Creatine Chronicles: Examining Safety and Dispelling Myths

Debunking Myths: The safety and side effects of creatine supplementation. In this episode of Daily Value we look into the safety concerns surrounding creatine supplementation. Creatine, a well-researched dietary supplement known for its muscle-building and performance-enhancing benefits, has sparked numerous myths about its effects on kidneys, hair loss, and dehydration. We will evaluate recent studies and scientific evidence to address these myths.

Topics include creatine's impact on water retention, kidney function, and hair health. Tune in to discover the truth about one of the most studied and [possibly safest] supplements available. 

00:00 Introduction: Creatine Myths 

00:46 Dietary Intake and Muscle Storage

01:28 Creatine's Cognitive and Anti-Aging Benefits

02:10 Addressing Common Creatine Myths

03:05 Myth 1: Creatine and Water Retention 

04:26 Myth 2: Creatine and Kidney Function

08:11 Myth 3: Creatine and Hair Loss

09:42 Comprehensive Safety Analysis

10:37 Conclusion: Is Creatine Safe

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Chapters

• 0:00 Creatine Misconceptions Unveiled
• 3:04 How Creatine Works in Your Body
• 4:44 Water Retention: Myth vs. Reality
• 6:06 Kidney Function and Creatine Research
• 9:51 Debunking the Hair Loss Connection
• 10:36 Overall Safety Profile and Conclusion

Transcript

Speaker 1: 0:00

What if one of the most well-studied supplements in the world, used by athletes, researchers and even clinicians, was still misunderstood? What if a compound known for building muscle and boosting performance had quietly sparked myths about kidneys, hair loss and dehydration that just won't die? In today's episode, we're peeling back the layers on creatine, not to talk about how effective it is, but to explore a different question Is it safe? Hello everyone, and welcome back to Daily Value. I'm William Wallace and today we're tackling some of creatine's biggest questions and concerns head on.

Speaker 1: 0:47

Creatine is one of the most well-researched dietary supplements in existence, and for good reason. It's a naturally occurring compound synthesized in the liver and kidneys and stored primarily in skeletal muscle as phosphocreatine. We also get some from our diet, mainly from meat and fish, but typical intake only delivers about 1-2 grams per day, which saturates muscle stores to around 60-80%. Supplementation can boost those stores significantly, by as much as 20-40%. And while creatine is best known for its role in athletic performance, increasing strength and lean mass, its reach goes much further. More recent evidence suggests that creatine may support cognitive performance, particularly in situations of mental fatigue or sleep deprivation. It may enhance hydration status, acting osmotically to increase intracellular water, and it's even being investigated for its potential anti-aging effects, particularly in conditions of muscle loss like sarcopenia or cachexia. That's a condition that causes significant weight and muscle loss, also known as wasting syndrome. Women in particular tend to have lower baseline creatine stores than men, and levels decline with age, making creatine not just for athletes but for healthy aging across one's lifespan as well.

Speaker 1: 2:10

Yet, despite creatine's impressive resume of benefits, myths and misconceptions about its safety persist. If you've ever searched the internet about creatine, chances are you've encountered some worrying claims. Does creatine cause kidney damage? Could it accelerate hair loss or even baldness? And what about bloating, dehydration or digestive problems? These concerns are not new and they're not isolated. They've floated around gyms, locker rooms and even healthcare offices for decades now. But how many of these claims have actual scientific merit and how many are simply misunderstandings amplified by anecdote, which, as we know, is one of the lowest decades now? But how many of these claims have actual scientific merit and how many are simply misunderstandings amplified by anecdote, which, as we know, is one of the lowest forms of scientific evidence, especially when looking to make broad recommendations at the population level? Today, we're looking at these questions head on. Let's look at the facts and separate myth from science. Let's start with one of the most common concerns you'll hear about creatine water retention. You might have heard that creatine supplementation can quickly cause weight gain, sometimes by one to three kilograms, or about two to seven pounds within the first week. This rapid increase is indeed real, but it's important to clarify what exactly is happening here.

Speaker 1: 3:26

Creatine is a hygroscopic molecule, meaning that it attracts water into your muscle cells. Early in supplementation. Typically within the first five to seven days, muscles become more hydrated at the cellular level. Research consistently shows a temporary reduction in urine output during these initial days, indicating this extra water is staying in your muscles rather than being excreted. And while that quick uptick on the scale might be alarming to some, it might actually be beneficial. Enhanced cellular hydration can improve muscle function, protect against muscle damage and speed up recovery after intense exercise. But here's a really important point this water retention effect isn't long-lasting. Studies tracking supplementation beyond the initial first few weeks show that these fluid shifts stabilize and the scale stops moving so dramatically. So while it's true creatine will initially add water weight, it's not harmful and it might even be a performance-enhancing bonus.

