Is creatine cycling necessary or is long term creatine use safe?

Creatine Cycling

There’s an enormous amount of misinformation about creatine, specifically dealing with its dosing and safety. In the previous article, we discussed why the popular strategy of loading creatine may be unnecessary. In this article, we’ll discuss whether you need to cycle creatine use on and off for short periods of time. Many argue in favor of using of creatine only for short periods of time. This is followed by a break before continuing use. Is this on and off cycling really necessary?

Creatine Safety Risks

Weight gain is one of the main effects of creatine supplementation. The majority of this quick weight gain comes from water retention. There is some research indicating that creatine also causes decreased urine output. Put together, these two can cause increased strain on the kidneys. There is older research showing issues with creatine use in those with existing kidney disfunction. Other side effects of creatine use include: muscle cramps, headaches, diarrhea, and gastrointestinal discomfort¹.

What does the research say about the safety of long term creatine use?

Study 1: Effects of Long-term Creatine Supplementation on Liver and Kidney Functions in American College Football Players¹

This study looked at the effects of long term creatine use on kidney and liver function in NCAA football players. Ten players who reported past creatine use ranging from 0.25-5.6 years were included in this study. The dose used by these athletes ranged from 5-20 grams per day. Another 13 players who did not use creatine served as the control group. Blood was drawn from all subjects and analyzed for markers of liver and kidney health.

The blood tests did not show a difference in any of the markers tested. The authors of this study concluded that there does not appear to be a detrimental health effect of long term creatine use.

Study 2: Long-term creatine supplementation does not significantly affect clinical markers of health in athletes²

This study examined the effects of long term creatine use on various health markers. Ninety eight NCAA football players were included in this 21 month study. They were assigned to either a creatine or placebo group. The creatine group took 15.75 grams per day for the first 5 days and 5 g/d thereafter. Samples were collected at multiple times throughout the 21 month period.

The results did not show any differences between the creatine and placebo groups. Tests were performed on serum metabolic markers, muscle and liver enzymes, electrolytes, blood lipids, hematological markers, and urinary markers. The researchers concluded that creatine use up to 21 months does not appear to negatively affect health.

Other Studies on Long Term Creatine Use

Study 3: This study looked at athletes using creatine for periods ranging from 10 months to 5 years. It did not find any difference in renal health between the creatine users and non-users³.

Study 4: This study looked at creatine’s health effects after 16 months of use. This study did not find any differences in overall health between users and non-users⁴.

The Bottom Line – Cycling vs. Long Term Creatine Use

None of studies above found any negative health consequences from long term creatine use. The first two studies discussed previous research showing that creatine use could negatively impact kidney health. The authors of both studies noted that past research showing a link between creatine use and a decline in kidney function was conducted on individuals who already had pre-existing kidney disease^1,2.

Furthermore, the International Society of Sports Nutrition (ISSN) has a reassuring stance on long term creatine use. They note that creatine has a number of therapeutic benefits in both healthy and diseased individuals ranging in age from infants to elderly. They state that there is no compelling evidence that use of up to 30 grams per day for periods lasting as long as 5 years has any detrimental effects on healthy individuals or diseased individuals who many benefit from its use⁵.

Creatine Recommendations

Cycling creatine on and off is unnecessary. There is no good research indicating that long term creatine use has any negative effects. The ISSN’s stance states that use of up to 30 grams per day for periods as long as 5 years is safe. Most research indicates as little as 3-5 grams per day is enough to see benefits.

• Long term creatine use without cycling is safe in the vast majority of individuals.
• Use 3-5 grams per day.
• If you have any existing health issues, specifically in your kidneys or liver, check with a doctor before beginning creatine use.

References

1. Mayhew, D. L., Mayhew, J. L., & Ware, J. S. (2002). Effects of Long-term Creatine Supplementation on Liver and Kidney Functions in American College Football Players. International Journal of Sport Nutrition and Exercise Metabolism, 12(4), 453–460. doi: 10.1123/ijsnem.12.4.453
2. Kreider, R. B., Melton, C., & Rasmussen, C. J. (2003). Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Molecular and Cellular Biochemistry, 244(1), 95–104. doi: 10.1023/A:1022469320296
3. Poortmans, J., & Francaux, M. (1999). Long-term oral creatine supplementation does not impair renal function in healthy athletes. Medicine & Science in Sports & Exercise, 31(8), 1108–1110. doi: 10.1097/00005768-199908000-00005
4. Groeneveld, G. J., Beijer, C., Veldink, J. H., Kalmijn, S., Wokke, J., & Berg, L. (2005). Few Adverse Effects of Long-Term Creatine Supplementation in a Placebo-Controlled Trial. International Journal of Sports Medicine, 26(4), 307–313. doi: 10.1055/s-2004-817917
5. Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., … Lopez, H. L. (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1). doi: 10.1186/s12970-017-0173-z