Creatine Monohydrate Before Surgery: Safe to Continue
You can safely continue taking your 5 mg daily creatine monohydrate supplement before your benign abdominal wall mass excision—there is no evidence-based reason to discontinue it.
Why Creatine Does Not Need to Be Stopped
No Perioperative Contraindications
The available perioperative guidelines do not identify creatine monohydrate as a supplement requiring discontinuation before surgery. The 2021 SPAQI consensus statement on preoperative dietary supplement management 1 does not list creatine among supplements that should be held before procedures. This guideline specifically addresses numerous supplements with potential perioperative risks, yet creatine is notably absent from their discontinuation recommendations.
Safety Profile in Healthy Individuals
Current evidence demonstrates that creatine monohydrate supplementation at recommended doses (3-5 g/day) is well-tolerated with no significant adverse effects on organ function in healthy individuals 2, 3. Your 5 mg dose is actually 1000 times lower than the typical supplementation dose (5 grams = 5000 mg), making safety concerns even less relevant.
Renal Function Considerations
The perioperative guidelines discuss serum creatinine as a marker of kidney function, not as a concern related to creatine supplementation 4, 5. These references address preexisting renal disease (creatinine levels ≥2 mg/dL) as a risk factor for postoperative complications—this is entirely separate from dietary creatine intake.
Research confirms that creatine supplementation does not impair kidney function in healthy individuals, even at doses far exceeding yours 2, 3, 6. Studies spanning 5 days to 5 years of supplementation at 5-30 g/day showed no adverse effects on glomerular filtration rate or other renal parameters in healthy athletes 6.
Important Caveats
Pre-existing Kidney Disease
If you have any history of kidney disease or elevated baseline creatinine levels, you should inform your surgical team. The evidence suggests caution with creatine supplementation in individuals with pre-existing renal dysfunction 6, 7, though this is based on theoretical concerns rather than your minuscule 5 mg dose.
Dose Context
Your 5 mg daily dose is extraordinarily low—typical athletic supplementation uses 5,000 mg (5 grams) daily. At your dose, you're consuming 0.1% of the standard supplementation amount, making any theoretical risks essentially negligible.
When to Mention It
While you don't need to stop taking it, do inform your anesthesiologist and surgical team about all supplements during your preoperative assessment. Complete medication reconciliation helps them provide optimal care, even for low-risk supplements.
Bottom Line
Continue your creatine monohydrate as usual. The evidence-based perioperative supplement guidelines do not recommend discontinuation, and your extremely low dose poses no documented surgical risk in healthy individuals. Focus instead on following the specific instructions your nurse provided about medications that genuinely require preoperative discontinuation (such as anticoagulants, antiplatelet agents, or herbal supplements with bleeding risks).