Should You Take Creatine?

Creatine is one of the best-selling muscle builders currently on the market. It is used by an estimated 28 percent of college-level athletes and manages to rake in around $44 million every year.

And for bodybuilders and other high-intensity athletes, one of the best aspects is that it is free of many of the side effects that plague stimulant-based supplements.

“Creatine is one of the most-researched sports supplements out there,” Dr. Chad Kersick, an assistance professor of exercise physiology at the University of Oklahoma, says. “And there’s no published literature to suggest it’s unsafe.”

However, what you’ll soon learn is that this level of safety only extends to how well you use creatine. It is possible to have a side effect-free experience with creatine, but you’ve got to be aware of the few potential side effects that do exist and the best ways to deflect them.

To help you do that, here’s a list of the top three most common creatine-relate side effects and some advice on how to deal with them.

1. Stomach Pain and Nausea

One of the most common side effects attendant with creatine usage is stomach pain, usually involving cramps and nausea.

Most public awareness of this side effect comes from anecdotes and other personal experiences, as researchers haven’t spent too much time conducting clinical studies on creatine-related nausea. However, stomach cramps and pain are often reported from beginning bodybuilders and there seems to be good reason for this effect.

Creatine helps produce greater stores of adenosine triphosphate, or ATP, in the body. ATP is used as energy and when more creatine is taken than is necessary, the reserve ATP can lead to the hyperactivity of major metabolic processes in the body.

This upsets both the stomach and the rest of the digestive system, which can lead to cramping and general abdominal discomfort. Other common side effects that fall into this category include diarrhea, dizziness, and gastrointestinal pain.

Another reason creatine use may be causing stomach pain is because of the amount of water taken into muscle cells when creatine hits the bloodstream. This can cause dehydration quickly if you aren’t careful, which raises your risk for headaches and nausea. Dehydration occurs more quickly when creatine is taken in conjunction with caffeine or diuretics. Muscle cramps can be another side effects of this approach to creatine supplementation.

What to Do: Try to drink as much water as possible while supplementing with creatine, especially when you are first beginning. Your body needs to get used to the dehydrating effect of creatine, and will be a little shaky at first. Keeping it well-hydrated is important.

You should also avoid common diuretics like caffeinated sodas, coffee, or tea. Drinking these will only further decrease your body’s supply of water, so it’s important to cut them out as much as possible.

Taking creatine with a small amount of food is another good idea for decreasing your likelihood of nausea.

2. Kidney and Liver Damage

Slightly more serious than nausea, there is also concern that excess oral supplementation with creatine could harm the kidneys or the liver. These effects have been observed with even moderate creatine supplementation if supplementation continues over time.

In terms of kidney damage, this could increase your likelihood of developing kidney stones. According to research done by Dr. Mark Jenkins of Rice University, creatine supplementation actually leads to urinary concentrations that are 90 times higher than normal. With such toxicity in the small tubes where urine is formed, kidney stone development is triggered. This could also lead to kidney damage over a long-term period.

Most research suggests that kidney damage is increasingly likely in doses of 25 grams per day or higher.

For the liver, creatine supplementation could mean damage as well. Because creatine is naturally produced by the liver, synthetic supplementation could cause damage. While this effect does not occur under short-term, low-dose usage, it can kick in after six months of straight usage.

According to a study in the American Journal of Physiology, mice that were given long-term doses of creating developed inflammatory lesions in their liver. While humans have not been the subject of a similar study, it is safe to assume that the same damage could occur in similar circumstances.

Another observational study showed that two athletes who took high-dose creatine developed jaundice. While one eventually recovered after ceasing supplementation, the jaundice returned soon after the athlete began taking creatine again.

Because of the effects to both the liver and the kidneys, patients with liver or kidney disease are frequently advised to avoid creatine supplements. For the same reasons, creatine should not be taken alongside drugs that are processed by the same liver enzymes. These include Motrin, Advil, and Aleve.

