Creatine is one of the safest and most-researched muscle building supplements around.

But despite its popularity, many trainees remain confused about the advantages, disadvantages, and side effects from regular use thanks to the amount of misinformation which has been published about it over the years.

Some of that misinformation dates back to the early 1990s, when creatine first arrived on the scene and there were initial concerns about how it worked, and more recently it’s come from supplement manufacturers themselves (!) who figured the best way to sell a newer, more expensive creatine blend was to talk s**t about the old one.

It’s time to end that.

If you read my Creatine 101 article you’ll know it’s second to none for helping you gain lean muscle mass and increasing strength output, and I would hate for any of these myths to deter a trainee from using what I consider to be the best muscle building supplement we have available to us today. So I put this article together, in which I’ll use the latest sports science to bust all of the biggest creatine myths for you. If you have a friend who believes any of the things on this list, share this article with them.

Table of Contents

• Creatine Myth 1: “Creatine Causes Weight Gain”
• Creatine Myth 2: “Creatine Causes Bloating”
• Creatine Myth 3: “Creatine Causes Muscle Cramps”
• Creatine Myth 4: “Creatine Causes Hair Loss”
• Creatine Myth 5: “Creatine Causes Kidney & Liver Damage”
• Creatine Myth 6: “Creatine Causes Gastrointestinal Distress”
• Creatine Myth 7: “Creatine Is Unsafe For Adolescents”
• Creatine Myth 8: “Creatine Is A Steroid”
• Creatine Myth 9: “Creatine Is Just For Men”
• Who Is Russ Howe PTI?

Creatine Myth 1: “Creatine Causes Weight Gain”

This is technically not a myth, because the early stages of creatine supplementation do come with a slight bump on the scales, but I’ve included it at the top of the list nonetheless because it’s more of a misconception.

You see, many people falsely credit this bump on the scales to an increase in fat mass, but that’s not the case.

Creatine pulls water into muscle cells, giving them a fuller, leaner look, properly hydrating your muscles which will lead to better performance in the gym. During the first 2-3 weeks of supplementation your body is attempting to saturate your muscle cells with water as quickly as possible, so this may result in a small weight increase. (1, 2, 3)

In terms of fat gain, though, you have absolutely nothing to worry about. In fact, studies show that long-term creatine supplementation leads to significant improvements in lean body mass alongside reductions in fat mass! (4, 5)

Creatine Myth 2: “Creatine Causes Bloating”

Nobody likes to feel bloated.

I f**king hate it.

And the supplement industry knows that, too, so when they were trying to think of ways to sell more costly versions of creatine to the public they came up with the misleading as f**k genius marketing strategy of claiming that creatine monohydrate causes bloating and water retention.

We now know this is nonsense, of course, and that they were just trying to capitalize on people’s insecurities in order persuade them to part with more money for a product which does the exact same thing as the original. That’s business for ya, huh?

You see, what they failed to take into consideration (or perhaps they knew all along) is that creatine has no effect on extracellular water. As explained above, the water retention from creatine happens as a result of it pulling water into your muscle cells (intracellular water). That’s why you perform better in the gym and your muscles look fuller and harder when using creatine, as opposed to creating a sloshy layer of liquid between your muscles and skin which would make your muscles appear blurry and puffy. This was comprehensively demonstrated in a 2020 study published in International Journal of Sports Nutrition and Exercise Metabolism, where researchers showed that trainees supplementing with creatine experienced lean body mass improvements and a reduction in fat mass, alongside significantly higher levels of total body water and intracellular water. (6)

Creatine Myth 3: “Creatine Causes Muscle Cramps”

This myth has always dumbfounded me.

Given that the job of creatine is to force more water into your muscle cells, therefore keeping them hydrated properly, it is hard to imagine how this could lead to muscle cramps which are generally associated with dehydration!

