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What are the possible side effects of creatine?

Laura Harcourt

Written byLaura Harcourt

sam-ward

Reviewed bySam Ward

Chocolate creatine powder being scooped from bucket
Creatine can be used to enhance athletic performance, but does it have any side effects? Learn about the potential side effects of creatine and more

Summary

1How much creatine should I take?

Emerging research suggests you’ll probably want to start with what’s called a ‘loading phase’ to get the most out of creatine without overdoing...

2Is creatine bad for you?

The short answer? No, not really – especially if you’re healthy and take it as recommended. Creatine can be a safe and effective supplement that...

3Possible side effects of creatine

Here are some of the most common potential side effects: weight gain: creatine can cause your muscles to retain water, stomach upset: high doses...

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If you’re eager to enhance your physical performance, creatine could be your secret weapon. This naturally occurring substance has been a game-changer for many athletes and gym enthusiasts.1

It’s been known in emerging research to boost strength, muscle mass and exercise performance, particularly for activities that demand quick bursts of energy.1 But, like any supplement, it’s important to use it responsibly and be aware of the potential side effects. 

Let’s explore creatine, its recommended dosage, possible side effects and overall safety.

What is creatine?

Creatine, produced by your liver, kidneys and pancreas, is thought to play an essential role in your body’s energy production. It’s stored in your skeletal muscles, where it can act as a catalyst for energy production during high-intensity exercises or heavy lifting. This energy boost is particularly beneficial for activities that require quick bursts of energy, such as sprinting or weightlifting.1

Although your body can make creatine, food sources like red meat, poultry and seafood can also contribute to its levels.2,3 However, current literature suggests that creatine supplements can ramp up muscle creatine beyond what food alone can provide, which is why many athletes and bodybuilders may use it to help enhance their strength and improve their athletic performance.4,5

Vegetarians and vegans may have lower levels of natural creatine stores since the primary sources of creatine are animal products. Creatine supplementation can help replenish these stores to support muscle function and overall energy levels. This is especially relevant for those following a plant-based diet and looking to enhance their physical performance.3 Learn about the best creatine supplements for vegans in our guide.

The most researched form of creatine supplement is creatine monohydrate. A few small scientific studies give it a thumbs up for being safe and effective. However, research is still limited and further larger high-quality studies are needed.1,5,6

Is creatine bad for you?

The short answer? No, not really – especially if you’re healthy and take it as recommended. Creatine can be a safe and effective supplement that can help enhance your physical performance.1,2,4,5,7 

A few scientific studies support the safety of long-term creatine use, suggesting it may possess therapeutic benefits in healthy people of all ages and those with certain medical conditions.1,2,4,5,6

However, as beneficial as it may be, it’s important to keep to guidance from a healthcare professional when taking creatine.

How much creatine should I take?

Finding the right dosage of creatine is to get the most benefit with the least side effects.

Emerging research suggests you’ll probably want to start with what’s called a ‘loading phase’ to get the most out of creatine without overdoing it. That means taking roughly around 20–25g daily, divided into four doses of about 5g each, for five to seven days. This can help to maximise your muscle creatine levels quickly according to some medical experts.

After the loading phase, you may want to shift to a maintenance phase, taking 3–5g of creatine daily. Research suggests that this may keep your muscle creatine levels topped up.5,8 Some smaller scale studies suggest that larger athletes may need to take a higher dose of 5–10g of creatine a day to maintain their levels.5 

If you’re not keen on the loading phase or if it upsets your stomach, you can skip straight to taking the maintenance dose right from the start. It’ll take a bit longer to increase your muscle creatine levels, but it can be easier on your digestion.1,9 

Remember, taking more creatine than recommended doesn’t offer more benefits. Once your muscles are fully saturated, any extra will be lost in your urine.5 So don’t waste money taking more than you need. 

Possible side effects of creatine

While creatine is safe for most, some people may experience side effects, particularly if they don’t stick to the recommended dosage. 

