Creatine – Is it Safe?


You've likely heard of creatine or the supplement creatine monohydrate but did you know that it is one of the most effective performance supplements in terms of improving high-intensity work capacity, muscle mass, strength, and over-all body composition? (1, 2)

In fact, it’s the most studied supplement on improved performance, and studies clearly show that it increases muscle mass, strength and exercise performance better that all other singular supplements on the market. (3, 4)

Additionally, many studies show that it also provides a number of other health benefits, such as protecting against neurological disorders. (5, 6, 7)

In light of the scientific research behind creatine, many people have been lead to believe that this supplement is unsafe and has a number of side effects, but these doctrines are not supported by any scientifically backed evidence. (8, 9)

In fact, Creatine has been around for more than a century and being one of the most studied supplements ever, with over 500 studies to support its safety and effectiveness, it comes stamped with an Outstanding Safety Profile by the International Society of Exercise Nutrition. (10)

What is Creatine?

Creatine is a substance that is found naturally in muscle cells. It helps your muscles produce energy during heavy lifting or high-intensity exercise.

Taking creatine as a supplement is very popular among athletes and bodybuilders in order to gain muscle mass, enhance strength and improve exercise performance. (11)

Chemically speaking, creatine shares many similarities with amino acids. In fact, the body produces its own creatine out of the amino acids glycine and arginine.

Several factors affect your body’s creatine stores, including meat intake, exercise, amount of muscle mass and levels of hormones like testosterone and Insulin-like growth factor 1 (IGF-1). (12, 13, 14) 

About 95 percent of the body’s creatine is stored in muscles, in the form of phosphocreatine. The other 5 percent is stored in the brain, kidneys and liver. (15, 16)

When you supplement, you increase your phosphocreatine stores. This increases storage energy in the cells by helping your body produce more APT molecules. (17)

ATP is often called the body’s energy currency. When you have more ATP, your body can perform better and longer during exercise, especially intense explosive movement. (18)

In addition, creatine also alters several cellular processes that lead to increased muscle mass, strength and recovery. (19, 20

How Does Creatine Work?

There are several ways that creatine can improve one’s athletic performance and health.

In high-intensity exercise, its primary role is to increase the phosphocreatine stores in your muscles. These additional stores can then be used to produce more ATP, which is the key energy source for heavy lifting and high-intensity exercise. (21, 22)

Creatine also has other substantial roles in improving muscle gain and performance, including:

  • Increase work load: It can enable more total work or volume in a single training session, which is a key factor in long-term muscle growth. (23)
  • Elevate anabolic hormones: Studies show that there is a significant rise in hormones, particularly IGF-1, after supplementation. (24, 25)
  • Increases cell hydration: It is well known for increasing the water content within muscle cells. This causes a cell volumizing effect that may play a role in muscle size and growth. (26, 27
  • Reduced protein breakdown: Supplementation may also help increase total muscle mass by reducing muscle breakdown. (28)
  • Lower myostatin levels: Elevated levels of the protein myostatin are well known for slowing or totally inhibiting new muscle growth. Supplementing can reduce these levels, increasing growth potential. (29, 30

Additionally, creatine supplements also increase phosphocreatine stores in the brain. This may improve brain health and protect against neurological disease. (31, 32, 33, 34)

Creatine on Lean Muscle Gain

Creatine has been shown to be very effective for short and long term lean muscle gain and strength gain. In fact, a large comparison of the most popular supplements found creatine to be the single most beneficial supplement available for adding muscle mass. (35, 36)

Equally, it’s been shown to be beneficial not only for elite athletes but for the general population and elderly as well. (37, 38, 39

A 12 week study in weight lifters found that the supplement increased muscle fiber growth two to three times more than training alone. While a 14 week study of the elderly found that adding creatine to a weight training program significantly increased leg strength and muscle mass. (40, 41)

Creatine on Exercise Performance and Strength

Creatine also improves strength, power and high intensity exercise performance. In fact, research found that by adding it to these types of training programs can increase strength by up to 8 percent, weight lifting performance by 14 percent and bench press (one rep max or 1RM) by up to 43 percent, compared to training alone. (42, 43)

In well trained strength athletes, 28 days of supplementation increased bike sprinting performance by as much as 15 percent and bench press performance by 6 percent. (44)

In addition, while tested during intense over training blocks, creatine was shown to help maintain strength and training performance while increasing muscle mass. These noticeable improvements are primarily caused by increased capacity to produce ATP. (45)

