7 Side effects of creatine you should be aware of

Creatine supplements are popular for enhancing muscle mass and improving workout performance. But it's not all about the gains; understanding the possible side effects is essential. 

This article outlines seven side effects ranging from mild discomfort to more serious health considerations. Knowing creatine can assist you in making an informed decision regarding its usage.

Whether you're a seasoned athlete or a gym newbie, being aware of what your body might experience is crucial for your health and fitness goals. Let's take a clear-eyed look at the potential drawbacks of creatine use.

What are creatine supplements?

The use of creatine supplements is popular among bodybuilders and competitive athletes. Approximately $14 million is spent on creatine supplements each year by Americans. 

High-intensity, short-duration sports (such as high jumping and weight lifting) may benefit from creatine because it increases lean muscle mass.

However, it is important to note that not every human study shows creatine improves athletic performance, and not every person responds to creatine supplements similarly. 

For instance, people with naturally high creatine levels in their muscles do not get the same energy boost from extra creatine.

Several clinical studies suggest that creatine may help prevent muscle weakness caused by heart failure and muscular dystrophy [1].

How does creatine affect the body in the short term?

It is almost certain that you will gain weight if you take creatine. Adding muscle with creatine is a quick way to gain weight, but you'll also gain water weight, according to Carolyn Brown, RD, Indigo Wellness Group nutrition counsellor [2]. Most people gain "two to four pounds of water retention in the first week."

However, it is good to have water weight. Adding creatine to your diet will increase the size and fullness of your muscles.

And if you're not adding weight to creatine in the short term, you may not drink enough water [3]. Taking creatine supplements requires you to stay hydrated.

How does creatine affect the body in the short term?

How does creatine affect the body over time?

According to Paul Greenhaff, PhD, professor of muscle metabolism at the University of Nottingham in England, subsequent gains result from increasing your capacity to handle workloads. If you keep pushing harder and harder in the gym, creatine will fuel you to make more significant gains.

Some people think that if they take creatine and don't work out, they'll gain fat, but it isn't true. This is because creatine contains no calories and has no impact on your fat metabolism. 

Taking creatine and not working out will lead to nothing. You can't take creatine, not work out, and expect to gain muscle. It just doesn't work that way.

Possible side effects of creatine

Creatine side effects vary depending on who you ask, but here are some that have been reportedly experienced by some users [4]:

1. Kidney damage

Although an older study suggested creatine might worsen kidney dysfunction in people with kidney disorders, creatine does not appear to affect kidney function in healthy individuals [5].

2. Liver damage

Creatine has been linked to this condition [6]. Its administration is known to decrease the consumption of S-adenosyl methionine and also reduce the homocysteine production in liver, diminishing fat accumulation and resulting in beneficial effects in fatty liver and non-alcoholic liver disease [7]. 

3. Kidney stones

While creatine users with a history of kidney stones are advised to monitor their condition with the guidance of a professional specialist, there has been no evidence to date to believe that creatine can cause kidney stones [8].

4. Weight gain

Water weight is a type of weight gain that can occur with creatine. As a result of the supplement drawing water into your muscles' cells, creatine can cause rapid water weight gain.

When your muscles hold onto this water, you'll feel bloated or puffy around your arms, legs, or stomach.

You may even see a bigger appearance of your muscles after just a few weeks of training. It is common for people to gain about 2 to 4.5 pounds in the first week of taking oral creatine [9].

5. Bloating

Also known as fluid retention, creatine can cause rapid water weight because the supplement draws water into your muscles' cells.

This water will cause your muscles to hold onto it, causing bloating or puffiness. Even if you have just started training, your muscles may appear larger [10].

6. Digestive issues

You can experience stomach discomfort if you take too much creatine at once. A study found that athletes who consumed 10 grams of creatine in a one-time dose experienced diarrhea, stomach upset, and belching. Side effects were not reported when supplementing with a 2- to 5-gram dose [11].

7. Compartment syndrome

The "5 's" are oftentimes associated with compartment syndrome: pain, pallor (pale skin tone), paraesthesia (numbness feeling), pulselessness (faint pulse) and paralysis (weakness with movements). Numbness, tingling, or pain may occur in the lower leg and foot [12].

Theoretically, the risk of compartment syndrome is increased during creatine monohydrate (CrM) supplementation because of fluid retention in muscle cells and the muscle tissue's overall size [13].

How safe is it to take creatine every day?

