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Learn > Nutrition > Supplements

profile avatar Charlie Seltzer, MD Contributor

Creatine Benefits, Side Effects, & Dosage For Best Results

By Charlie Seltzer, MD - Updated 7/7/2022
Updated 7/7/2022

creatine-side-effects

Creatine is an organic acid that plays a key role in supplying energy for muscle cells during intense activity.

Creatine is produced naturally by the body and found in small quantities in animal products. Creatine stored in muscle cells helps produce ATP, which is the primary energy currency in the body.

While creatine is not an essential nutrient because the body can synthesize it, it’s one of the most widely used supplements because there is strong evidence it can improve performance and is safe for most people. Additionally, creatine may have other health-promoting properties beyond its ability to make a person stronger or faster.

Creatine Supplementation vs. Creatine In Foods

An average human body contains between 3.5 and 4 grams of creatine per kilogram of muscle. However, it is capable of storing up to 5 grams per kilogram. The idea behind supplementation is that by saturating the body with creatine, you augment its benefits. The richest sources of creatine from food are beef and fish, which contain between 2 and 5 grams per pound.

Because most research on the benefits of creatine is done on dosages of 5 grams, it is largely impractical for most people to try to reap the benefits seen in studies without supplementation. Of course, the potential risks of any supplement should be weighed against the benefits before using. But, should you decide to use creatine as a muscle builder, you will need to supplement in order to receive its effects.

Creatine Benefits

Extensively studied for both its safety and benefits, some of creatine’s supposed benefits are supported by research and some are not. Creatine also shows promise outside of the athletic and performance setting, but more research is needed in these areas.

  1. Increase in muscle size – Creatine supplementation causes an increase in the water content of muscles, making them “larger.” This is not due to an increase in the size of the muscle fibers. However, creatine can increase “real” fat free mass over time, as its strength and power-boosting properties allow higher quality training and thus, better gains.1
  2. Improved athletic performance – A large body of research shows that oral creatine supplementation can make an athlete faster and stronger when performing high intensity activity.2 3 4 5
  3. Increased muscle protein synthesis – I found a few studies which refuted this claim.6 7 Still, if someone who uses creatine can lift more weight, muscle protein synthesis should increase; although, the creatine itself simply increases the available energy supply (ATP) for muscle contraction. Creatine itself does not stimulate protein synthesis. Remember, there has never been a scientifically controlled study showing that jumping out of an airplane with a parachute is any better than jumping out without one.

Creatine Side Effects & Risks

Creatine supplementation should be safe when used by healthy individuals. Most of the health risks attributed to creatine (kidney and liver damage, increased risk of injury) have not been shown in clinical studies.8

Although no long term studies have examined use of creatine, I am unaware of any reports of physical harm from supplementation in a person without kidney disease. However, there is evidence creatine supplementation can damage unhealthy kidneys.9

Dehydration is also a concern with supplementation, as creatine will draw water into the muscle cell. If you use creatine, be sure to drink plenty of water, which you should be doing anyway. And as with all supplements, due to a lack of regulation, toxins and impurities in a product are always a concern. Buying a reputable brand makes this less of an issue.

GI distress is a common side effect of creatine. Taking it with food, not “loading” (see below) or perhaps using a form besides monohydrate may lessen or eliminate this reaction.

Again, creatine is very safe for most people. However, since kidney and liver disease, in their early stages, may not produce any symptoms, it is a good idea to have your doctor test your kidney and liver function, especially if you plan on using supplements.

Creatine Recommendations & Dosage

There are many different kinds of creatine available. If you look on the shelves of a supplement store, you will see creatine monohydrate, creatine ethyl ester, creatine hydrochloride, creatine AKG and others.

The oldest form is creatine monohydrate, and this has been the compound used in essentially all of the well-designed studies. For this reason, I recommend this form over the newer, non-research backed forms. It also happens to be the cheapest. I recommend a pharmaceutical grade product such as Myogenix (affiliate link) to avoid the possibility of toxins or impurities in the product.

Creatine users often do a “loading phase” of taking 20 grams throughout the day for 5-7 days before moving a maintenance phase of 2-5 grams per day. Research has shown this to increase the rate at which muscles become saturated.10 However, loading is not necessary for creatine to exert its positive effect.11.

In some models, the presence of insulin increases the amount of creatine that is absorbed into the muscles.12 Caffeine may lessen it.13

Conclusion:

Take 3-5 grams of creatine monohydrate with either your pre or post workout shake. Should you choose to load, take 5 grams 4 times per day for 6 days followed by 3 grams per day, after your doctor tells you your kidneys are healthy.

