Creatine: Health Benefits, Use & Side Effects

Creatine is a natural substance stored mostly in the muscles. It’s best known for increasing muscle mass and improving exercise performance in athletes, but creatine may also support fitness, general health, and well-being for non-athletes.

Besides being naturally produced in the body, creatine is found naturally in red meat and seafood. It’s also sold as a supplement in more concentrated amounts.

Dietary supplements are minimally regulated by the FDA and may or may not be suitable for you. The effects of supplements vary from person to person and depend on many variables, including type, dosage, frequency of use, and interactions with current medications. Please speak with your healthcare provider or pharmacist before starting any supplements.

Benefits of Creatine

A majority of sports nutrition supplements contain creatine.¹ But on top of its athletic performance and muscle mass effects, creatine has other potential benefits.

Improves Athletic Performance

For athletes, creatine supplementation increases the energy available in muscles during high-intensity exercise or heavy lifting, leading to improved exercise performance. Creatine may also improve post-exercise recovery and injury prevention, resulting in greater athletic performance.

For the everyday exerciser, creatine supplementation may improve exercise performance
by 10-20% when weight training or doing a variety of fitness activities, including
golf, volleyball, ice hockey, running, and swimming.

Increases Muscle Mass and Strength

For athletes, creatine increases the energy in cells during anaerobic activities like strength training and decreases protein breakdown in the muscles, leading to increased muscle mass. With greater muscle mass, there is potential for increased endurance and improved physical performance.  

For older adults, creatine may help with age-related muscle loss, called sarcopenia. The loss of muscle mass and strength that occurs with aging can cause significant limitations in daily activities and living.

Although research has presented mixed results, an analysis of 22 studies showed creatine supplementation—combined with resistance training—resulted in greater
muscle mass and upper and lower body strength in participants aged 57–70 years old.

Creatine has also been suggested as an aid in physical rehabilitation after injury and as a way to help with muscle strength after being immobile for an extended period of time. More research is needed to confirm its effectiveness in these ways.

May Help Manage Type 2 Diabetes

Taking a creatine supplement might help people with type 2 diabetes manage their blood sugar levels better. Some research shows creatine supplements improve insulin sensitivity and glucose uptake into cells, which could lead to improved blood sugars after a meal and over time.

Early research suggests that people who were recently diagnosed with type 2 diabetes have lower glucose levels after means when they have taken 3-6g of creatine for five days. In fact, 3g of creatine twice a day had an effect similar to that of the diabetes medication metformin when taken twice-daily at 500mg.

More research is needed to confirm any relationship. The research would also need to be for longer periods of time, as the effects of creatine on diabetes are only known up to five days.

May Aid Brain Health

Creatine’s effect on cognitive health has been mixed. For instance, one study among U.S. adults 60 or older found that those who took 0.95g of creatine per day through their diet had better cognitive function performance for a test that asked participants to match symbols and numbers. Other research among older adults have not shown a difference in cognitive function between those who took creatine and those who took placebo.

Among healthy adults, creatine may improve short term memory, intelligence, and reasoning. These effects have not been demonstrated among young adults, though.

May Support Heart Health

Supplementing with creatine may support heart health for people who have reduced blood flow to the heart (myocardial ischemia).

One study showed creatine improved the energy available to the heart, decreased the frequency of arrhythmias (an irregular heartbeat), and improved overall heart function. The researchers noted that larger studies are needed to confirm these results.

Good Sources of Creatine

The human body makes about half of the creatine you need each day. Eating red meat and fish makes up the other half you need.

Certain populations, like people follow a vegetarian diet, may need to take creatine supplements to get the needed amount.

How To Take Creatine Supplements

As a supplement, creatine is available in capsule and powder form. It is frequently added to sports nutrition supplements and protein powders. Creatine should be taken with plenty of water. And for athletic performance purposes, it is most effective when consumed right after a workout.

Dosage

Creatine supplements are often started with a one-time loading dose of up to 20g for up to seven days, followed by a maintenance dose of 2.25-10 grams daily for up to 16 weeks. However, it’s always best to talk with a healthcare provider to find out what type and dose might be best for your specific needs.

Is Creatine Safe?

Creatine appears to be safe in the short term and possibly in the long term. The following doses have been documented to be safe for adults to take:

• Up to 25g daily for up to 14 days
• Up to 4–5g daily for up to 18 months
• Up to 10g daily for up to five years

Research has shown creatine is likely safe for children to take short-term for the following age groups and in the following doses:

• 3–5g daily for two to six months for children 5–18 years old
• 2g daily for six months for children 2–5 years old
• 0.1–0.4 grams/kilogram daily for up to six months for infants and children

Creatine is not recommended for people who are pregnant or breastfeeding because there isn’t enough reliable information to know if it’s safe.

Creatine is also not recommended for people who have bipolar disorder or kidney disease, as the substance may make both conditions worse.

Research has shown that taking caffeine and creatine together may worsen symptoms of Parkinson’s disease, so caffeine should be avoided in this situation.

Before taking creatine, talk with a healthcare provider to be sure it’s safe for you.

Potential Interactions

There are no known drug interactions with creatine. However, creatine may negatively interact with caffeine.

When creatine and caffeine are taken in combination, it’s believed that caffeine may decrease creatine’s beneficial effects on athletic performance.

When the two are taken with ephedra, there may be an increased risk for serious adverse effects. One case report showed that an athlete who took the triple combination for six weeks had an ischemic stroke.

What To Look For

When buying creatine, you will notice that most supplements contain creatine as the monohydrate salt (creatine monohydrate).

Since the U.S. Food and Drug Administration doesn’t regulate supplements, you’ll want to look for products that are third-party tested. This means that organizations like NSF and USP have tested the supplement to ensure the supplement is free of contaminants and contains what is specified on the label.

Can You Take Too Much Creatine?

Creatine appears to be generally safe for healthy adults in doses of up to 25g for up to 14 days. Creatine is possible safe in the long term. There is not enough information to say whether you can take too much creatine.

Side Effects of Creatine

Most studies have found no significant side effects at the doses used for up to six months. Potential side effects of creatine supplementation may include:

• Dehydration
• Diarrhea
• Upset stomach
• Muscle cramps
• Water retention

A Quick Review

Creatine is a substance your body naturally makes. Your body typically makes enough to supply you with half of the creatine you need. The other half comes from red meat and seafood. You can also obtain creatine through supplements.

In supplement form, creatine is most notably used to increase muscle mass and improve athletic performance. Some studies have also shown that creatine may support general health, fitness, and well-being for non-athletes. More research is needed to confirm the benefits of creatine for conditions like type 2 diabetes, as well as heart and brain health.

Although taking creatine is generally safe for most people, it’s always best to talk with a healthcare provider before starting creatine or any supplement.