Deciding Whether to Take Creatine? What Are the Pros and Cons of Taking This Supplement

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    Creatine is a hugely studied supplement because of its many benefits for sports performance and overall health. Here we discuss the pros and cons.

    What Are the Pros of Creatine Monohydrate?

    Creatine is a supplement that is frequently used by athletes because it supports many aspects of fitness, performance, and health. Here’s a summary of the ways that creatine may support physical health, based on the latest research.

    1. May Increase Strength & Muscle Size

    Creatine supports lean muscle growth. This is a main reason why athletes gravitate to creatine supplements. The body uses certain amino acids, like creatine, to build muscle, repair tissue, and generate cellular energy. During intense exercise and high intensity training, the muscles contract and stretch in ways that lead to small tears. As the body responds to repair these tears, muscle tissue gets bigger and stronger. But this process only happens efficiently when plenty of amino acids like creatine are readily available before, during, and immediately after workouts.

    Creatine supplements don’t increase muscle strength or tissue unless they are used in conjunction with exercise and strength training. On its own, creatine does not encourage the growth of new muscle tissue.The best training to develop muscle includes high-energy cardio exercises, like running, swimming, and jogging, along with HIIT and resistance training.

    2. May Combat Muscle Loss & Speed Up Muscle Recovery

    Not only does creatine support muscle growth after resistance training, but research also shows that it can help to address muscle loss, which occurs naturally as part of the aging process. While resistance and strength training can help older adults to maintain some muscle mass, research has found that training alone without proper recovery, nutrition, and rest can still result in decreased muscle strength and mass.

    Creatine supplements will not address muscle loss from physical inactivity or undernutrition. But alongside resistance training, creatine may provide an additional buffer for healthy muscle maintenance in adults as they get older.

    3. May Boost Brain Function

    Your brain uses an incredible amount of energy, which relies on efficient oxygen delivery and cellular processes. Having enough energy in the brain and nervous system impacts how your body physically performs (quick physical reactions and response times) but also how your brain cognitively responds (short-term memory, reasoning, fast decision making, and more). Research that has studied the impact of creatine in the brain has found that people who supplement with creatine have brains that respond better to situational changes, like oxygen delivery. A different study found that creatine can help to support cognition and overall brain responses after short-term sleep loss. Both of these studies were small, so large-scale clinical trials need to be done to fully make this connection, but the research is promising.

    A systematic review of six clinical trials with a total of 281 participants found that creatine supplementation supported short-term memory and reasoning in healthy adults, concluding that since creatine is a generally safe supplement, more studies should be done to understand how creatine can specifically support brain health. Another systematic review noted that creatine may enhance brain health for older adults.

    4. Enhances Energy Production

    Cells are designed to efficiently generate a steady stream of energy (known as ATP), but high-performance activities can demand ATP faster than cells can keep up. Creatine can help enhance the energy that muscles have access to, which may enable longer workouts or stamina in athletic events. The effects are not necessarily noticed in all types of physical activity, and runners or swimmers may not notice much of a difference. But for activities that require more frequent short bursts of energy (like weight training, football, hockey, or HIIT), creatine may help.

    5. Improves Exercise Performance

    For certain types of exercise or athletic training, combining creatine supplementation with caffeine may lead to improvements in exercise performance. These effects were mostly noted after at least five days of creatine loading. Higher quality research, with larger study populations and longer clinical trials, needs to be done to understand who may benefit from this specific combination.

    6. May Improve Endurance

    Some types of training or sports activities depend heavily on endurance, but endurance is also needed in the general population to maintain regular exercise routines and overall daily life wellness. In a study of 45 older adults who were not athletes, creatine paired with regular resistance training was able to double the amount of strength gained, which could play a major role in endurance and exercise stamina in older populations. Creatine did not improve quality of life scores or how the body’s antioxidant defenses behaved. The same effect is not found in people who are already highly trained athletes. A meta-analysis of 13 studies found that creatine had no benefits for endurance athletes.

