Creatine — Wonder Supplement or Dangerous Cocktail?

the word creatine written on a white powder. wellness concept.

Key Points

  • Creatine is a naturally-occurring substance in the body that facilitates muscle development and energy.

  • Creatine is also available in supplement forms to enhance health and wellness.

  • Proper dosage and supplementation are necessary to yield beneficial results from creatine.

Creatine, a naturally-occurring compound found in your muscles, has gained popularity in the fitness world as a supplement. Known for its ability to improve athletic performance and muscle growth, versions of creatine get snatched up quickly by athletes and bodybuilders for significant results.

Creatine is studied for its potential health benefits, including improvements in brain function and the prevention of certain neurological diseases. Even with ongoing research on its efficacy and potential side effects, creatine remains a subject of hot discussion among fitness professionals and amateurs alike.

What Is Creatine?

Creatine is produced in the liver, kidneys, and pancreas. It's also obtained from dietary sources such as meat and fish. It's essential in providing quick energy to muscles during high-intensity exercises and activities that require short bursts of extreme energy, like sprinting and weightlifting.

Stored in muscle as phosphocreatine, Creatine quickly breaks down to provide energy for muscle contractions. Its energy-production properties replenish adenosine triphosphate (ATP), a primary fuel source for all cells in the body. By donating a phosphate molecule, creatine efficiently regenerates ATP, broken down for several metabolic processes and physical movements.

How Does It Work?

In addition to boosting energy, creatine aids in muscle growth through several factors, including:

  • Increased workload

  • Improved cell signaling

  • Raised anabolic hormones

  • Increased cell hydration

  • Reduced protein breakdown

  • Lower myostatin levels

Creatine also increases phosphocreatine stores in the brain, benefiting brain health and improving symptoms of neurological conditions such as Alzheimer's disease, Parkinson's disease, and epilepsy. A six-month study involving children with traumatic brain injuries revealed that creatine supplementation yielded an impressive 70 percent improvement in brain function.

Natural Creatine Storage

Natural levels of creatine in the body vary depending on factors such as gender, age, and muscle mass. On average, a healthy adult male has around 120-140 grams of creatine stored in the body at any time. A healthy adult female typically stores around 80-100 grams.

Levels can swing widely between individuals and may change depending on lifestyle factors and stressors. While natural creatine levels in the body are a routine and safe part of muscle function, supplementation with high doses of creatine leads to potential health complications. Consult a healthcare professional before adding a supplement to your fitness regimen.

Creatine powder overflows from scoop with gym equipment in background

Benefits of Creatine Use and Supplementation

People choose to supplement with creatine for various reasons related to health and fitness. Supplementation increases muscle mass, strength, and exercise performance, particularly during high-intensity exercises that rely on your phosphagen systems, such as weightlifting, sprinting, jumping, and other vigorous activities. Creatine supplementation also has neurological benefits, as it increases phosphocreatine stores in the brain and improves cognitive function in older adults and those with neurological disorders.

Supplementation is generally safe for healthy individuals when taken within recommended dosages, and it's widely available in many forms, including powders, capsules, and liquids. Many devoted users of creatine supplementation report significant mind/body benefits, including:

Improved Muscle Cell Efficiency and Function

Creatine supplementation increases the amount of phosphocreatine stored in muscles. Phosphocreatine is a critical factor in the formation of ATP, your source of cell fuel. The rate at which a person synthesizes ATP significantly impacts their ability to perform maximum-intensity exercise. You increase your phosphocreatine stores by supplementing with creatine, leading to more efficient muscle function.

Boosted Muscle Mass

Creatine also facilitates the growth of new muscle mass. One of the ways it does this is by affecting cellular pathways that contribute to growth and strength. Creatine supplements also boost insulin-like growth factor levels, a hormone stimulating muscle growth. Some studies suggest that creatine lowers myostatin levels, a molecule that usually inhibits growth and development.

