Creatine is generally considered to be safe when taken properly, and is not considered a banned substance by the International Olympic Committee, and the National Collegiate Athletic Association. (1) It’s important to know that while it may not help everyone who uses it, it likely won’t hurt, either.
“If you’re an athlete looking for a competitive edge, creatine may be able to help you,” says Bates. “However, if you are using creatine as a supplement for your normal workout routine, you may not require it.”
Still, any supplement should be used carefully and after discussion with a dietitian or doctor. And professional or college athletes should make sure that they choose a creatine supplement that’s certified by NSF International or Informed Sport. These are organizations that test dietary supplements to make sure they’re safe as well as free of substances banned by sports organizations.
There are some potential health risks and side effects that you should be aware of before taking creatine. Muscle cramping, nausea, diarrhea, dizziness, gastrointestinal pain, dehydration, weight gain, water retention, heat intolerance, and fever have all been linked to the supplement. (13)
Weight gain might be the most common side effect. “Creatine can cause your body to hold on to water by pulling fluid into your cells via osmosis,” says Bates. “It doesn’t necessarily cause you to gain weight as fat, but it can increase edema, or water weight.” Also, muscle is denser than fat, so in some cases building muscle can increase body weight overall (even if you’re simultaneously burning fat).
There have also been concerns that creatine can cause kidney damage, and doctors warn that people with a history of kidney disease or conditions, such as diabetes, that increase the risk of kidney problems should steer clear of the supplement. (1) Combining creatine with nephrotoxic drugs — drugs that might damage the kidneys — like nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen sodium (Aleve), should also be avoided, according to the U.S. Department of Health and Human Services.
Also note that taking creatine with caffeine may decrease its efficacy. (1)
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