Does creatine damage your kidneys?

Not in healthy people, according to the sports-nutrition position stand, which found no credible evidence of adverse kidney, liver or cardiovascular effects including long-term use at up to 30 g a day for five years. Existing kidney disease is a reason to ask your doctor first.

How much creatine should I take?

The maintenance dose in the literature is 3 to 5 g a day, or about 0.1 g per kilogram of body mass daily, taken every day rather than only on training days.

Will creatine make me gain weight?

It can raise the scale in the first week or two, because creatine draws water into the muscle cell. That is a change in where your body water sits, not fat gained.

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Is creatine safe, and does it actually work?

Last updated: 2026-09-26

Yes to both, with a modest effect. Pooled randomised trials show a small but significant improvement in lower-limb strength over placebo^[3], and the sports-nutrition position stand calls creatine monohydrate the most effective supplement available for high-intensity capacity and lean mass during training^[1]. On safety, there is no credible evidence of kidney, liver or cardiovascular harm in healthy adults even at up to 30 g a day for five years^[1], and users report less cramping and dehydration, not more^[2].

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What creatine is, before what it does

Creatine is not a hormone, a stimulant or a steroid. It is a compound your liver and kidneys already make, that you also get from meat and fish, and that sits in your muscle as phosphocreatine, where it regenerates the immediate fuel for short, hard efforts. Supplementing raises how much of it your muscle is holding, which is the entire mechanism.

That mechanism explains both why it works and why it is not dramatic. It buys you a little more work in the efforts that last a handful of seconds — the last repetition of a heavy set, the second and third sprint — and it does nothing for a long slow run. Over months, a little more work per session accumulates into a measurable difference, which is the honest description of the effect.

Does it actually work?

This is one of the few supplement questions where the evidence is not ambiguous. Pooling randomised placebo-controlled trials of lower-limb strength — 60 studies, 646 people supplementing against 651 controls — found a small but statistically significant improvement over placebo^[3].

The sports nutrition position stand is blunter, describing creatine monohydrate as the most effective supplement available for increasing high-intensity exercise capacity and lean body mass during training^[1]. Note the two conditions buried in that sentence: high intensity, and during training. It is an amplifier for work you are already doing. It does not build anything on its own, and it will not rescue a programme that has no progression in it.

The side effects people worry about

Three concerns come up every time, and all three have been examined directly.

Kidneys. There is no credible evidence of adverse kidney, liver or cardiovascular effects in healthy people, including long-term use at up to 30 g a day for five years^[1]. A raised blood creatinine reading in a creatine user is a known artefact of the supplement rather than a sign of kidney injury — but say so to the doctor reading your results.
Cramping and dehydration. The opposite of the folklore. Reviewing the literature, creatine users experienced less cramping, heat illness and dehydration than non-users^[2]. This matters in a Gulf summer, where the advice to avoid creatine before outdoor training has no evidence behind it.
Hair loss. The majority of available evidence does not support a link between creatine and hair loss^[2]. The fear traces back to a single small study of rugby players measuring a hormone, not hair.

What is real is water. Creatine is osmotically active and pulls water into the muscle cell, so the scale can rise in the first week or two without any fat being gained — the same reading problem as what BMI tells you and what it doesn't describes from the other direction. That is a change in where your body water sits, not a change in body fat.

How it is taken

Creatine monohydrate is the form that has been tested; the newer forms sold at a premium do not have a comparable evidence base behind them. The maintenance dose in the literature is 3 to 5 g a day, or about 0.1 g per kilogram of body mass a day^[2], taken every day rather than only on training days, because you are topping up a store rather than dosing a session.

A loading phase reaches saturation faster; skipping it reaches the same place more slowly, which for most people is fine. Timing is not a variable worth managing. Take it with a meal you will not forget.

Who should leave it alone

Anyone with existing kidney disease, anyone pregnant or breastfeeding, and anyone under 18 should not start it on the strength of an article — the safety literature above was built in healthy adults, and absence of evidence of harm in that group is not evidence of safety in a group that was not studied. If you take prescribed medication, ask the person who prescribed it.

And keep the order of operations straight. A supplement with a small effect sits below the things with large ones: enough total protein, which the guide on how much protein you actually need covers, a calorie target that matches your goal, described in how your daily calories are calculated, and a training programme that gets harder over time. Creatine is worth taking once those are in place. It is not worth taking instead of them.

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