The Safety Of Creatine

Is creatine safe for use? This article will answer the question once and for all.

Within the past five years creatine has emerged as the top selling nutritional supplement in the world, Creatine sales totaled over 400 million dollars in last year alone! There is a good reason for this increase in creatine sales: it is safe and it works! There are a great number of studies touting it's effectiveness and its safety, however, over the past few years some people have questioned creatine's safety with opinions that are not verified by science.

This has led to a large-scale spread of misinformation among the public about creatine. Some people have claimed that creatine causes multiple problems from muscle cramps and dehydration to kidney failure. Due to this misinformation many coaches and schools have forbidden creatine usage and teams like the Tampa Bay Buccaneers do not even allow it in the locker room. The NCAA has recently banned the distribution of creatine by colleges to its players and is even considering banning the use of creatine. The time has come to stop this spread of misinformation about creatine so people can make intelligent decisions about creatine supplementation, based on scientific evidence, not opinion.

What Is Creatine?

Creatine is a combination of three different amino acids, glycine, arginine, and methionine. It is produced by the liver and can be found in foods such as meat and fish, usually at a concentration of four grams per kilogram of meat. Most people ingest about one gram of creatine per day and the body makes about one gram of creatine per day.

When creatine is taken in the form of a supplement it has several benefits for hard training athletes. After creatine is ingested it bonds with a phosphate group to form creatine phosphate. CP (creatine phosphate) can then donate a phosphate molecule to ADP (adenosine tri-phosphate) to form ATP (adenosine tri-phosphate). ATP is the energy currency of the cell and is used to drive almost all cellular functions and is a crucial molecule in muscular contraction. Supplementing with creatine increases the body's ATP production thus enhancing performance and decreasing fatigue in intense, short duration activities such as weightlifting and sprinting (NCAA).

Another benefit of creatine to athletes is its ability to hydrate muscle cells. Creatine pulls fluid from outside the muscle cell into the cell. This increase in water retention by the cell also causes more ions such as Nitrogen to be pulled into the cell, which increases muscle protein synthesis. This increase in muscle protein synthesis allows athletes to recover from exercise faster and in turn grow more muscle(5). One can easily see the obvious benefit of creatine supplementation to athletes who engage in high intensity sports that require quick bursts of energy or athletes that merely want to improve their strength and speed.

Long Term Side Effects?

Opponents of creatine supplementation cite several reasons for not using creatine. The NCAA recently banned the distribution of creatine by college's to their athletes "because of the lack of long-term studies on possible side effects (6)." They claim that since creatine is a relatively new supplement there is no way to tell whether or not it has any long-term side effects [(busted creatine myths)]. This statement is misleading as it is only recently that creatine has become popular, however creatine itself has been around for quite some time. Steven Scott Plisk, director of sports conditioning at Yale University says, "it has been used in the United Kingdom since the early 1980's without any problems... if creatine caused long-term side effects, there would be indicators in the shorter studies. With anabolic steroids, you see some signs in the short term that warn you about what's coming in the long term, and you don"t see any of that with creatine (7)." There have been several studies conducted on creatine supplementation, which concluded that long term creatine use has no side effects (8 and 9).

Cramping And Dehydration?

Some coaches claim that creatine has caused dehydration and muscle cramps among their athletes. Ross Bailey, head athletic trainer at Texas Christian University believes that creatine is the cause of frequent cramping and pulled hamstrings among athletes at Texas Christian. "We have no scientific evidence, but the use of creatine is the only thing that has changed" says Bailey(4). There is no scientific evidence to support his claims as he states, there are only anecdotal reports. The cause of muscle cramps and dehydration are both due to inadequate water consumption, not creatine supplementation. There is scientific evidence to verify that creatine does not cause dehydration or muscle cramps among college athletes.

Two similar studies on creatine's effects were conducted upon college athletes by the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) which demonstrated creatine safety. One study looked at the side effects associated with creatine supplementation on Division I-A football players during 3-a-day practices. The other study was almost exactly the same, the only difference being that Division I-A baseball players were studied during the fall collegiate baseball. Both studies concluded that there were "no perceived side-effects or health-status problems associated with creatine supplementation" in the athletes during the time period in which they were examined(2 and 3). Opponents of creatine supplementation sometimes try to discredit studies such as these by stating that they are only looking at a short period of time and cannot determine how creatine supplementation affects dehydration and muscle cramping in athletes over a long period of time. Once again, there is scientific evidence to counter their argument. A recent study examined the relationship between adverse health effects and long-term creatine supplementation in athletes. The researchers concluded that there "were no differences in incidences of cramps, muscle injury, or side effects between athletes and controls (9)."

