Ramirez-Campillo R, et al. Effects of plyometric training and creatine supplementation on maximal-intensity exercise and endurance in female soccer players. J Sci Med Sport. 2016;19(8):682–7. Williams MH. Facts and fallacies of purported ergogenic amino acid supplements. Clin Sports Med. 1999;18(3):633–49. Yes, taking creatine monohydrate daily within recommended doses is generally safe for healthy individuals.

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Candow DG, et al. Low-dose creatine combined with protein during resistance training in older men. Med Sci Sports Exerc. 2008;40(9):1645–52.

McMorris T, et al. Effect of creatine supplementation and sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state, and plasma concentrations of catecholamines and cortisol. Psychopharmacology (Berl). 2006;185(1):93–103. Op’t Eijnde B, et al. Effect of oral creatine supplementation on human muscle GLUT4 protein content after immobilization. Diabetes. 2001;50(1):18–23. Galvan E, et al. Acute and chronic safety and efficacy of dose dependent creatine nitrate supplementation and exercise performance. J Int Soc Sports Nutr. 2016;13:12. McMorris T, et al. Creatine supplementation, sleep deprivation, cortisol, melatonin and behavior. Physiol Behav. 2007;90(1):21–8. Watanabe A, Kato N, Kato T. Effects of creatine on mental fatigue and cerebral hemoglobin oxygenation. Neurosci Res. 2002;42(4):279–85.

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Green AL, et al. Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans. Am J Physiol. 1996;271(5 Pt 1):E821–6.

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Sullivan PG, et al. Dietary supplement creatine protects against traumatic brain injury. Ann Neurol. 2000;48(5):723–9. Kilduff LP, et al. The effects of creatine supplementation on cardiovascular, metabolic, and thermoregulatory responses during exercise in the heat in endurance-trained humans. Int J Sport Nutr Exerc Metab. 2004;14(4):443–60.

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Tarnopolsky MA, MacLennan DP. Creatine monohydrate supplementation enhances high-intensity exercise performance in males and females. Int J Sport Nutr Exerc Metab. 2000;10(4):452–63. When assessing costs, take into account how many servings you will get, rather than just going by the cost per tub. The recommended dose is 3-5g (up to one teaspoon) of creatine after training, so 1kg will last many months. Wallimann T, Schlosser T, Eppenberger HM. Function of M-line-bound creatine kinase as intramyofibrillar ATP regenerator at the receiving end of the phosphorylcreatine shuttle in muscle. J Biol Chem. 1984;259(8):5238–46.

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Easton C, Turner S, Pitsiladis YP. Creatine and glycerol hyperhydration in trained subjects before exercise in the heat. Int J Sport Nutr Exerc Metab. 2007;17(1):70–91. Neves Jr M, et al. Beneficial effect of creatine supplementation in knee osteoarthritis. Med Sci Sports Exerc. 2011;43(8):1538–43. Kreider RB, et al. ISSN exercise & sport nutrition review: research & recommendations. J Int Soc Sports Nutr. 2010;7:7. Osbakken M, et al. Creatine and cyclocreatine effects on ischemic myocardium: 31P nuclear magnetic resonance evaluation of intact heart. Cardiology. 1992;80(3–4):184–95. With regard to the question of whether creatine has effect on renal function, a few case studies [ 249, 250, 251, 252] reported that individuals purportedly taking creatine with or without other supplements presented with high creatinine levels and/or renal dysfunction [ 249, 250, 251]. Additionally, one study suggested that feeding rats with renal cystic disease 2 g/kg/d of creatine for 1 week (equivalent to 140 g/day for a 70 kg individual) and 0.4 g/kg/d (equivalent to 28 g/day for a 70 kg individual) for 4 weeks exacerbated disease progression. These reports prompted some concern that creatine supplementation may impair renal function [ 253, 254, 255, 256] and prompted a number of researchers to examine the impact of creatine supplementation on renal function [ 22, 51, 85, 114, 156, 172, 243, 244, 245, 246, 247, 248, 257, 258, 259]. For example, Ferreira and associates [ 260] reported that creatine feeding (2 g/kg/d for 10 weeks equivalent to 140 g/kg/d in a 70 kg person) had no effects on glomerular filtration rate and renal plasma flow in Wistar rats. Likewise, Baracho and colleagues [ 261] reported that Wistar rats fed 0, 0.5, 1, or 2 g/kg/d of creatine did not result in renal and/or hepatic toxicity. Poortmans and coworkers reported that ingesting 20 g/day of creatine for 5 days [ 243], and up to 10 g/day from 10 months to 5 years [ 257] had no effect on creatine clearance, glomerular filtration rate, tubular resorption, or glomerular membrane permeability compared to controls. Kreider et al. [ 22] reported that creatine supplementation (5–10 g/day for 21 months) had no significant effects on creatinine or creatinine clearance in American football players. Gualono and associates [ 262] reported that 12 weeks of creatine supplementation had no effects on kidney function in type 2 diabetic patients. Finally, creatine supplement has been used as a means of reducing homocysteine levels and/or improving patient outcomes in patients with renal disease [ 263, 264, 265] as well as ameliorating birth asphyxia related renal dysfunction in mice [ 228]. Moreover, long-term, high dose ingestion of creatine (up to 30 g/d for up to 5 years) in patient populations has not been associated with an increased incidence of renal dysfunction [ 23, 155, 156, 172]. While some have suggested that individuals with pre-existing renal disease consult with their physician prior to creatine supplementation in an abundance of caution, these studies and others have led researchers to conclude that there is no compelling evidence that creatine supplementation negatively affects renal function in healthy or clinical populations [ 5, 6, 22, 53, 259, 266, 267].

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Moon A, et al. Creatine supplementation: can it improve quality of life in the elderly without associated resistance training? Curr Aging Sci. 2013;6(3):251–7. Robinson TM, et al. Dietary creatine supplementation does not affect some haematological indices, or indices of muscle damage and hepatic and renal function. Br J Sports Med. 2000;34(4):284–8.Thorsteinsdottir B, Grande JP, Garovic VD. Acute renal failure in a young weight lifter taking multiple food supplements, including creatine monohydrate. J Ren Nutr. 2006;16(4):341–5. Scofield DE, Unruh S. Dietary supplement use among adolescent athletes in central Nebraska and their sources of information. J Strength Cond Res. 2006;20(2):452–5. Matthews RT, et al. Neuroprotective effects of creatine and cyclocreatine in animal models of Huntington’s disease. J Neurosci. 1998;18(1):156–63.