It’s easy to see why creatine is one of the most popular sports supplements on the market.
Creatine, a substance naturally synthesized in the body from amino acids, plays a key role in the production of adenosine triphosphate (ATP), the body’s main energy supplier. (ATP captures chemical energy generated by the breakdown of food molecules and releases it as fuel for cells.)
Creatine supplements can help athletes perform more reps, outlast an opponent and move faster. In fact, research shows that increasing your creatine levels can improve your performance during intense or repetitive exercise by 5 to 15 percent. It’s not surprising, then, that many people use creatine supplements to get a head start on their fitness goals.
But like any dietary supplement, creatine has potential risks and side effects. If you are considering adding creatine (or any other supplement) to your diet, talk to your doctor or sports dietitian and find out why it may or may not be right for you.
Here’s what you need to know about some of the potential pitfalls of creatine supplements and how to take them safely and effectively.
What research shows about the safety of creatine supplements
According to a review in the journal, creatine is generally considered safe when taken as a supplement Current sports medicine reports, published by the American College of Sports Medicine. The review notes that the safety of supplementing with creatine has been thoroughly investigated, and that research shows that when creatine is taken as prescribed for a short or long period of time (up to 30 grams [g] per day for five years or less), it has been found to be generally safe and without side effects in healthy people.
One example: A small study of 18 men found that seven days of creatine supplements had no effect on several organs or blood and urine health markers in a group of volunteers, notes Michael Roberts, PhD, a professor at the School of Kinesiology at Auburn. University in Alabama.
What are the side effects of creatine supplements?
Although creatine supplements are generally considered safe, experts warn that they can cause side effects in some people. Side effects may include muscle cramps, dehydration, diarrhea, nausea and seizures, according to the American Academy of Orthopedic Surgeons (AAOS).
That said, according to the researchers, there isn’t much evidence to support the suggestion that creatine causes dehydration and muscle cramps. Current sports medicine reports judgement. In fact, the authors pointed to several studies that found the opposite: that creatine supplementation reduced the frequency of muscle cramps.
The only side effect for which there is evidence is weight gain. “It’s hard to generalize, but most people experience a five-pound gain when consuming [creatine] supplements,” says Dr. Roberts.
On the other hand, those gains come in the form of water weight, and “there’s actually a benefit because the water is in the muscle cells, so it helps hydrate your muscles,” explains Kelly Jones, RD, a board-certified specialist in sports dietetics based in Philadelphia. “So any weight gain you see from creatine is simply water and better hydration.”
Additionally, muscle is denser than fat, which means that if you take creatine supplements and build muscle, you may see an increase in body weight overall. That weight gain may be the result of extra muscle mass, not fat.
Who should not use creatine?
Although some small studies from decades ago linked creatine to kidney problems, recent research has found no such evidence. According to a review of common misconceptions about creatine, the idea that creatine causes kidney damage is a myth. The authors note that after more than 20 years of research, including multiple clinical trials, there is no evidence of negative effects of recommended doses of creatine supplements on kidney health.
But since creatine supplements can increase blood levels of the compound creatinine, a waste product of muscle activity, AAOS recommends that anyone with kidney disease avoid creatine. AAOS also notes that there is not yet enough information to indicate whether creatine supplements are safe for people who are pregnant or breastfeeding. Additionally, people taking creatine supplements should use caution and consult their doctor before combining creatine supplements with over-the-counter medications, prescriptions, vitamins and energy drinks.
Ultimately, it is important to discuss any supplement with a healthcare professional, such as a dietitian or doctor, before taking it. And while creatine is not considered a banned substance by the International Olympic Committee and the National Collegiate Athletic Association (NCAA), professional or college athletes should still make sure they choose a creatine supplement that has been third-party certified by NSF International or Informed Sports. These agencies test dietary supplements for safety and screen for substances banned by sporting organizations, although the risks have not been completely eliminated, according to a review article in the journal. Sports medicine.
How much creatine do you need?
Your body produces creatine naturally – about 1 g per day, according to Mayo Clinic. Additional amounts come from animal foods such as seafood and red meat, but at levels well below what you can get from supplements.
Dietary supplements – including creatine – may not be necessary if you eat a healthy, balanced diet that includes red meat and seafood. According to a position paper from the International Society of Sports Nutrition (ISSN), a normal diet containing 1 to 2 g of creatine per day will saturate muscle creatine stores by 60 to 80 percent.
However, if you’re looking to build muscle mass or strength, adding a daily creatine supplement to your diet can be a good move, says Roberts.
The standard daily dose is 3 to 5 g of creatine monohydrate. “That’s what most studies recommend,” says Jones. There are other forms of creatine available on the market, but creatine monohydrate is the additional form supported by research, she notes.
Depending on your diet, it may take a few weeks before your creatine stores are fully saturated and you notice a difference. “If someone follows a vegan diet and never eats meat or fish, it may take a little longer than someone who regularly incorporates these into their diet,” Jones explains.
Bottom Line: Creatine supplements are generally safe and have few side effects. You may notice a slight weight gain, but that is usually due to water retention or an increase in muscle mass rather than fat tissue. Despite creatine’s relative safety, it is essential that you consult a doctor or dietitian before taking any supplement, especially if you are pregnant or breastfeeding.
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