Creatine and its Dangers

By Patrick Garrard

How Creatine Works

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The Theory Behind Creatine

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Studies about Creatine

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Is Creatine Safe?

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Creatine is a very controversial supplement on the market today.  Many endorse the uses of creatine, but others are skeptical about the advantage a person receives from taking it and the dangers one inherits as a result of creatine consumption.  The debate remains due to the short amount of time that creatine has been available.  People base their opinions on preliminary studies that have been done but no one knows the long-term effects of creatine on the body.  Many take the risk without vast knowledge, but others still remain skeptical based on preliminary evidence that discourages the intake of creatine.

How Creatine Works

Creatine is naturally produced in the body in the liver, pancreas, and kidneys.  It can also be provided to the body through the consumption of fish and meat. (  Creatine aids in the process of ATP which is energy used for quick, explosive activities such as the sports listed above.  When ATP levels drop, muscles become fatigued.  “Regeneration of ATP is essential if fatigue is to be delayed,” according to Charles P. Bolotte, MD. (  In theory, taking more creatine supplements allows for more creatine to be available to synthesize more ATP and therefore causes less fatigue in muscles.  ATP is readily available energy for the body that is used in everyday activity.  The synthesis of ATP is needed for all activities in the daily lives of people.  It is used in the transmission of nerve signals, the movement of muscles, the synthesis of proteins, and cell division.  Energy is released when one of the bonds between the end phosphate group is broken and the molecule becomes ADP.  Creatine converts ADP back to ATP.  Without ATP, muscles are too tired to work at high levels of exercise.  Creatine allows for increased storage of ATP.  “The transfer of a molecule of phosphorous from creatine phosphate to adenosine diphosphate(ADP) results in the formation of ATP.  …since the muscle creatine phosphate concentrations can fall to almost zero, it(creatine consumption) can make a significant contribution to the energy supply needed for brief bursts of very high-intensity exercise,” says Dr. Bolotte.  The equation for the synthesis of ATP from creatine phosphate and ADP is as follows: PCr + ADP forms ATP + Cr. (  Also, lactic acid levels, which cause muscles to burn during workouts, are lowered by the consumption of creatine.  Without the burning sensation, athletes don’t feel the need to stop exercising.  Athletes begin their creatine process with a loading phase of twenty grams per day for five days.  Then, they consume three to five grams per day. (  Many studies have exhibited gains after this process of consumption.

The Theory Behind Creatine

The supplement creatine is used for faster recovery for muscles after short periods of exercise.  The theory is an athlete on creatine can exhibit more explosive bursts of energy allowing for longer weight workouts, more sprints, etc.  Increased muscle mass and bulk are two of the ideas behind creatine, but they only occur as long as people work out while taking the substance.  It doesn’t create muscle mass, but it allows for more work to be done by muscles due to greater energy source that allows for increases in muscular gains. (  According to Richard Kreider, PhD, creatine is “an important storehouse of energy in muscle.” (  A significant point is that creatine is good for short bursts of energy.  This means that it aids in sports such as football, weightlifting, sprints, which are characterized by short, highly intense periods of exercise. 

(picture from NBC’s Olympic coverage of the 2000 Olympic games in Sydney)

Studies about Creatine

Studies have been done to show the immediate effect of creatine on the body.  One such study was done at Ekblom in Stockholm.  The study was double-blinded with a creatine group and a placebo group.  Using high-intensity pedaling on a stationary bike in Ekblom’s study (1996), the subjects did six seconds of exercise with thirty-second breaks in between each set of pedaling.  The scientists conducting the study desired the subjects to pedal at 140 revolutions per minute.  All of the subjects from the creatine group were able to achieve this high level of exercise while the placebo group could not.  The creatine group made gains with the short explosive exercise while the placebo group remained stagnant.  During the same study, the two groups were placed on treadmills and were tested on their endurance in an approximately twenty minute run after consuming creatine, and there were no gains in comparison between the creatine group and placebo group.


            Another similar study was done by Richard Kreider PhD, who is the associate professor and assistant chair of department of human movement sciences and education at the University of Memphis.  In Dr. Kreider’s experience creatine proved to be a success.  He used twenty-five NCAA division 1A football players and did a double-blinded study for four weeks with a creatine group and a placebo group.  The football players went through high intensity sprinting, weight lifting and football agility drills, and the creatine group made greater gains in weight lifting volume, sprint performance, and weight gain than the placebo group. ( 

According to MH Stone et al. (1999), creatine has a positive impact on athletes.  They used forty-two American football players and four different groups.  The groups received either a placebo, creatine monohydrate, calcium pyruvate, or a combination of calcium pyruvate and creatine.  The subjects performed testing before and after supplementation which was a fifty week supplementation period.  The subjects were then tested for one repetition maximum bench press, one repetition maximum squat and bench press, and static vertical jump.  Both the creatine monohydrate group and the combination of calcium pyruvate and creatine monohydrate made great gains over the placebo group and strictly calcium pyruvate.  The creatine monohydrate group made the greatest gains of all.  The strictly calcium pyruvate group made no gains which makes one believe that it was only the creatine monohydrate in the combination group that caused the athletes to make positive gains.   

