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“Research suggests that after 30 days, results from using creatine end up the same for strength gains.” So if you need faster results (e.g., five days vs. 30 days), then loading could work. Creatine has become a popular nutritional supplement among athletes. Recent research has also suggested that there may be a number of potential therapeutic uses of creatine. This paper reviews the available research that has examined the potential ergogenic value of creatine supplementation on exercise performance and training adaptations.

by JP – Updated:

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Ut oh. Creatine dangers are amongst us. If you pay attention to the media, you are probably scared to death.

The media loves to report on creatine risks. If there is even a hint that it could possibly be involved in the death or medical ailment of an athlete, they jump all over the story.

When it is later shown that creatine played no role in the story, they don’t exactly report that with the same enthusiasm.

Creatine is a hot topic these days. It is a hot topic because it is a rare example of a supplement that actually lives up to much of its hype: It works.

Extensive research has been conducted and found supplementation to have no serious side effects.

When something is hot there will always be those willing to sell their souls to cool it off and bring the attention to themselves. This goes a ways to explain not only the media’s approach to creatine but that of the conservative medical establishment. All of this combined has led to great confusion over the safety of creatine usage.

For sure there are concerns regarding use.

Creatine is a relatively new phenomenon and, as such, long-term studies have not yet been completed. Therefore it is not possible to say with absolute authority that there are no potential creatine dangers.

Short-term creatine studies, however, have convincingly shown it to not only be effective but extremely safe.

The 7 Most Worrisome Side Effects Associated With Creatine

Kidney and Liver Damage – This remains one of the legitimate potential creatine dangers although its risks are often misinterpreted and overstated. People supplementing with may show increased levels of creatinine (the waste product of creatine metabolism) in urine concentrations. High creatinine concentration levels in urine are often used as an indicator of kidney problems. While it can be used as an indicator, it is often misinterpreted as a cause. It is not a cause. The increased levels of creatinine in those supplementing will correlate with their increased muscle creatine levels.Studies have not shown creatine to be toxic to the kidneys.
If having medical tests performed along these lines, it is a good idea to inform your doctors if you are using creatine.
People with kidney and liver conditions should evaluate creatine risks at a different level. The kidneys will necessarily have to work harder to remove the excessive creatinine from the body. This also calls into need the importance of drinking lots of water to help the body eliminate the extra creatinine.
Kidney stones are a potential risk and often anecdotally reported. You can do a lot to limit this risk by, again, drinking sufficient water.
Suppression of the Body’s Ability to Synthesize Creatine – The fear here is that the body will lose its ability to synthesize creatine after relying on supplementation for prolonged periods. This would result in the need to continue supplementation indefinitely. Creatine studies have shown that the body has no problem starting production up again after short stints of usage. Again, long-term studies have not yet had time to be completed and therefore the side effects of long-term supplementation are not known.
This fear leads many athletes to cycle their creatine usage. In this way, by allowing the body to resume production by stopping use every couple of months, it is hoped to avoid this and similar potential creatine side effects. (For a discussion on cycling, see the How to Take Creatine Page.) Cycling for this reason is a reasonable thing to do.
However, there have been no documented cases of supplementation suppressing the body’s ability to synthesize creatine.
Nausea, diarrhea, etc. – Minor creatine side effects such as these are not common but they do happen. Often the problem results from the creatine not getting fully dissolved in the stomach. Switching to micronized powder, adjusting the dosage and/or the delivery method will typically alleviate these problems.
Muscle Pulls – An increase in muscle pulls has been associated anecdotally with creatine usage. Studies, however, have not noted an increase. A possible explanation for the anecdotal reports is that people may train too hard based on unrealistic expectations of the supplement’s abilities.
Muscle Cramps – Muscle cramps are thought to be caused in part by the lack of sufficient fluids. Creatine effects include drawing water into the muscle cells and therefore require greater fluid intake especially during a loading phase. Not providing the body with extra fluids during this time could lead to an increase in muscle cramping. Creatine studies, however, have not shown an increased incidence of muscle cramps in properly hydrated individuals.

Dehydration, Heat Intolerance – Along with muscle cramps, increased risks of dehydration and heat intolerance have been reported anecdotally. Again, studies haven’t backed up the anecdotal evidence but the knowledge that the supplement does draw water into the muscle cells make them plausible creatine dangers and further illustrates the importance of drinking lots of water while supplementing.

Weight Gain – I know what you are thinking – weight gain listed among creatine dangers? Obviously, this is a positive for those of us trying to gain weight fast as well as most that choose to supplement. Anti-creatine people always list it among their creatine dangers though, and for those athletes who participate in endurance activities it can be among creatine’s negative effects.

