Creatine supplementation may lead to short-term water retention, which can cause bloating. The body produces and stores creatine, an amino acid (protein building block) in food. As a supplement, it is used to improve muscle strength and lean muscle mass and address certain health problems.

Bloating is most common in the first few days of taking a creatine supplement in what’s known as a loading dose (a higher initial dose). During this time, the muscle cells can retain creatine and water, causing a short-term, harmless increase in water weight.

Creatine Loading and Bloating

While the amount of creatine you take as a supplement can vary based on individual factors such as age, body size, and goals, many people start creatine supplementation with a loading dose.

This loading dose can help people achieve their fitness goals quickly. A loading dose saturates your muscles with energy to help them achieve large gains faster rather than waiting for your creatine stores to build over time with smaller doses gradually.

A loading dose typically consists of the following:

• Consuming 20 to 25 grams of creatine daily for five to seven days.
• The doses are consumed in 5-gram portions taken four to five times daily.
• After a week of taking a loading dose, your muscles reach a creatine saturation point.
• Switch to the standard maintenance dose of 3 to 5 grams of creatine daily.

While creatine loading may help you achieve results faster, research indicates that this practice can also increase water retention and uptake, causing bloating in some people. This occurs because creatine draws water into your muscle cells.

As creatine levels increase during the loading phase, more water is pulled into your muscle cells to balance the creatine levels and water inside and outside your cells. As more water is retained, it can cause an increase in total body water, resulting in bloating.

How Creatine Bloating Feels and Looks

Creatine bloating occurs when water is retained in muscles. This type of bloating can feel and look different from gastric bloating, which is caused by intestinal gas or eating too fast.

Gastric bloating occurs in your abdomen when your gastrointestinal (GI) tract becomes filled with air or gas from food. Your stomach may feel full or tight. It can also cause abdominal distension (an abnormally swollen abdomen).

While symptoms of gastric bloating are limited to your GI tract, symptoms of creatine bloating from water retention can be more widespread. Bloating from water retention can occur in the muscles in your face, legs, feet, arms, and abdomen with the following symptoms:

• Sensations of heaviness or pain in your muscles
• Skin indentation (pitting) after pressing on an area of bloated skin
• Stretched or shiny skin
• Swelling or puffiness
• Weight gain

When Bloating Subsides

Creatine bloating is typically a short-term problem that does not lead to excessive or permanent water retention. You can expect the water retention to level off after a few weeks of consuming a standard maintenance dose. Creatine bloating also subsides if you decide to discontinue using the creatine supplement.

Self-Care With Creatine Bloating

Creatine bloating during the loading phase of supplementation is considered normal, though it may not affect everyone. While this type of short-term bloating is not harmful, you may be able to help reduce water retention and feel more comfortable with the following strategies:

• Reduce the amount of salt in your diet: Salt contains sodium, which naturally attracts water molecules and promotes water retention in your body.
• Drink more water: This allows your body to flush out excess salt and waste more easily.
• Follow your regular strength-training routine: Despite the appearance of swollen muscles, an improvement in strength will occur gradually.
• Increase movement: Regular exercise or movement can support the normal function of your circulatory system. This can help move fluid toward your lymphatic, urinary, and digestive systems for removal from your body.
• Wear compression socks, sleeves, or stockings: Wearing compression socks can increase the blood flow to your legs and arms to reduce swelling from water retention.
• Elevate your feet: Putting your feet up promotes fluid flow out of swollen ankle and foot muscles.

Prevention Tips

Creatine bloating is linked to creatine loading during the first five to seven days of use. While this practice can promote faster gains, skipping creatine loading can help prevent the risk of bloating.

You do not have to practice creatine loading to achieve the creatine saturation point your muscles need to gain strength. While skipping the loading dose can delay maximum intramuscular creatine storage, you can reach the benefits of creatine supplementation by starting with the maintenance dose and continuing to use that amount.

In one study, creatine accumulation was similar in participants who consumed 3 grams per day for 28 days and those who consumed 20 grams for six days.

Other tips to prevent creatine bloating include:

• Drink sufficient water throughout the day to remain well-hydrated. Consuming at least eight 8-ounce glasses of water daily helps flush out excess fluid and reduce bloating.
• Eat to avoid bloating by consuming adequate high-fiber produce and potassium-rich foods like bananas. Watermelon and other high-water-content fruits can also help you flush out sodium.
• Stretch out muscles to counter the effects of bloating. Applying slight extra pressure with compression garments or during stretching can help prevent swelling.

Other Side Effects

Most healthy people can tolerate the short- and long-term use of creatine supplementation. Research indicates that healthy people who consume up to 30 grams of creatine daily and those who take creatine for health conditions are not at risk of detrimental effects when creatine supplementation is used in these amounts.

Factors such as age, chronic health conditions, and medications may affect your risk of side effects. You have a greater risk of side effects from creatine if you consume this supplement in higher amounts or more frequently than directed. Potential side effects of creatine include:

Taking Creatine Safely

Over 1,000 studies have been performed on creatine supplementation in the form of creatine monohydrate. The results support creatine supplementation as a safe and effective practice that may provide health and performance benefits without adverse effects when taken in the recommended dosages.

To ensure you take creatine safely, consult your healthcare provider to confirm that you can use this supplement without a risk of adverse effects. Since creatine may interact with other medications, it is important to get medical advice before taking creatine if you use any of the following drugs:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Advil, Motrin (ibuprofen), Aleve, Naprosyn (naproxen), Bayer, Ecotrin, Bufferin (aspirin)
• Caffeine
• Diuretics (water pills that increase urine production to remove excess water and salt from your body)
• Tagamet (cimetidine)
• Nephrotoxic drugs (drugs that cause kidney damage)
• Probalan (probenecid)

You should not take creatine if you have a risk of kidney damage or have one of the following conditions:

• Arrhythmia (abnormal heart rhythm)
• High blood pressure
• Kidney disease
• Liver disease
• Purpuric dermatosis (a group of skin diseases in which inflamed tiny blood vessels called capillaries cause discoloration in the skin from blood leakage)

Since the safety and efficacy of creatine supplementation have not been well-researched in people under 19, the consumption of creatine by children and teens is controversial.

However, in a review of existing studies, researchers advised that creatine supplementation in children and adolescent athletes may be acceptable as an alternative to dangerous anabolic androgenic drugs (steroids) for athletes who are:

• Consuming a well-balanced diet designed to enhance performance
• Involved in serious or competitive supervised training
• Knowledgeable about ways to use creatine safely
• Taking creatine in the recommended dosage

Summary

Creatine bloating is a somewhat common short-term side effect of taking this supplement. It occurs because creatine draws water into the muscles to improve their strength and size.

Bloating usually occurs when taking a loading dose to help gain faster results and subsides with a lower maintenance dose. To reduce the risk of bloating, skip the loading dose and start taking the maintenance dose. Effects are the same but may occur more slowly.

While creatine is regarded as safe and has little risk of adverse effects, consult a healthcare provider before you start taking it or any new supplement.