    7. Can Aid in Hydration

    Creatine is a substance that is transported via water molecules, so increasing creatine in the body could theoretically support an increase in body water concentration. However, recent studies on creatine activity in the body note that it generally only helps the body hold onto water in the short-term and that over time, it doesn’t really affect fluid balance either inside or outside of cells.

    What Are the Cons of Creatine?

    Creatine may have some exciting benefits for athletes or people who are looking to support muscle growth, energy, and healthy aging. However, like most supplements, there are some downsides and it is not necessarily good for everyone. Before starting creatine, you should check with your doctor, especially if you have any health conditions, are pregnant, or breastfeeding.

    1. Kidney Concerns

    There are many discussions about creatine and its impact on kidneys, though most of these concerns are for people who already have kidney issues or may be at higher risk for them. Creatinine (not to be confused with creatine, the supplement) is a waste product that the muscles make in response to normal activities. The kidneys filter creatinine from the blood and then it is removed from the body via urine.

    The concern among healthcare providers and researchers over the last 20 years has been that creatine supplements increase creatinine levels and harm the kidneys, based mostly on a few case reports and animal studies. Creatinine tests are mostly used to monitor kidney health, because if there’s an issue, the kidneys struggle to remove creatinine and levels increase. Clinical trials and more recent research do not support the idea that creatine is bad for healthy kidneys. In some people, creatine supplements may elevate creatinine on blood tests, but this has not been shown to be associated with harm to the actual kidneys. High protein diets can also increase creatinine levels. Research on people who have kidney conditions needs to be done to understand the connection between creatine and kidney health, but creatine supplements are generally considered safe for people who are already healthy and have no pre-existing conditions.

    2. Bloating and Stomach Upsetness from Water Retention

    When we start a creatine supplement, the body goes through an initial loading phase as it acclimates to the intake, and more water enters muscular cells. For the first few days, some people may experience a higher amount of water retention, but this does not happen for everyone. Additionally, if you use a higher serving size of creatine, you may notice digestive discomfort compared to starting at a smaller serving size and gradually increasing over time. You should discuss creatine supplementation with your healthcare provider before starting it. If you experience sudden bloating or water retention, make sure to let them know.

    3. Digestive Issues

    Some people who supplement with creatine may have temporary digestive symptoms, like gas or loose stools. This is more likely as they are first starting or if they are using higher serving sizes, though not everyone will experience digestive issues.

    4. Non-Responders

    Studies show that people can have different reactions to creatine, ranging from excellent responders to people who have almost no response. Much like other supplements or nutrients, responses may be highly individualized. Scientists have not identified any common characteristics among people who don’t respond to creatine, so for healthy people who want to try it, the only way to know whether it works or not is to try it.

    5. Need for Consistent Use

    For creatine to work, it needs to be taken consistently. Whether you start by using a loading phase or just by using smaller amounts to begin with, you need to keep taking creatine so that it remains in your body to do its work. It does not work when taken only occasionally. Some people take breaks from creatine for certain periods of time (a few weeks or months) before starting it up again, but to support your body with creatine, it has to be taken daily.

    6. Potential Interaction with Other Supplements/Medications

    There are no definitively known interactions between creatine and other medications for healthy adults. However, if you take any medications, over-the-counter medicine, or other supplements, you should always check with your healthcare provider before starting anything new.

    7. Overall Safety Concerns

    Creatine has GRAS status (generally recognized as safe) status from the U.S. Food and Drug Administration (FDA). This means that the FDA generally considers creatine to not be harmful in the healthy population, but that does not mean that it is safe for everyone.

    Consult your healthcare provider first. As with any supplement, read all labels carefully since creatine supplements may contain other ingredients or additives. Follow serving sizes and instructions for your specific product.

    Creatine Dosage

    There are two ways to take creatine:

    • Loading dose: Start by taking 0.3 grams per kilogram of body weight per day for 5-7 days, then use a maintenance dose of at least 0.03 grams per kilogram of body weight. The initial daily loading amount can be taken in divided doses throughout the day to minimize gastrointestinal side effects. Be sure to be well-hydrated as you increase your creatine intake.
    • Lower dose: If you want to start taking creatine but don’t want to use a loading dose, you can start taking 2-10 grams per day (in divided doses on the higher end). Your muscles will still reach a saturation point, just slower than if you used a loading dose. Once your muscles are saturated, you can continue taking the same amount, or reduce it, to continue the maintenance phase.