Show 13 References

  1. Volek, J., Duncan, N., Mazetti, S., Staron, R., Putukian, M., Gomez, A., Pearce, D., Fink, W., Kraemer, W. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training . PT Clinical. 2013. ↩
  2. Prevost, M., Nelson, A., Morris, G. Creatine Supplementation Enhances Intermittent Work Performance . Exercise and Sport. Quarterly. V. 68, 1997. ↩
  3. Skare, O., Skadberg, O., Wisnes, A. Creatine Supplementation improves sprint performance in male sprinters . Scandinavian Journal of Medicine and Science in Sports. V. 11, Apr 2001. ↩
  4. Kreider, B., Ferreira, M., Micahel, W., Grindstaff, P., Plisk, S., Reinardy, J. Cantler, E., Alamada, A. Effects of creatine supplementation on body composition, strength, and sprint performance . V. 30. Sep 2007. ↩
  5. Juhn, M., Tarnopolsky, D., Maek, M. Oral Creatine Supplementation and Athletic Performance: A Critical Review . Clinical Journal of Sports Medicine. Oct 1998. ↩
  6. Parise, G., Mihic, S., MacLennan, S., Yarasheski, K., Tarnopolsky, M. Effects of acute creatine monohydrate supplementation on leucine kinetics and mixed muscle protein synthesis . Applied Physiology. Nov. 2009. ↩
  7. Magali, L. Poortmans, J., Francaux, M., Berre, J., Boisseau, N., Brassine, E., Cuthbertson, D., Smith, K., Babraj, J., Waddell, T., Rennie, M. No effect of creatine supplementation on human myofibrillar and sacroplasmic protein synthesis after resistance exercise. Clinical Journal of Physiology. Jun 2003. ↩
  8. Kreider, R. Creatine supplementation: analysis of ergogenic value, medical safety, and concerns. Exercise Physiology. Apr 1998. ↩
  9. Edmunds, J., Jayapalan, S., DiMarco, N., Saboorian, H., Aukema, H. Creatine Supplemention Increases Renal Disease Progression in Han: SPRD-cy Rats. American Journal of Kidney Diseases. V. 37. Jan 2001. ↩
  10. Hultman, E., Soderlund, K., Timmons, J., Cederblad, G., Greenhaff, P. Muscle creatine loading in men. Americal Physiological Journal. Jul 1996. ↩
  11. Vandenberghe, K., Van Hecke, P., Van Lemputte, M., Hespel, P. Phosphocreatine resynthesis is not affected by creatine loading . Medicine and Science in Sports and Exercise [1999, 31(2):236-242 ↩
  12. Haugland, R., Chang, D. Insulin Effect on Creatine Transport in Skeletal Muscle. Biology and Medicine. Exp Biol Med (Maywood) January 1975 vol. 148 no. 1 1-4. ↩
  13. Vandeberghe, K., Gillis, N., Leemputte, M., Van Hecke, P., Vanstapel, F., Hespel, P. Caffeine counteracts the ergogenic action of muscle creatine loading. Applied Physiology. Journal of Applied Physiology February 1, 1996 vol. 80 no. 2 452-457 ↩
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41 Comments

  1. profile avatar
    Marty van den Bosch Jul 08, 2013 - 16:56 #

    Great write up with excellent detail and references.
    This is the one from reference 16 that kills me >> “This ergogenic effect, however, is completely eliminated by caffeine intake.”
    I just love my coffee, the caffeinated kind, lots of it.
    I do not take creatine as a result of reading this some time ago as studies suggest I need to give up my caffeine in order to benefit from this, and I am not quite ready to give up one of my last vices 🙂

  2. profile avatar
    Marc Perry, CSCS, CPT Jul 08, 2013 - 17:49 #

    Definitely an impressive number of references. Excellent job with this article. I used creatine in college and it without a doubt increases strength on subsequent lifting sets and anaerobic power. I do remember that our team would at times get serious cramps because we weren’t drinking enough water while we were taking it. I don’t take creatine anymore as I try to be as natural as possible, but there is no question it’s effective and it works. It’s almost a required supplement for power related athletes (football etc.).

  3. profile avatar
    Lorenzo Jul 09, 2013 - 06:51 #

    Creatine definitely works. I’ll offer my own anectdotal experience, however, that it can make you very horny, irritable, and tempermental. If you use it, pay attention to your moods and be honest with yourself.