In terms of research, there’s absolutely nothing to suggest that creatine causes muscle cramps, with some studies even showing the opposite is true and that it improves both hydration and body temperature during exercise. I believe the only way this issue could arise is if the trainee wasn’t drinking enough water, in which case that’s the problem to correct, not the use of creatine. (7, 8)

The final nail in the coffin for this creatine myth came via a two year study from Arkansas State University. A team of researchers worked with a group of college footballers during the 1998, 1999, and 2000 seasons to see if continuous creatine usage would lead to an increase in injury, muscle cramps, dehydration, muscle tightness, illness, or muscle pulls of any kind. It did not. (9)

Creatine Myth 4: “Creatine Causes Hair Loss”

Seeing as I’m bald, perhaps I’m not the best person to talk about this one!

Seriously, though, this runs in my family.

I can still remember the exact moment I realized the game was up for me. I was looking through some old family photos, and I noticed that no matter how far back in time I went, even to my baby photos, my Dad’s gleaming cranium was always there. Sure enough, by my 23rd birthday the glorious full head of Bon Jovi-eqsue hair I had throughout my teens (yep) was no more, and I became the Russ you know today.

Anyway, back to creatine! The link between creatine and hair loss stems from one study performed by Dutch researchers in 2009, in which they discovered that trainees who had higher levels of creatine also had higher levels of DHT (dihydrotestosterone), a hormone which leads to hair loss. The researchers weren’t sure why this link appeared, so in the years that followed there’s been several more studies which aimed to get to the bottom of it, but none have been able to replicate the results of the 2009 study. (10, 11, 12, 13, 14, 15)

Finally, a 2021 meta-analysis declared:

“The current body of evidence does not indicate that creatine supplementation increases total testosterone, free testosterone, DHT or causes hair loss/baldness.”

– Journal of the International Society of Sports Nutrition (1)

Creatine Myth 5: “Creatine Causes Kidney & Liver Damage”

This one is mainly caused by the confusion between creatine and creatinine.

Most people in gyms don’t know the difference between the two.

Creatinine is one of the markers which will show up on a blood test, and unexplained higher-than-normal levels of this can be an indication of kidney dysfunction. It doesn’t cause it, but it’s one of the things which people who suffer from kidney damage all have, so it’s a useful marker when trying to identify whether somebody may have kidney dysfunction. To put this into a real life scenario, have you ever noticed how all of those angry women who berate shop workers have the same haircut? The haircut isn’t the problem, but it’s a good marker!

Now, when you supplement with creatine part of it is actually broken down into creatinine, therefore increasing the body’s total level of creatinine. So if a bodybuilder who uses creatine visits a doctor and his/her bloodwork shows higher-than-normal levels of creatinine, this doesn’t automatically mean their kidneys are damaged. You see, the key word above is unexplained – because the moment the doctor knows this person is using creatine, it explains why their creatinine levels are higher and it’s no longer unexplained.

This myth was everywhere in the late nineties after the media reported what appeared to be the poor kidney health of a young trainee as a result of using creatine supplements. Of course, the media being the controversy-chasing c**k-toboggans they are, they failed to mention that the trainee was diagnosed with kidney damage eight years previously, and that it wasn’t from creatine use! (16)

This myth resurfaces to the headlines every few years thanks to social media, and I occasionally hear it on gym floors, which is a shame because it means people have been given bad information

So let me put it to rest for you. There’s over 20 years of academic research showing that creatine supplementation is completely safe for the kidneys and liver, and even the studies which deliberately used way higher doses than a regular person would take have a 100% success rate. The only exception to the rule would be if you, like the trainee I mentioned above, have pre-existing kidney damage. (17, 18, 19, 20)

Creatine Myth 6: “Creatine Causes Gastrointestinal Distress”

Creatine can cause minor gastrointestinal distress when taken in very large doses (20g+), but seeing as the clinical dose dose is only 5-10 grams this shouldn’t be a problem for the vast majority of trainees.

