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by cj 11 days ago
Direct link to the study: https://jpbs.hapres.com/htmls/JPBS_1766_Detail.html

I wanted to check the dosages they used. Looks like the review includes studies ranging from 5g/day to 20-25g/day.

(Typical dosage you'll see for daily use is 5 grams)

4 comments

Just in case anyone is thinking about trying it: 25g seems pretty high. It’s worth it to review what that means for the rest of your body before starting this regime. Kidneys are really useful organs to have working.
This is a myth, its not bad for your kidneys. The reason this gets spread is because you will have higher levels of creatine in your urine if your Doctor tests your urine for kidney function, which indicates kidney disease.

However, If you reveal to that doctor that you're supplementing Creatine it will not be concern them.

My dad's GP didn't know about this, and despite my dad saying "it's fine, I'm taking creatine", sent him for a kidney check-up. Then they found an unrelated tumor on the ultrasound. Seems to be benign and hopefully all will be well. If so, creatine saved his life ;)
> creatine saved his life

Or more correctly, the myth saved his life.

Perhaps sometimes we should listen to conspiracy theorists. /s

I've even had doctors unaware that the regular eGFR tests needs to be adjusted for body mass to be remotely accurate if you're bigger than average - e.g. lifting weights or obese. Couple that with creatine and you get some "fun" moments when your doctor tries to gently break to you how messed up they think your kidneys are. The first time I had that I'd warned my doctor ahead of time to expect elevated creatinine, and he still freaked out.
Creatinine not Creatine
This has been my understand as well. I have CKD and my doctors have always been chill about it as long as I stop taking it about a week before having blood work done.

EDIT: I don't do 25g though... sounds like a lot...

You're lucky your doctor is aware of it. I've had several who did not understand, and insisted creatine must be dangerous if it elevated creatinine levels, and/or didn't understand the effects.
If your egfr is above 80 it’s you won’t notice it. But CKD is a late in life problem so you are basically making your end of life worse by making your kidneys work harder now. You might as well take up smoking: claiming it doesn’t hurt now is a lot different to 20 years of constant use.
At the risk of sounding stupid. Doesn’t this mean it would mask actual kidney disease? So you’d be ignoring potential warning signs.
There is a much more accurate test called Cystatin C that can be used instead, and it isn't subject to being thrown off by creatine, muscle mass, etc.
IF you tell your doc, they can adjust their interpretation of the test.

Edit: see comment below (i.e. better to stop taking creatine at least a week before a test).

If you have a good dr they'll just ask you to stop taking it for two weeks, then do a blood test.
creatinine != creatine
It's pretty clear they understand that. Creatinine is, however, the waste product of creatine. So the more creatine you consume, the more creatinine is in and discharged from your system.

Precisely and correctly as they said, normal eGFR presumes average musculature and average creatine consumption. If either of these out of the norm, eGFR becomes inaccurate and potentially flagging false positives for damage. Creatinine, the waste product of creatine, raises in a way that can get confused with kidney damage, which is precisely how the confusion about it causing kidney damage or being bad if you have a compromised kidney came about.

In some studies, people with CKD actually improved with creatine supplementation, though notably this was not people with PKD where it could increase cyst growth.

I started taking creatine after trying to clarify which one of those was which and found the dearth of negative consequences
Careful.

Creatine metabolizes into creatinine which is major indicator of kidney function because not being able to clear creatinine means your kidneys aren’t working. Adding more creatinine to your system decreases your ability to clear it leading to fatigue, edema, high blood pressure etc.

So it isn’t bad for your kidneys: it is bad for everything else.

Creatinine can be an indicator that your kidneys are not working well. It's a cheap red flag that can be screened for in a common blood test. But if heightened creatinine is a result of one's creatine supplementation, then there are none of the downsides associated with kidney disease.

Creatinine itself doesn't cause fatigue, edema, or high blood pressure. Kidney disease does.

Except many many many decades of research has not shown any of that to be true.
I'm not aware of any evidence that creatine harms the kidneys if your kidney function is remotely normal. You'd probably want to check with your doctor if your kidney function is already compromised.

Creatine supplementation will freak out a lot of doctors if they're not warned of it ahead of time, though, and sometimes you'll even need to explain to them that they will see elevated levels of creatinine on the tests and it won't be an accurate predictor of kidney function.

