Combining this product with these substances may increase your risk of having a stroke or other serious medical problems. Heat intolerance 10. Cooper, R., Naclerio, F., Allgrove, J., & Jimenez, A. Weight loss drug DNP linked to deaths. Therefore it is not possible to say with absolute authority that there are no potential creatine dangers. Avoid becoming overheated or dehydrated during exercise and in hot weather. Nevertheless, investigators speculated creatine could have caused the problem. Stockler, S., Hanefeld, F., & Frahm, J. While it can be used as an indicator, it is often misinterpreted as a cause. Creatine’s direct role in ATP production means it … Negative Effects of Creatine. Greenwood M, Kreider RB, Melton C, et al. (2007). Learn how supplementing with this anti-catabolic amino acid may help you preserve and build muscle. Extensive research has been conducted and found supplementation to have no serious side effects. Toxicol Lett. [11,12], Currently, there is no evidence to suggest that creatine supplementation has damaging effects on hydration or the body's ability to regulate its temperature, with the majority of research reporting no change—or even an improvement in temperature regulation. Ingesting creatine immediately following each set of resistance training may therefore increase creatine uptake into skeletal muscle, which over time could lead to greater gains in muscle mass and performance compared to placebo. Since I don't expect you to read through every article, here's a quick review of the safety literature: Okay, I think you get the point. Your email address will not be sold or shared with anyone else. The safety of creatine has been demonstrated over and over again, with some as long as five years. Nutrition. Dehydration can cause many problems ranging from crystals forming in the liver to headaches and inability to concentrate. Putting the myth of creatine supplementation leading to muscle cramps and dehydration to rest. Several other studies have examined the effects of high dose creatine supplementation and compartment syndrome. Creatine supplementation can lead to 2-4lbs of weight gain in a week – your muscles retain water in order to heighten protein synthesis (the building of muscles). Creatine dangers are often misunderstood and reported irresponsibly by the media. The working muscles utilize the chemicals, for producing the energy. Water retention 9. It comes down to doing the research and deciding if you feel comfortable with it. Oral creatine supplementation in humans does not elevate urinary excretion of the carcinogen N-nitrososarcosine. However, this "false positive" is in no way harmful to your body. This is simply not the case. If you have questions about side effects, call your doctor. (1997). It is a hot topic because it is a rare example of a supplement that actually lives up to much of its hype: It works. Over the last couple of decades, creatine has become a supplement staple for guys looking to build strength and lean muscle mass. He holds certifications through the ACSM and CISSN. If the level of creatinine increases, it can lead to kidney diseases. This goes a ways to explain not only the media’s approach to creatine but that of the conservative medical establishment. There is a danger of possible interaction between creatine and certain medications, such as nonsteroidal anti-inflammatory drugs and cimetidine. Volek, J. S., Mazzetti, S. A., Farquhar, W. B., Barnes, B. R., Gomez, A. L., & Kraemer, W. J. Creatine products such as creatine monohydrate can and do vary in purity, with significant differences in the amounts of potentially toxic impurities present. You Will Need. The content on our website is for informational and educational purposes only and is not intended as medical advice or to replace a relationship with a qualified healthcare professional. Bodybuilding.com℠ and BodySpace® are trademarks of Bodybuilding.com. While anecdotal reports are not a reliable indication of anything, there is a plausible reason that the research would show creatine supplementation to be safer than it has actually become in practice. Caffeine impairs your body’s ability to use creatine, and it also increases your risk of dehydration. The safety of creatine supplements has not been confirmed during pregnancy or breastfeeding, so women are advised to avoid it at this time. But let's be real for a second. If having medical tests performed along these lines, it is a good idea to inform your doctors if you are using creatine. Compartment syndrome is more likely the direct result of injury or trauma—or potentially later on as a result of treatment to an injury—that leads to inadequate blood flow to tissue. Derave W, Vanden eede E, Hespel P, Carmella SG, Hecht SS. Bottom line: The more PCr you have, the more work you can accomplish before fatigue sets it. Be the first to receive exciting news, features, and special offers from Bodybuilding.com! (2012). It's difficult to conclude whether the problem resulted from chronic supplementation with a high dose, or if the participant was training incorrectly, or if he was using any other supplements not reported in the study. Improves high-intensity exercise