From the Guidelines
Creatine is generally not bad for the heart in healthy individuals. The current scientific evidence suggests that creatine supplementation is safe for most people when used at recommended doses [ 1 ]. In fact, some research indicates that creatine may potentially offer cardiovascular benefits by improving metabolic health and reducing homocysteine levels, which is a risk factor for heart disease.
Key Considerations
- Individuals with pre-existing kidney or heart conditions should consult with their healthcare provider before taking creatine supplements, as they may need to exercise caution or avoid creatine altogether [ 1 ].
- It's also important to stay properly hydrated when taking creatine and to purchase supplements from reputable manufacturers to ensure product quality and safety.
- The body naturally produces creatine, and it's also found in foods like meat and fish, which further supports its safety profile when used appropriately as a supplement.
Safety Profile
Some studies have raised concerns about the potential nephrotoxicity of certain dietary supplements, including creatine [ 1 ]. However, the evidence suggests that creatine is not directly nephrotoxic, and its use in patients with a solitary kidney did not alter kidney function [ 1 ].
Recommendations
- Healthy individuals can safely use creatine supplements at recommended doses (typically 3-5 grams daily) without significant concerns for their heart health [ 1 ].
- Individuals with pre-existing medical conditions should consult with their healthcare provider before taking creatine supplements to discuss potential risks and benefits.
From the Research
Creatine and Heart Health
- The current evidence suggests that creatine supplementation is generally safe and may have beneficial effects on heart health 2.
- Creatine plays a key role in heart contraction and energy metabolism, and supplementing with creatine may increase creatine content in the heart, even in healthy individuals 2.
- In heart failure, creatine and phosphocreatine levels decrease, which can lead to decreased contractility reserve of the myocardium and increased mortality risk 2.
- Creatine supplementation may be useful in heart failure, as it has been shown to improve specific parameters of heart failure and increase muscle strength and endurance in heart failure patients 2.
Potential Risks and Considerations
- While creatine supplementation is generally considered safe, high doses or combination with other supplements may increase the risk of liver and renal complications 3.
- Creatine supplements may transiently increase serum creatinine levels, which can mimic kidney disease or lead to overdiagnosis of chronic renal failure 4.
- Individuals with chronic renal disease or those taking potentially nephrotoxic medications should avoid using creatine supplements 4.
- The majority of studies on creatine supplementation have focused on its effects on muscle performance and exercise, with fewer studies examining its specific effects on heart health 5, 3, 6.
Research Gaps and Future Directions
- Further studies are needed to fully understand the effects of creatine supplementation on heart health, particularly in patients with heart failure or other cardiovascular diseases 2, 6.
- Additional research is required to determine the optimal dosage, duration, and route of administration for creatine supplementation in patients with heart failure or other cardiovascular conditions 6.
- The potential benefits and risks of creatine supplementation in different populations, such as older adults or individuals with underlying medical conditions, require further investigation 5, 2.