What are the potential side effects of creatine supplementation?
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Potential Side Effects of Creatine Supplementation
Weight Gain and Water Retention
One of the most commonly reported side effects of creatine supplementation is weight gain, primarily due to water retention. This can be particularly problematic for athletes involved in mass-dependent activities such as running and swimming, where additional weight may impede performance1 2 3. The increase in body mass is generally attributed to an increase in fat-free mass, specifically skeletal muscle mass, although the exact mechanisms remain under debate2 9.
Gastrointestinal Disturbances
Gastrointestinal issues such as nausea, diarrhea, and stomach cramps are occasionally reported by individuals taking creatine supplements. These effects are generally mild and anecdotal, with no strong evidence linking them directly to creatine supplementation in well-controlled studies3 4 6. However, severe gastrointestinal discomfort has led some individuals to discontinue use4.
Renal and Hepatic Function
Concerns about the impact of creatine on renal and hepatic function have been widely discussed. Most studies indicate that creatine supplementation does not significantly affect kidney function in healthy individuals, even over long-term use2 3 5 7 9. However, it is generally advised that individuals with pre-existing renal conditions avoid creatine supplementation, as the increased load on the kidneys could potentially exacerbate their condition2 10. Similarly, no significant adverse effects on liver function have been observed in controlled studies3 6 7.
Muscle Cramps and Dehydration
Muscle cramps and dehydration are other side effects that have been reported, although these claims are largely anecdotal and not supported by robust scientific evidence3 6. The increase in body mass due to water retention could potentially lead to a higher risk of muscle cramps, but this has not been conclusively proven.
Contaminants and Purity
The purity of commercially available creatine supplements is another concern. Contaminants generated during the industrial production of creatine could pose health risks, although this is more related to the quality of the product rather than creatine itself2 6.
Gender-Specific Effects
Studies focusing on female participants have shown that creatine supplementation does not lead to significant adverse outcomes, including weight gain, gastrointestinal issues, or renal and hepatic complications. However, comprehensive reporting and surveillance of adverse outcomes in females are recommended for future studies8.
Conclusion
Overall, creatine supplementation appears to be safe for healthy individuals when taken at recommended doses. The most common side effects include weight gain due to water retention and occasional gastrointestinal disturbances. There is no strong evidence linking creatine to significant renal or hepatic dysfunction in healthy individuals, although those with pre-existing conditions should exercise caution. The purity of the supplement and proper dosing are crucial to minimizing potential risks.
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Most relevant research papers on this topic
Potential Side Effects of Oral Creatine Supplementation: A Critical Review
Oral creatine supplementation may cause weight gain due to water retention, hinder performance in mass-dependent activities, and has not been studied long-term effects on kidney, liver, and other organ systems.
Systematic Review
Highly CitedSide effects of creatine supplementation in athletes.
Creatine supplementation may increase muscle mass, but its safety and effectiveness in maintaining kidney function remain in question.
Literature ReviewAdverse Effects of Creatine Supplementation
Creatine supplementation does not show evidence of deleterious effects in healthy individuals, but large amounts may increase load on the liver and kidneys, requiring regular monitoring.
Literature ReviewHighly CitedFew adverse effects of long-term creatine supplementation in a placebo-controlled trial.
Long-term creatine supplementation in patients with amyotrophic lateral sclerosis does not cause significant adverse effects or increase plasma urea levels or micro-albuminuria.
RCTHighly CitedEffects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis.
Creatine supplementation does not cause renal damage in the studied amounts and durations.
Meta-AnalysisIs the use of oral creatine supplementation safe?
Oral creatine supplementation is an effective and safe ergogenic aid for healthy individuals, with only a documented increase in body mass.
Literature ReviewLong-term creatine supplementation is safe in aged patients with Parkinson disease.
Long-term creatine supplementation is safe in aged Parkinson's disease patients, with gastrointestinal complaints as the main side effect, and no altered kidney function.
RCTHighly CitedRisk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis
Creatine monohydrate supplementation in females does not increase the risk of total adverse outcomes, weight gain, or renal or hepatic complications.
Meta-Analysis
Very Rigorous JournalAcute creatine loading increases fat-free mass, but does not affect blood pressure, plasma creatinine, or CK activity in men and women.
Acute creatine loading increases fat-free mass without affecting blood pressure, renal function, or plasma creatinine activity, but may have a greater effect on men than women.
RCTHighly CitedPotential Adverse Effects of Creatine Supplement on the Kidney in Athletes and Bodybuilders.
Creatine supplementation has no detrimental effects on kidney function in healthy athletes and bodybuilders without underlying kidney diseases, but it is advised not to use it if pre-existing kidney disease or at risk for kidney dysfunction.
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