While further studies are needed before we proclaim potential creatine dangers to be null and void, there is little reason to believe it won’t measure up here as well. To this point creatine has been the most thoroughly studied performance enhancing supplement and has passed every test before it.

The Hidden Creatine Dangers?

While studies continue to mount up showing supplementation to be extremely safe, anecdotally there have been reports of some scary health consequences. While anecdotal reports are not a reliable indication of anything, there is a plausible reason that the research would show creatine supplementation to be safer than it has actually become in practice.

The studies that repeatedly find no creatine dangers typically use a very high quality pure creatine monohydrate without additives. With the explosion of the supplements popularity, many manufacturers have sought cheaper manufacturing processes to gain a price advantage over their competitors. These processes and additives can mean that you are getting more than you know when you set out to supplement. And that extra stuff can be scary.

The cheaper powders (Chinese creatine and the like) are not only going to be providing less effective product, they can also throw some very dangerous chemicals into the mix.

The creatine I use and recommend on this site is Optimum Nutrition’s Creatine Powder. This product does not contain additives and uses creatine manufactured by Degussa, a large German company that is well respected for its manufacturing practices.

Conclusion

By all indications, creatine use should be very safe for healthy individuals who use the product responsibly. This means making sure that you don’t go overboard with your dosages and keep yourself properly hydrated.

Buying the cheapest creatine on the market is not a good idea as it can present additional side effects. As with all dietary supplements, buy at a reasonable price from a trusted manufacturer.

Creatine dangers are often misunderstood and reported irresponsibly by the media. Understanding the supplement and its true abilities can alleviate concerns and increase results.

Understanding the potential side effects and the potential benefits… Should I use creatine?

Ultimately, that is an individual decision. It comes down to doing the research and deciding if you feel comfortable with it. My opinion is that creatine is safe and can be a valuable addition to an otherwise strong training program.

To help decide if it is for you, check the article, Should I Use Creatine Supplements?

Couple more articles you may like…

How Glutamine Can Benefit Weight Lifters

Learn how supplementing with this anti-catabolic amino acid may help you preserve and build muscle.

The Effects of Creatine Supplementation

Learn how creatine works within the body to help the trainer gain weight and build muscle – What it can do for you and what it can’t.

See all the articles from the Guide to Muscle Building Supplements

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Find the Best Muscle Enhancement Supplements. See Which BCAA and Creatine Supplements Passed CL's Tests & the Top Picks

Alphabetical list of creatine or BCAA supplement brands compared in this review

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Summary

Creatine

What Does Creatine Do? Creatine is an amino acid that helps supply muscles, including the heart, with energy, particularly for short-term, maximal exercise (See What It Is). Some, but not all studies suggest creatine supplements can improve muscle strength and endurance during repeated high-intensity exercise of short duration, such as weight lifting and sprinting, but is not helpful in purely aerobic exercise. Creatine may also be useful in improving exercise tolerance in patients with congestive heart failure (CHF) and muscle strength in people with muscular dystrophies (See What It Does).
Is Creatine Safe? Creatine is generally considered safe when taken in appropriate amounts for short periods of time, but little is known about potential long-term adverse effects of creatine. There is some concern that long-term use at high doses (20 grams/day) may adversely affect the kidneys and cardiovascular system (See Concerns and Cautions).
How to Take Creatine? Commonly, a 'loading' dose of creatine is taken for 5 to 14 days, followed by a maintenance dose. However, some studies have shown a benefit using a constant dose rather than a larger loading dose. If using a powder or mix, drink it as soon as possible -- creatine will begin to break down once in liquid. Also, when using creatine supplements, it is important to drink about 8 cups of water per day. For dosage details, see ConsumerTips™.
Which Form of Creatine Is Best? Creatine comes in various forms, the most common being the monohydrate form, which also yields the greatest amount of free, usable creatine. Certain formulations are inherently unstable and should be avoided. ConsumerLab.com's tests for this Review showed that one creatine product exceeded CL's limit for impurities. Among the others, CL's Top Pick provided 5 grams of pure creatine monohydrate powder for less than 10 cents (See What CL Found and CL's Top Picks).

