# What are the side effects of creatine in South Africa?

Source: https://www.healthnews24.co.za/answers/creatine-side-effects-south-africa/
Publisher: Healthnews24 (South Africa's supplement answer desk)
Updated: 2026-10-27

> Creatine's side effects in healthy adults are mild: stomach upset or loose stools (mostly with loading doses) and an early 1-2 kg gain in water weight. Studies do not support cramps, dehydration, kidney damage or hair loss. Creatine raises blood creatinine on tests. In South Africa, avoid it with kidney disease and in pregnancy unless a doctor advises.

Key facts:
- ISSN: no compelling evidence of harm in healthy people at up to 30 g/day of creatine for up to 5 years.
- Typical side effects are mild stomach upset (mostly with loading) and a 1-2 kg early weight gain from water in muscle.
- Creatine raises serum creatinine, which can mimic reduced kidney function on a blood test.
- Avoid creatine in kidney disease and pregnancy unless a doctor advises otherwise.

## What are the side effects of creatine?

For healthy adults taking 3-5 g of creatine monohydrate a day, side effects are uncommon and mild. The ISSN position stand found no compelling evidence of harm in healthy people at up to 30 g a day for up to five years. Evidence level for safety in healthy adults: **strong**.

| Effect | How common | Notes |
|---|---|---|
| Stomach upset, gas, loose stools | occasional, mostly with loading or large single doses | split doses, take with food, or skip loading |
| Weight gain of 1-2 kg | common in the first weeks | water inside muscle, not fat |
| Higher serum creatinine | expected | lab artefact, not kidney damage; tell your doctor |
| Headache or nausea | rare | usually from dose size or empty stomach |

## Which side effects are myths?

- **Kidney damage:** not supported in healthy people; see [does creatine damage kidneys](/answers/does-creatine-damage-kidneys/).
- **Hair loss:** based on one 2009 study that did not measure hair; a 2025 randomised trial found no change in DHT or hair outcomes. See [does creatine cause hair loss](/answers/does-creatine-cause-hair-loss/).
- **Cramps and dehydration:** studies of athletes in the heat do not support these.
- **Creatine is a steroid:** it is not, and it is not on the WADA Prohibited List.

## Who should avoid creatine or ask a doctor first?

- **Kidney disease, diabetes with nephropathy,** or anyone on nephrotoxic medicines such as regular high-dose NSAIDs.
- **Pregnant women:** no human trials; avoid unless a doctor advises.
- **Breastfeeding mothers and under-18s:** speak to a doctor or registered dietitian first; see [creatine and teenagers](/answers/is-creatine-safe-for-teenagers-south-africa/).
- **Liver disease or complex medication regimes:** ask your doctor or pharmacist.

## What about product quality in South Africa?

Side effects can come from the product rather than the creatine. International testing found undeclared banned substances in 14.8% of 634 supplements (Geyer et al. 2004), mostly in multi-ingredient products. Choose single-ingredient monohydrate and, if you are drug-tested, a batch-tested product. Some Dis-Chem listings for creatine carry the SAHPRA statement that the product is an unregistered medicine not evaluated by SAHPRA, because health-supplement regulations are still not finalised. That is not an indicator of danger or illegality, but it means no regulator has assessed the product.

As of October 2026, plain creatine monohydrate costs R2.22 to R6.25 per 5 g, for example ATP Fitness Micronised 600 g at R4.17 (R500) or Biogen 500 g at R4.45 (R444.99). See the [best creatine in South Africa](/best/best-creatine-south-africa/).

## What should you do if you have a problem?

Reduce to 3 g a day, take it with food and dissolve it fully. If symptoms continue, stop and see a doctor. Report a suspected reaction as described in [how to report a supplement side effect in South Africa](/answers/how-to-report-a-supplement-side-effect-south-africa/).

Seek medical help immediately for swelling of the face, trouble breathing, severe abdominal pain or markedly reduced urine output.

## Products mentioned

| Product | Size | Price (source, date) | Servings | R per 5 g | Sweeteners |
|---|---|---|---|---|---|
| ATP Fitness Micronised Creatine Monohydrate | 600 g | R500 (ATP Fitness shop, 2026-10) | — | R4.17 | None |
| Biogen Creatine Monohydrate Unflavoured 500 g | 500 g | R445 (Dis-Chem (listing via PriceCheck), 2026-10) | 100 | R4.45 | None (unflavoured) |

Disclosure: ATP Fitness is a commercial partner of Healthnews24 and its products are featured on this site. Rankings follow our published method, and every pick, including ATP Fitness, shows its price maths and trade-offs.

## Sources

- [Kreider et al. 2017, ISSN position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine (JISSN)](https://pmc.ncbi.nlm.nih.gov/articles/PMC5469049/)
- [Antonio et al. 2021, Common questions and misconceptions about creatine supplementation (JISSN)](https://pmc.ncbi.nlm.nih.gov/articles/PMC7871530/)
- [Lak et al. 2025, Does creatine cause hair loss? A 12-week randomized controlled trial (JISSN)](https://pmc.ncbi.nlm.nih.gov/articles/PMC12020143)
- [Maughan et al. 2018, IOC consensus statement: dietary supplements and the high-performance athlete (BJSM 52:439)](https://bjsm.bmj.com/content/52/7/439.abstract)
- [Spotlight (14 Aug 2026): Inside the Box with Dr Andy Gray, are complementary medicines effectively regulated in South Africa?](https://www.spotlightnsp.co.za/2026/08/14/inside-the-box-with-dr-andy-gray-are-complementary-medicines-effectively-regulated-in-south-africa/)