Creatine is a chemical substance that occurs naturally in the human body, especially in the muscle tissue (95%). It is available on the market in various forms (creatine phosphate, creatine malate, creatine citrate, creatine ethyl ester), but more often under the name creatine monohydrate. Creatine monohydrate is the most effective substance and frequently demanded by athletes to increase muscle mass, strength and stamina. It should be noted that although creatine is not a drug but a dietary supplement, it should be taken only after consulting a doctor and elimination of contraindications to its use.
How creatine acts
Creatine is involved in the metabolism of multifunctional energy-containing molecules – ATP (adenosine triphosphate) – required to sustain intracellular structures.
Creatine is a fairly safe substance when used in normal doses. The likelihood of side effects is minimum. However, there may be the following adverse reactions:
- Gastrointestinal disorders – the most common symptom. Includes feeling of a bloated stomach, belching, pain in the epigastric region, flatulence, loud rumbling in the tummy, stool disorders, nausea, and diarrhea. This side effect is often easily eliminated with lower doses of creatine.
- Muscle spasms – since creatine facilitates the production of new myocytes (muscle cells) more than the increase in individual cells, there are often common side effects such as muscle spasms, muscle tension, accompanied by severe pain symptoms. In severe cases, there may even be muscle and tendon ruptures.
- Weight gain – occurs mainly due to the ability of creatine to retain water in the muscle tissue, and not due to muscle development as many people would like. Often, significant weight gain begins to appear after 2 weeks of taking creatine in high doses.
- Dehydration – because the muscles retain water in themselves, the internal water of the body is redistributed to the muscle tissue thereby dehydrating the remaining cells. This condition can be very dangerous and manifests in the form of general weakness, dizziness, low blood pressure, cold moist skin, rapid pulse, and in severe cases – loss of consciousness, severe electrolyte disturbances.
- Headaches – often caused by a dehydration condition. The only effective way to combat dehydration is to fill the liquid level, not only during exercise, but also before and after exercise.
- Formation of kidney stones – primarily because of the renal path of excretion from the body, when used in high doses, creatine can accumulate in the urinary tracts, leading to the development of urolithiasis. Excessive dose of creatine can even lead to renal and hepatic failure.
Rare side effects
- Pigmented purpuric dermatosis;
- Increased irritability;
- Mood swings;
Serious side effects
The most serious of these side effects of creatine are, of course, dehydration (especially severe dehydration), renal failure and emergence of life-threatening arrhythmias. Therefore, it is important to use creatine in recommended doses agreed with your doctor.
Changes in laboratory tests:
- Increased concentration of creatinine (a substance that is converted into creatine in the body) in the blood, as well as the presence of creatinine in the urine may indicate an overdose of creatine and a renal failure.
- Increased protein in the biochemical analysis of blood.
- Increased hemoglobin, hematocrit and red blood cells in the overall analysis of blood.
- Hypernatremia in the biochemical analysis of blood.
Side effects in pregnant women
There is lack of scientific information on the use of creatine during pregnancy and breastfeeding. Therefore, it is better not to risk the health of the child and refrain from taking creatine during this period, all the more so that the substance is not prescribed under emergencies.
Side effects in children
In children and adolescents, creatine should be used only during emergencies, such as during the inability of the enzyme systems to synthesize endogenous creatine, as well as during certain neuromuscular dystrophies. In other cases – to increase muscle development, taking of creatine should begin no earlier than from 18-19 years old. The side effects in children and adolescents are similar to those in adults and most often include muscle spasms, tension, dizziness, obesity, hypertension and gastrointestinal disorders.
Warnings and recommendations
Due to the dehydration effect of creatine, it is necessary to monitor the additional supply of water in the body, try not to exercise in hot rooms, or do excessive strenuous activity. Creatine is not recommended for people suffering from diabetes and urolithiasis. Caution should be taken when taking creatine while undergoing treatment with drugs that have nephrotoxic effects, such as NSAIDs (including ibuprofen, naproxen, indomethacin, piroxicam), aminoglycoside antibiotics, some immunosuppressants such as cyclosporine, etc. People suffering from renal or hepatic failure are also not recommended to take creatine. Caution should be taken when combining creatine with caffeine, ephedrine (increases the risk of side effects on the cardiovascular system, such as stroke), and diuretics. So, if you are taking other medicines, be sure to consult your doctor about the possibility of taking creatine.
Creatine and alcohol
Despite the fact that there is no direct evidence of the incompatibility of creatine and alcohol, these substances have opposite effects. First, creatine retains water, while alcohol has a strong diuretic effect. Secondly, an important metabolic product of the conversion of ethanol in the body is acetaldehyde, whose toxicity is 20-30 times higher. Acetaldehyde causes all the intoxication effects of alcohol. The body requires increased amounts of fluid to extract toxic acetaldehyde, but because of water deposition in the tissues under the influence of creatine, the toxic effect of alcohol persists for much longer. If the need arises, then alcohol and creatine are better used at different times of the day so that the concentration of one of them can have time to as much as possible lower the intake of the other into the body.