Health, fitness and the supplement aisle.
Creatine · Answer
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.
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 |
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.
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.
Seek medical help immediately for swelling of the face, trouble breathing, severe abdominal pain or markedly reduced urine output.
| 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) |
Educational information, not medical advice. Speak to a doctor, pharmacist or registered dietitian before using supplements if you are pregnant or breastfeeding, under 18, taking medication, or living with kidney, liver or heart disease. Prices were observed in October 2026 and are not offers.