This was an issue during the early years of creatine development in the 1990s, though, when manufacturers would instruct trainees to begin supplementation with a two-week loading phase. During a loading phase the user quadruples the daily dose in order to saturate the muscle cells more quickly, before switching to a regular 5-10 gram dose from the third week onward. This is where most people experienced gastrointestinal distress, because those loading phase doses were massive! (21, 22)

Research now shows us that the loading phase is unnecessary (although many manufacturers still tell you to do it, because they want your product to run out faster). Going straight in with a 5-10 gram clinical dose will let you bypass any gastrointestinal distress from creatine, and a 1996 study showed that the only real difference when athletes use it this way is that it takes a bit longer to fully saturate the muscle cell (about 3 weeks as opposed 1 week of loading). (23, 24)

Finally, if you are one of the very small percentage of users who still experience gastrointestinal distress even at a low 5-10 gram dose, but you’re desperate to unlock the huge training benefits it offers, then I recommend switching to a different form of creatine, such as creatine HCL (creatine hydrochloride), which is slightly more expensive but will perform the exact same job as creatine monohydrate in about half the dose, making it easier for your body to absorb! (25)

Creatine Myth 7: “Creatine Is Unsafe For Adolescents”

There’s lots of research documenting the safety of creatine in adults, but usage in adolescents remains a somewhat grey area in most gyms.

Thankfully, it needn’t be.

A comprehensive review study published in Frontiers in Nutrition in 2018 looked at the entire body of research surrounding creatine supplementation in various adolescent (15+) athlete populations and found no evidence of any adverse effects. This came after earlier research from the legendary McMaster University, Canada, (famous for its studies which led to the popularization of HIIT) discovered that creatine supplementation significantly increased the muscle mass and strength output of young adults with muscular dystrophy, and research from Brazil which confirmed there are no negative effects from creatine supplementation on kidney function, oxidative stress and bone health in young adults. (26, 27, 28)

In terms of athletic performance, an interesting 2009 study from Hungary showed that creatine dramatically improved the power output of highly trained elite junior swimmers, who were able to perform repeated bouts of faster sprint times and saw an increase to their anaerobic metabolism. (29)

On the whole it appears that the training benefits of creatine are slightly smaller in adolescents than what we’d see in a fully grown adult, but these benefits are still very noticeable, and the main thing is it’s safe.

Creatine Myth 8: “Creatine Is A Steroid”

Creatine is sometimes mistakenly linked to anabolic steroids.

This is largely down to the way it is marketed by supplement manufacturers, as opposed to any actual connection. Tubs are often plastered with sleeve-busting biceps and bold claims of “packing on slabs of lean muscle in a matter of weeks!”, so it’s no surprise people worry about this.

In reality the two are very different things. Anabolic steroids are a synthetic version of the hormone testosterone, whereas creatine is a combination of three amino acids – arginine, glycine, and methionine – which are all perfectly safe, and likely things you are already consuming as part of your daily diet. (23, 30)

This easy misunderstanding often leads people to worry whether they need to cycle a creatine supplement in order to stay safe (i.e. two months on, one month off, like they would with certain steroids). This is unnecessary. Many athletes use creatine all year round, and studies show this is totally safe. Given the benefits and the proven safety of doing so, cycling off it would be akin to giving up whey protein or green vegetables for a month. (31)

Creatine Myth 9: “Creatine Is Just For Men”

The final myth is that creatine is just for men, or more specifically, just for bodybuilders!

Women can and should use creatine, especially if they lift weights. It’ll work in the same way it would for a guy; increasing explosive strength, helping muscles appear more defined, and improving in-gym performance.

Heck, I wouldn’t even limit the audience to just people who lift weights, in fact I believe every adult should be using it! You see, alongside the well-documented performance perks it offers creatine also brings some unique benefits to the table which get overlooked, such as its ability to improve brain function, and decrease the likelihood of depression (especially in women). (32, 33)

Obviously people who lift weights will unlock these too, but these non-training-related benefits help elevate creatine into a category that most other supplements cannot touch. It’s far more than just a training aid!