Improved Parkinson's Disease and Other Neurological Disorders

A decrease in dopamine levels characterizes Parkinson's disease, a critical neurotransmitter. Associated with brain cell death and severe physical symptoms such as loss of muscle function, tremors, and speech impairment are low dopamine levels. Studies involving moderate supplementation with creatine revealed a significant improvement in a patient's ability to perform daily activities.

Other neurological conditions such as ischemic stroke, Alzheimer's, Huntington's, and even ALS are significantly improved and slowed by creatine supplementation.

Man drinks creatine before his workout

Improves Blood Sugar and Diabetes Symptoms

According to research, creatine supplementation decreases blood sugar levels by enhancing the activity of glucose transporter type 4, a molecule responsible for transporting glucose into muscles. In a 12-week study that examined the effects of creatine on blood sugar levels after a high carbohydrate meal, those who combined creatine with exercise showed better blood sugar regulation than those who exercised without supplementation.

Sugar clearance from the blood after a meal clearly indicates diabetes risk. The faster your body clears sugar from the blood, the better.

Enhances Brain Function

Creatine plays a critical role in maintaining brain health and proper function. Your gray matter needs considerable ATP to complete challenging cognitive tasks. Using creatine boosts brain function by raising dopamine levels and enhancing mitochondrial function.

Reduces Fatigue

Creatine supplementation is linked to a reduction in fatigue. Six-month studies involving people with traumatic brain injuries revealed that those who supplemented with creatine experienced a 50 percent decrease in dizziness compared to those who did not supplement.

Potential Side Effects of Creatine Use

Even with all of the benefits gained from proper creatine supplementation, a few risks are associated with its use.

Kidney Damage

Although older studies suggest that creatine may worsen kidney dysfunction in those with kidney disease, supplementation doesn't appear to significantly impact those with healthy kidney function.

Liver Damage

Some case reports point to liver damage associated with creatine use, but these reports are rare, and the link between its use and liver damage is not fully established. In some of these reports, individuals had pre-existing conditions and were taking other supplements or medications that interfered with creatine's function in the body.

Man drinks creatine shirtless at the gym

Kidney Stones

Some evidence suggests that long-term, high doses of creatine increase your risk of developing kidney stones. This risk appears relatively low and only applies to those who consume larger-than-normal amounts of creatine for long periods.

Creatine increases the excretion of calcium in your urine, which leads to the formation of kidney stones in susceptible individuals. To minimize your risk, stay hydrated when supplementing, and do not exceed recommended doses. Consult with your healthcare professional if you have a history of kidney problems or are at an increased risk for developing kidney stones.

Weight Gain

Creatine supplementation often leads to an increase in water weight, an undesirable form of weight gain. The supplement draws water into your muscle cells, resulting in a rapid gain of water weight. This may cause uncomfortable bloating and puffiness in the arms, legs, and stomach as your tissues hold onto excess water.

Stomach Upset

Overconsumption of creatine in a single dose can lead to stomach and digestive issues. Recent studies involving athletes who took 10 grams or more in one sitting reported diarrhea, stomach upset, nausea, and excess gas symptoms. Studies reported no such side effects when taking creatine in moderate doses of 2 to 5 grams per serving.

Man mixes creatine and water before a workout

Compartment Syndrome

Compartment syndrome is commonly linked to the five following symptoms:

  • Pain

  • Pallor (pale skin tone)

  • Paraesthesia (numb sensation)

  • Pulselessness (weak pulse)

  • Paralysis (weakness of movement)

Using creatine monohydrate (CrM) supplements increase the risk of compartment syndrome due to the retention of fluids in muscle cells and their subsequent enlargement.

About Creatine Monohydrate

Many fitness enthusiasts and professionals prefer to use creatine monohydrate as their preferred supplementation method, as it is the most readily available form of creatine on the market. Of all types of creatine available to consumers, it has the most scientific research supporting its use, and it is readily available and affordable for most.

