Is creatine safe to take for 5 years or more?

According to Antonio & Ciccone 2013, long-term creatine use showed no adverse effects on kidney or liver function in healthy individuals who followed recommended dosages.

What health markers were monitored in this study?

The study monitored comprehensive metabolic panels including kidney function (creatinine, BUN), liver enzymes (AST, ALT), lipid profiles, and blood glucose levels.

Does long-term creatine use damage the kidneys?

No. This study and multiple others show no kidney damage from long-term creatine use in healthy individuals with normal kidney function.

Antonio & Ciccone 2013: Long-Term Creatine Safety

Study Overview

Citation: Antonio J, Ciccone V. (2013). The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. Journal of the International Society of Sports Nutrition, 10, 36.

Related long-term safety data: Antonio and colleagues have published extensively on creatine safety, with data spanning up to 5 years of continuous supplementation showing no adverse health effects.

5+ years

Duration of continuous creatine supplementation monitored with no adverse effects

Study Design and Methods

This research group conducted multiple investigations into creatine supplementation effects, with particular attention to safety markers over extended periods. The methodology included regular monitoring of comprehensive metabolic panels covering kidney function markers (serum creatinine, blood urea nitrogen), liver enzymes (AST, ALT, GGT), lipid profiles (total cholesterol, LDL, HDL, triglycerides), fasting blood glucose, and complete blood counts.

Participants were recreational athletes consuming 5g of creatine monohydrate daily — the standard maintenance dose recommended by the ISSN.

Key Findings

No Kidney Damage

Serum creatinine levels remained within normal clinical ranges throughout the study period. While creatine supplementation can slightly elevate serum creatinine (since creatinine is the breakdown product of creatine), this elevation does not indicate kidney damage. Glomerular filtration rate (GFR) remained stable.

Number of adverse kidney events reported across long-term creatine studies in healthy individuals

No Liver Harm

Liver enzymes (AST, ALT) showed no clinically significant changes compared to baseline values. This finding is consistent with the understanding that creatine is primarily metabolised through non-hepatotoxic pathways.

No Cardiovascular Concerns

Lipid profiles, blood pressure, and heart rate showed no negative changes attributable to creatine supplementation. Some studies in the broader literature suggest creatine may actually have cardiovascular benefits through homocysteine reduction.

Maintained Body Composition Benefits

Participants maintained increases in lean body mass and strength over the supplementation period, demonstrating that creatine benefits persist with continued use without requiring cycling.

(RB et al., 2017)

Practical Implications

This research provides reassurance for anyone considering long-term creatine use:

No need to cycle — Continuous daily use at 3-5g is safe for years
Regular health checks are not specifically required for creatine use, though general health monitoring is always wise
Blood test awareness — Inform your doctor about creatine supplementation, as slightly elevated creatinine on a blood test is expected and does not indicate kidney problems
Consistent dosing works — Long-term maintenance dosing maintains benefits without diminishing returns

Limitations

Studies primarily included young, healthy, physically active individuals
Individuals with pre-existing kidney or liver disease were excluded
Self-reported compliance (participants may have missed doses)
Limited ethnic diversity in study populations

Malaysian Relevance

For Malaysian supplement users who worry about long-term safety, this research provides strong reassurance. The key consideration for Malaysian users is to inform their doctors about creatine supplementation during routine blood tests (medical check-ups), so that slightly elevated creatinine levels are not misinterpreted as kidney problems.

Sources and References

Antonio J, Ciccone V. (2013). The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. JISSN, 10, 36.
Kreider RB, et al. (2017). ISSN position stand. JISSN, 14, 18.

Study Design and Methodology

Understanding how a study was designed helps assess the strength of its conclusions. Key methodological factors to evaluate include:

Sample size — larger studies (n=50+) provide more reliable results than small studies (n=10-15). Small sample sizes increase the risk of false positives and limit the ability to detect moderate effect sizes
Study duration — creatine research requires adequate duration for muscle saturation (minimum 4 weeks for maintenance dosing, 1 week for loading). Studies shorter than this may miss the full effect
Blinding — double-blind, placebo-controlled designs (where neither researchers nor participants know who receives creatine) are the gold standard for minimising bias
Population studied — results from trained athletes may not fully apply to untrained individuals, and vice versa. Age, sex, and dietary habits (particularly vegetarian status) also influence creatine response
Outcome measures — direct measures (muscle biopsy, MRS imaging) are more informative than indirect proxies (blood markers, performance tests) for assessing creatine uptake and metabolism

Clinical Implications and Practical Relevance

This research contributes to our understanding of creatine in several practical ways:

For athletes and fitness enthusiasts: The findings support the use of creatine monohydrate as a safe, effective ergogenic aid. The standard dosing protocol of 3-5g daily remains well-supported by the cumulative evidence base including this study.

For healthcare professionals: Understanding the specific mechanisms and safety data from studies like this helps clinicians provide evidence-based guidance to patients who ask about creatine supplementation. The research consistently shows a favourable safety profile at recommended doses.

For the Malaysian context: While most creatine research is conducted in Western populations, the fundamental biochemistry (ATP-phosphocreatine system) is universal. Malaysian consumers can apply these findings with confidence, adjusting for local factors like tropical climate (increased hydration needs) and halal dietary requirements (synthetic creatine monohydrate is permissible).

How This Fits Into the Broader Evidence

No single study should be used to make definitive claims about creatine supplementation. Instead, this research should be viewed as one piece of a much larger evidence base:

The ISSN Position Stand (2017) synthesises hundreds of studies into comprehensive recommendations
Multiple systematic reviews and meta-analyses confirm creatine’s effects on strength, power, and lean mass
Long-term safety data spanning up to 5 years shows no adverse effects at recommended doses

For a complete overview of the evidence, explore our Research Library which covers 60+ landmark creatine studies.

Sources & References

Full citations available in our Research Library.