Kidney Problems?

Opponents of creatine supplementation also like to state that creatine is hard on the kidneys and can cause kidney damage with long term use. Once again, there is no scientific evidence to back up their claims. There is scientific evidence to refute these claims however. A new study examined whether or not oral creatine supplementation affected the kidneys of athletes over short-, medium-, and long-term periods of supplementation. The researchers concluded that "no detrimental effects on athletes' kidney functions from short-, medium-, or long-term use of this supplement (8)." Jeff Volek, a doctoral student at the Center for Sports Medicine at Pennsylvania State University recently completed a study that found no negative side effects to creatine use states, "because it is a naturally occurring compound, side effects are not as likely... and it has been proven to be readily handled by the kidneys(4)".

Unfair Competitive Advantage?

Still opponents of creatine find other ways to discredit it. Some opponents claim that creatine may give athletes an unfair advantage. Once again this is a ludicrous claim. Creatine is available to anyone and is very affordable (a 250-day supply can be found for as little as $19.99 on Using the same notion that creatine may provide an unfair advantage to athletes using it one would have to consider whether vitamins provide an unfair advantage to athletes who use them. Should athletes thus be discouraged from supplementing with vitamins? Obviously not. Creatine should not be treated differently. Unfortunately, it is because of ludicrous claims such as these that the NCAA has banned the distribution of creatine stating that there are a number of schools that have more money than others and can provide items that others can't (6).

Once again if one follows this idea that some colleges have more money and may be able to provide it's athletes with creatine where other schools cannot, should the NCAA then ban or limit the spending the quality of training equipment (among other things) that schools are allowed to buy? Following the NCAA's logic superior training equipment may be an unfair advantage to schools with more money, but do they ban or limit the amount or quality of training equipment a school can buy? Of course not, creatine however seems to be treated differently because of the misconceptions that surround it.


Over the past few years creatine has emerged as an effective and safe supplement that benefits athletes who are looking to increase strength, size, and power. It's safety and effectiveness has been supported in numerous peer-reviewed studies and many experts in the field of sports nutrition. How unfortunate it is that unfounded statements regarding creatine's safety by people looking to stir up controversy has caused the spread of misinformation throughout the country and has even led the NCAA to ban the distribution of creatine. Hopefully, in the years to come this wave of misinformation will be replaced by scientific reasoning and allow people to make educated decisions regarding creatine.


  1. Sahelian, Ray. Creatine--just the FAQs ma'am. Better Nutrition. May 2000 v62 i5 p26
  2. Kreider et. al. Perceived Fatigue Associated With Creatine Supplementation During the Fall Collegiate Baseball Series of Division I Players. Journal of Athletic Training. April-June 2001 v31 i2 pS 83.
  3. Greenwood et. al. Perceived Health Status and Side-Effects Associated With Creatine Supplemenation of Division I-A Football Players During 3-a-Day Training. Research Quarterly for Exercise and Sport. March 2001 v72 i1 pA-29.
  4. Huggins, Sally. Energy Supplement Stirs up Debate. The NCAA News. October 28, 1996.
  5. Medicine and Science in Sports and Exercise (New in Review). Journal of American Dietetic Association. May 2002 v102 i5 p740(2)
  6. NCAA Clamps Down on Supplements (New NCAA rule disallowing creatine distribution draws criticism). Momentum Media. August/ September 2000.
  7. Hawes, Kay. Creatine Boom Creates Administrative Challenges. The NCAA News. September 14, 1998.
  8. Poortmans, Jacques R. and Marc Francaux. Long-term Oral Creatine Supplementation Does not Impair Renal Function in Healthy Athletes. Medicine and Science in Sports and Exercise 31 (1999): 1108-1111.
  9. Schilling, Brian K., et al. Creatine Supplementation and Health Variables: a Retrospective Study. Medicine and Science in Sports and Exercise 33 (2001): 183-186