CrM has a proven track record of safe use, with few users reporting adverse side effects with proper supplementation practices. Other types of creatine available for use include:

Creatine Ethyl Ester

This form of creatine claims to have better absorption than monohydrate due to its increased solubility. Research on this type of supplement shows little evidence to support its claims.

Creatine Hydrochloride

Creatine hydrochloride also claims to have better solubility and absorption rates than monohydrate. This is a more volatile form of the compound, and a qualified medical professional should provide supervision.

Buffered Creatine

Buffered creatine is pH-neutral and causes less gastrointestinal distress than creatine monohydrate. Those with digestive issues and sensitive stomachs may find this supplementation preferable.

Woman scoops creatine powder from a container

Micronized Creatine

Micronized creatine, created by grinding monohydrate into smaller particles, claims to improve absorption and reduce stomach discomfort. Those new to the game or with stomach and digestive issues find the micronized form of creatine more comfortable assimilating.

How To Determine Proper Dosage

Proper creatine dosage depends on many factors, including body weight, muscle mass, exercise routine, and your response to supplementation. A general recommendation for monohydrate supplementation is 3 to 5 grams daily, taken before or after workouts.

Athletes use higher doses of creatine during a "loading phase" to rapidly increase creatine stores. It's not uncommon to load 20 to 25 grams of creatine per day for five to seven days, followed by three to five grams daily maintenance doses.

The purpose of loading is to saturate muscles with creatine more quickly than if you were to start with a maintenance dose. You experience the benefits of improved strength and endurance during high-intensity exercise, and muscle growth occurs more rapidly than with maintenance doses.

Long-term loading is not a good strategy for health and wellness. If your body is not used to the effects of creatine, you could be at risk for developing health complications from excessive use. Always consult with your physician to ensure that your supplementation doesn't interfere with other aspects of your health.

Creatine Supplementation Options

Creatine supplements come in several different forms. Choosing the right one for you involves finding a supplement that yields results while minimizing uncomfortable side effects. Creatine options come in the following forms:

Creatine Powder

Creatine powder is shelf stable and easily mixed with water or juice. Stir until the powder dissolves, then take your dose in one sitting for the most significant effect. Follow the recommended dosage on the product container according to your body weight.

Tablets and Capsules

Creatine capsules and tablets are every bit as effective as other forms of the supplement. The primary difference between these forms is their convenience and ease of use.

Capsules and tablets offer the advantage of precise dosing and are more convenient for people on the go. They also eliminate your need to bring liquid and mixing containers to the gym.


Creatine liquid supplements are shelf-stable, but checking product labels for specific storage instructions is important. Some may require refrigeration, while others do not.

Most create supplements, including liquid forms, have an expiration date on the packaging. Expired creatine supplements may not work as intended and could potentially be harmful.

Liquid supplements may require mixing with water, while others are stand-alone, allowing you to drink straight from the package. Choose a high-quality supplement from a reputable brand to ensure the best results.

Man mixes creatine powder on a weight bench

Pre-Made Drinks

Several pre-made nutritional and sports drinks contain creatine that benefits athletic performance. Other ingredients such as caffeine, beta-alanine, and nitric oxide boosters are included to enhance both taste and efficacy. When choosing these convenient drinks, read package labels carefully to ensure that added ingredients won't put you at risk for undesirable side effects. For example, those who are caffeine sensitive should look for pre-made drink options without this added energy boost.

Supplementation and Your Wellness Protocol

American entrepreneur Jim Rohn knows that all aspects of life and health are equally important: "Take care of your body; it's the only place you really have to live." Undoubtedly, Rohn has spent as much time proactively managing his health as he has building businesses to yield fantastic success.

Ultimately, the choice is yours to include creatine in your health and wellness protocol. With a proven track record of safe, effective use by many, the benefits may outweigh any potential side effects and complications. Follow the advice of your health professionals and adhere to safe and effective dosing, and see what significant changes may unfold as you gain strength, muscle, and definition.

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