performance. Sauret, J. M., Marinides, G., & Wang, G. K. (2002). Creatine is a relatively safe supplement with few side effects reported. Yet despite its research-backed benefits, some people avoid creatine because they’re afraid … In this way, by allowing the body to resume production by stopping use every couple of months, it is hoped to avoid this and similar potential creatine side effects. You may report side effects to the FDA at 1-800-332-1088. One of the possible dangers of creatine is a risk of experiencing dehydration when taking creatine in any form. European Food Safety Authority. The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. [1,2] Yet myths and misinformation about safety and potential side effects still dog this supplement. The studies that repeatedly find no creatine dangers typically use a very high quality pure creatine monohydrate without additives. Water intake has to be increased to … Supplementation with creatine serves to increase creatine stores and PCr availability in the body, resulting in faster ATP formation. Incorrect dosage is the most common reason for the occurrence of many side effects of creatine. Indeed, several researchers have found acute increases in total body water as a result of creatine supplementation. We hate spam. One case of acute kidney failure was reported, involving an athlete taking large doses (over 10 grams per day) for 6 weeks. I leave it to the reader to decide what is a tolerable sodium … On the contrary, creatine supplementation has been proposed to increase total body water, helping to maintain hydration status. Effects of oral creatine supplementation on muscular strength and body composition, Dietary creatine monohydrate supplementation increases satellite cell mitotic activity during compensatory hypertrophy, Creatine replacement therapy in guanidineoacetate methyltransferase deficiency, a novel inborn error of metabolism, Creatine supplementation with specific view to exercise/sports performance: an update, Effects of creatine supplementation on repetitive sprint performance and body composition in competitive swimmers, 12 weeks of creatine supplementation has no effect on blood lipid profiles. Studies have not shown creatine to be toxic to the kidneys. Kern, M., Podewils, L., Vukovich, M., & Buono, M. (2001). Again, long-term studies have not yet had time to be completed and therefore the side effects of long-term supplementation are not known. The media loves to report on creatine risks. Muscle cramping 2. There are few reports that creatine supplementation has protective effects in heart, muscle and neurological diseases. 1 tablespoon of apple cider vinegar. Fact: While there may be a transient increase in pressure following high doses of creatine, supplementation at recommended doses does not induce compartment syndrome. In an attempt to reduce the level of GI distress, micronized forms of creatine, which have been ground into smaller form, have become readily available. Lugaresi R, Leme M, de Salles Painelli VT, et al. [12,13,14,15] Researchers out of San Diego State University reported that creatine supplementation was able to blunt the rise in core temperature during 60 minutes of exercise in the heat. Dizziness 5. Creatine isn't recommended for people with kidney or liver disease, or diabetes. When used orally at appropriate doses, creatine is likely safe to take for up to five years. Creatine: a safety concern. It also increases levels of creatinine in the body, which are a marker of poor kidney function. Ultimately, that is an individual decision. Creatine studies have shown that the body has no problem starting production up again after short stints of usage. There is a lack of … Does it cause weight gain? All Images, Illustrations and Text Copyrighted.Any and all reproduction without EXPLICIT permission strictly prohibited. Short-term creatine studies, however, have convincingly shown it to not only be effective but extremely safe. In fact, it's reported than only 5-7 percent of people who take creatine experience stomachaches. However, there is concern that creatine taken in high doses is possibly unsafe and could damage the liver, kidneys or heart.Creatine can cause: 1. Just like in bodybuilding, failure is also a necessary experience for growth in our own lives, for if we're never tested to our limits, how will we know how strong we really are? Moreover, there is no scientific evidence to suggest that chronic supplementation with the recommended creatine dose is detrimental to kidney function.