre-existing kidney disease, you should not take creatine. Creatine supplementation increases the load on your kidneys and elevates creatinine levels, which could worsen your condition and interfere with monitoring your kidney health.

Creatine is not recommended for pregnant or breastfeeding women. There is insufficient human research to confirm safety for both the mother and the developing fetus or infant, and professional medical advice is to avoid use during these periods.

Yes, creatine can potentially trigger or exacerbate manic episodes in individuals with bipolar disorder. Those with this condition should speak with a healthcare provider before considering creatine supplementation.

Generally, creatine is not recommended for individuals under 18. Medical and pediatric organizations advise against its use due to a lack of research on its long-term effects on adolescent growth and development.

Diabetics should consult their doctor before taking creatine. While some studies suggest benefits for Type 2 diabetes with exercise, creatine can affect blood sugar levels and potentially strain the kidneys, requiring careful monitoring.

Creatine pulls water into your muscle cells, increasing your overall fluid needs. Inadequate hydration, especially during exercise or in hot weather, can lead to dehydration and other negative side effects like stomach upset and muscle cramps.

For healthy individuals, creatine has not been shown to cause liver damage. However, those with pre-existing liver disease should exercise caution and consult a healthcare provider, especially since interactions with alcohol may exacerbate liver issues.