79 Comments

Creatine has been helping my mother and I since I read that it would support methylation. I have been using about 5 grams in a serving of bean soup for her (Alzheimer's) and she has been more functional. Thanks Chris.

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Jun 24Liked by Chris Masterjohn, PhD

Be aware that serum creatinine (a measure of renal function, used to calculate estimates glomerular filtration rate aka eGFR) will increase about 10% on 5 grams per day of creatine. Your physician will be alarmed and concerned that kidney function has deteriorated. But this is an "artifact" of supplementation, the kidneys are not deteriorating. Most physicians are clueless, so stop creatine supplementation about 1 week before lab tests.

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author

You can use cystatin C instead.

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Yes but Medicare does not cover cystatin C (in CA) unless you have advanced chronic kidney disease, a ridiculous policy.

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Not easily accessible here in Australia and I suspect in many other places too.

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Hi Bob, isn't CMJ a genius?! I was just about to send out a creatine newsletter when this article came out, lucky me although this would be TMI for MOST of my patients!

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thanks for sharing - reminds me of when a client had done very strenuous exercise too close to the blood draw and his kidney markers were pretty scary. It wasn't until later that I learnt that lots of markers can be affected by this level of exercise and other factors too close to the blood draw. I wish I'd known at the time I was looking at his results!

I give clients instructions on how to prep for blood tests and will add this to it.

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My serum creatinine doubled from about 70 to 140 on 1tsp/day (~3.25g) of creatine monohydrate. What might that indicate?

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My serum creatinine increased from 0.83 to 1.13 on creatine, I rechecked after holding creatine for one week and it came back down to 0.88, within the margin of error for return to previous level. 1.13/.83= 1.36, so a 36% increase on creatine. Unfortunately I am not aware of any studies showing the distribution of creatinine increase associated with creatine use. I suspect if you have lower body muscle mass the increase could be greater, but that is just speculation. Cystatin C is not affected by creatine supplementation so that would be the test to get if you are concerned something else is going on with kidney function. I hope that helps.

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Thanks. I was on creatine monohydrate for ~25 days before my serum creatinine was measured. 0.74 before (eGFR 94), 1.4 after (eGFR 52). ~1.5 months later it was 1.16 (eGFR 63). I ended the monohydrate soon after, and then ~3.5 months later my creatinine had dropped to 0.8 (eGFR 95), and my Cystatin C was 1.02 [ref. range 0.62-1.16], with a computed CKD-EPI Cystatin C eGFR of 72.8. After another ~1.25 months, my creatinine was still 0.8 (eGFR 97), but my Cystatin C had dropped to 0.84 (eGFR 94.2). Our conclusion was that creatine monohydrate was stressing my kidneys, and I was better avoiding that supplement.

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It would have helpful to get the cystatin C while on the creatine monohydrate to determine if your kidney function was truly compromised. The elevated creatinine was likely due to the creatine because creatine is metabolized to creatinine, not because it was damaging the kidneys. Too bad you did not get a cystatin C before you stopped the creatine.

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Thanks. It was the still elevated Cystatin C at the upper end of normal ~3.5 months after ending the creatine monohydrate supplementation (and its subsequent drop 1.25 months later) that had us conclude taking it was problematical. It's probably worth trying the creatine again, with close monitoring via Cystatin C. If I take creatine monohydrate again, I'll be certain to do that.

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In my 30s and 40s. I got pretty heavily into weight-lifting. I am relatively small-boned and have more of a runner's body than a bodybuilder's. But I lifted a lot of heavy weights - heavy by my standards at least - and though I became muscular, I saw other guys lifting the same weights as me and getting a lot bigger. I never used steroids, thank gawd, but I tried every over-the-counter supplement known to man, and the only one that worked, that made be bigger and stronger, was creatine.

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For those of us unlucky enough to suffer from insomnia when supplementing with creatine: would supplementing with glycine solve this problem? I have tried creatine multiple times with the same result each time. Horrible insomnia and feeling “wired” at night.

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First thing I would try

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Dimethylglycine, half teaspoon in water before bed can help cool the body into sleep mode. You still need to calm your mind and have lights out, etc, to promote sleep mode. A cooler body is part of sleep onset though. A cooler bedroom helps sleep, 65'F is nice.

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Same thing here. How much glycine are you expecting to supplement with during the day?

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Thanks for this practical and informative article. I've lost a fair amount of muscle mass since having a bad COVID/Long COVID experience, and I am now excited about experimenting with increased creatine supplementation and precursors. Will also up the TMG.

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Jun 24Liked by Chris Masterjohn, PhD

Great discussion Chris, thank you, I have been taking 5 grams per day for a few years.

bob hansen MD

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I don't take many supplements, but creatine is one of them. It's good for our digestive tract as well I believe?

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It says that in the article.

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Thanks for the detailed article. As a vegetarian, it seems I am then in the danger zone and might have to do adjustments. Interesting. Well, you just gave me something new I would like to get tested :) Thanks for your article. I have restacked it

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Sep 20Liked by Chris Masterjohn, PhD

Entertaining (to me) and incredibly interesting article

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Creatine makes me super constipated, no idea why. I do like how I feel when I take it otherwise though. And I have methylation issues.

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author

I’d see if more potassium helps.

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Creatine supplements I have taken include instructions that recommend consuming plenty of water while supplementing with creatine. Some folks report symptoms of dehydration when they don't up their water intake when taking creatine

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I'm embarrassed to admit I didn't think of this. Thanks for the suggestion.

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May sound trite, but eat 3 or 4 prunes a day... The naturally occurring compounds in prunes will assist regularity .. Well known constipation assist in these parts (UK)

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Is it OK to take creatine in a protein shake or does it need to be taken alone?

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author

That’s fine

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Jun 24Liked by Chris Masterjohn, PhD

I mix creatine into a shake that includes other supplements in powder form.

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And Dr. Joel Brind says everyone is deficient in glycine so that may be more limiting than it seems.

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author

Doubtfully given it never being shown, but yes most people need more glycine.

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I think it may get generally ignored because it’s such a common, nonessential AA, that most folks assume it’s plentiful and so not “sexy” enough to research.

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Cool. This was super informative and helpful for me. Thank you, Chris! Any opinion on brands and/or specific products? I'm seeing that a number of creatine supplement brands claim to be or contain Creapure creatine monohydrate. Just curious if there are any brands in particular that you like or can recommend (and, if there are any you *don't* recommend).

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author

It’s all just the same stuff white labeled.

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Jun 24Liked by Chris Masterjohn, PhD

Got it. thanks ✌️

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based on the information you presented, it seems like children could also (especially?) benefit from creatine supplementation. What are your thoughts on use in children?

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Creatine gives me an anxiety doom and gloom panic state and would really like to understand the mechanism behind that. Glycine does the same thing. I really would like to take Creatine because of many of the reasons listed in the article.

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i also have very bad mental reactions to glycine

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author

See the side effects article.

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Great article and helpful for Covid sufferers.

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