For years, creatine has been shrouded in controversy, often linked to scary stories about kidney damage and dehydration. However, a growing body of scientific evidence is setting the record straight. Research now clearly indicates that creatine monohydrate is one of the safest and most effective dietary supplements for healthy individuals when consumed in recommended amounts. The widespread fears often stem from myths and anecdotes, not from rigorous, controlled clinical trials.
What is Creatine and Who Can Benefit?
Creatine is a naturally occurring compound, primarily stored in our muscles. It plays a crucial role in rapidly regenerating energy during short, high-intensity activities like sprinting, heavy weightlifting, or jumping. The body produces it from amino acids, and it can also be obtained from foods like red meat and seafood.
The International Society of Sports Nutrition (ISSN) has published a definitive position stand titled "International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine." This document confirms consistent improvements in strength, lean muscle mass, and athletic performance with creatine monohydrate supplementation, particularly for exercises involving quick bursts of power.
While it is exceptionally useful for weightlifters and athletes in explosive sports like football or sprinting, its benefits extend further. Recent analyses, including a 2025 paper "Effect of creatine supplementation on kidney function" and the review "Creatine supplementation is safe, beneficial throughout the lifespan" in Frontiers in Nutrition, highlight potential advantages for older adults, brain health, and certain clinical rehabilitation scenarios where regaining strength and muscle is critical.
Debunking the Top 3 Creatine Myths
Myth 1: Creatine Harms Your Kidneys
The fear of kidney damage is the most persistent, largely because creatine supplementation can cause a slight, expected increase in blood creatinine levels—a marker also used to assess kidney function. However, key studies have found this does not equate to actual harm.
A 2019 systematic review and meta-analysis, "Effects of Creatine Supplementation on Renal Function," concluded that while serum creatinine might rise modestly, creatine did not significantly impair the glomerular filtration rate (GFR), which is the primary measure of how well the kidneys are working. An updated 2025 systematic review reaffirmed this finding, noting no harmful change in GFR across healthy populations and even in some medically managed groups. Long-term studies in clinical populations, such as one involving aged patients with Parkinson's disease, have also failed to find meaningful kidney damage.
Myth 2: It Causes Dehydration and Muscle Cramps
Many athletes have been warned that creatine pulls water into muscles, dehydrating the rest of the body and leading to cramps, especially in hot conditions. Science strongly contradicts this. A landmark study published in the British Journal of Sports Medicine, "Putting to rest the myth of creatine supplementation leading to muscle cramps and dehydration," monitored athletes training in hot and humid environments. It found no increased risk of cramps or dehydration among creatine users; some even experienced fewer cramps and better body temperature regulation.
Another comprehensive review, "Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?", supports this, stating that controlled studies do not validate dehydration or cramping as side effects when standard doses are used. Maintaining normal hydration is always important, but creatine itself does not cause the dangerous drying effect many fear.
Myth 3: It's a Steroid or Only for Bodybuilders
Creatine is often mistakenly grouped with anabolic steroids, but they are chemically and legally entirely different. Creatine is a nutrient-like compound, whereas steroids are synthetic hormones. The ISSN and multiple scientific reviews emphasize that creatine monohydrate is a legal, well-researched performance aid, not a steroid.
The outdated notion that it's only for male bodybuilders seeking a bulky physique is also false. Scientific evidence demonstrates benefits for women, older adults, and various patient groups. The gains are typically healthy increases in lean mass and functional strength, not an inevitable "bulky" appearance.
So, Is Creatine for Everyone?
Despite its strong safety profile, creatine is not universally recommended for every single person or situation. Individuals with pre-existing kidney disease, uncontrolled high blood pressure, serious liver conditions, or those taking medications that are toxic to the kidneys should only consider creatine under strict medical supervision, as most long-term trials have excluded these groups.
Furthermore, adolescents, pregnant or breastfeeding women, and people with complex medical histories should consult a doctor before use, as high-quality research in these specific populations is still limited. For the vast majority of healthy adults engaging in resistance training or explosive sports, however, the scientific consensus is clear: creatine monohydrate is a safe and highly effective supplement.