Here are some of the most common potential side effects: 
  • weight gain: creatine can cause your muscles to retain water, which may result in a slight uptick on the bathroom scales – this isn’t fat gain, just your muscles storing more water, which can make them appear more toned8 
  • stomach upset: high doses of creatine may upset your stomach, causing issues like diarrhoea or gas. To avoid this, try taking smaller doses throughout the day9 
Some people may report other issues when taking creatine, but these are more likely to be related to dehydration than creatine itself, for example: 
  • muscle cramps: some gym-goers claim to experience muscle cramps when taking creatine, but some scientific research may argue that creatine might actually reduce the risk of cramps under certain conditions, such as dehydration and heat1
  • dehydration: some people claim creatine causes dehydration, but this is thought to be a myth, creatine doesn’t dehydrate you. But remember, staying hydrated during workouts is still key1,11
  • dry mouth: this is when your salivary glands don’t produce enough saliva, often because you’re dehydrated. While creatine doesn’t cause dehydration, an intense workout can lead to water loss through sweating, so it’s crucial to keep a water bottle handy and sip regularly to stay hydrated10 
  • dizziness: there’s no direct link between dizziness and creatine use, but it could signal dehydration from intense workouts. If you feel lightheaded, check that you’re drinking enough water12 
  • hair loss: although there’s speculation that creatine causes hair loss, no medical evidence supports this claim1 
  • liver and kidney damage: for those in good health, creatine isn’t associated with liver or kidney damage when you take it in recommended doses1 
Creatine can therefore be classified as a tried and tested supplement and generally gets the green light for safety when used responsibly. However, everyone’s body reacts differently, and what works for one person may not work for another.

The final say

Creatine can be a safe and effective supplement for most people. A few small studies have shown it can enhance exercise performance and support muscle growth. 

Some people may notice temporary side effects, such as digestive discomfort or increased water weight.6,7 However, you can often manage these by adjusting the amount of creatine you take.

If you have any health conditions or concerns, it’s best to consult with a healthcare professional before adding creatine or any new supplement to your routine. They can provide personalised advice and ensure that creatine aligns with your fitness goals and overall health.

Disclaimer

The advice in this article is for information only and shouldn’t replace medical care. While we strive for accuracy and balance, please be aware that this article may discuss products available for purchase through Holland & Barrett. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements mustn’t be used as a substitute for a varied and balanced diet and a healthy lifestyle.
 

Sources

  1. Antonio, J., et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? Journal of the International Society of Sports Nutrition. 2021;18(1). https://doi.org/10.1186/s12970-021-00412-w 
  2. Ostojic, SM. Creatine as a food supplement for the general population. Journal of Functional Foods. 2021;83:104568. https://doi.org/10.1016/j.jff.2021.104568 
  3. Kaviani, M., et al. Benefits of creatine supplementation for vegetarians compared to omnivorous athletes: A systematic review. International Journal of Environmental Research and Public Health. 2020;17(9):3041. https://doi.org/10.3390/ijerph17093041
  4. Wu, SH., et al. Creatine supplementation for muscle growth: A scoping review of randomized clinical trials from 2012 to 2021. Nutrients. 2022;14(6):1255. https://doi.org/10.3390/nu14061255 
  5. Kreider, RB., et al. International Society of Sports Nutrition position stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition. 2017;14(1). https://doi.org/10.1186/s12970-017-0173-z 
  6. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition [Internet]. 2017 Jan 3 [cited 2024 Jul 4];14(1). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5469049/ 
  7. Balestrino M, Adriano E. Beyond sports: Efficacy and safety of creatine supplementation in pathological or paraphysiological conditions of brain and muscle. Medicinal research reviews [Internet]. 2019 Apr 23 [cited 2024 Jul 4];39(6):2427–59. Available from: https://onlinelibrary.wiley.com/doi/10.1002/med.21590 
  8. Bird SP. Creatine supplementation and exercise performance: a brief review. Journal of sports science & medicine. 2003;2(4):123–32. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963244/ 
  9. Ostojic, SM., et al. Gastrointestinal distress after creatine supplementation in athletes: Are side effects dose dependent? Research in Sports Medicine. 2008;16(1):15–22. https://doi.org/10.1080/15438620701693280 
  10. NHS Inform. Dry mouth [Internet]. [cited 2024 Apr 23]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/mouth/dry-mouth 
  11. Baker, LB. Sweating rate and sweat sodium concentration in athletes: A review of methodology and intra/interindividual variability. Sports Medicine. 2017;47(S1):111–28. https://doi.org/10.1007/s40279-017-0691-5 
  12. Taylor, K., et al. Adult dehydration [Internet]. StatPearls Publishing; 2022. [cited 2024 Apr 23]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555956
 

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