January 01, 2021

Is the strength-building supplement creatine effective and safe?

Q: In the online weightlifting and fitness group I belong to, other men of all ages are taking a creatine supplement to help build muscle. I'm 69 and kidney problems run in the family. Is this a safe supplement for someone like me?

A: Creatine is an amino acid naturally produced by the body that helps muscles release energy. It's also found in seafood and red meat. Creatine monohydrate is a popular supplement among strength-oriented fitness buffs, with the goal of improving short-burst athletic performance and increasing muscle mass.

Creatine supplementation at appropriate doses is generally considered safe for most people — even older adults. However, there is some concern that creatine supplementation could cause kidney damage. That's why it's best to talk to your doctor before trying it. Creatine supplementation is best avoided if you have kidney disease or are at increased risk of kidney disease. Also, generally be cautious of muscle-building products, as many contain more than just creatine.

Taking a creatine supplement can also lead to water retention within muscles, which can result in weight gain of up to several pounds. This isn't necessarily bad, but you'll want to keep yourself hydrated to compensate for this, and also realize that most weight gain is probably water, not muscle.

Good evidence indicates that creatine supplementation can result in small strength gains if coupled with a routine strength training program or vigorous exercise in most people.

Creatine appears to be absorbed best when taken with a meal containing protein and carbohydrates. Many programs suggest a five- to seven-day, high-dose "loading" phase, followed by a maintenance phase of about 2 to 3 grams daily. However, simply taking the maintenance dose for about a month provides similar or even better results.

If you don't exercise regularly, creatine supplementation isn't likely to...