<aside> 🎯

Goal: Provide a clear, evidence-based guide on creatine, addressing its function, safety, and usage for improving performance and well-being while addressing some concerns.

</aside>

⚡️ Creatine

• Creatine is stored in muscles and rapidly regenerates ATP, the cell’s energy source, during short bursts of high-intensity activity (e.g., sprints).
• Creatine is converted to phosphocreatine, which donates a phosphate to ADP to regenerate ATP. The remaining creatine is broken down into creatinine, a waste product excreted in urine.

🛡️ General Safety

• Creatine is one of the safest supplements available, supported by extensive research. No significant clinical adverse effects have been reported in healthy individuals (children, elderly, athletes).
• The most common side effect is mild gastrointestinal distress, which can be mitigated by dividing doses throughout the day. Rare reports of cramping or water retention have been noted.

🩺 Kidney Health Concerns

• Serum creatinine levels are dependent on muscle mass and may be elevated in athletes and creatine users, which can sometimes be misinterpreted as kidney dysfunction.
• Creatinine-based estimated glomerular filtration rate (eGFR) calculations, used as proxy for kidney function, are not always accurate for athletes due to the formula's reliance on age and fixed height. This makes creatinine less reliable for detecting kidney dysfunction.
• A more accurate measure for kidney function is Cystatin C, which is independent of muscle mass and provides a more sensitive assessment of kidney health. Combining creatinine and Cystatin C offers even better accuracy for eGFR.
• Despite persistent rumors, no studies have demonstrated that creatine causes kidney damage in healthy individuals. Athletes should inform healthcare providers of creatine use when undergoing kidney tests to avoid misinterpretation and ask for Cystatin C being measured in stead of creatinine.

<aside> 🩸

If your blood test shows "elevated" creatinine levels or an estimated glomerular filtration rate (eGFR) outside the reference range, don't be alarmed, even if your physician is. Elevated creatinine is common in athletes and creatine users. A more accurate measure of kidney function is Cystatin C. Ask your physician to order this test, either instead of or in addition to creatinine.

</aside>

💡 Hair Loss Concerns

• A common concern is that creatine causes hair loss. While one(!) study noted an increase in DHT (a hormone linked to hair loss), hair loss itself was not measured as an outcome. Though DHT is associated with male pattern baldness, there is no direct evidence that creatine causes hair loss. Mechanism does not imply outcome.

🌟 Benefits

• Creatine is well-established for enhancing muscle mass, strength, and power output, making it highly beneficial for everyone.
• Emerging research suggests creatine may offer neuroprotective benefits, potentially slowing the progression of neurodegenerative diseases such as Parkinson’s and Alzheimer’s.
• Creatine may improve cognitive performance under stress, such as sleep deprivation, but the evidence for cognitive benefits under normal conditions is still emerging.

📊 Dosage, Cost, and Accessibility