Creatine, for all its popularity, has also been the center of a minor controversy. People have claimed that the widely used supplement is a steroid – complete with the fits of the rage and hair loss – or it causes a host of health problems, including kidney and liver damage, and side effects like water retention.
And yet, creatine usage hasn't really slowed down. So, we're left with the question: is creatine safe?
Is It A Steroid?
Put plainly, there is no connection between steroids and creatine powder. For one thing, they are structurally totally different. But, most people aren't necessarily concerned with the chemical shape of their supplements – they want to know what it does and how it does it.
The performance-enhancing benefits of steroids, though, are rooted in the fact that they are hormones – generally synthesized testosterone. The resulting artificially elevated levels of testosterone are also responsible for the highly-publicized negative effects of steroids.
Creatine, however, is not a hormone and probably has no effect on hormone levels (we'll cover this in greater detail later). This means that not only can it not be classified as a steroid in any way, but any assertions that it has the same ill effects are unfounded.
Liver and Kidney Health
Some worry that creatine can have a negative impact on the liver and/or kidneys – especially with prolonged use.
In part, this is likely because creatine becomes creatinine when broken down by the body – a substance that is measured when testing kidney health. So, a blood test looking at kidney health could see elevated levels of creatinine caused by creatine supplementation and create a false positive. This is harmless and has never been linked to any real problems.
Some studies have even shown that an individual with only one functioning kidney experienced no ill effects from prolonged creatine usage – even at a loading dose of 20g per day.
Similarly, creatine can change the results of a liver function test, raising concerns for no reason. Again, no studies have shown any damage to the liver from creatine use.
All that being said, though, individuals with an existing kidney or liver disease should speak with their doctor before talking creatine, or any supplement.
Hormone Levels and Baldness
As mentioned, there has been some concern over creatine causing baldness. In truth, though, this is based on one study and – even if this one study was enough evidence – the findings would only apply to men with Male Pattern Baldness.
Actually, the study in question did not look directly at the effects of creatine on hair loss but, rather, on the testosterone metabolite dihydrotestosterone (DHT). This single study did find that creatine use increased levels of DHT in male rugby players to varying degrees. In theory, anything that increases DHT levels could increase the risk of hair loss in men with Male Pattern Baldness.
The problem, though, is that these findings have never been replicated and have even been contradicted by other research teams. While creatine might have some impact on levels of DHT, more thorough research is needed to be sure. In the meantime, no negative effects have been reported.