Other studies have been done that discourage the benefits of creatine.  One was done by Melvin Williams, PhD, who is the professor emeritus in the department of exercise science, physical education, and recreation at Old Dominion University.  He examined athletes doing the sixty-meter sprint.  His study involved a creatine group and a placebo group, as well.  He found no vast improvement for a creatine group versus a placebo group.  Studies have also shown that creatine will not do anything for the endurance athlete.  Marathon runners and distance swimmers will not benefit from the consumption of creatine but may suffer from it.  Creatine causes an increase in weight that slows down these athletes. (

Is Creatine Safe?

Despite the positive gains made by people on creatine, many remain skeptical about the safety of taking the supplement.  Dr. William Bryan, the Houston Astros’ team physician, believes the major risk of creatine is dehydration due to water retention in the muscles.  Other risks include heat-related illnesses, reduced blood plasma volume, tetanic muscle cramping, muscle strain, and electrolyte imbalance.  The Tampa Bay Buccaneers and the Cincinnati Bengals discourage the use of creatine by their players mainly due to the risk of cramping. (  Dr. Bryan also believes that athletes will exhibit bad nutritional habits while taking creatine.  In a survey done of the members of the Association of Professional Team Physicians, eight-five percent of respondents do not endorse the supplement at this time due to lack of knowledge over the long term effects of creatine. (

            One major fear over the use of creatine is kidney disease.  Overdoses of creatine can cause stress on the kidneys.  The creatine that is not used by the muscles is converted to creatinine and is a waste product.  Repeated excesses of creatinine put a lot of stress on the kidneys and can cause problems for the kidneys. (  A twenty-year old man on twenty grams of creatine a day for nearly a month developed interstitial nephritis, a disease of the kidney.  The patient was hospitalized and stopped the use of creatine.  After ceasing the intake of creatine, the patient improved dramatically.  This provides evidence that the abuse of the supplement can cause great harm to the kidneys. (

            Concerns arose after the stroke of a thirty-three year old man suffered a stroke after taking large amounts of Mahuang extract and creatine monohydrate.  Vahedi, Domigo, Amarenco, and Bousser (2000) released a paper over the findings in this case.  The man worked out two hours daily at a high intensity level.  He consumed nearly 6000 milligrams of creatine daily for six weeks.  He awoke one morning in January and suffered a stroke in 1999 (Vahedi et al.).  The doctors did not confirm that creatine was the cause as the patient was taking other supplements at the time but it raises the question about the safety of numerous supplements including creatine.  One big question that was raised was: is creatine safe when taken with other supplements?

            Another fear involves the dehydration and heat-related illnesses that can occur.  Three wrestlers died in a very short period of time while using ridiculous methods to “cut weight” for wrestling matches.  All three wrestlers were on creatine.  Heat stroke was a possible cause of death for these wrestlers since they were training in very warm temperatures.  Some argued that the addition of the creatine in their bodies caused their bodies to be put over the limit.  Creatine is not proven to be the reason for the death of the three wrestlers but numerous questions were raised because all three consumed the supplement.

            Age is another issue in the fight over the safety of creatine.  People wonder when it is safe for their child to take creatine.  Ronald L. Terjung, professor of physiology in biomedical sciences at the University of Missouri-Columbia, discourages the use of creatine before the age of sixteen due to the lack of knowledge about creatine.  “We don’t know the effects, so it’s better to be safe than sorry.”  He encourages kids to stick with what is proven, hard work in athletic training. (


Only one website used in the information above sold the product of creatine, but this site was very good about providing information over the advantages and disadvantages of the product.  The rest of the sites were merely informative sites for the general public.  Most showed the positives and negatives of the consumption of creatine.

            The debate remains over creatine about the advantages and disadvantages to the product.  Studies show that it helps, and others show that it doesn’t.  Some studies suggest that there are dangerous side effects to taking creatine.  Juhn and Tarnopolsky (1998) raised their concerns over the limited knowledge of the side effects of creatine.  According to Juhn and Tarnopolsky, creatine is found in cardiac muscle, brain, and testes but these areas have very little research done in these areas.  They concluded that studies need to be done in the future with large randomized studies testing the long term and short-term effects on all major organ system (Juhn, Tarnopolsky 1998).  Creatine is still in the process of being studied and for now the only proven method for increasing physical shape and muscle mass is hard athletic training.


Ekblom, B. (1996).  Effects of creatine supplementation on performance.  American Journal of Sports Medicine, 24, 38-39.

Juhn, M.S. & Tarnopolsky M. (1998).  Potential side effects of oral creatine supplementation: a critical review.  Clinical

            Journal of Sport Medicine, 8, 298-304.


Stone, M.H. et al. (1999).  Effects of in-season (5 weeks) creatine and pyruvate supplementation on anaerobic performance

            body composition in American football players.  International Journal of Sport Nutrition, 9, 146-165.


Vahedi, K. & Domigo, V. & Amarenco, P. & Bousser M.G. (2000).  Ischaemic stroke in a sportsman who consumed

Mahuang extract and creatine monohydrate for body-building.  Journal of Neurology, Neurosurgery, and Psychiatry,

68, 112-113.





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