Normally, ATP becomes depleted after 8 to10 seconds of high intensity activity. Supplementation helps you produce more ATP, allowing you to maintain optimal performance longer and recover faster. (46, 47)  

Creatine on Brain Health

One of the most exciting prospects has to do with brain health and the treatment of neurological diseases. Like muscles, the brain stores phosphocreatine and requires plenty of ATP for optimal function. (48, 49)

Supplementing has shown promise to improve the following conditions:

  • Alzheimer’s disease (50)
  • Parkinson’s disease (51)
  • Huntington’s disease (52)
  • Epilepsy (53)  
  • Motor neuron disease (54)
  • Cognitive performance in the elderly (55

However, despite the potential benefits of creatine for treating neurological disease, most of the current research that has been performed through animal studies.

But, one study was conducted in children with Traumatic brain injury (TBI). And the six month study found a 70 percent reduction in fatigue and a 50 percent reduction in dizziness. (56, 57) 

Creatine Supplements

The most common and most researched form is called creatine monohydrate. And although there are many other forms of creatine available, some of which are claimed to be superior, there is no research that supports their superiority. So, until new research suggests otherwise, creatine monohydrate seems to be the least expensive and best option available today. (58)


Many people who supplement start with a “loading phase.” This strategy leads to a rapid increase in muscle stores.

To load with creatine, take 20 grams per day for 5 to 7 days. This should be split into four (5 gram servings) throughout the day. (59)

Absorption may be slightly improved with a protein or carb based meal due to the release of insulin. (60)

Following the loading period, take 3 to 5 grams per day to maintain the elevated levels within the muscle. There is no benefit to cycling creatine, so you can stick with the 3 to 5 gram dose for a long time.

If you choose not to do the loading phase, you can simply consume 3 to 5 grams per day. However, it may take three to four weeks to maximize muscle stores. (61)

As creatine pulls water into the muscle cell, it is also advised to take it with water and make sure to stay well hydrated throughout the day.

Safety and Side Effects

Creatine is one of most well-researched supplements available, and studies lasting up to four years have shown no negative effects using this supplement. In fact, one of the most comprehensive studies to date measured 52 blood markers and found no adverse effects following 21 months of supplementation. (62, 63

There is also no evidence that it harms the liver and kidneys in healthy people who take normal doses. That being said, people with pre-existing liver or kidney problems should consult with a doctor before supplementing. (64

Although people often believe it can cause dehydration and cramps, this is not supported by research. In fact, studies have shown it can reduce cramps and dehydration during endurance exercise in high heat conditions. (65, 66)

Bottom Line:

Although creatine has been sighted as an unsafe supplement with a number of side effects, these dogmas are untrue and not supported by any scientifically backed evidence.

In fact, creatine, being around for more than a century and being one of the most studied supplements ever is proven to be one of the safest and effective supplements on the market today.


Stop Dieting & Start Eating 

Did you ever sit back and wonder why even though more people are dieting and exercising today than at any other time in history we’re actually getting fatter and sicker as a result and not leaner and healthier?




“Our body is biology not math. That’s why when I hear things like a “calorie is a calorie” or it’s all about “calories in vs. calories out” I shake my head knowing that the human body is much more complex than a simple math equation”. — Coach Tony

Tony’s introduction into the world of health and fitness began in the summer of 1969 at the very early age of 8. He says “I can remember (like it was yesterday) picking up my first copy of Joe Weider’s Muscle Builder magazine, which is now known as Muscle & Fitness” and being completely enthralled by muscles. “I would literally fantasize about having muscles like the men in that magazine”. As he journeyed through life, those thoughts never left his mind. This was Tony’s beginning of what would become a lifelong journey into the world of fitness and nutrition.

Over the following four decades Tony has spent his time in the health and fitness industry as a competitive athlete, trainer, nutrition coach, educator, speaker, publisher and author.

In his competitive years, Tony became fascinated, biologically, with how nutrition and the foods we consumed had a profound effect on performance, body composition and over-all blood chemistry, as well as, state of mind. “These laws governed by the food /body relationship were completely different from what I had been taught about conventional mainstream nutrition”.

Over the past 30 years Tony has devoted his time to educating, coaching and mentoring people to take charge of their own health’s destiny.

He says “As we continue to listen to outdated nutritional advice, it’s clearly evident that our approach has completely missed the mark proven by the fact that society is getting bigger and sicker as a result, not leaner and healthier”.

Tony has been a dedicated writer, blogger and educator, and has spent time writing for several publications and national websites as a health advocate on topics including nutrition, fitness, chronic disease prevention and personal 

Coach Tony – CNS, CMT

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