Does Creatine Cause Dehydration? (Here’s Why It Doesn’t)

Creatine, recognized for its remarkable benefits in enhancing performance, accelerating muscle growth, and expediting recovery, is a powerhouse supplement. Despite its widespread acclaim, there remains some uncertainty about the side effects of creatine – for example, dehydration. Because hydration plays a crucial role in performance, it’s important to know if creatine does disrupt your body’s fluid balance.

Creatine does not lead to dehydration when taken in the recommended amounts and can protect against dehydration.

Although some athletes have reported feeling dehydrated when using creatine, it’s essential to scrutinize the research to determine if this effect is due to creatine or other possible reasons.

Because creatine is such a popular supplement, many research studies have looked at the potential side effects of creatine, including the impact of creatine on hydration.

Does Creatine Cause Dehydration?

The notion that creatine leads to dehydration emerged in the early 2000s following the American College of Sports Medicine (ACSM) advising individuals engaged in exercise in hot environments to steer clear of creatine supplementation ^{[1, 2]}.

This idea originated from the premise that taking creatine causes water retention in the cells, causing a 1 – 3 kg increase in body weight in the first week of a creatine loading protocol (20g/d for 5 – 7 days) ^{[3, 4]}.

Theoretically, this would mean that more water would be inside the muscle cells and less water outside the cells, leading to electrolyte imbalances, muscle cramps, and other heat-related problems.

However, this statement from the ACSM was premature, as evidence for the association between creatine and dehydration was insufficient ^[1].

Numerous studies have since then been published showing no effects of creatine on dehydration in recommended dosages, as summarised in a systematic review of 10 articles ^[5].

Even if athletes were already dehydrated before taking creatine, no creatine effects were found to worsen dehydration ^[6]. On the contrary, studies have shown that creatine can be beneficial to prevent dehydration ^[1].

Does Creatine Help With Dehydration?

Not only is there no conclusive evidence that creatine does not lead to dehydration, but some studies have shown that taking creatine might be beneficial to combat cramps and dehydration.

In a study looking at injuries in 72 Division 1 NCAA collegiate football players, players could take either creatine with a standard loading phase and maintenance phase throughout the season or a sports drink ^[8].

The players taking creatine had less cramping, dehydration, and heat illness than those taking only a sports drink.

Another study looked at hospital patients receiving hemodialysis who often experienced muscle cramps. These patients were given creatine 5 minutes before hemodialysis, reducing the frequency of their muscle cramping by 60% ^[7].

Why You Feel Dehydrated When Taking Creatine

So, if creatine does not affect your hydration status, why do some athletes claim to feel dehydrated while using creatine?

Various studies have researched athletes’ experiences with creatine supplements. For instance, one study involved 219 college athletes, with 41% of them using creatine. Among these creatine users, 38% reported issues like muscle cramps and gut problems ^[9].

Another study focused on 1249 high school football players, of which 418 used creatine ^[10].

Of these, 17% reported experiencing muscle cramps, dehydration, and gut discomfort. In a separate study with 52 college football and baseball players using creatine, 16 reported experiencing gut problems like diarrhea, while 13 experienced muscle cramps ^[11].

However, that study found that 91% of these athletes experiencing problems took more creatine than recommended ^[11].

Additionally, although 43% of the athletes were taking other supplements alongside creatine, none of these studies looked at the impact of these supplements on gut issues, cramps, and dehydration ^[11]. This might show that using more creatine than recommended can have adverse effects.

If you’ve been told before that creatine leads to dehydration, you might experience dehydration after taking it due to a phenomenon called the “placebo effect.” This means you might feel a side effect because you believe you should, even though it’s not caused by creatine itself.

This is especially prevalent in beginner creatine users.

Summary

Contrary to popular belief, there is no substantial evidence proving that creatine does cause dehydration. In fact, some studies suggest that creatine may even have protective properties against dehydration.

Athletes who report experiencing dehydration after using may take higher-than-recommended doses, use other supplements that can lead to dehydration (such as weight loss supplements or diuretics), or experience dehydration due to the placebo effect.

References

1. Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021;18(1):13. doi:10.1186/s12970-021-00412-w
2. Dalbo VJ, Roberts MD, Stout JR, Kerksick CM. Putting to rest the myth of creatine supplementation leading to muscle cramps and dehydration. Br J Sports Med. 2008;42(7):567-573.
3. Ziegenfuss T, Lowery LM, Lemon P. Acute fluid volume changes in men during three days of creatine supplementation. J Exerc Physiol Online. 1998;1:1.
4. Kraemer WJ, Volek JS. Creatine supplementation. Its role in human performance. Clin Sports Med. 1999;18:651–666.
5. Lopez RM, Casa DJ, McDermott BP, Ganio MS, Armstrong LE, Maresh CM. Does creatine supplementation hinder exercise heat tolerance or hydration status? A systematic review with meta-analyses. J Athl Train. 2009;44(2):215–223. doi:10.4085/1062-6050-44.2.215
6. Watson G, Casa DJ, Fiala KA, Hile A, Roti MW, Healey JC, … & Maresh CM. Creatine use and exercise heat tolerance in dehydrated men. J Athl Train. 2006;41(1):18.
7. Chang CT, Wu CH, Yang CW, Huang JY, Wu MS. Creatine monohydrate treatment alleviates muscle cramps associated with haemodialysis. Nephrol Dial Transplant. 2002;17(11):1978-1981.
8. Greenwood M, Kreider RB, Melton C, Rasmussen C, Lancaster S, Cantler E, Milnor P, Almada A. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003;244:83–88. doi:10.1023/A:1022413202549.
9. Juhn, M. S. (1999). Oral creatine supplementation in male collegiate athletes: a survey of dosing habits and side effects. Journal of the Academy of Nutrition and Dietetics, 99(5), 593.
10. McGuine TA, Sullivan JC, Bernhardt DT. Creatine supplementation in high school football players. Clin J Sport Med. 2001;11:247–253.
11. Greenwood M, Farris J, Kreider R, et al. Creatine supplementation patterns and perceived effects in select division I collegiate athletes. Clin J Sport Med. 2000;10:191–194.