Would you be happy if your teen started using creatine? I have recently had a spate of young men and women cycling through the clinic and many of them on creatine. At the same time I was asked about it by family, and my initial reaction was no… terrible stuff. It’s artificial for one. Lots of processing in a laboratory using crude materials from petrochemicals isn’t it?. While I wasn’t wrong on some of those points, I decided to get the facts rather than my preconceived notion, some of which, threw out surprising results i.e. the potential benefits regarding cognitive function. There was no shortage of data which ranged from patchy to thorough and interesting, but with sometimes tinted interpretation. Amongst the deep dive into research papers I also read from die-hard user blogs who are fully enthralled with the undisputed benefits (physically) and retailers who are protecting their bottom line. I deduced somewhere in between lies the truth or at the very least some serious and sensible consideration should be applied if taking this supplement. Lets think beyond the gym and more in terms of longevity!
How safe is Creatine?
What is Creatine?
Michel Eugene Chevreul became the first man to successfully extract creatine from meat and it later became synthesised in a lab using calcium cyanamide and sarcosinate. It didn’t become mainstream however until the mid 1990’s following the Barcelona 1993 olympics where it was used by some athletes. Creatine is a molecule that the body can naturally produce. It’s made primarily in the kidneys and completed in the liver, by three amino acids: glycine, arginine and methionine. .
How is it produced?
There are several ways to produce creatine monohydrate, all of which involve chemical synthesis. One method is combining raw materials sarcosinate and cyanamide. These are petroleum waste by-products which can be contaminated. In a 2011 study organic contaminants were found in 33 samples of creatine supplements from the market. Creatinine resulted to be the major organic contaminant in 44% of the samples. It is not uncommon to see a rise in creatinine blood levels when patients are taking creatine monohydrate. I can vouch for this in my own clinic up to present day 2024.
Creatine and Kidney Health
First up its important to say that much of the evidence around creatine supplementation and kidney health concludes that apart from high creatinine levels showing in blood tests there are no risks and this result is seemingly harmless!! Yet research often concludes it is best to avoid if you have kidney damage and I would go further to say or a history of kidney / bladder weakness. Here is why!. Continued high creatinine can cause bladder retention and fluid retention. Urine is a waste product. When the flow is obstructed, bacteria that enters the urinary tract may not be flushed out. This reduces functionality and vitality of the kidney organs. Creatine users should be mindful of reduced urinary flow, dark or smelly urine and either adjust their liquid intake or simply and probably wiser, stop taking this supplement.
Simply put more ATP provides cellular energy and mitochondrial function. This extends beyond body building to benefit the whole body including brain performance and organ health. Creatine is not the only supplement that increases ATP though. There are many herbs that have proven to increase ATP levels. Examples are Solomons seal (polygonatum), Reishi, Rhodiola, Ginsengs and Ashwagandha. ………………………
Continued high creatinine can cause bladder retention and fluid retention.
The most widely known fact about creatine is it draws water into the tissue and increases muscle mass when coupled with exercise. It also increases energy so you are more likely to want to workout. About 95% of creatine is stored in the muscles and known as creatine kinase. Supplementing with creatine increases creatine phosphate stores. This in turn helps your body produce more ATP (mitochondrial adenosine triphosphate). More ATP provides cellular energy and supports mitochondrial function. This extends beyond body building to benefit the whole body including brain performance and organ health. As we age ATP is decreased which can cause the build up of cellular waste. This leads to oxidative stress, inflammation and ultimately tissue damage. Fortunately there are many herbs that can also increase ATP levels. Examples are Solomons Seal (polygonatum), Reishi, Rhodiola, Ginsengs and Ashwagandha.
CREATINE AND DOPAMINE – Preliminary studies have shown that creatine may be potentially neuroprotective by preventing losses of dopaminergic neurons. It is being investigated for a number of conditions such as Parkinson’s and depression. CREATINE AND HEART – Those with reduced cardiac output tend to have low creatinine levels and symptoms include muscle wasting. Taking creatine improves muscle strength and frame.
CREATINE SIDE EFFECTS
Creatine’s many potential side effects, includes weight gain, headache, abdominal pain, and diarrhoea or constipation. This is because creatine pulls water from the bowels into other parts of the body. This may increase risk of dehydration or heat illness due to the fluid shifts caused by the substance and potential electrolyte imbalance. A more serious side effect from this fluid shift can be tachycardia or heart palpitations and anxiety in an otherwise healthy heart. Creatine also increases a type of white blood cell count call eosinophils. These type of cells tend create an allergic type response such as asthma, hay fever, skin rashes and chest tightness. Asthmatics beware! There is evidence that creatine increases dihydrotestosterone DHT levels. An overgrowth of DHT can cause a number of undesirable affects in both men and women. Dosage is key. Lower doses will lessen the potential side effects.
- Caffeine – Caffeine may make it hard for your body to use creatine, and taking creatine and caffeine may increase the risk of dehydration.
- Diuretics (water pills) – Taking creatine with diuretics may increase the risk of dehydration and kidney damage. Water pills can also be a part of a collective in blood pressure medication.
- Cimetidine reduces stomach acid like Nexium – taking creatine while taking H2 blockers or PPI’s may affect how creatine is broken down and used.
- Drugs that affect the kidneys – Using creatine along with any medication that affects the kidneys may raise the risk of kidney damage.
- Drugs that reduce uric acid to treat gout – like probenecid may increase the risk of kidney damage.
Important tips for taking creatine
- Take with warm water. 2 – 5g depending on weight seems to be recommended lower dose.
- Stay hydrated.
- Watch bowel abnormality – you should make 1-2 easy formed stool bowel motions per day
- Observe bladder function, urine flow and colour.
- Avoid if you are prone to allergies as it may aggravate the condition.
- If medicated seek professional advise from an informed health care provider.
- Creatine for Men Cautions. Those with high PSA levels, worried about prostate cancer, poor kidney function, history of kidney disease or family history, poor bowel function, anxiety, ADHD. Those with prostate cancer. Those with symptoms of excess DHT equals acne (young men in particular), prostate enlargement, sudden onset of male pattern baldness.
- Creatine for Women Cautions. High DHT symptoms = male pattern baldness, facial hair, deepening of voice, ovarian cysts, poor kidney, bladder function, poor bowel function, anxiety.
Creatine without a doubt increases muscle mass and is a highly attractive solution for bulking, building muscle, improving performance in sport and overall appearance. It is repeatedly listed has having a high safety record. I wonder whether that is because users are not drawing parallels with the potential side effects because they don’t know what to look for?. As a herbalist formulas are our specialty and dosing can make unexpected variable responses. Less is always more if taking anything long term and cycling on and off ‘artificial’ supplements or even natural ones is best practise for the body to find homeostasis. Ultimately I believe there are plenty of safer alternative gym supplements. I am however very interested in how it may be used as a medicine for cognitive decline or those with medical conditions with low creatinine and Reduced Cardiac Output or muscle wasting. I hope this article has raised awareness around both the obvious changes and more subtle changes that may occur in the presence of creatine supplementation.
Licenced Medical Herbalist Nutritionist & Yoga Therapy