    1. profile avatar
      Marc Perry, CSCS, CPT Jul 09, 2013 - 13:52 #

      @Lorenzo – wow, never heard of those side effects, but thanks for sharing.

  4. profile avatar
    uncadonego Jul 09, 2013 - 11:29 #

    Marc, you’ve answered part of the question I have. If some of the BUILTlean team doesn’t mind discussing somewhat personal things, I’d be interested in hearing about their past and present supplementation use and their feelings on it.

    1. profile avatar
      Charlie Seltzer, MD Jul 10, 2013 - 10:54 #

      Currently, I am using an essential amino acid mixture with dextrose pre workout, BCAAs with dextrose during my workouts and hydrolyzed whey with dextrose post worktout. I use fish oil, CLA and Greens Pak daily as well as micellar casein before bed. Since my genetics make it very hard for me to build muscle and lose fat, I need all the help I can get, and I have chosen my supplement regimen based on efficacy data and favorable benefit to risk ratios.

  5. profile avatar
    uncadonego Jul 10, 2013 - 14:37 #

    Great answer, thanks. I hope we get a couple more replies as well.

  6. profile avatar
    Taaza Jul 15, 2013 - 05:11 #

    The article really impressed and persuaded me. I had been looking to aid my muscle growth in some way as weight lifting has taken a lengthy period. Majority of people in my family are relatively slim so I’m not sure if it has to do with my genetics. Buying my first supplement soon and will no doubt post my progress in the coming months.

  7. profile avatar
    lewis Jul 19, 2013 - 19:31 #

    Really cool publish, highly educational and professionally written..Good Work

  8. profile avatar
    Andy Jul 24, 2013 - 17:35 #

    Thanks for the information on Creatine. I’m about to buy some for my fitness programme but do I take Creatine instead of a Protein supplement/shake or as well as a Protein supplement ? If so what sort of Protein would you suggest ?

    Many thanks

    Andy

  9. profile avatar
    Andy Jul 25, 2013 - 08:06 #

    If you take Creatine in your fitness program is it instead of protein supplements or as well as protein supplements ?

    Thanks

    1. profile avatar
      Marc Perry, CSCS, CPT Jul 25, 2013 - 13:12 #

      @Andy – creatine doesn’t replace a protein supplement and a protein supplement is simply another way to get protein. I refer to whey protein powder as a powdered form of chicken breast that digests quickly, that’s really it is.

      1. profile avatar
        Andy Jul 26, 2013 - 09:00 #

        Ok thanks for that.

  10. profile avatar
    Shanti Nov 04, 2016 - 04:13 #

    Plz tell me how would I gain weight because I am lean

    1. profile avatar
      Kristin Rooke, CPT Nov 04, 2016 - 11:18 #

      Hi Shanti,

      I’m guessing that you want to gain lean muscle, and not body fat, correct? Building lean muscle without adding a ton of fat generally requires that you follow a good nutrition and exercise strategy. For advice on how to build muscle, I recommend reaching out to [email protected], and one of our elite BuiltLean Coaches will be able to give you some guidance on how to get started. Alternatively, we have a workout & nutrition program specifically designed to meet this goal – BuiltLean Muscle. The program will be available some time in 2017, so if you’re interested I recommend that you sign up for updates. Hope that helps!

      -Kristin, BuiltLean Coach & Managing Editor

  11. profile avatar
    Rahul chh Nov 06, 2016 - 12:27 #

    I have recently joined a gym, and I’m a beginner. Could you please suggest which supplements are good for me? Which ones will not have any negative side-effects?

    1. profile avatar
      Kristin Rooke, CPT Nov 07, 2016 - 15:22 #

      Hi Rahul,

      Congrats on joining a gym and getting active! That’s a great question. At BuiltLean, we don’t recommend any particular supplements. The truth is, supplements are generally expensive and unnecessary to achieving your workout goals. The only supplement that we suggest as an option (but that’s also not necessary) is a protein supplement. You could use a whey protein isolate (if you tolerate dairy), or you could use an egg-, goat-whey, or plant-based protein powder. Protein powders are a great way to meet your daily protein goals, and aren’t associated with negative side effects (as long as you’re not allergic or sensitive to the ingredients). Hope that helps!

