Can creatine supplements cause elevated Aspartate Aminotransferase (AST) levels?

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Last updated: May 5, 2025View editorial policy

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From the Research

Creatine supplements are unlikely to cause elevated AST levels in healthy individuals, and any potential elevation is generally temporary and not indicative of liver damage. When considering the potential effects of creatine supplements on AST levels, it's essential to evaluate the evidence from recent and high-quality studies. According to the most recent study 1, creatine supplementation does not increase the prevalence or frequency of side effects, including elevated AST levels, compared to placebo. This study analyzed data from 685 human clinical trials and found no significant differences in side effects between creatine and placebo groups.

Key Findings

  • The study 1 found that creatine supplementation does not increase the risk of side effects, including elevated AST levels.
  • Another study 2 found that creatine supplementation can protect against diet-induced non-alcoholic fatty liver disease, but exacerbates alcoholic fatty liver disease.
  • A review of the literature 3 found that creatine supplementation is relatively well-tolerated, especially at recommended dosages, and does not cause kidney damage or renal dysfunction.

Recommendations

  • Healthy individuals can safely take creatine supplements without significant concern for elevated AST levels.
  • Individuals with pre-existing kidney or liver conditions should consult with a healthcare provider before starting creatine supplementation.
  • If you notice persistently elevated AST levels while taking creatine, it's advisable to temporarily discontinue use and consult with a healthcare provider for proper evaluation.

Mechanism

The potential elevation in AST levels associated with creatine supplementation is thought to be related to the release of creatine kinase and AST from muscle cells, especially during intense exercise, rather than direct liver toxicity 4. This elevation is typically mild to moderate and returns to normal once supplementation is discontinued.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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