Creatine is popular among fitness enthusiasts for its ability to support muscle growth and enhance strength training. Of course, like all supplements, it may come with some drawbacks. Today, we want to explore one important question surrounding the creatine industry: is creatine safe for the liver?

Although some evidence suggests that creatine may not be suitable for those with liver dysfunction, it's not necessarily harmful to a healthy liver when used responsibly. Let's dive into the science surrounding creatine’s impact on liver function to further highlight its safety and potential drawbacks.

First, some basics:

• Creatine supplements have little to no impact on the liver when used responsibly for periods of up to six months.

• Those with existing liver issues should not take creatine supplements.

• Always talk to your doctor before starting new supplements or making changes to your current wellness routine.

Creatine is a naturally occurring compound that is produced by the liver, kidneys, and pancreas. It's found primarily in muscle cells, where it plays a crucial role in energy production during high-intensity activities like weightlifting and sprinting.

Our body makes about half of its creatine naturally. Creatine can also be obtained through dietary sources such as meat and fish. However, creatine supplementation has been linked to a wide range of benefits that make it appealing to athletes, fitness enthusiasts, and those looking for cognitive support.

For instance, creatine supplementation may:

• Enhance muscle strength and power during high-intensity activities (2021 )

• Increase muscle mass and hypertrophy ( 2022 )

• Improve exercise performance, especially in short-duration, high-intensity activities like weightlifting and sprinting ( 2012 )

• Accelerate post-exercise recovery, reducing muscle soreness and fatigue ( 2024 )

• Enhance brain function and cognitive performance, particularly in tasks requiring short-term memory and decision-making ( 2023 )

• Provide potential protective effects against neurological diseases like Parkinson's and Alzheimer's, although further research is needed to confirm these benefits ( 2014 )

• Improve hydration status due to creatine's ability to increase water retention in muscle cells, which may benefit overall athletic performance and exercise endurance ( 2012 )

As we mentioned, the liver plays a crucial role in producing creatine for the body. After production, the liver takes care of the waste created during creatine synthesis, removing it from the body through the excrement systems.

It’s also known that creatine supplementation can raise creatinine levels in the blood. Creatinine levels are used to indicate various kidney and liver conditions. However, increased creatinine levels do not necessarily cause damage to the liver.

Because creatine production has a direct impact on the liver, it makes sense to investigate its impact on liver health.

Here are the facts:

• Creatine has been found to have no impact on a healthy liver when used in moderate doses for a short term.

• Long term, high-dose creatine use may be associated with liver damage in animal trials.

• People with liver disease should not use creatine supplements.

Let’s dig further into these facts:

According to various studies, short term creatine use has no significant adverse effect on the liver. Two of these studies ( 2020 , 2020 ) found no markers indicative of liver or kidney changes after creatine consumption.

Most research involves healthy athlete models using regular doses of creatine for short periods of up to six months, but some evidence involves longer dosing periods.

One 2002 study published in the International Journal of Sports Nutrition and Exercise Metabolism found that creatine had no significant liver impact on elite athletes when taken daily for different durations, ranging from three months to over 5 years. Another study lasting 4 years came to a similar conclusion, stating that the data they found “suggest that long-term creatine supplementation does not result in adverse health effects.”

Currently, the International Society of Sports Nutrition maintains the opinion that creatine is not harmful to the liver and that its benefits may outweigh its risks for healthy athletes.

A 2009 study published in the journal Digestive Diseases and Sciences found that high doses of creatine for 6 weeks caused liver damage in rats. The study suggested that long-term, high-dose creatine use may cause liver damage. However, keep in mind that rats were given 5 grams of creatine per kilogram of body weight–far more than traditionally used for supplementation.

While creatine may not be damaging to a healthy liver when used in moderate doses, it’s not safe for those with liver or kidney disease or who have experienced prior liver-related complications.

Liver disease impairs the body’s ability to produce creatine, and supplementing may only make the problem worse. Organ damage can occur if the creatine cannot be processed properly due to impaired liver function.

Talk to your doctor if you have liver-related concerns before taking creatine supplements.

If you want to get started with creatine supplements, here’s how to do so safely:

• Start with a conservative dosage: When beginning creatine supplementation, it's advisable to start with a lower dosage to assess tolerance and individual response.
  
  (Note: Some athletes start with a creatine “loading” phase where daily doses of 20 grams or more are taken for up to a week before transitioning to regular daily doses of 2-5 grams. This loading phase is not necessary and hasn’t been proven to be beneficial.)
  
