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.


Clinical Takeaways from This Episode

• 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).

Guest Introduction

Jeff Gladd, MD is a practicing integrative physician at GladdMD and the Chief Medical Officer at Fullscript. He specializes in translating nutrition and metabolic research into practical, evidence-informed clinical decision support for healthcare professionals.


Labs, Nutrition, and Lifestyle Support


Nutrition & Lifestyle Foundations Discussed

• 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 Supplement Quality

• 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).

Labs to Consider When Clinically Indicated

• 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).

Key Moments from the Episode

• 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
  
  

Clinician FAQ: Creatine Use in Children and Adolescents


Is creatine naturally present in the body?
Yes. Creatine is synthesized daily from amino acids and obtained from dietary sources, supporting normal cellular energy metabolism (Kreider, 2017).


Is creatine considered safe for kids and teens?
Available evidence suggests creatine is well-tolerated in healthy youth at usual doses, though long-term pediatric-specific data remain limited (Kreider, 2017) (Jagim, 2021).


Who should use creatine with caution?
Individuals with known kidney disease or fluid balance concerns may warrant closer clinical evaluation (Antonio, 2021).


Are labs required before starting creatine?
Routine labs are not necessary, though a basic metabolic panel may be considered in select cases (Kreider, 2017).


Why is supplement quality emphasized?
Risks are more commonly associated with blends or pre-workout supplements that contain other / unlisted ingredients, not creatine monohydrate itself (Geyer, 2004).

Want to elevate your practice? The Root Cause Medicine Podcast is sponsored by Fullscript, a comprehensive care delivery platform designed to support whole-person, integrative healthcare. Fullscript allows clinicians to streamline supplement dispensing, lab ordering, and patient education in one centralized system. For practitioners, Fullscript offers access to professional-grade supplements, evidence-informed protocols, and lab integrations that can support more efficient treatment planning and follow-up. For patients, it provides a clear, organized way to receive recommendations, manage refills, and stay engaged in their care. 
Disclaimer


The views expressed on this podcast are those of the hosts and guests and don’t necessarily reflect those of Fullscript or any affiliated organizations. This podcast is for informational and educational purposes only and is not intended to be medical advice. For your safety, always consult a qualified healthcare provider before making changes to your health routine.


Citations

• 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.