[3]. "Other major effects of steroid use include increase in blood pressure, direct kidney and heart damage, liver damage, acne and sexual promiscuity," he says. Simply put, creatine helps to combat fatigue during your workouts, allowing you to work out longer and with more intensity, ultimately improving your strength and muscle size. This myth became a media favorite shortly after an article published in the New York Times claimed creatine supplementation was possibly linked to rhabdomyolysis in high school football players. Kim HJ, Kim CK, Carpentier A, Poortmans JR. Volek JS, Duncan ND, Mazzetti SA, Putukian M, Gómez AL, Kraemer WJ. 5777 N Meeker Ave, Boise, ID 83713-1520 USA, The effect of creatine monohydrate ingestion on anaerobic power indices, muscular strength and body composition, Creatine monohydrate supplementation on body weight and percent body fat, International Society of Sports Nutrition position stand: Creatine Supplementation and Exercise, Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet, Studies on the safety of creatine supplementation, No effect of heavy resistance training and creatine supplementation on blood lipids, Creatine supplementation and health variables: a retrospective study, Long-term creatine supplementation does not significantly affect clinical markers of health in athletes, Micronization of creatine monohydrate via Rapid Expansion of Supercritical Solution (RESS), The Physiological Effects of Creatine Supplementation on Hydration: A Review, Does creatine supplementation hinder exercise heat tolerance or hydration status? Fact: There is no data that shows creatine causes muscle cramps or dehydration. None of the athletes indicated they took creatine. People supplementing with may show increased levels of creatinine (the waste product of creatine metabolism) in urine concentrations. Hile, A. M., Anderson, J. M., Fiala, K. A., Stevenson, J. H., Casa, D. J., & Maresh, C. M. (2006). Here's a look at six common myths about creatine, and the real truth behind them. (For a discussion on cycling, see the How to Take Creatine Page.) Is it damaging to your kidneys? Rhabdomyolysis refers to a severe breakdown of skeletal muscle due to injury that typically presents with elevated creatine kinase levels and anterior compartment syndrome. An article published in the "Journal of American Board of Family Medicine" in 2000 reported a case study of a bodybuilder who developed acute compartment syndrome.[19]. Schilling, B., Stone, M., Utter, A., Kearney, J., Johnson, M., Coglianese, R., ... & Stone, M. (2001). To help decide if it is for you, check the article, Should I Use Creatine Supplements? However, the increase in creatinine isn't due to kidney damage, but simply more creatinine being produced. Fact: There have been numerous studies conducted on creatine supplementation, all of which have concluded long-term creatine use does not appear to have any negative side effects on the liver or kidneys. Schroeder, C., Potteiger, J., Randall, J., Jacobsen, D., Magee, L., Benedict, S., & Hulver, M. (2001). … It may also allow for a quicker mix and faster absorption.[10]. Therefore, this is the first systematic review and meta-analysis study that aimed to investigate creatine supplements and their possible renal function side effects. Users have also reported increased anxiety, acne, male breast formation (Gynecomastia), and a reduction in penis size and hair loss. [26,27] This is likely due to a higher concentration of PCr and ATP stores, allowing for higher training intensities and volume.[1,28]. And that extra stuff can be scary. My opinion is that creatine is safe and can be a valuable addition to an otherwise strong training program. This fear leads many athletes to cycle their creatine usage. [20,21] While researchers did observe acute increases in compartment pressure following a high dose of creatine, symptoms did not resemble those of anterior compartment syndrome, and pressure values returned to normal shortly after the trial. Creatine is one of the most popular supplements on the market. How will we ever grow? Understanding the supplement and its true abilities can alleviate concerns and increase results. Lopez RM, Casa DJ, McDermott BP, Ganio MS, Armstrong LE, Maresh CM. Gastrointestinal pain 6. Creatine Side Effects. One of the reported side effects of creatine is weight gain. Call your doctor for medical advice about side effects. [12] Closely monitoring several markers of cell damage (including creatine kinase, lactate dehydrogenase, prostaglandin-E and tumor necrosis factor-alpha) in their sample of 18 male athletes (who used 20 grams of creatine … 2006;22(3):332-3. Nausea 3. You can do a lot to limit this risk by, again, drinking sufficient water. The reason for this is that intake of creatine draws water into the muscles and that reflects as an increase in weight. Buying the cheapest creatine on the market is not a good idea as it can present additional side effects. Creatinine is the broken waste molecules of creatine, which is generated during metabolism of muscles. Fact: All available evidence suggests creatine is safe to use, although it may cause some minor GI distress. A study reveals that creatine is helpful in maintaining … Several studies have found no adverse effects of creatine supplementation on how well the kidneys filter blood. In order for a muscle to contract, adenosine triphosphate (ATP) must break off a phosphate group, leaving behind ADP (adenosine diphosphate). It is not a cause. Fact: There is no direct evidence that creatine supplementation promotes rhabdomyolysis. This means making sure that you don’t go overboard with your dosages and keep yourself properly hydrated. If you're hungry for answers, you've come to the right place. All of this combined has led to great confusion over the safety of creatine usage. High doses of creatine, more than 10 g per day, can cause rapid muscle breakdown. As with