  

• Gradually increase dosage: If well-tolerated, gradually increase the dosage of creatine over time to reach an optimal level that yields desired effects without causing discomfort or adverse reactions.
  
  

• Follow recommended guidelines: Refer to established guidelines and recommendations for creatine dosage based on body weight, activity level, and specific goals. Avoid exceeding recommended limits to minimize potential side effects.
  
  

• Stay Hydrated: Proper hydration is crucial when taking creatine supplements. Maintaining adequate water intake, along with considering electrolyte balance, is essential for sustaining optimal hydration levels and supporting overall performance and well-being.
  
  

• Track progress and effects: Keep a record of dosage, timing, and effects experienced with caffeine and creatine supplementation. This can help identify optimal strategies and inform future adjustments to dosage and timing for enhanced performance and well-being.
  
  

• Discuss supplement routine with your doctor: Always discuss changes to your wellness routine with your doctor. He or she will be able to help you determine the individualized risks and benefits of creatine supplementation.

Although creatine supplementation is generally considered safe and does not lead to liver problems, there are several potential side effects and drawbacks to be aware of. While these side effects are typically mild and temporary, it's essential to understand them before starting a creatine regimen.

• Gastrointestinal Issues: Some individuals may experience gastrointestinal discomfort, such as nausea, diarrhea, or stomach cramps, when taking creatine supplements, especially in high doses or when not adequately diluted in water.
  
  

• Muscle Cramps: Muscle cramps are another common side effect reported by some users of creatine supplements. These cramps are typically mild and transient but can be uncomfortable for some individuals.
  
  

• Dehydration: Creatine supplementation may increase water retention within muscle cells, leading to dehydration if fluid intake is not sufficient. It's crucial to stay hydrated when using creatine to prevent dehydration-related side effects such as headaches or dizziness.
  
  

• Weight Gain : Due to its water-retaining properties, creatine supplementation may lead to temporary weight gain, primarily from increased water retention in muscle tissue. This weight gain is typically minor and not associated with fat accumulation.
  
  

• Kidney Strain: While there is limited evidence to suggest that creatine supplementation may strain the kidneys, individuals with pre-existing kidney conditions should exercise caution and consult with a healthcare professional before using creatine supplements.
  
  

• Interactions with Medications: Creatine supplements may interact with certain medications or health conditions. Individuals taking medications for kidney disease, diabetes, or high blood pressure should consult with a healthcare provider before using creatine supplements.

It's essential to note that many individuals tolerate creatine supplements well and experience minimal side effects, if any.

However, it's always advisable to start with a low dose and monitor for any adverse reactions, especially when first introducing creatine into your supplement routine. If you experience persistent or severe side effects, discontinue use and consult with a healthcare professional.

If you’re worried about whether creatine is safe for your liver, you can breathe a sigh of relief. Creatine, when taken at normal doses for short periods of time, doesn’t cause liver impairment. In fact, most evidence shows that creatine supplements have little to no impact on the liver at all. So, you can get on with your muscle-building, brain-boosting creatine regimen without worry–creatine is safe for a healthy liver.

Creatine can raise creatinine levels, which is a marker of liver dysfunction. However, this effect is temporary and does not indicate liver damage.

Many people can safely take 2-5 grams of creatine per day for periods of up to 6 months without adverse effects. Drink plenty of water when taking creatine.

Creatine doesn’t directly cause liver damage in healthy individuals. The liver can repair itself (barring further complications) if the underlying cause of liver damage is addressed.

Creatine is considered safe and causes no long term damage to kidneys or liver when taken in moderate doses. People with kidney or liver disease should not take creatine.

While taking creatine might not help all athletes, evidence suggests that it generally won't hurt if taken as directed. Although an older case study suggested that creatine might worsen kidney dysfunction in people with kidney disorders, creatine doesn't appear to affect kidney function in healthy people.

Individuals with fatty liver should discuss creatine supplementation with their doctor. Limited evidence suggests that creatine supplementation may help to prevent fatty liver, but more evidence is needed to fully understand this link.

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2. “Creatine supplementation post-exercise does not enhance training-induced adaptations in middle to older aged males” https://link.springer.com/article/10.1007/s00421-014-2866-1

3. “CREATINE SUPPLEMENTATION ALTERS THE HORMONAL RESPONSE TO RESISTANCE EXERCISE” https://www.webofscience.com/wos/woscc/full-record/WOS:000279896700003?SID=USW2EC0A26WF27O7Hn5oztRZgNLJq

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“Effects of High-Dose Creatine Supplementation on Kidney and Liver Responses In Sedentary and Exercised Rats” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761536/