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Vegetarians and other people who have lower total creatine levels when they start taking creatine supplements seem to get more benefit than people who start with a higher level of creatine. Skeletal muscle will only hold a certain amount of creatine; adding more won't raise levels any more. This "saturation point" is usually reached within the first few days of taking a "loading dose."
When taken by mouth in high doses, creatine is POSSIBLY UNSAFE. There is some concern that it could harm the kidney, liver, or heart function. However, a connection between high doses and these negative effects has not been proven. Creatine can also cause stomach pain, nausea, diarrhea, and muscle cramping.
Creatine causes muscles to draw water from the rest of your body. Be sure to drink extra water to make up for this. Also, if you are taking creatine, don't exercise in the heat. It might cause you to become dehydrated.
Many people who use creatine gain weight. This is because creatine causes the muscles to hold water, not because it actually builds muscle.
There is some concern that combining creatine with caffeine and the herb ephedra (also called Ma Huang) might increase the chance of having serious side effects such as stroke.
There is concern that creatine might cause irregular heartbeat in some people. But more information is needed to know if creatine can cause this problem.
There is concern that creatine might cause a skin condition called pigmented purpuric dermatosis in some people. But more information is needed to know if creatine can cause this problem.
Special Precautions & Warnings:Pregnancy and breast-feeding: Not enough is known about the use of creatine during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Kidney disease or diabetes: Do not use creatine if you have kidney disease or a disease such as diabetes that increases your chance of developing kidney disease. There is some concern that creatine might make kidney disease worse.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.