How safe is creatine? 7 side effects of the strength-boosting supplement

Creatine boosts muscle energy. It works by increasing the availability of energy in the form of adenosine triphosphate, which is crucial for muscle contractions during short bursts of high-intensity activities like sprinting, weightlifting, or jumping. While some people get enough creatine through their diet, some people also rely on creatine supplements. But as with any supplement, it is best to consult with a healthcare professional before using this, especially if you have any pre-existing health conditions. In general also, you must know creatine side effects before you use a supplement.

What is creatine?

Creatine is a naturally occurring compound found mostly in muscle cells. It plays a key role in energy production, especially during high-intensity, short-duration activities like weightlifting or sprinting. Creatine is stored in muscles as phosphocreatine, which helps regenerate adenosine triphosphate, the primary energy source for muscle contractions during exercise.

Our bodies can make creatine from glycine arginine, and methionine, which are amino acids, according to the Harvard Health Publishing. “It can also be obtained through foods like red meat and fish or as a dietary supplement, which is mostly used to improve athletic performance,” says nutritionist Haripriya N.

How does creatine work?

Creatine works in the following ways to increase muscle power, recovery and strength:

• When you use creatine as a supplement, it gets stored in your muscles as phosphocreatine, which is a high-energy molecule.
• During intense physical activity, your muscles use adenosine triphosphate (ATP) for energy, breaking it down into adenosine diphosphate (ADP). Creatine donates a phosphate group to ADP, quickly converting it back into ATP, which is then used for further energy production.
• By replenishing ATP quickly, creatine allows you to perform with much more power and strength for a long time. This can result in improved endurance, more reps during exercise, and enhanced overall performance.
• Creatine also increases water retention within muscle cells, leading to muscle growth.

Are there side effects of creatine?

There are a few concerns around creatine usage. Here are some of the potential creatine side effects, according to nutritionist Haripriya N.

1. Creatine may affect kidneys

Creatine is excreted via the kidneys. In people with pre-existing kidney conditions, excess creatine consumption may put added strain on the kidneys. No adverse effects were seen on the kidney function in healthy people who consumed recommended doses of creatine supplements, as per a 2021 study published in the Journal of the International Society of Sports Nutrition.

2. May lead to weight gain

It is likely that creatine may lead to weight gain. It is not necessarily a side effect as the weight gain is generally not in the form of fat, explains Haripriya. The two main reasons for weight gain while using creatine are:

• Water retention: During a 2007 study published in the Journal of the International Society of Sports Nutrition, some participants who consumed creatine gained 1 to 2 kg in one week, mostly due to water retention. Creatine draws water into muscle cells, leading to increased water weight.
• Increased muscle mass: Over time, creatine helps increase lean muscle mass by allowing you to train harder and recover faster. “This muscle growth can lead to gradual increase in weight, which can be great for those who want to build muscle and strength,” says the expert.

3. May cause acne

There is no scientific evidence that proves creatine causes the skin problem. But if you experience acne while using creatine, it may be due to increased sweat during exercise. Exercise and sweating lead to a buildup of bacteria and dirt on the skin, which can cause acne, according to the American Academy Of Dermatology.

4. May lead to hair loss

Creatine has been linked to hair loss because it may increase levels of DHT (dihydrotestosterone), a hormone that contributes to hair loss. For a 2009 study, published in the Clinical Journal of Sport Medicine, young athletes had creatine supplements for three weeks. They experienced an increase in the levels of dihydrotestosterone associated with hair loss.

5. May cause muscle cramps

During a 2002 study published in the Nephrology Dialysis Transplantation journal, the frequency of muscle cramps decreased by 60 percent in the group that used creatine. The participants were haemodialysis patients. But some individuals may have muscle cramps while using creatine, especially while working out. “The risk of cramps may increase if hydration is not maintained since creatine increases water retention in muscle cells,” says Haripriya.

6. May interact with medicines

Creatine can potentially interact with certain medications like nephrotoxic drugs. “Creatine may increase the strain on the kidneys when taken alongside medications that affect kidney function,” says the expert. Combining creatine with diuretics may lead to dehydration, increasing the risk of kidney problems.

7. May affect sleep

There is no direct evidence linking creatine to sleep disturbances. However, some people may experience minor sleep disruption due to increased energy levels, especially if taken later in the day. “It’s recommended to take the supplements with creatine earlier in the day rather than just before sleeping,” says the expert.

What is a safe dose of creatine?

It is best to consult a healthcare professional regarding the suitable dose of creatine. It is generally safe to take creatine daily, but adequate hydration is a must. Since creatine draws water into muscles, it may cause dehydration if water intake is not adequate. “You can start with a loading phase of 20 grams per day (divided into 4 doses) for about a week to saturate their muscles faster. Then follow it up with a maintenance dose of 3 to 5 grams per day,” says Haripriya. Eating a meal with foods rich in carbohydrates or proteins may help absorb creatine in the body.

Remember that including too much creatine may lead to nausea, diarrhea, stomach cramping and bloating.

FAQs

1. Is creatine a steroid?

No, creatine is not a steroid. Even though both help in enhancing muscle performance, they differ in composition. While creatine increases the availability of ATP that leads to more production of energy during high-intensity physical activities, steroids promote muscle gain by binding to androgen receptors, and influencing protein synthesis.

2. Can creatine cause liver issues?

Creatine is synthesised in the liver, and doses recommended by an expert are typically well tolerated by the liver. So, creatine does not cause liver damage in healthy individuals.

3. How much creatine is safe for kidneys?

Healthy adults can go for a dose of 3 to 5 grams of creatine in a day, but people who have kidney problems should check with their doctor before including creatine in their routine.

Creatine is safe only if taken in recommended doses. But people with specific health conditions or those on certain medications should consult a doctor before using it. Regular hydration and moderation are key to avoiding potential side effects of creatine.