Is Creatine Safe for Kids? What Parents and Practitioners Should Know

Creatine is one of the most extensively researched nutrients in sports, metabolic, and brain health, yet parents and practitioners alike have questions about its use in children and adolescents. In this episode, Dr. Kate Kresge speaks with Jeff Gladd, MD, Chief Medical Officer at Fullscript, to clarify how creatine functions in normal physiology, what the research shows about pediatric safety, and how clinicians can guide families with confidence. Together, they explore growth-related energy needs and practical clinical considerations—offering an evidence-informed framework for responsible conversations about creatine use in youth.

Is Creatine Safe for Kids? What Parents and Practitioners Should Know

• Creatine Supports Pediatric Energy Metabolism: Creatine is synthesized endogenously and obtained through diet, primarily from meat and fish. Average turnover is estimated at 2–4 g/day in adults, with children excreting approximately 14–15 mg/kg/day, reflecting ongoing metabolic demand during growth (Wang, 2018).
• Available Evidence Supports Safety in Healthy Youth: Although long-term pediatric-specific trials are limited, existing studies and decades of clinical use report no serious adverse events in healthy children and adolescents at typical doses (Kreider, 2017)
• Creatine Status Is Associated With Lean Mass and Bone Health: Lower creatine availability has been linked to lower lean mass accrual, lower bone mineral content, and less favorable body composition in youth (Korovljev, 2021).
• Clinical Context and Product Quality Are Key: Caution may be appropriate for individuals with known kidney disease. Professional-grade, single-ingredient creatine monohydrate is preferred over blends, which may contain unintended additives (Kreider, 2017).
• Emphasize a nutrition-first framework, with supplements as adjunctive support
• Review total protein and animal protein intake, especially in low-meat or vegetarian diets
• Assess caloric adequacy during growth spurts and high physical activity
• Adequate sleep and recovery during growth and training
• Balanced training loads to reduce overuse and endurance-related stress (Kreider, 2017).
• Creatine monohydrate is the most studied and evidence-supported form of creatine
• Professional-grade, third-party tested products, including NSF Certified for Sport® options for athletes. Practitioners can prescribe these through Fullscript (Kreider, 2017).
• Basic metabolic panel to assess renal function and electrolytes
• Body composition tracking when relevant
• Additional evaluation only when rare creatine synthesis or transport disorders are suspected (Kreider, 2017).
• 00:00 – Why creatine raises concerns for kids and teens
• 03:28 – How the body produces and uses creatine
• 05:39 – Low creatine availability and body composition
• 07:18 – Safety data and common side effects
• 09:07 – Addressing the “gateway supplement” myth
• 10:48 – Labs clinicians may consider for patients taking creatine
• 12:44 – Why supplement quality matters
• 13:45 – Choosing NSF Certified for Sport® creatine monohydrate
• 14:47 – Practical takeaways for families and clinicians
• Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017 Jun 13;14:18. doi: 10.1186/s12970-017-0173-z. PMID: 28615996; PMCID: PMC5469049.
• Wang W, Du C, Lin L, Chen W, Tan L, Shen J, Pearce EN, Zhang Y, Gao M, Bian J, Wang X, Zhang W. Anthropometry-based 24-h urinary creatinine excretion reference for Chinese children. PLoS One. 2018 May 23;13(5):e0197672. doi: 10.1371/journal.pone.0197672. PMID: 29791502; PMCID: PMC5965866.
• Korovljev D, Stajer V, Ostojic SM. Relationship between Dietary Creatine and Growth Indicators in Children and Adolescents Aged 2-19 Years: A Cross-Sectional Study. Nutrients. 2021;13(3):1027. Published 2021 Mar 23. doi:10.3390/nu13031027
• Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021 Feb 8;18(1):13. doi: 10.1186/s12970-021-00412-w. PMID: 33557850; PMCID: PMC7871530.
• Jagim AR, Stecker RA, Harty PS, Erickson JL, Kerksick CM. Safety of Creatine Supplementation in Active Adolescents and Youth: A Brief Review. Front Nutr. 2018 Nov 28;5:115. doi: 10.3389/fnut.2018.00115. PMID: 30547033; PMCID: PMC6279854.
• Geyer H, Parr MK, Mareck U, Reinhart U, Schrader Y, Schänzer W. Analysis of non-hormonal nutritional supplements for anabolic-androgenic steroids - results of an international study. Int J Sports Med. 2004 Feb;25(2):124-9. doi: 10.1055/s-2004-819955. PMID: 14986195.