References:

1. Antonio J., et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr (2021).
2. Kutz M. R., et al. Creatine monohydrate supplementation on body weight and percent body fat. J Strength Cond Res (2003).
3. Bemben M. G., et al. Creatine supplementation during resistance training in college football athletes. Med Sci Sports Exerc (2001).
4. Antonio J., et al. The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. J Int Soc Sports Nutr (2013).
5. Becque M. D., et al. Effects of oral creatine supplementation on muscular strength and body composition. Med Sci Sports Exerc (2000).
6. Ribeiro A. S., et al. Creatine Supplementation Does Not Influence the Ratio Between Intracellular Water and Skeletal Muscle Mass in Resistance-Trained Men. Int J Sport Nutr Exerc Metab (2020).
7. Sobolewski E. .J, et al. The Physiological Effects of Creatine Supplementation on Hydration: A Review. Am J Life Med (2011).
8. Kern M., et al. Physiological response to exercise in the heat following creatine supplementation. JEP online (2001).
9. Greenwood M., et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem (2003).
10. van der Merwe J., et al. Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clin J Sport Med (2009).
11. Vatani D. S., et al. The effects of creatine supplementation on performance and hormonal response in amateur swimmers. Sci Sport (2011).
12. Arazi H., et al. Effects of short term creatine supplementation and resistance exercises on resting hormonal and cardiovascular responses. Sci Sport (2015).
13. Cook C. J., et al. Skill execution and sleep deprivation: effects of acute caffeine or creatine supplementation – a randomized placebo-controlled trial. J Int Soc Sports Nutr (2011).
14. Cooke M. B., et al. Creatine supplementation post-exercise does not enhance training-induced adaptations in middle to older aged males. Eur J Appl Physiol (2014).
15. Rahimi R., et al. Creatine supplementation alters the hormonal response to resistance exercise. Kinesiology (2010).
16. Pritchard N. R,. et al. Renal dysfunction accompanying oral creatine supplements. Lancet (1998).
17. Persky A. M., et al. Safety of creatine supplementation. Subcell Biochem (2007).
18. de Souza E., et al. Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis. J Ren Nutr (2019).
19. Gualano B., et al. Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Eur J Appl Physiol (2011).
20. Gualano B., et al. In sickness and in health: the widespread application of creatine supplementation. Amino Acids (2012).
21. Harris R. C., et al. Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin.Sci (Lond) (1992).
22. Ostojic S. M., et al. Gastrointestinal distress after creatine supplementation in athletes: are side effects dose dependent? Res Sports Med (2008)
23. Kreider R. B., et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr (2017).
24. Hultman, E. et al. Muscle creatine loading in men. J Appl Physiol (1996).
25. Miller D. et al. Oral bioavailability of creatine supplements: Is there room for improvement? Annual Meeting of the International Society of Sports Nutrition (2009).
26. Jagim A. R., et al. Safety of Creatine Supplementation in Active Adolescents and Youth: A Brief Review. Front Nutr (2018).
27. Tarnopolsky M. A., et al. Creatine monohydrate enhances strength and body composition in Duchenne muscular dystrophy. Neurology (2004).
28. Hayashi A. P., et al. Efficacy and safety of creatine supplementation in childhood-onset systemic lupus erythematosus: a randomized, double-blind, placebo-controlled, crossover trial. Lupus (2014).
29. Juhasz I., et al. Creatine supplementation improves the anaerobic performance of elite junior fin swimmers. Acta Physiol Hung (2009).
30. Kersey R. D., et al. National Athletic Trainers’ Association National Athletic Trainers’ Association position statement: anabolic-androgenic steroids. J Athl Train (2012).
31. Schroder H., et al. Risk assessment of the potential side effects of long-term creatine supplementation in team sport athletes. Eur J Nutr (2005.
32. Twycross-Lewis R., et al. The effects of creatine supplementation on thermoregulation and physical (cognitive) performance: a review and future prospects. Amino Acids (2016).
33. Kondo D. G., et al. Creatine target engagement with brain bioenergetics: a dose-ranging phosphorus-31 magnetic resonance spectroscopy study of adolescent females with SSRI-resistant depression. Amino Acids (2016).

Who Is Russ Howe PTI?

Featured in Men’s Fitness magazine and voted in the world’s top 50 fat loss coaches by HuffPost, Russ is among the UK’s most subscribed personal trainers with 104,357 people getting his free weekly fitness tips e-mail.

In the gym, clients range from busy parents, to models, to athletes and actresses. Russ also worked alongside the UK government for 8 years in a venture combating childhood obesity in England.

Outside of the gym, he’s a proud Dad to three young boys.

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