    Best Form of Creatine

    Creatine comes in different forms, but creatine monohydrate has been studied the most. It is widely considered to be the most effective and it is also more affordable. Creatine ethyl ester has not been found by researchers to have any added benefits, and it’s typically more expensive.

    Creatine supplements are most widely available in powdered form, since the typical daily intake is 5 grams and this would mean having to take several capsules. However, some creatine supplements may be available in capsules, tablets, or liquids.

    How to Take Creatine

    Creatine can be taken at any time of the day. Loading doses are typically taken at different times throughout the day. If you take creatine once a day, you’ll get the most benefits if you take it right after your workout. If you don’t exercise every day, then many people choose to take it at the same time each day for consistency.

    If you’re using a powdered supplement, you can easily mix it into any liquid, although cold drinks are most common. Creatine does not have a strong flavor on its own, but if you can taste the powder in plain water, you can easily add it to juice or electrolyte drinks to camouflage the slight flavor.

    Creatine Use for Specific Populations

    Creatine has mostly been studied in athletes and older adults. There is limited research on its use in more specific populations.

    Age & Gender Considerations

    Creatine studies have been conducted almost exclusively on adults, so while a healthcare provider may recommend or suggest creatine supplements in younger people, it should generally be assumed that creatine supplements are for people ages 18 and older.

    Creatine does not have gender-specific benefits. Adults born male or female can supplement with creatine.

    Pregnant and breastfeeding people should speak to healthcare providers before taking creatine. A Cochrane review concluded that there is not enough evidence to decide if creatine could be beneficial in pregnancy, while other research suggests that in some circumstances, creatine has the potential to be beneficial for pregnancy. Ultimately, there have been no human trials to determine safety, benefits, effects, or potential adverse effects. Only a medical provider can advise on creatine in pregnancy.

    Creatine for Vegetarians and Vegans

    Creatine can come from dietary sources as well as supplements, but all creatine-rich foods are sourced from animals. Vegans and vegetarians consume far less dietary creatine compared to people who eat meat, seafood, and poultry.

    When choosing a creatine supplement, it’s essential to read labels, as not all creatine supplements are vegan or vegetarian compatible.

    Creatine for Individuals with Pre-Existing Health Conditions

    While creatine is considered to be generally safe for healthy adults, anyone who has existing health conditions should check with their medical provider before starting creatine or any other supplements to avoid potential complications or interactions.

    Is It Worth It to Take Creatine?

    Creatine has several potential benefits and very few notable risks, especially if you want to support healthy muscle synthesis and energy. Athletes, older adults, and many others may find that creatine is a welcome addition to their daily health routine alongside a healthy diet and regular physical activity (especially resistance training).

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    Dr. Carla Montrond Correia ND, CNS
    Medical Content Manager
    Dr. Montrond-Correia is a licensed naturopathic physician and a certified nutrition specialist (CNS). She holds degrees from University of Bridgeport, Georgetown University, and University of Saint Joseph, and supplemented her education with internships in the health and wellness space. She's focused on research, herbal medicine, nutrigenomics, and integrative and functional medicine. She makes time for exercise, artistic activities, and enjoying delicious food.
    Mia McNew, MS
    Freelance Contributor
    Mia McNew is a nutrition science researcher with bachelor's and master's degrees in nutrition science and biochemistry. She holds additional certifications in clinical nutrition and formerly managed a private nutrition practice focusing on fertility and the management of chronic health and autoimmune disorders. She is currently pursuing a PhD in human nutrition with a research focus on disability, underserved populations, and inequities in popular nutrition therapy approaches. She has extensive experience as a fact-checker, researcher, and critical research analyst and is passionate about science and health communications that provide practical support.