If you're supplementing with creatine and need your kidneys tested it's easiest to stop a couple of weeks before, or ask for a Cystatin C test and make sure they use the relevant adjustments for body mass as well if you e.g. lift weights - I've more than once had doctors imply they were worried I had kidney disease because they were entirely unaware of the effects both creatine and large body pass has on the regular tests.

Yes, the labeling does caution against using it if you have kidney disease. Not sure how much of a risk there is if your kidneys are functioning normally. Maintaining good hydration is always a good idea.
I can second this, do NOT start at 25g of creatine. If you're too lazy to read the literature a friendly AI tool will summarize it.
If your intention is to take creatine long term, skip the loading phase.

It might take longer to see full effects, but who cares if you’re intending to take it indefinitely.

Most guidance I’ve seen says to start with a loading phase of 25-30g per day for several days, then go down to 5g per day maintenance.
The loading phase frankly was designed for studies. Studies are often short-term, say 6 weeks. You've got to get everyone's creatine supplies "loaded up" quickly in an effort to make sure the bulk of the study is on folks with relatively comparable creatine stores. The easiest way to do this is to have everyone do a loading phase to reach max intramuscular creatine concentration. It is not for the benefit of the study participants; it's for the benefit of the study.

We humans not in studies are generally looking for a health benefit, not max intramuscular creatine concentration as fast as possible at the price of side effects. We are optimizing for something different than study authors. 5 g is fine.

This sounds intense... I'm a small female and I recently started at 5g a day and now I've dropped down to 2g a day because even at just 5g I was getting signs of dehydration, despite tripling my water intake. It does seem to make a difference in my physical performance so I'm overall happy with it.

Also the NIH fact sheet for creatine specifically recommends against higher starting doses.

I did the 25g a day loading phase and I could not tell any sort of effect at all one way or another. I do lift either more weight or do more reps pretty much every time I work out now. What was repping to failure a month or two ago is not even a working set now.
Per day being a key part of that. 30g at once is going to give a good chunk of people pretty severe cramping or a trip to the bathroom.
I don't think you can even do 30g at once in terms of mixing it. Even 5g in water it seems like theres some that will just stay crashed out of solution no matter what. I have done 25g over the course of a day though for a week long loading phase, and didn't notice any ill effects.

I think a lot of the anecdata on creatine is probably from people misplacing confounding issues to the creatine use. People in this thread are talking about heart palpitations or trouble sleeping. Stressful days at work are enough to trigger that.

Creatine isn't water soluble. I just take a 5g scoop daily and wash it down with water. I could do 6 scoops in a row without problem, but not sure what the point would be. The latest research fits with the 5g/day no need to load.

When I first started taking creatine in the late 90s (it had already been heavily studied then as one of the only supplements that improved athletic performance), I would mix it with juice. There were some studies that sugar would help the uptake.

If you're too lazy to read the literature, then just don't take it.

Going to something that frequently hallucinates or misstates things to the point where it's "trust, but verify by reading the source" means you may as well just read the literature you'd have to verify the summary against anyway.

Also if you want to try creatine, after a week or so you'll probably gain 2-6 pounds of water weight. Don't be afraid of it, it's not real weight, and will go away within a week or two after stopping it.
if you take it right before bed it'll make you dreams loads and sleep haaard, if you can get to sleep; the restless legs are a motherfucker.
Hei more than that - as an avid weed consumer - drugs are not dangerous by themselves especially when you don't like them - they are dangerous when you create space for them and get along with them. I like to believe weed is my little "cheat" - but i'd argue that any product is an abuse on a daily basis - so taking creatine once in a while might be fun to try out - but i would warn about anything on the spectrum of "regime" that plan for a daily basis etc... especially as you rightfully justified, without a doctor or an expert being able to know what effect this is going to have on a said person.
You need creatine to live. Your body typically makes enough from protein to survive (vegetarians and vegans might need extra vigilance here).

This is just taking more to optimize performance.

It's not the same.

right...

https://www.google.com/search?q=artificial+creatine+side+eff...

kidney damage. liver damage. kidney stones. weight gain. bloating. dehydration. hair loss. muscle cramps.

The fact that you estimate weed as a drug is correct - the fact that you don't realize that everything is basically a drug depending on the amount an potency is worrying.

Water is bad for you if you drink too much.
Yes because taking advice to medicine itself everyday based on an online entrepreneur forum to "boot-yourself" is 100% a good advice that you should take blindly without taking a notice on what you are doing.