What to Do: The best thing you can do for yourself in this situation is to take moderate amounts of creatine and cycle your use as you go.

If you are concerned about kidney damage, for example, it is best not to take creatine in doses higher than 25 grams per day. According to an article in the Journal of the International Society of Sports Nutrition, most adults who are healthy and supplement with creatine at a dose of less than 25 grams never experience difficulty with their kidneys.

This has been borne out by a series of controlled studies looking and creatine use and kidney dysfunction.

For the liver, a similar guideline of no more than 20 grams per day should be observed.

This supplementation limit should be no difficulty for the average bodybuilder, as doses of five to 10 grams are usually sufficient for significant improvement. Excess creatine is either flushed from the body as waste, or goes on to cause these and other damages.

And, after eight weeks of continuous use of creatine, it’s a good idea to take a couple of weeks off. You can still work out and gain the benefits of creatine because there will be enough built up in your system for your body to feed off of.

3. Weight Gain

According to Dr. Paul Greenhaff with the University of Nottingham in the U.K., if there is one side effect that you can count on with creatine, it’s weight gain.
Greenhaff says that because creatine pulls water into muscle cells, water weight gain is inevitable. In fact, in the first week of supplementation, Greenhaff advises you to expect a gain of between two and four pounds.

This result was observed in a 2003 study published in the Journal of Strength and Conditioning Research. According to researchers, the loading phase of creatine use lasts between five and seven days and results in weight gain of one to three pounds. Researchers agreed with Greenhaff, stating that most of this weight gain is a direct result of increased water retention by cells in your muscle tissue.

It follows, then, that the higher dosage of creatine you use, the more weight can expect to gain. According to the same study, participants who supplemented with the high dose of 30 grams of creatine per day gained significantly more weight than those who supplemented with 15 grams a day.
Participants taking the higher dosage actually gained an average of 33 pounds over a four-week period.

What to Do: You want to gain muscle with creatine, not fat, so it’s important to work off that water weight and instead use it to enhance muscle growth. That extra water can be used to facilitate greater protein synthesis, and with exercise, this will result in increased muscle fibers.

According to a 2003 review in the journal Molecular and Cellular Biochemistry, the decreased dosage of creating after your loading phase also helps level off weight gain.

And because you’ll be gaining more lean muscle mass, you can burn body fat in the long run. This is due to the fact that new muscle allows your body to oxidize existing body fat. More muscle also improves your metabolism, which works to extract nutrients from your body and flush waste as quickly as possible.

So you can see that if you are dedicated to your exercise routine, you should have no problem using this increase in cellular water for your benefit.

Side Effect-Free Creatine Supplements

Now that you know the potential side effects of creatine, you’re likely wondering if there are certain products that are better at deflecting them than others.

The answer lies in the form of creatine used. While creatine monohydrate is among the most popular forms of creatine used in supplements—and among the most effective—it is also among those that cause the greatest severity of side effects. Users of creatine monohydrate report more muscle cramps and nausea than do users of other forms of creatine.

A better alternative is Kre-Alkalyn creatine, a form of creatine that has been manipulated to protect against absorption before creatine hits the muscle tissue. This means less bloating and fewer incidences of stomach upset. While Kre-Alkalyn creatine can be expensive because of the technology involved in manipulating it, it is well-worth the money if you want to supplement with creatine without side effects.


And in fact, you can sometimes get Kre-Alkalyn creatine at a lower price—provided you know where to look. One of the best sources for inexpensive Kre-Alkalyn creatine is Myoswell, a supplement that provides this form of creatine, along with some other useful amino acids, for as low as $44.95.

To buy Myoswell for this price, you need to check out places like and other third-party vendors.

Other forms of creatine to watch out for that cause fewer side effects are creatine ethyl ester, micronized creatine, and tri- and di-creatine malate.

If you watch for these and guard against other side effects by following the behaviors outlined above, you should be able to have all the advantage of creatine without any of the negative side effects.

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