Side Effects of Creatine Supplementation in Athletes
Open accessAbstract
Context: Allegations about side effects of creatine supplementation by athletes have been published in the popular media and scientific publications. Purpose: To examine the experimental evidence relating to the physiological effects of creatine supplementation. Results: One of the purported effects of oral creatine supplementation is increased muscle mass. A review of the literature reveals a 1.0% to 2.3% increase in body mass, which is attributed to fat-free mass and, more specifically, to skeletal-muscle mass. Although it is unlikely that water retention can completely explain these changes, increase in muscle-protein synthesis has never been observed after creatine supplementation. Indirect evidence based on mRNA analyses suggests that transcription of certain genes is enhanced. Although the effect of creatine on muscle-protein synthesis seems irrefutable according to advertising, this allegation remains under debate in the scientific literature. The kidneys appear to maintain their functionality in healthy subjects who supplement with creatine, even over several months. Conclusion: The authors, however, think that creatine supplementation should not be used by an individual with preexisting renal disease and that risk should be evaluated before and during any supplementation period. Even if there is a slight increase in mutagenic agents (methylamine and formaldehyde) in urine after a heavy load of creatine (20 g/day), their excretion remains within a normal range. No data are currently available regarding the potential production of heterocyclic amines with creatine supplementation. In summary, the major risk for health is probably associated with the purity of commercially available creatine.
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Considering the activity of the sodium-potassium pumps, intracellular sodium concentration is not likely to be dramatically affected by creatine supplementation.
“However, considering the activity of the sodium-potassium pumps, it is not likely that intracellular sodium concentration is dramatically affected by creatine supplementation [39].”
From Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? (2021) · cites this paper as [39]
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- Authors
- Francaux, M., & Poortmans, J. R.
- Affiliations
- UCLouvain (BE)
- ORCID
- Francaux, Marc
- Venue
- International Journal of Sports Physiology and Performance
- Publisher
- Human Kinetics
- Published
- 2006-12
- Volume
- 1
- Issue
- 4
- Pages
- 311-323
- ISSN
- 1555-0265 (ISSN-L)
- 1555-0273
- OpenAlex
- W2170564578
- Cited by
- 40
- References
- 41
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 4 · 2013: 1 · 2012: 3
- FWCI
- 0.03
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- International Journal of Sports Physiology and Performance (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (submittedVersion, other-oa)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Physiology › Biochemical effects in animals
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- creatine supplementation, athletes, adverse effects, muscle mass, fat-free mass, water retention, muscle protein synthesis, gene transcription, renal function, kidney disease, mutagenic compounds, heterocyclic amines
- MeSH terms
- Administration, Oral, Creatine, Drug Contamination, Gastrointestinal Diseases, Humans, Kidney Diseases, Neoplasms, Risk Factors, Practice Guidelines as Topic, Muscle, Skeletal, Risk Assessment, Evidence-Based Medicine, Dietary Supplements, Muscle Development, Athletic Performance, Chemical and Drug Induced Liver Injury
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