Creatine is a nitrogenous organic acid that occurs naturally and plays a role in providing energy to all cells in the body — but primarily 95% is stored in muscle. It does this by increasing production of adenosine triphosphate, a molecule that helps transfer energy between cells.
About creatine
Creatine, which is made up of amino acids, is produced in the kidneys, liver, and pancreas and stored in muscle. It's found naturally in animal meat, including fish. Since the organic acid is stored in muscle, creatine supplements are popular with those seeking to build muscle mass. Creatine first became popular in the 1990s because it is known as a natural way to develop lean body mass.
Recommended dose
Typically, the recommended dose for an anaerobic athletes over the age of 18 starting creatine for the first time is 5g, four times a day, for two to five days, followed by 2g to 5g daily. But the effects of it are absorbed in the body best when it's taken with, carbohydrates, such as fruit, fruit juice, and starches.[2,4]
Sources
Half of the creatine needed by the body should come from food and/or supplements. The food that is richest in creatine is wild game. Other good sources are red meat, tuna, salmon, and herring. Creatine can also be obtained through the consumption of supplements. Most commonly, the supplements are sold in powder form, but they also come in tablets, liquid, energy bars, and drink mixes.
Benefits
Leaner body mass and greater athletic ability, as a result of creatine supplementation, seems to occur during weight lifting and other short duration, high intensity exercises.
Other benefits of creatine may may include the prevention or treatment of:
Reduce triglycerides
Creatine supplements may reduce triglycerlide levels in the blood in patients with high trigclycerides. It's possible that heart patients take a supplement, along with standard medical treatment, can do more exercise compared to patients who take a placebo, according to a small study that observed short-term supplementation on 20 heart failure patients. Finally, the Mayo Clinic has established that patients with chronic heart failure tend to have lower levels of creatine in their heart. More studies are needed to fully verify this effect.[6]
Improve COPD side effects
Taking creatine may increase endurance, muscle mass, and strength in COPD patients. In one study, patients who took a placebo had less improved health status compared to COPD patients who took the supplement.
Improve strength for muscular dystrophy patients
Muscular dystrophy patients may have less creatine in their muscles, which can lead to weakness. Supplementation may increase muscle strength, according to one small study.[2]
Improve strength in Parkinson's disease patients
Taking creatine may improve exercise ability and endurance in Parkinson's disease patients. It may also help boost their mood.[1]
Medication interactions

A common question is whether creatine causes kidney damage. The answer is typically 'no', unless you already have kidney problems.
Creatine should not be consumed in large amounts by people who are taking certain medications, such as, but not limited to:
Non-steroidal anti-inflammatory drugs (NSAIDs)
Pain medications, such as ibuprofen and naproxen, can cause kidney damage when taken in combination with creatine.
Caffeine
When combined with creatine, caffeine increases the risk of dehydration. On its own, caffeine may reduce your body's ability to use creatine.
Diuretics
Taking creatine with diuretics, also known as water pills, could increase the risk of kidney damage and dehydration.
Cimetidine
This antihistamine, used for treating stomach acid and peptic ulcers, could interact with creatine and cause kidney damage.
Drugs that affect the kidneys
Could lead to kidney damage and/or failure.
Probenecid
Creatine, taken with this gout drug, could lead to kidney damage.
Side effects
Despite over 700 well-performed studies on creatine that prove it to be safe and effective after long-term use, there remains enormous amount of FUD (fear, uncertainty, and doubt).
Common side effects seen with creatine consumption include unwanted weight gain (although this is typically an intended effect), cramps if taken with too little water, and diarrhea if too much is taken.
It does not cause mood swings.
As with any supplement, people with pre-existing medical conditions should consult with a doctor before using it.
Considerations
Not everyone seems to have the same reaction to creatine. While the supplement became notorious for building lean muscle mass, according to the University of Maryland, "not all human studies have shown that creatine improves athletic performance."[2] People who naturally have have high levels of the organic acid in their muscles do not experience the energy-boosting effect when they take additional doses of creatine.
Warnings
In rare cases, medical research has shown that irregular heart beats (palpitations) or skin conditions resulted from creatine use. Many factors, such as the person's current liver function level, may have been a contributing factor to these findings. Often, when a person has a skin condition, the underlying cause is liver function problems. Heart palpitations can often be serious, so creatine should be taken with caution. If any negative side effects are experienced, one should discontinue using it.
Who should not take creatine
Taking creatine has been known to prevent the body from producing stores naturally. Talk to your healthcare provider before starting a new supplement.
You should not take creatine supplements if:
- You are under the age of 18
- You have pre-existing kidney disease
- You have ppoor liver function
- You have high blood pressure
Possible side effects
When used at a normal dose for up to six months, chances of experiencing side effects are low. But those who do experience adverse effects typically report:
Weight gain
Muscle cramps, strains, and pulls
Upset stomach and/or diarrhea
Dizziness
High blood pressure
Liver problems
Kidney damage
More research is needed to determine if creatine plays a role in causing an irregular heartbeat or a skin condition known as purpuric dermatosis.
References
- Bender A, et al.; Neurology; "Creatine supplementation in Parkinson disease: a placebo-controlled randomized pilot trial;" 2006
- University of Maryland Medical Center; "Creatine;" Updated 2013
- Mayo Clinic; "Creatine: Dosing;" Updated 2012
- Cornelissen VA, et. al.; Clinical Rehabilitation; Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial; 2010
- Mayo Clinic; "Creatine: Evidence;" Updated 2012
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