You are so right.

I use it as a supplement because I do weightlifting. 5g/day. I did 20g/day for a week once, and didn't notice it made any difference, so I'm back to 5g now. In terms of stuff like memory, mood, etc. I can't say it's made any improvement but the idea that it might be helping prevent decline is nice.
I've found it helps cognitively if under a lot of stress and/or sleep deprived. If I'm not especially stressed and am well rested, I don't know that I notice any difference.
Its changed my life. Im also a long time vegan with MTHFR gene mutations and sleep issues though.
For vegans, creatine is among the recommended supplements, because the amount that is produced internally is insufficient for most people, so they need some extra amount in food. (The same is true for a few other substances, e.g. choline, taurine, menaquinone.)

I also take some creatine, for this reason.

I've heard others say it helps with mood, energy, depression, etc. and if that's the case for some people then great. I don't notice it myself but that's just me. Not everyone has the same body chemistry.
Did you try higher dose. You need to take 0.35g/kg body weight for effects on brain, atleast thats the doses that are usually used in the studies. I believe your body will distribute it to your muscles before any goes to the brain, so you need to take a dose that will saturate your muscles and then have extra left over. I take 25grams whereas the usually reccomend daily dose is 5grams
I did a week trial at 20 or 25g/day once. This was after being on the standard weightlifter's 5g/day for a while so muscles should have been fairly saturated. Didn't notice any effect. 0.35g/kg dose seems like way more than our bodies would have ever had even in a prehistoric hunter's diet. For me that would be 30g/day.
I also have MTHFR gene mutations and sleep issues.

What exactly helped you?

As a vegan you dont get any creatine since you're not eating meat, so your body has to make it itself, which requires a ton of methylation and if you're like me and have bad genes for methylation your body had a hard time with it as it is. So by supplmenting creatine you're reducing some of that burden.

As far as sleep goes, high dose creatine has been studied to have an extermely positive effect on brain function during sleep deprevation, better than stimulants/caffine

I think the prescribed dosing for creatine and sleep deprevation is 0.35g per KG, much higher than the typically recommended dose of 5gs a day for muscle. The positive effects on the brain come at much higher doses. Which is perfectly safe for your kidneys, this is a myth (as long as you dont already have poor kidney function).

https://www.nature.com/articles/s41598-024-54249-9

https://pubmed.ncbi.nlm.nih.gov/16416332/

Also note, that if someone is going to start taking creatine they need to up their hydration - likely a lot.
That’s a pretty amazing acronym if real
Say MTHFR one more time, I dare you.

Never heard of the acronym though so not sure what the mutation implies.

For lifting you hit a saturation point quickly where your muscles will only hold so much of it. Not sure if there is an equivalent for any brain related effects.
I'm sure there's something for the brain too. The thing is, there's a floor for the brain. If your muscles aren't saturated already and you don't "megadose" (from a muscle perspective) then you won't see any cognitive effects it seems.
>CONFLICTS OF INTEREST

DC has conducted industry-sponsored research involving creatine supplementation and received creatine donations for scientific studies and travel support and speaking honoraria for presentations involving creatine supplementation at scientific conferences and on social media. In addition, DC serves on the Scientific Advisory Board for Alzchem and Create (companies that manufacture creatine products) and as an expert witness/consultant in legal cases involving creatine supplementation. NF declares no conflicts of interest

A nice unbiased study, I may as well ask Exon Mobil for their opinion on climate change at this point

High dosage is not for your daily intake

It’s called a loading phase to quickly saturate the tissues i.e for a week or so for someone who never took the creatine. You can absolutely skip this.

I wouldn’t go higher than 10g daily on a regular basis.

I personally take 7.5g for the last couple of years.

The entire point is that >10G is justified if you're going for cognitive effects. For muscles you don't need to go above 5G. For brain, >15G.
For now there are zero studies that I know of that support this.

The only ones are for sleep deprived.

There are a number of studies on the topic of varying quality but I think that's besides the point.

> It’s called a loading phase

This is not about a loading phase. "It's called a loading phase" indicates that the reason you would take high doses is for the muscular saturation that some people think is required. You're right that you can absolutely skip the loading phase, but that's not the point. The point is that you would take the higher dose for the cognitive effects.

Please give me a link to at least one study with verified cognitive benefits of high-intake creatine which is not for sleep-deprived case.
I'm not going to Google this for you, sorry! They're out there though.