Can creatine (creatine monohydrate) supplementation increase the risk of exacerbating amyotrophic lateral sclerosis (ALS) by affecting creatine kinase levels?

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Last updated: June 19, 2025View editorial policy

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From the Research

Creatine monohydrate supplementation does not appear to increase the risk of exacerbating amyotrophic lateral sclerosis (ALS) by affecting creatine kinase levels. In fact, creatine has been studied as a potential therapeutic agent for ALS, though with limited success. Creatine works by enhancing energy production in muscle cells by helping regenerate adenosine triphosphate (ATP), which is particularly important in high-energy demanding tissues like muscles and the brain. While creatine supplementation can temporarily increase creatine kinase levels in healthy individuals, this effect is not linked to worsening ALS progression. Typical supplementation involves 5 grams of creatine monohydrate daily, often with a loading phase of 20 grams daily for 5-7 days. For ALS patients considering creatine supplementation, it's essential to maintain adequate hydration and consult with their neurologist before starting any supplement regimen, as individual responses may vary and interactions with other medications should be evaluated.

Some key points to consider:

  • A study from 1 found that higher serum creatine kinase levels were correlated with higher overall survival in ALS patients, suggesting that creatine kinase levels may be a prognostic factor for survival in ALS.
  • Another study from 2 also found that creatine kinase enzyme level correlates positively with serum creatinine and lean body mass, and is a prognostic factor for survival in ALS.
  • However, a systematic review from 3 found that creatine supplementation did not have a statistically significant effect on survival, ALS functional rating revised scores (ALSFRS-R) progression, or percent predicted forced vital capacity (FVC) progression in ALS patients.
  • It's also important to note that creatine supplementation has been shown to be well-tolerated in ALS patients, with no evidence of renal failure or serious adverse events specifically attributable to creatine 4, 3.

Overall, the current evidence suggests that creatine monohydrate supplementation is unlikely to exacerbate ALS by affecting creatine kinase levels, and may even have potential benefits as a therapeutic agent for ALS. However, more research is needed to fully understand the effects of creatine supplementation on ALS progression and survival.

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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