From a Peak Performance article, by no means the bible, but a quick google shows no conclusive evidence of any harm in long term usage.
But more than 10 years of widespread creatine use and hundreds of published studies have produced little or no evidence that long-term creatine use poses a threat to kidney health. Quite the contrary, in fact. For example, a study carried out earlier this year looked at the effects of long- term high-dose creatine supplementation on 175 patients with a disease known as amyotrophic lateral sclerosis, which causes damage to motor neurones in the brain and spinal chord (2). These patients were randomly assigned to 310 days’ treatment with either creatine monohydrate or placebo (animal studies had suggested that extra creatine could delay the progression of this disease).
The researchers monitored the patients carefully for any signs of adverse effects, particularly on kidney function, but found no significant differences between the groups. Given that the creatine group were ingesting 10g per day – three times the dose needed by athletes to maintain muscle creatine saturation – this study provides strong evidence for the safety of long- term supplementation by athletes.
Two years earlier, an even lengthier study looked into the health effects of creatine on 98 college footballers, split into four treatment groups as follows (3):
* No creatine (control);
* Up to 6 months’ use;
* 7-12 months’ use;
* 13-21 months’ use.
The footballers in the three creatine groups were given 15.75g per day of creatine monohydrate for five days and an average of 5g per day thereafter. Urine and fasting blood samples were collected throughout the study to assess a wide range of metabolic parameters, clinical status and kidney function. Analysis of the results showed no measurable differences in metabolism or in kidney function between any of the groups.
Other studies on the link between creatine use and kidney damage have also drawn a blank, although most researchers have continued to advise against long-term creatine use by people with a history of kidney problems, because of the theoretical risks outlined above. Even for such individuals, though, there is little evidence that creatine use poses a risk in reality. Although no studies on long-term creatine use in kidney- impaired humans have been carried out, some animal studies have suggested that there is no risk to speak of.
Andrew Hamilton BSc, MRSC, trained as a chemist and is now a consultant to the fitness industry and an experienced science writer
References
1. Clin J Sport Med 1998; 8(4):298-304
2. Int J Sports Med 2005; 26(4):307-13
3. Mol Cell Biochem 2003; 244(1-2):95-104
4. Nephrol Dial Transplant 2003; 18(2):258-64
5. Nutrition 2005; 21(3): 301-7
6. Med Hypotheses 2000; 54(5):726-8
7. Pharmacotherapy 2005; 25(5):762-4
8. J Appl Physiol 2004; 97(3):852-7