      -Kristin, BuiltLean Coach & Managing Editor

  12. profile avatar
    Sajid Patel Nov 30, 2016 - 02:00 #

    Great article. I am 41 years old and my weight around 70 kg and my height is 5.9″. I am doing gym since 1 and half year. Which supplement you suggest for me to build muscles. My body doesn’t look as it should be. Can I take Creatine or Whey protein?

    1. profile avatar
      Kristin Rooke, CPT Nov 30, 2016 - 13:10 #

      Hi Sajid,

      It’s great that you’ve been regularly working out for 1.5 years so far! When it comes to changing your body, the truth is that you don’t need supplements. We don’t actually recommend supplements to our clients or members. You can get incredible results by following a well-designed workout program and nutrition plan. If you want to lose fat, you have to focus on your nutrition. Losing fat requires that you eat fewer calories than you burn. I would recommend tracking your food in an app like MyFitnessPal for a 3-5 days to determine your average daily calorie intake. Then, decrease your daily calories by 250-500. Continue to strength train while eating a calorie deficit, and you should begin to lose fat while maintaining lean muscle. That’s how you get that lean, defined look.

      Hope that helps! If you have more questions, feel free to ask.

      -Kristin, BuiltLean Coach & Managing Editor

  13. profile avatar
    Abhishek Dec 28, 2016 - 09:34 #

    I started creatin monohydrate as per direction on pack but after few dosage i got several fewer and digestion problem is this because creatine not suited my body or any allergy symptoms ?

    1. profile avatar
      Kristin Dec 28, 2016 - 10:24 #

      Hey Abhishek – while creatine is a safe supplement for most people to use, about 5-7% of people experience gastrointestinal upset from using it. It sounds like you might be someone that doesn’t tolerate creatine. The good news is that supplements aren’t necessary to either lose fat or build muscle. You can accomplish your fitness goals by following a well-designed workout and nutrition program. Hope that helps! If you have more questions, feel free to ask.
      -Kristin, BuiltLean Coach & Managing Editor

      1. profile avatar
        Abhishek Jan 03, 2017 - 04:11 #

        Thanx kristin, your answer helped me lot to understand the fact? can you also help me with good nutritions which will help me in better health as i workout daily from last 2 months

      2. profile avatar
        Kristin Jan 03, 2017 - 12:08 #

        Abhishek – in general, we recommend eating a diet comprised primarily of whole, unprocessed foods. Specifically – vegetables, fruits, lean proteins, healthy fats, and whole grain carbs. These foods are more nutrient-dense, more satiating, and lower in calories than processed and packaged foods. You also want to make sure to include some protein with every meal and snack. This will help you meet your daily protein requirements. Eating adequate protein, and choosing mostly whole foods at least 80% of the time is a great way to boost health, energy, and performance.

        Hope that helps!
        -Kristin, BuiltLean Coach & Managing Editor

  14. profile avatar
    Sam gill Dec 29, 2016 - 03:25 #

    nice post and very helpful information about creatine

    1. profile avatar
      Kristin Dec 29, 2016 - 10:14 #

      Glad you found it helpful!
      -Kristin, BuiltLean Coach & Managing Editor

  15. profile avatar
    Adil Jawaid Jan 02, 2017 - 05:18 #

    please can you send me best diet plane for weekly purpose. i am 34 year old male and doing gym from 5 year but not regular. like 3 months then i left and after 4 month i join again. so please guide me. what should i do. and what should i take. when i take much amount of food i get fats on my sides. and its really very embarrassing. so guide me some best work out for lower belly and sides obliques and side fats.. thanking you.. my personal id is [email protected] please reply me over my id. because i don’t have time to use Net..

    1. profile avatar
      Kristin Jan 02, 2017 - 11:35 #

      Adil – since you’re interested in a workout and nutrition program to lose weight and fat, I highly recommend checking out the BuiltLean Transformation Program. BuiltLean Transformation tells you exactly what to eat and what workouts to do in order to lose fat and get lean. It takes the guesswork out of eating and exercise, so all you have to do is follow the program to see the results you want. BuiltLean Transformation is 12-weeks long, and has you working out 3x per week. From what you’ve told me about yourself, I think you’re a great candidate for this workout program.
      -Kristin, BuiltLean Coach & Managing Editor

  16. profile avatar
    raju beigh Jan 02, 2017 - 15:40 #

    I have recently joined gym what should I have to do for my muscle growth and to reduce my lower fat .
    I also use a supplement (whey protein) should I use caretine to enhance my energy level?