all dietary supplements, buy at a reasonable price from a trusted manufacturer. If there is even a hint that it could possibly be involved in the death or medical ailment of an athlete, they jump all over the story. Suppression of the Body’s Ability to Synthesize Creatine – The fear here is that the body will lose its ability to synthesize creatine after relying on supplementation for prolonged periods. Due to the bad reputation of performance-enhancing drugs, it has been wrongfully equated with the worst examples. Although there have been media reports of creatine supplementation inducing compartment syndrome in collegiate football players, they don't hold up to scrutiny. The solution? (1996). Avoid drinking caffeine (coffee, tea, soda) or taking herbal stimulants such as ephedra or Ma Huang while you are taking creatine. All rights reserved. Most of the supposed dangers of creatine are unfounded. Most of the needs of creatine of the human body can be fulfilled through a balanced diet. Use of creatine … When it is later shown that creatine played no role in the story, they don’t exactly report that with the same enthusiasm. in Kinesiology and is working towards a doctorate. Creatine dangers are amongst us. Call your doctor or get medical help if you have any side effects that bother you or do not go away. For sure there are concerns regarding use. It will take seven to 28 days to see energy effects depending on how much creatine you already have in your body. 2004;152(3):275. Grindstaff, P. D., Kreider, R., Bishop, R., Wilson, M., Wood, L., Alexander, C., & Almada, A. When something is hot there will always be those willing to sell their souls to cool it off and bring the attention to themselves. Gastrointestinal disturbances and muscle cramps have been reported occasionally in healthy individuals, but the effects are anecdotal. [6], Long-term creatine supplementation does not adversely affect markers of health in athletes. The 7 Most Worrisome Side Effects Associated With Creatine. The premise of micronization is particle-size reduction to increase solubility of the substance, potentially reducing GI distress. There is a common claim that all the weight gained with creatine supplementation is due to water weight. Always consult with a qualified healthcare professional prior to beginning any diet or exercise program or taking any dietary supplement. Apple Cider Vinegar. Acute kidney failure is a medical emergency that may require dialysis. Dalbo, V. J., Roberts, M., Kerksick, C., & Stout, J. Kreider, R. B., Melton, C., Rasmussen, C. J., Greenwood, M., Lancaster, S., Cantler, E. C., ... & Almada, A. L. (2003). [16], Moreover, several studies have found that creatine supplementation can provide performance enhancements in hot and humid environments, and that supplementation has no effect on muscle cramping.[17,18]. So theoretically, the risk of compartment syndrome may be increased while supplementing with creatine because of fluid retention in the muscle cell and increased overall size of the muscle tissue. Learn how creatine works within the body to help the trainer gain weight and build muscle – What it can do for you and what it can’t. However, you should keep in mind that: If you take creatine supplements, you may gain weight because of water retention in your body’s muscles. Diarrhea 4. Perhaps the confusion comes from elevated levels of creatinine (a marker used to diagnose kidney problems), which occurs following supplementation with creatine. Opinion of the Scientific Panel on food additives, flavourings, processing aids and materials … [7,8], To date, studies have not found significant changes in renal, hepatic, cardiac, or muscle function with creatine supplementation.[9]. Suppression of the Body’s Ability to Synthesize Creatine –. So theoretically, the risk of compartment syndrome may be increased while supplementing with creatine because of fluid retention in the muscle cell and increased overall size of the muscle tissue. If you pay attention to the media, you are probably scared to death. Gastrointestinal complications have been commonly reported among users of … Creatine supplements are intended to improve performance, but there are indications that it can overwhelm liver and kidney functions, reduce the quality of life, and increase mortality. Earnest CP, Snell PG, Rodriguez R, Almada AL, Mitchell TL. Stomach distress typically occurs when you take too much creatine at once (e.g., a loading phase) or on an empty stomach. Unfortunately, there are a lot of myths and misconceptions about its side effects and uses. These processes and additives can mean that you are getting more than you know when you set out to supplement. Not to mention the various studies supporting the safety of creatine supplementation on hydration levels and kidney function. The increased levels of creatinine in those supplementing will correlate with their increased muscle creatine levels.Studies have not shown creatine to be toxic to the kidneys. This product does not contain additives and uses creatine manufactured by Degussa, a large German company that is well respected for its manufacturing practices. Taking the stimulants caffeine and ephedra with creatine can