5 Creatine Side Effects You Need To Know Before Taking It

Found naturally in muscle cells and acquired through dietary staples such as meat and fish, creatine is a well-known supplement celebrated for bolstering creatine stores and enhancing performance in high-intensity exercises. Yet, as with any supplement, you may be wondering if taking creatine comes with any side effects.

The only significant “side effect” of using creatine is increased weight in muscle mass, which is the goal when taking the supplement. Aside from this, no concrete evidence exists that having creatine regularly and in recommended dosages will lead to side effects like fat gain, dehydration, cramps, or hair loss.

In fact, because creatine is so widely researched, its safety and lack of adverse side effects have been proven in several studies.

Creatine Side Effects – Do They Exist?

Weight Gain

Many athletes, especially women, avoid creatine due to the fear of weight gain – specifically, fat gain. Remember that weight gain is only what you see on the scale, and if you see the scale number going up, it does necessarily mean that you are gaining fat.

If you are on a fitness journey, having other measurements of progress might be a good idea – like body composition, progress photos, or clothing sizes in conjunction with scale weight to keep perspective.

During the initial loading phase of creatine supplementation, involving a daily intake of 20 grams for 5-7 days, there is typically a rise in body mass ranging from 1 to 3 kilograms, primarily attributed to water retention ^{[1, 2]}.

Despite this being a short-term response, many athletes believe this lasts over the long term, even though there is not enough research to back this up ^[3].

Scale weight might also increase due to gains in muscle mass, a significant reason many athletes opt for creatine supplementation ^[4].

This aspect is one of the few noteworthy “side effects,” as revealed in a systematic review of various studies ^[5].

Importantly, because this is what most athletes fear when talking about “weight gain,” there is no evidence supporting the idea that creatine intake leads to fat mass gain across diverse population groups.

Numerous short-term studies, spanning 1 to 8 weeks, conducted on older women ^[6], older men ^[7], young adult men engaging in resistance training (ages 20-23) ^[8], adult recreational male bodybuilders ^[9], young men ^[10], exercising males and females ^[11], and rugby union players ^[12], have consistently shown that creatine intake does not impact fat mass.

Stomach Issues

The ISSN has concluded that no evidence exists that creatine intake increases the risk of gut issues like cramping, diarrhea, and bloating ^[4] if taken in the recommended doses. That is the critical thing to keep in mind: recommended doses.

In a study involving 59 elite male soccer players, participants were segregated into three groups: a placebo group, a group receiving two daily doses of 5 g each, and a group receiving a single 10 g dose daily for 28 days.

Notably, no significant gastrointestinal issues were observed in the placebo and 5 g creatine dose group. However, some stomach issues were reported in the 10 g group.

This suggests that the likelihood of experiencing gastrointestinal issues from creatine may be dose-dependent, and the risk can be minimized by opting for lower doses, such as 5 g at a time ^[13].

Dehydration

Some athletes claim to have a dry mouth and dehydration as a side effect of using creatine, and many people assume that creatine can cause dehydration due to increased water retention.

However, no concrete evidence of dehydration can be found when we dive into the literature.

Numerous studies ^{[8, 14, 15]} have indicated that incorporating creatine supplementation into training and/or competition either exhibits no impact or diminishes the occurrence of musculoskeletal injuries, dehydration, and/or muscle cramping.

These studies showed 15–25 g/day of creatine monohydrate for 4 – 12 weeks to athletes undergoing rigorous training, with no documented side effects.

Hair Loss

The myth that you can lose hair while using creatine has made its way into mainstream media and social media.

This myth can be traced back to a singular study conducted in 2009 ^[16]. In this study, males aged 18-19 consumed 25 g of creatine per day for a week (referred to as a “loading phase”), followed by a maintenance phase of 14 days.

Compared to the placebo group, the creatine-consuming group exhibited a 56% increase in DHT levels (a hormone associated with hair loss) after the 7-day loading phase and a 40% increase above their initial levels during the 14-day maintenance period.

Although the study did not specifically investigate hair loss as an outcome, many individuals inferred a potential link between creatine and hair loss due to the observed increases in DHT levels.

A review of all the literature on hair loss and creatine use found no evidence that creatine use leads to hair loss.

Twelve other studies have looked at the effects of creatine supplementation on testosterone levels, with dosing protocols ranging from 3 – 25 grams per day for 6 days to 12 weeks ^[4].

Ten studies found no significant variations in testosterone concentrations. Five studies measuring free testosterone found no increases ^[4], and only two found small, insignificant increases in testosterone after 6 – 7 days of supplementation  ^[4].

Kidney Function

The International Society of Sports Nutrition has concluded that, based on all the available evidence on creatine and kidney function, creatine does not negatively impact kidney function of both athletes and non-athletes, including American football players ^[17], healthy athletes ^[18], diabetic patients ^[19], resistance training athletes ^[20], and even patients with renal disease ^{[21, 22, 23, 24])}

Summary

The main “side effect” reported from using creatine is increased muscle mass – beneficial for increasing strength, performance, and resting metabolic rate.

Supplementation with creatine does not cause side effects like fat gain, dehydration, cramps, or stomach issues, and there is a robust body of research showing that creatine is safe in a variety of populations – from infants to the elderly ^[4].

References

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2. Deminice, R., Rosa, F. T., Pfrimer, K., Ferrioli, E., Jordao, A. A., & Freitas, E. (2016). Creatine Supplementation Increases Total Body Water in Soccer Players: a Deuterium Oxide Dilution Study. *International Journal of Sports Medicine, 37*, 149–153.
3. Francaux, M., & Poortmans, J. R. (2006). Side effects of creatine supplementation in athletes. *International Journal of Sports Physiology and Performance, 1*, 311–323. https://doi.org/10.1123/ijspp.1.4.311.
4. Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. *Journal of the International Society of Sports Nutrition, 14*, 18. https://doi.org/10.1186/s12970-017-0173-z.
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22. Taes, Y. E., et al. (2004). Creatine supplementation does not decrease total plasma homocysteine in chronic hemodialysis patients. *Kidney International, 66*(6), 2422–2428. doi: 10.1111/j.1523-1755.2004.66019.x.
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