Long-term consequences of creatine use

The use of creatine in the athletic arena is a relatively recent practice, less than two decades. Consequently, the long-term consequences of creatine supplementation aren’t fully understood. In other words, the phenomenon of athletic creatine supplementation is much too recent for a complete epidemiological profile to be available. Of particular concern, however, is the time required for synthesis and transporter function to fully recover after prolonged exposure to elevated creatine levels. This information is simply not known for humans (see Question #4). It is therefore that I advise that the loading phase not exceed 5 days.

Clinical situations, however, do exist where low doses of creatine have been used for several years with no signs of adverse side effects. For example, Gyrate Atrophy is a disease of the eye (retina) that is characterized by progressive narrowing of the visual fields. A secondary component of the disease is a deficiency in creatine synthesis. Consequently, this disease is also characterized by a reduction in the size of fast muscle fibers. Creatine supplementation has been shown to alleviate the muscular symptoms associated with this disease, although the visual symptoms persist. Other than mild weight gain, however, low doses of creatine (1.5 grams/day) when administered for the duration of several years produced no obvious adverse effects.

On the other hand, with each passing day it is becoming increasingly apparent that creatine supplementation possesses long-term benefits, especially when accompanied by B-vitamin supplementation. These “unexpected long-term benefits” have to do with an enhancement in cellular methylation rate that accompanies creatine supplementation.

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