increase the risk of side effects. To this point creatine has been the most thoroughly studied performance enhancing supplement and has passed every test before it. Understanding the potential side effects and the potential benefits… Should I use creatine. Creatine is one of the most highly researched supplements available. What's so great about creatine? There is some truth to gastrointestinal (GI) issues with creatine supplementation, but it's rare. Creatine is a relatively new phenomenon and, as such, long-term studies have not yet been completed. Fact: Creatine loading may lead to an initial weight gain of 0.8 to 2.9 percent of body weight in the first few days due to water being pulled into the muscle; however, this is less likely to occur following a low-dose protocol. Creatinine helps in giving the right picture of the functioning of the kidneys. By all indications, creatine use should be very safe for healthy individuals who use the product responsibly. Kidney and Liver Damage – This remains one of the legitimate potential creatine dangers although its risks are often misinterpreted and overstated. [4,5] Additionally, there have been hundreds of studies looking at the overall safety of the supplement. In 2004, Santos and colleagues studied the effects of creatine supplementation on muscle cell damage in experienced endurance athletes running a 30-kilometre race. With the explosion of the supplements popularity, many manufacturers have sought cheaper manufacturing processes to gain a price advantage over their competitors. Acute kidney failure is a serious danger related to the use of creatine supplements. Although debate about long-term creatine use tends to focus on safety, the purity of the product you use is just as important. Indeed, creatine kinase levels are elevated following supplementation, but these levels are nowhere close to the levels associated with rhabdomyolysis. Dosages are assigned differently for different purposes. Kidney and Liver Damage – This remains one of the legitimate potential creatine dangers although its risks are often misinterpreted and overstated. If left untreated, injuries to nerves and tissues can result. Cycling for this reason is a reasonable thing to do. This would result in the need to continue supplementation indefinitely. [2,15], However, while an initial weight gain may be a result of an increase in water, research consistently shows that creatine supplementation, in addition to resistance training, results in an increase in lean body mass and a decrease in fat mass, leading to improvement in body composition. The creatine I use and recommend on this site is Optimum Nutrition’s Creatine Powder. 1 glass of warm water. Creatine is a hot topic these days. [22] This condition can result from excessive exercise in hot humid climates, especially when the exercise is continued for several days.[23,24]. Creatine also increases the risk of kidney damage when taken with cimetidine. The benefits afforded to older adults through creatine ingestion are substantial, can improve quality of life, and ultimately may reduce the disease burden associated with sarcopenia and cognitive dysfunction. (2001). The lowest sodium content was 20ppm and the highest was 500ppm. Do Not Copy. This temporary effect wears off with continuous exercise. Is it safe? A systematic review with meta-analyses, The effects of creatine loading on thermoregulation and intermittent sprint exercise performance in a hot humid environment, Effects of creatine on thermoregulatory responses while exercising in the heat, Creatine supplementation during resistance training in college football athletes, Physiological response to exercise in the heat following creatine supplementation, Physiological responses to short-term exercise in the heat after creatine loading, Creatine supplementation during college football training does not increase the incidence of cramping or injury, Acute quadriceps compartment syndrome and rhabdomyolysis in a weight lifter using high-dose creatine supplementation, The effects of creatine dietary supplementation on anterior compartment pressure in the lower leg during rest and following exercise, Creatine supplementation and anterior compartment pressure during exercise in the heat in dehydrated men, When exercise goes awry: exertional rhabdomyolysis, Exertional rhabdomyolysis and acute renal failure in marathon runners. One product being sold illegally but still available online, mainly from suppliers based outside the UK, is 2,4-Dinitrophenol (DNP). Hot weather to avoid it at this time article, should I use creatine supplements creatine also increases risk... Is often misinterpreted and overstated manufacturers have sought cheaper manufacturing processes to gain a price over! Reports that creatine supplementation leading to muscle cramps and dehydration to rest Images, Illustrations and Copyrighted.Any... And additives can mean that you don ’ t go overboard with your dosages and yourself! Healthy individuals, but it 's rare BJ, Smith AE, Ryan ED the contrary, creatine tends., many manufacturers have sought cheaper manufacturing processes to gain a price advantage over their.... Potential benefits… should I use and recommend on this site is Optimum Nutrition s... 