Speaker 1: 4:26

Among the most enduring concerns about creatine supplementation is its impact on kidney function. This apprehension primarily arises because creatine is metabolized into creatinine, that's a waste product filtered by the kidneys. Elevated serum creatinine levels are often interpreted as a sign of impaired kidney function. However, in the context of creatine supplementation, this interpretation can be misleading. Recent research, including a 2025 published study by Sergei Jyxlab and published in the Journal of the American Nutrition Association, looked at dietary creatine intake in individuals with and without existing kidney dysfunction. The study found no association between creatine supplementation and elevated levels of cystatin C. Cystatin C is a protein made by all nucleated cells in the body. It's constantly produced and released into the blood, and it's filtered out by the kidneys. It's actually a quite reliable biomarker for kidney function. High blood levels of cystatin C suggest the kidneys aren't filtering properly. The findings not only showed no association between creatine intake and cystatin C levels, but actually an inverse relationship, meaning that creatine does not adversely affect renal health, even in those with pre-existing conditions, and in fact, it might be considered a renal protective nutrient, although it is important to note that this study looked at specifically food-derived creatine and did not distinguish between that and supplementation, which tends to be higher than regular food intake.

Speaker 1: 6:04

Further supporting this study, a 2019 systematic review and meta-analysis concluded that creatine supplementation does not induce renal damage when consumed in recommended amounts for recommended durations. The review found no significant changes in key kidney function markers such as GFR and serum creatinine levels, beyond the expected transient increase due to higher creatine intake. It's important to note that while creatine supplementation can lead to a temporary rise in serum creatinine, this does not equate to kidney damage. The increase reflects a high turnover of creatine, not impaired renal clearance. In healthy individuals, the kidneys adapt to this change without compromising their function.

Speaker 1: 6:51

A very recent publication this year published by the International Society of Sports Nutrition, found no safety concerns over renal function when creatine is used as recommended. An earlier study published in 2003 looked at Division I American football players and showed that up to 21 months of creatine supplementation at between 5 and 10 grams a day did not significantly affect markers of health or renal function. Two studies from 1999 and 2002 showed that chronic creatine supplementation, even over extended periods like five years, does not adversely affect kidney function in healthy athletes. Now it is still recommended that caution be advised for individuals with pre-existing kidney disease, while current evidence does not indicate harm. These populations were admittedly underrepresented in the studies on the topic to this point and the long-term effects remain less clear. Therefore, it's recommended that individuals with renal conditions consult with trusted healthcare professionals before initiating creatine supplementation. In summary, for healthy individuals, creatine supplementation does not impair kidney function. The concerns largely stem from misinterpretations of creatinine levels rather than evidence of actual harm.

Speaker 1: 8:11

Next up, one of the most persistent fears surrounding creatine supplementation is the concern that it could accelerate hair loss, particularly in men that are genetically predisposed to baldness. This claim largely originated from a single 2009 study showing that creatine supplementation might increase levels of dihydroxytestosterone, usually abbreviated to DHT. That's a potent androgen hormone closely associated with male pattern baldness. However, new research that was published this past April in the Journal of the International Society of Sports Nutrition has significantly shifted our understanding on this topic. This is the first and only controlled double-blind randomized trial to date that has been conducted specifically to address this question. Researchers gave resistance-trained males either 5 grams of creatine monohydrate or a placebo for up to 12 weeks. They measured testosterone, free testosterone, dht, and, for the first time, they directly assessed hair follicle health. Their findings no significant differences between groups in DHT levels, testosterone to DHT ratios or any measures of hair follicle health, density, thickness or growth phases. Simply put, creatine supplementation did not lead to hair loss or negatively affect hair follicle physiology. While anecdotes and individual stories about hair thinning may circulate online, this controlled evidence provides strong reassurance Creatine supplementation does not appear to cause hair loss To this point.

Speaker 1: 9:43

We've talked about specific myths water retention, kidney function and hair loss but what about the bigger picture? Fortunately, we now have a comprehensive analysis published in 2025 by Kreider and colleagues. This was another ISSM publication. It looked at the reported side effects of creatine supplementation across nearly 700 clinical trials spanning over 26,000 participants. This extensive review confirmed what smaller studies have suggested for years Creatine supplementation does not meaningfully increase the risk of side effects compared to a placebo. Specifically, issues like gastrointestinal discomfort or muscle cramping were rare, and the difference between creatine users and placebo was negligible. Interestingly, despite widespread use, adverse event reports mentioning creatine in international databases were exceptionally rare less than 1 in 100,000 reports. Today we've tackled myths, clarified misconceptions and highlighted robust recent research, and in doing so, I hope we've cleared the path for you to make an informed decision about creatine without the noise.

Speaker 1: 10:49

Is creatine safe? The overwhelming scientific consensus says yes, but as always, context matters. If you're healthy, sticking to recommended doses and ensuring you stay adequately hydrated. The data strongly supports creatine as a safe and beneficial supplement. However, those with pre-existing medical conditions, particularly kidney-related issues, should always consult with a trusted that key word is trusted healthcare professional first. If you take away only one point from this episode, I hope it's this. Creatine monohydrate is not only one of the most studied supplements in history, but it's also among the safest. Thank you for joining me today on Daily Value. As always, stay informed and stay healthy.