Creatine monohydrate supplementation is quite popular in athletes and physically active individuals. It’s safety has also been well documented, and this is especially true when creatine is ingested at the recommended dosages (i.e. 3-5 g/day OR 0.1g/kg body mass/day). Despite all the research that has been conducted on this supplement, the misinformation about creatine continues to make its rounds. For example…
Does creatine supplementation cause kidney/renal damage? This narrative gained some traction way back in 1998 when a case study was published about a hospitalized young male suffering from kidney damage. It was discovered that the patient had been ingesting creatine at safe, recommended doses for the past 7-8 weeks prior to the hospitalization. Immediately, creatine was blamed for his deteriorating kidney status. The only problem was that this patient had a history of kidney disease for the past 8 years of his life and his worsening symptoms were likely due to disease progression rather than creatine supplementation. All of the creatine research since that case study has pointed towards creatine being extremely safe in healthy individuals when taken at recommended doses.
Does creatine supplementation lead to dehydration and muscle cramping? This thought stems from a statement made by the American College of Sports Medicine in the early 2000’s: “athletes controlling their weight and exercising intensely or in hot environments should avoid the use of creatine supplementation.” This statement was made purely on speculation and linked to the mechanism of action creatine has on muscle tissue. Essentially, creatine may allow muscle tissue cells to uptake more water than they normally would. This means less water in other locations throughout the body which could lead to dehydration/cramping. This position statement is in direct conflict with an experimental study on D1 college football players. The study found that athletes supplementing with creatine reported significantly less cramping, heat illness, dehydration, muscle tightness, muscle strains, and total injuries over the course of the season when compared to non-creatine users.
Is creatine harmful for children and adolescents? This question is hard to answer with 100% certainty because of limited research on this particular topic. However, the overall consensus of studies that do look at creatine use in children/adolescents conclude that it appears to be safe and may potentially be beneficial. For example, a study looking at 30 children with Duchenne muscular dystrophy (a muscle wasting disease) found that 4 months of creatine supplementation significantly increased fat-free mass and hand grip strength. Furthermore, another study reported significant improvements in traumatic brain injury-related outcomes in children/adolescents who supplemented with creatine over a 6-month span after the initial injury. The potential neurological benefits of creatine may have future applications when treating concussion patients.
In conclusion, creatine is a very safe supplement when taken at the recommended dose. As always, if you are looking to start taking a new supplement make sure to consult with a trained professional first!