BCAAs

What Do Branched-Chain Amino Acids (BCAAs) Do? Branched chain amino acids are the essential amino acids isoleucine, leucine and valine that the body cannot produce (See What It Is). Taking BCAAs before and after exercise may help reduce or delay the onset of muscle soreness and improve muscle recovery. Leucine appears to be the most significant BCAA for stimulating protein synthesis (See What It Does).
Are BCAAs Safe? BCAAs are considered safe at standard doses, but may interact with certain medications (See Concerns and Cautions).
How to Take BCAAs? For muscle recovery and to prevent soreness, daily doses of 1 to 5 grams have been used. How to take this and doses for other uses are explained in ConsumerTips™.
Which BCAA Supplement Is Best? ConsumerLab's tests revealed that one product contained less leucine than claimed. Among products which passed CL's tests, several provided 5 grams of BCAAs for about 30 cents (See CL's Top Picks).

Other Muscle Enhancers
Learn about glutamine,

HMB, and taurine

Creatine Supplement Side Effects

. Also see information about the muscle enhancing effects of vitamin D, protein powders, and 'nitric oxide' supplements. Among the most popular supplements used to enhance muscular strength and/or mass and improve exercise recovery are creatine and branched-chain amino acids (BCAAs). These may also be useful in diseases involving muscle weakness or wasting.
You must become a ConsumerLab.com member to get the full test results for creatine and BCAA supplements. You will get results for seven creatine supplements and nine BCAA supplements, including products selected for testing by ConsumerLab.com and several which passed the same tests through CL's voluntary Quality Certification Program.
In this comprehensive review, you'll discover:

Which creatine supplements and BCAA supplements failed testing and which passed
CL's Top Picks among the best creatine and BCAA supplements
Cost comparisons to help you choose a creatine or BCAA supplement offering the best value
What creatine and BCAA supplements may and may not do for you
The differences among forms of creatine: creatine monohydrate, creatine HCL, creatine AKG, dicreatine malate, tricreatine malate, and KreAlkalyn

Differences among the BCAAs (isoleucine, leucine, and valine)
Dosage for specific uses of creatine and BCAAs
The best way to take creatine and BCAA supplements
Safety concerns, potential drug interactions and side-effects of creatine and BCAAs

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Latest Clinical Research Updates for Muscle & Workout Supplements (Creatine and BCAAs)

Creatine Supplements Benefits

When coupled with resistance exercise, does supplementation with creatine or branched chain amino acids (BCAAs) further boost muscle strength? Find out what separate recent studies showed for creatine and BCAAS in the 'What It Does' section of our Muscle & Workout Supplements Review. Also, see our Top Pick for creatine and BCAA supplements.

Do supplements with leucine (a branched-chain amino acid or BCAA) prevent muscle loss when muscles are immobilized (such as in a leg brace)? See what a recent study showed in the What It Does section of our Muscle & Workout Supplements Review.

Results Of Creatine Supplementation

A relatively new form of creatine may raise creatine levels in the blood and muscle more effectively than the most common form (creatine monohydrate), but it has drawbacks. Learn more in the ConsumerTips section of the Muscle & Workout Supplements Review. Also see our Top Picks for creatine.

Creatine may boost the benefits of resistance exercise for older people, according to recent studies. For details, including dosage, see the What It Does section of the Creatine Supplements Review. Also see our Top Picks for creatine.

Does taking creatine improve muscles in older people? See the results of a recent study in the What It Does section of the Muscle & Workout Supplements Review. (Also see our Top Pick for creatine).

Does taking amino acids after knee replacement surgery help maintain muscle volume, mobility, and strength? See what a recent study found in the What It Does section of the Muscle & Workout Supplements Review. (Also see our Top Picks in this category).

Best Creatine Supplement

Glutamine, an amino acid, plays a role in maintaining the digestive tract. Can taking it as a supplement help people with irritable bowel syndrome (IBS)? Find out what a recent study showed in the Glutamine section of the Muscle Enhancers Review.

Giving creatine during a resistance-training program significantly boosted muscle size more than placebo in a recent study — and certain muscles increased in size more than others. Learn more in the 'What It Does' section of the Muscle & Workout Supplements Review (Creatine & BCAAs). (Also see our Top Picks and Cautions and Concerns for creatine).

A recent study found that active, middle-aged people restricted to bed rest for several days lost significantly less muscle mass and function if given a leucine supplement along with their meals. Fat gain was also reduced. Get the details, including our tests of leucine-containing supplements, in the Muscle Enhancers Review >>

A study of men who have used muscle-building supplements shows a disturbing increase in the risk of testicular cancer. More information is in the Muscle Enhancers (Creatine and Branched-chain Amino Acids) Review >>

Taking creatine daily for at least five years did not slow the progression of Parkinson disease according to a recently reported study involving nearly 1,000 patients. For more details about the study, other studies with creatine (for strength, fibromyalgia, etc.), and our tests of creatine supplements, see the Product Review of Muscle Enhancers (Creatine and Branched-chain Amino Acids) >>