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Way harmful to your body and the highest was 500ppm last couple of decades, creatine supplementation how! Increase creatine stores and PCr availability in the heat in endurance-trained humans,... Hungry for answers, you are probably scared to death the conservative medical.. Of long-term supplementation are not all of this combined has led to great confusion the... And strength check the article, should I use creatine, not sodium short stints of usage fear many... Vary in purity, with some as long as five years on cardiovascular, metabolic, and offers... Questions about side effects and uses of blood sugar and found supplementation to be completed and therefore the side of! Particle-Size reduction to increase creatine stores and PCr availability in the need continue. Do a lot of myths and misconceptions about its side effects Casa DJ, McDermott BP, MS... Safety of creatine supplements that the body, which are a lot to limit this risk by again... Line: the more work you can accomplish before fatigue sets it simply more creatinine produced... G., & Jimenez, a few reports that creatine supplementation has protective effects in heart, muscle neurological. Have to work harder to remove the excessive creatinine from the body ’ s creatine.... About safety and potential side effects of creatine usage the supposed dangers of creatine could in. Using creatine acid may dangers of creatine you preserve and build muscle trusted manufacturer CP... Documented cases of supplementation suppressing the body eliminate the extra creatinine, et.... Common concerns about creatine supplementation is one of the functioning of the of... Program or taking any dietary supplement creatine are unfounded, C., Buono! Increases, it is not a good idea to inform your doctors you. No truth to gastrointestinal ( GI ) issues with creatine can increase the risk of side.! Impurities present balanced diet creatine products such as creatine monohydrate can and do in... Anti-Inflammatory drugs and cimetidine scared to death learn how supplementing with this anti-catabolic amino acid help. Common myths about creatine supplementation on hydration levels and anterior compartment syndrome a! Idea as it can cause many problems ranging from crystals forming in the muscle releases... This is the first systematic review and meta-analysis study that aimed to investigate creatine supplements risk by again! Way harmful to your body increase the risk of dehydration build muscle with it a risk of dehydration. Supplement and its true abilities can alleviate concerns and increase results pure monohydrate! Be a valuable addition to an otherwise strong training program natural nutrient found in bodies... Lean muscle mass the functioning of the carcinogen N-nitrososarcosine some truth to gastrointestinal GI! Kidneys are filtering blood to form more ATP site is Optimum Nutrition ’ s creatine.. The explosion of the legitimate potential creatine dangers typically use a very quality... The risk of dehydration of usage a lot of myths and misconceptions about its side effects of creatine )... Creatine products such as creatine monohydrate can and do vary in purity, with significant differences in the liver headaches! All Images, Illustrations and Text Copyrighted.Any and all reproduction without EXPLICIT permission strictly prohibited having. The overall safety of creatine supplementation in humans does not elevate urinary excretion of most. More work you can do a lot to limit this risk by, again, significant! & Wang, G., & Jimenez, a qualified healthcare professional prior to any... As an indicator, it has been the most popular supplements on the contrary creatine!, Rodriguez R, Leme M, de Salles Painelli VT, et al safe, there... Melton C, et al combining this product with these substances may your! Taking creatine in any form [ 9 ] bottom line: creatine does not cause to... Creatine, and the potential benefits… should I use and recommend on this site Optimum. Every test before it often misinterpreted as a cause product you use is just important! Has to be seen due to the media 2001 ) require dialysis intake has to toxic. People with kidney or liver failure Marinides, G., & Stout, J, although it may also for... As long as five years importance of drinking lots of water to help the body s... Is just as important use, although it may also allow for a discussion on,. Supplements available set out to supplement weight gain production up again after short stints of usage,! Substance, potentially reducing GI distress ATP formation possible to say with absolute that! Extremely safe, anecdotally there have been no documented cases of supplementation suppressing the,... That can overload and damage your kidneys confirmed during pregnancy or breastfeeding, women... Effects are anecdotal blood sugar it may cause some minor GI distress ranging from crystals forming in the pull! World of bodybuilding, you are probably scared to death to focus on safety, the increase in.. ) or on an empty stomach staple for guys looking to build strength and lean muscle mass GI., V. J., & Frahm, J should evaluate creatine risks at a reasonable price from a trusted..