    1. profile avatar
      Kristin Jan 03, 2017 - 12:25 #

      Great questions, Raju. It sounds like you want to lose fat and build muscle at the same time. In general, we recommend focusing on one goal, or the other. Not both simultaneously. Since fat loss is one of your goals, we think you should start there.

      Fat loss requires that you eat fewer calories than you burn each day, while still performing strength training. This encourages your body to maintain lean muscle so that you mostly lose body fat. For more information on this topic, check out our article on why you should lose fat first (before building muscle).

      Supplements are not necessary to lose fat, or build muscle. Taking whey protein can be useful to help you meet your daily protein requirements, but you don’t have to take it. You can lose fat, or build muscle, by eating whole foods in the right amounts.

      If you’re interested in following a workout and nutrition program that takes the guesswork out of fat loss, you should check out the BuiltLean Transformation program. It gives you a 12-week workout program to follow, as well as specific meals to eat to lose fat and get lean.

      Hope that helps!
      -Kristin, BuiltLean Coach & Managing Editor

  17. profile avatar
    Adil Jawaid Jan 03, 2017 - 05:30 #

    Thank you Kristin. but dear i don’t want to get much lean. i want to improve size in biceps chest shoulder abs legs with sharpness can it be possible with only best food. not with supplements or creatine send me detail of best work out for all these with food chart can you give me your e-mail id. so i can catch you easily thank you

    regards adil

    1. profile avatar
      Kristin Jan 03, 2017 - 12:05 #

      Adil – if you want to build muscle, you need to do two things: (1) Eat more calories than you burn, and (2) follow and muscle building workout program. We don’t provide individualized workout and nutrition programs at this time, but there are a few articles on BuiltLean that could help you reach your goal of building muscle.

      Are You Eating Enough Protein To Build Muscle?

      How Do Muscles Grow? The Science Of Muscle Growth

      How Fast Can You Build Muscle? 5 Factors That Affect Muscle Growth

      Those articles should help you get started towards creating an eating and exercise routine to get bigger and stronger.

      -Kristin, BuiltLean Coach & Managing Editor

  18. profile avatar
    Saurabh Jan 07, 2017 - 14:10 #

    great work..kristin……all articles are very helpful…thanks alot..

  19. profile avatar
    Rick Jan 12, 2017 - 16:04 #

    What is the best way to lose belly fat and get chiseled abbs? I do crunches, work them on the machines at the gym but can’t seem to lose the small “spare tire” I have. I’m 59 and just started going back to the gym about 3-4 months ago. Help.

    1. profile avatar
      Marc Perry, CSCS, CPT Jan 16, 2017 - 19:34 #

      Hey Rick, I think the best way is by focusing on your nutrition. Consider 7 Reasons To Keep A Food Journal, which can really help you take control of your eating and lose more fat. If you eat fewer calories than you burn, continue exercising, the fat will come off. And congrats on getting back into exercise!

  20. profile avatar
    Garry Aug 04, 2017 - 13:12 #

    My age is 17, and i am going to gym from last 8 months.
    I have a slim body so can I go for creatine to gain muscle?

    1. profile avatar
      Marc Perry Aug 05, 2017 - 13:17 #

      Hey Garry – consider discussing with your doctor before taking a new supplement.

  21. profile avatar
    Wellyn Aug 05, 2017 - 10:47 #

    Hi. I bought universal creatine lately but never try to drink because i am worried about some side effects that i have read. I also bought universal fat burber. My question is, is it safe to take this two supplement everyday? And is it true about side effects of taking creatine may cause to stroke or kidney failure? Please need your utmost response. Right now i am starting working out on a gym. My aim is to build muscle… I am 42 y/o male… Tnx

    1. profile avatar
      Marc Perry Aug 05, 2017 - 13:16 #

      Hi Wellyn, thanks for your questions, but they are best for your doctor to answer. Charlie provided the research which shows creatine supplementation is safe for most people and is one of the safest and well-researched supplements on the market.

      1. profile avatar
        Wellyn Aug 05, 2017 - 13:27 #

        Hello marc perry. Thanks for the answer. But, may i know who is Charlie? What article he wrote. Thanks

      2. profile avatar
        Wellyn Aug 05, 2017 - 13:31 #

        Marc, my apology. I am mislead. I know who is Charlie. Just had read he’s article. Tnx anyway

  22. profile avatar
    Wellyn Aug 05, 2017 - 13:26 #

    @marckperry. Thanks for the answer. But, may i know who is Charlie? What article he wrote. Thanks

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