Consuming creatine supplements daily, even over a long period, is safe. People who take high doses of creatine (30 grams/day) for up to five years do not appear to experience any significant side effects. Studies show positive health benefits in athletes who take daily creatine supplements for long periods.

Who should avoid creatine?

Jim King, MD, president of the American Academy of Family Physicians, doesn't recommend anything with minimal improvement and potential risks. It would be better to weigh the negatives and the benefits before you try it.

King recommends avoiding creatine for children under 18. Children are still growing, and we do not know what effect creatine may have on their muscles and bones. "I strongly feel that middle and even high schoolers shouldn't use it." 

How can you minimize creatine side effects?

Managing the side effects associated with creatine is straightforward with the right approach. Here are practical steps to keep them under control:

1. Start small

Kick off your creatine intake with a small dose. This gives your body time to adjust, reducing the likelihood of adverse reactions.

2. Hydration is key

Creatine can lead to water retention, so it's vital to drink ample fluids. Aim for at least eight glasses of water a day, and increase this if you're exercising intensely.

3. Combine with carbs

Taking creatine with a carbohydrate source can boost its uptake by your muscles and lessen stomach discomfort. Consider a banana or a slice of whole-grain bread.

4. Smart timing

Try taking creatine shortly before or after your workouts when your muscles are primed to absorb it.

5. Listen to your body

Pay attention to how your body responds to creatine. If side effects occur, lower your dose or consult a healthcare provider.

6. Take breaks

Implementing cycles, such as using creatine for 12 weeks followed by a four-week break, can help your body reset.

7. Consult professionals

Before starting creatine, especially if you have existing health issues, speak with a healthcare professional to personalize your supplementation plan.

By following these guidelines, you can enjoy the benefits of creatine while keeping potential side effects to a minimum. Health and fitness should always work in tandem, with your well-being as the priority.

When should you see a doctor for creatine side effects?

Creatine is generally safe for many, but there are certain signs that suggest you should seek advice from a healthcare provider:

1. Persistent gastrointestinal discomfort: If you experience ongoing stomach pain, diarrhea, or nausea after taking creatine, it's time to check in with a doctor.

2. Unusual swelling or weight gain: Some water retention is normal, but rapid weight gain or swelling, especially in the legs or ankles, warrants professional attention.

3. Changes in urination: Watch for changes in the color of your urine, frequency, or any discomfort, as these could indicate kidney issues.

4. Muscle cramps or stiffness: While minor cramps are common, persistent or severe muscle pain and stiffness could be a sign of an underlying problem.

5. Fatigue or weakness: Feeling unusually tired or weak despite adequate rest and nutrition might be a signal that your body isn't responding well to creatine.

6. Allergic reactions: Seek immediate medical attention if you notice symptoms of an allergic reaction, such as hives, swelling, or difficulty breathing.

It's always better to err on the side of caution. If something feels off, or if you have pre-existing health conditions, discussing your creatine use with a healthcare provider can help ensure your regimen is safe and effective. Remember, supplements should complement your health, not compromise it.

Closing thoughts

Understanding the potential side effects of creatine is just as important as recognizing its benefits. While most people use it without issue, staying informed and vigilant about how your body reacts is crucial. 

It's important to start with lower doses of creatine, stay hydrated, and consult a healthcare professional if any adverse symptoms occur. By following these precautions, you can safely incorporate creatine into your fitness routine.

Always prioritize your health and well-being above all, ensuring that your path to enhanced performance is both responsible and sustainable.

FAQs

Can creatine be considered a steroid?

No, creatine is not a steroid; it is a naturally occurring compound that helps supply energy to muscles. Unlike anabolic steroids, creatine increases energy availability in muscle cells for growth.

Can creatine affect liver?

There is no conclusive evidence that creatine adversely affects liver health in healthy individuals. However, those with pre-existing liver conditions should consult a healthcare provider before supplementing with creatine.

Will I lose muscle if I stop creatine?

Stopping creatine supplementation may lead to a decrease in muscle water retention, which can slightly reduce muscle size but does not equate to losing actual muscle mass. Your muscles' ability to generate energy without creatine will return to the baseline levels prior to supplementation.

Can creatine cause kidney stones?

Creatine itself has not been shown to cause kidney stones; however, individuals with a history of kidney stones should be cautious and consult a healthcare provider, as creatine may affect water and mineral balance. It's important to stay well-hydrated when using creatine to support kidney health.

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