Creatine is a very popular dietary supplement among athletes and bodybuilders. Used to improve physical performance and increase muscle mass, it nevertheless raises questions about its safety and potential side effects.
Here, we will examine all the risks associated with creatine.
What is creatine?
Creatine is a substance naturally present in the human body, mainly stored in muscles and the brain. It is synthesized from three amino acids: glycine, arginine, and methionine.
As a sports supplement, it is generally found in the form of creatine monohydrate, the most common and most studied form.
The effect of creatine on your body
Creatine is fundamental for your cellular energy production. It participates in the regeneration of adenosine triphosphate (ATP), the main energy source used by muscles during intense and short-duration efforts.
By increasing phosphocreatine reserves in the muscles, creatine supplements allow you to prolong the duration of maximum effort and improve your athletic performance.
Safe consumption of creatine
General use
Numerous studies show that creatine is relatively safe for most individuals, provided that the doses are appropriate and the user is in good health.
The International Society of Sports Nutrition states that creatine is well-tolerated, even at high doses of 30g/day in healthy adults.
Effects on kidney and liver function
Concerns about the effects of creatine on kidney and liver function have been extensively studied. A review of 19 studies on bodybuilders consuming between 5 to 30g of creatine per day over periods ranging from 5 days to 5 years showed no alteration in kidney function.
However, athletes with kidney disease are advised to consult a healthcare professional before using creatine.
Potential side effects
Side effects associated with creatine are generally minor and temporary. The most common include stomach upset, nausea, and loose stools.
These effects are often related to difficult absorption in some people. You should therefore know when to take creatine. To minimize these effects, it is recommended to take creatine with your meals and stay adequately hydrated.
Water retention
Creatine can lead to intracellular water retention, which can increase body weight.
While this is beneficial for hydration and muscle performance, it can be perceived as a disadvantage in weight-category sports.
Precautions to take
Quality and purity of supplements
You must choose high-quality creatine supplements to avoid contamination by toxic substances such as heavy metals.
Certified and tested products, such as those bearing the AFNOR NF 17444 standard, are recommended to guarantee purity and safety.
Interactions with other medications
Creatine can interact with certain medications, including anticoagulants, thus increasing the risk of bleeding.
It is essential to consult a healthcare professional if you are taking medication or have a pre-existing medical condition.
Contraindications
Some people should avoid creatine or use it with caution:
- People with kidney disorders: Medical consultation is necessary.
- Pregnant or breastfeeding women: The safety of creatine during pregnancy and breastfeeding is not well studied.
- People with liver disease or diabetes: These conditions require particular attention and medical advice.
Myth or reality: Is creatine a doping product?
It is important to clarify that creatine is not considered a doping product. It is naturally present in the body and its use as a supplement is legal. Official anti-doping organizations do not recognize it as a prohibited substance.
However, it is important to choose pure creatine products to avoid any contamination by doping substances.
Recommended doses
Commonly recommended creatine doses generally range from 3 to 5 grams per day. Some practice a "loading phase" with higher doses (20g/day) for one week, followed by a maintenance dose.
However, high doses are not necessary to obtain beneficial effects and may increase the risk of adverse effects.
Potential side effects
Digestive problems
Some creatine users report digestive problems such as stomach pain, nausea, or diarrhea.
These effects are generally temporary and can be minimized by taking creatine with your meals and staying adequately hydrated.
Muscle cramps
Muscle cramps can occur, although this effect is rare and often linked to dehydration.
It is therefore crucial to maintain adequate hydration when taking creatine.
Water retention
Water retention is a common side effect of creatine. While this can increase muscle volume, it can also lead to temporary weight gain.
Athletes in weight-category sports should be aware of this and adjust their supplementation accordingly.
Creatine and kidney problems
It has long been suggested that creatine could lead to kidney problems. However, extensive studies show that creatine has no harmful effect on kidney function in healthy individuals.
A study conducted on bodybuilders consuming high doses of creatine for prolonged periods showed no alteration in kidney function.
Contraindications and precautions
Kidney disorders
People with kidney disorders should avoid creatine or use it under strict medical supervision.
While creatine does not appear to affect kidney function in healthy individuals, it could worsen existing kidney conditions.
Pregnancy and breastfeeding
The safety of creatine during pregnancy and breastfeeding has not been sufficiently studied. As a precaution, pregnant or breastfeeding women are advised to avoid creatine.
Diabetes and liver diseases
People with diabetes or liver diseases should consult a healthcare professional before taking creatine, as it could interact with their medical conditions.
Creatine is an effective and safe dietary supplement for improving physical performance, increasing muscle mass, and accelerating recovery. Although minor side effects may occur, they are generally temporary and can be minimized by following recommended doses and choosing high-quality products.
As with any supplement, it is important to consult a healthcare professional before starting supplementation, especially if you have pre-existing medical conditions. By following these tips, you can enjoy the many benefits of creatine while minimizing potential risks.
Sources:
- Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr., 18(1):13. doi: 10.1186/s12970-021-00412-w. PMID: 33557850. Free PMC article. Review. : https://pmc.ncbi.nlm.nih.gov/articles/PMC7871530/
- Wang CC, Fang CC, Lee YH, Yang MT, Chan KH. (2018). Effects of 4-Week Creatine Supplementation Combined with Complex Training on Muscle Damage and Sport Performance. Nutrients, 10(11):1640. doi: 10.3390/nu10111640. PMID: 30400221. Free PMC article. Clinical Trial. : https://pmc.ncbi.nlm.nih.gov/articles/PMC6267111/
- Wax B, Kerksick CM, Jagim AR, Mayo JJ, Lyons BC, Kreider RB. (2021). Creatine for Exercise and Sports Performance, with Recovery Considerations for Healthy Populations. Nutrients, 13(6):1915. doi: 10.3390/nu13061915. PMID: 34199588. Free PMC article. Review. : https://pmc.ncbi.nlm.nih.gov/articles/PMC8233702/
- Vega J, Huidobro E JP. (2019). Effects of creatine supplementation on renal function. Rev Med Chil., 147(5):628-633. doi: 10.4067/S0034-98872019000500628. PMID: 31859895. Free article. Review. : https://pubmed.ncbi.nlm.nih.gov/31859895/
- Wyss M, Kaddurah-Daouk R. (2000). Creatine and creatinine metabolism. Physiol Rev., 80(3):1107-213. doi: 10.1152/physrev.2000.80.3.1107. PMID: 10893433. Free article. Review. : https://pubmed.ncbi.nlm.nih.gov/10893433/
- Jiaming Y, Rahimi MH. (2021). Creatine supplementation effect on recovery following exercise-induced muscle damage: A systematic review and meta-analysis of randomized controlled trials. J Food Biochem., 45(10). doi: 10.1111/jfbc.13916. Epub 2021 Sep 2. PMID: 34472118. Review. : https://pubmed.ncbi.nlm.nih.gov/34472118/