Creatine Side Effects and Safety

My regular readers/subscribers know creatine monohydrate is one of the few supplements I believe in (see also: Does Creatine Work?).  I’ve been using it for years without any problems, and the extensive body of research speaks to the efficacy and safety of this supplement.

Let’s first talk about safety.  One of the concerns I hear about is possible kidney problems, but I don’t see why this would be an issue for those without any preexisting disease.  The Journal of the International Society of Sports Nutrition recently published a randomized, double-blind, placebo-controlled studied done on trainees who were also eating a high protein diet.  Subjects were randomly chosen to either take creatine monohydrate (a loading phase of 20 grams a day for five days, followed by maintenance of five grams a day) or a placebo.  Researchers found so significant differences in kidney function between groups after 12 weeks.1

Now let’s talk about side effects.  The two I hear about most often are gastric issues (stomach upset, etc.) and bloating.  I’ll address both:

I think the simplest solution to avoid any gastric issues is to buy micronized creatine and use warm water to dissolve it before you drink it.   I believe most people have problems because they try to drink this supplement undissolved.  Here’s the issue: creatine doesn’t dissolve very quickly in cool liquids.  Water and other liquids are likely to pass through with undissolved creatine still sitting around in your guts. The body will attempt to solubilize (dissolve) substances like creatine that remain in the digestive tract in powder/granular form.    This is often accomplished by drawing fluids out of the cells inside the digestive organs.  As you can imagine, this isn’t likely to feel good.

creatinemonohydrateNow to the bloating issue.  Creatine causes fluid retention in the muscles, so I’m a little skeptical when it comes to claims of bloating.  I believe this problem is normally the result of inferior formulas that contain sodium and sugar.  It could also be the result of a horrible diet (blame the supplement, not the pizza).  I’m not aware of any research to back up the claims of “bloating.” One study, in fact, found that creatine use did not affect fluid distribution.2

There’s one more thing I should mention in this discussion.  Some unscrupulous supplement companies will try to hype up these supposed side effects of creatine because they are trying to market some “new improved” formula.  Don’t fall for it.

References:

1. JISSN 2013, 10:26 doi:10.1186/1550-2783-10-26 Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet?

2. J Athl Train. 2003 Mar;38(1):44-50. Creatine Supplementation Increases Total Body Water Without Altering Fluid Distribution.

Does Creatine Work?

Creatine Monohydrate definitely “works.”  If I had to chose just one bodybuilding supplement, this would be it.  Research has proven time and again that it actually helps most of the people who use it.  Over 500 studies have been done, and most (about 70%) concluded this supplement to be effective in terms of improving performance.

. . . creatine supplementation during training has been reported to promote significantly greater gains in strength, fat free mass, and performance primarily of high intensity exercise tasks. Although not all studies report significant results, the preponderance of scientific evidence indicates that creatine supplementation appears to be a generally effective nutritional ergogenic aid for a variety of exercise tasks in a number of athletic and clinical populations.1

But I don’t believe in any of the “buffered” creatine formulas, such as creatine ethyl ester and kre-alkalyn.  Contrary to what some claim, creatine monohydrate does not rapidly degrade during digestion, and 99% of what you ingest actually makes it to the muscle tissue.  Furthermore, there is not really any solid evidence that “novel” forms of creatine are safer or any more effective than plain ‘ole monohydrate.2

Unfortunately, the effectiveness of creatine has been manipulated by some unethical supplement companies–something I learned from Pilon’s book (see: How Much Protein do You Need to Build Muscle).  Here’s how the scam works:

1. A supplement manufacturer will develop a “cutting” edge product with a bunch of random (worthless) ingredients.

2.  The before-mentioned supplement will have one ingredient that does work: creatine monohydrate.

3.  Studies on this new supplement will yield impressive results in the subjects who use it (as I’ve demonstrated, creatine monohydrate usually produces significant, measurable improvements).

4.  People are fooled into buying the over-priced supplement when they would have done just as well to buy creatine alone.

So check the ingredients of any new supplement–you may find there’s nothing really new about the effective ingredient.

Conclusion:
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Creatine Monohydrate is on my “short list” of useful, cost-effective supplements.  I would recommend bodybuilding.com’s brand, but any brand with the creapure mark will do.  Some prefer to load it, but I usually just take 3-5 grams a day.

Here’s one more very important tip--I’d recommend you use a micronized creatine and mix it with warm water until completely dissolved.  You body can’t absorb this supplement if is undissolved, and undissolved creatine is likely to cause gastric problems (upset stomach, etc).

References:

1. Effects of creatine supplementation on performance and training adaptations.

2. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine