From the Guidelines
Creatine supplementation is generally safe and beneficial for most people, but individuals with pre-existing kidney issues should exercise caution and consult a doctor before use. Benefits of creatine:
- Increased muscle strength and power
- Enhanced muscle growth
- Improved exercise performance, especially for high-intensity, short-duration activities
- Potential cognitive benefits Risks and side effects:
- Mild water retention, which usually subsides
- Gastrointestinal discomfort in some people
- Potential kidney stress if taken in very high doses or by those with pre-existing kidney issues, as noted in a study on the nephrotoxic potential of dietary supplements 1 Recommended use:
- Start with a loading phase of 20 grams per day for 5-7 days, split into 4 doses
- Maintain with 3-5 grams daily thereafter
- Take with water or carbohydrates to enhance absorption
- Stay well-hydrated while using creatine It is essential to note that creatine supplementation can affect creatinine clearance measurements, potentially leading to misclassification of acute kidney injury 1. Additionally, a study on Duchenne muscular dystrophy found no clear benefit of creatine supplementation and recommended discontinuing its use in patients with renal dysfunction 1. However, the most recent and highest-quality study on the topic, published in 2020, suggests that creatine supplementation is safe for individuals with a solitary kidney, but it is crucial to monitor kidney function closely 1.
From the Research
Benefits of Creatine Supplementation
- Increases strength, fat free mass, and muscle morphology with concurrent heavy resistance training 2
- Improves high-intensity endurance activities, likely due to increasing anaerobic work capacity 3
- Enhances glycogen resynthesis and content, an important fuel to support high-intensity aerobic exercise 3
- Lowers inflammation and oxidative stress and has the potential to increase mitochondrial biogenesis 3
- Increases time to exhaustion during high-intensity endurance activities 3
- Improves performance in sports that require multiple surges in intensity and/or during end spurts, such as cross-country skiing, mountain biking, and cycling 3
- Increases muscle performance in short-duration, high-intensity resistance exercises 4
- Improves strength endurance, even without changing maximal strength, RPE, fatigue index, blood lactate, and mood state 5
Risks of Creatine Supplementation
- Transient water retention in the early stages of supplementation 4
- Potential liver and renal complications when combined with other supplements or taken at higher than recommended doses for several months 4
- Increases body mass, which may offset the potential positive effects, particularly in weight-bearing activities 3
- Perception of safety cannot be guaranteed, especially when administered for long periods of time to different populations (athletes, sedentary, patient, active, young or elderly) 2
Common Misconceptions about Creatine Supplementation
- Does not lead to water retention, kidney damage, renal dysfunction, hair loss, dehydration, or muscle cramping 6
- Is not an anabolic steroid 6
- Is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day) 6
- Does not increase fat mass 6
- Is beneficial for older adults and not only useful for resistance/power type activities or males 6