Creatine: Potential Benefits, Known Risks, and More

Note: The U.S. Food and Drug Administration (FDA) does not approve supplements for safety or effectiveness. Talk to a healthcare professional about whether a supplement is the right fit for your individual health, and about any potential drug interactions or safety concerns.

“Creatine is one of the most well-studied and versatile supplements,” says Pooja Gidwani, MD, a double board-certified physician in obesity medicine and internal medicine in Beverly HIlls, California. “While it’s most commonly associated with athletic performance in men, the growing body of research shows it has broad applications for healthy aging, cognitive support, and mental health in both men and women.”

But like any dietary supplement, creatine has both potential upsides and risks. Learn more about this compound to help determine if it’s the right fit for you.

May Increase Muscle Mass and Strength

“Over time, this enhances training capacity, leading to significant increases in lean muscle mass and strength,” says Dr. Gidwani.

Supports Muscle Recovery

Creatine also helps reduce muscle cell damage, inflammation, and soreness after intense exercise. Gidwani says it helps the body rebuild glycogen (a type of sugar) stores after they’ve been depleted by exercise, “which can improve recovery time and performance in repeated bouts of training,” she says.

Enhances Cognitive Function

Your brain consumes a great deal of energy, and creatine plays a key role in maintaining the ATP levels that support cognitive performance, says Gidwani.

May Boost Antidepressant Drugs

While creatine isn’t a replacement for antidepressant medications, there is promising evidence that it may enhance the effects of antidepressant therapy, says Gidwani.

While creatine supplementation is well-studied, it’s not for everyone. More research is still needed to support all of its purported benefits, particularly beyond those of athletic performance.

Risks

Side Effects

• Dehydration
• Diarrhea
• Nausea

Another side effect with evidence to support it is weight gain. “It’s tough to generalize, but most people experience a five-pound gain while consuming [creatine] supplements,” says Michael Roberts, PhD, a professor in the School of Kinesiology at Auburn University in Alabama.

However that gain comes in the form of water weight — not extra body fat — and “there’s a benefit there because the water is in the muscle cells, so it helps to hydrate your muscles,” explains Kelly Jones, RD, a board-certified specialist in sports dietetics based in Philadelphia. “So weight gain you might see from creatine [may be] water and better hydration.”

• Powders
• Tablets
• Capsules
• Gummies
• Liquids
• Energy bars

“So far, no form has consistently outperformed creatine monohydrate in terms of efficacy or absorption,” says Gidwani. “Monohydrate remains the gold standard because it's the most researched, widely available, and affordable.”

It’s important to pick a safe and effective creatine supplement and store it properly to ensure the ingredients don’t break down.

Selection

There are a lot of options available on store shelves and online, so it helps to know a little bit about how to narrow your options down.

“When choosing a creatine supplement, look for products that contain pure creatine monohydrate with no unnecessary additives or fillers,” Gidwani says. “This is the most researched and reliable form.”

To choose a quality supplement, check the label for USP, NSF, or Consumer Labs. This means the product has undergone third-party testing for quality and purity.

Storage

Creatine should be stored in a cool, dry place, away from direct sunlight and moisture.

“Exposure to heat or humidity can cause creatine to degrade into creatinine, which may reduce its effectiveness,” says Gidwani.

Keep the lid tightly sealed and avoid storing it in bathrooms or near stovetops. If you're mixing it into a beverage, it's best to consume it soon after, says Gidwani, since creatine can break down in liquid over time.

If you’re looking to build muscle mass or strength, however, adding a daily creatine supplement to your diet may be helpful, under your doctor’s guidance, Roberts says.

“If someone’s following a vegan diet, never eating meat or fish, then it might take them a bit longer than someone who’s regularly including those in their diet,” Jones explains.

Always speak to your doctor for dosing recommendations before starting a new supplement, since safety, drug interactions, and dosage vary by person.

• Creatine supplements are generally safe for healthy people and may boost muscle strength and recovery, as well as cognition and mood.
• Side effects of creatine may include dehydration, diarrhea, and nausea. You may also notice slight weight gain if you take creatine, but that typically comes from either water retention or increased muscle mass.
• Creatine is not recommended for those who have pre-existing kidney conditions, children under 18 or pregnant or breastfeeding women. Check with a doctor or dietitian before adding any new supplement into your diet.