What up, creatine savage!

Before we drag the kidney myth into the alley and make it explain itself under a flickering fluorescent light, quick housekeeping item.

Technically, the sale on the Complete Creatine Manual expired last night.

I extended it until this coming Monday at midnight PST.

Why?

That is not my normal move. I do not like deadline necromancy, fake scarcity, or dragging a sale corpse around the internet like some marketing department taxidermist with espresso breath...

...but my business email stopped working because the company managing it apparently wandered into the woods, joined a raccoon cult, and went out of business without telling me.

Thus I lost access to that entire account.

Long story short, I spent many, many hours stapling the system back together with duct tape, caffeine, and the kind of computer rage that makes your Apple mouse file a restraining order.

Then, because the universe has jokes, I crashed the Creatine eBook sales page in the process.

Yep -a clown car full of server errors, but 11+ hours later I know more than you ever want to know about DNS, servers, work around, DMARC, etc

Therefore ,the code DRMIKE save you 10 clams below

​https://creatine.miketnelson.com​

Now let us bury the kidney lie.

The Creatinine Panic Ritual

Picture this.

Your client walks into the gym Monday morning looking like they just saw Mike Mentzer's ghost doing reverse lunges in the squat rack.

"My doctor saw my bloodwork. Creatinine was high. He said stop the creatine."

You ask the obvious question because you are not a lab-coated panic button with shoes: was anything else off?

"Nope. Just that one number. He said my kidneys."

I have heard this story for the better part of two decades.

It crawls through gyms, coaching circles, Facebook groups, and wellness forums like a supplement rack parasite wearing a tiny stethoscope.

Creatine goes in.

Creatinine goes up a smidge.

Everyone screams "kidneys" as if the nephron police just kicked down the door.

Meanwhile, the physiology is sitting in the corner, exhausted, holding a clipboard, begging someone to read the darn mechanism.

The Boring Truth

Creatine inside your muscle is not a permanent tenant. It does not sign a lease, hang curtains, and live there forever.

A small fraction spontaneously degrades into creatinine every day - roughly 1.7% of the total pool - and your kidneys flush that creatinine into urine.

This is normal.

Your kidneys are not being attacked by creatine artillery. They are doing their job: clearing waste from the blood like a sanitation crew after a midnight metal festival.

Clinicians use serum creatinine as a proxy for kidney function because, under normal conditions, creatinine production is fairly stable.

When clearance drops, blood creatinine rises, and the lab throws up a flag.

Fine. Good. Useful.

Now add 5 grams per day of creatine.

You changed the input.

More creatine in the system means a little more creatinine coming out the other end.

The lab does not know you supplement. It only sees the number and grabs the nearest conventional explanation.

That is not kidney damage.

It is bookkeeping confusion dressed up like a crime scene.

What The Safety Literature Actually Says

The modern safety data does not whisper. It walks into the room with steel-toed boots and drops a stack of papers on the table with a loud boom.

Across controlled trials and adverse event analyses, creatine looks boring in the best possible way: side effects track similarly to placebo, with the usual human background noise - gut grumbles, headaches, random weirdness, the normal circus of being a mammal with opinions (Kreider et al., 2025).

A 2025 kidney-focused systematic review and meta-analysis reported a modest, transient bump in serum creatinine that is likely due to creatine-to-creatinine turnover rather than renal impairment, with kidney function preserved in the studied populations (Naeini et al., 2025).

Translation for the back row: the marker can move without the organ being damaged.

Highest Dose Ever ...For Years

The longest high-dose clinical record is the CREST-E Huntington disease trial: up to 40 grams per day, for years, under clinical monitoring (Hersch et al., 2017). The intervention did not slow Huntington disease progression, but the safety signal did not turn into a smoking crater either.

Dr. Darren Candow, who has spent his career neck-deep in this literature, put it bluntly:

"The entire body of evidence suggests it is probably the most safest, effective ergogenic aid that we can now take. And the potential downside is - what? I cannot find one."

I would phrase the grammar differently because my inner academic editor is a caffeinated raccoon with a red pen, but the point stands.

The Caveat - Because Adults Live In Reality

Creatine is not magic fairy dust you sprinkle on every human with a pulse.

There are populations where creatine can increase risk.

Chronic kidney disease stages 3-5. Single kidney. Polycystic kidney disease. Chronic nephrotoxic medication use. High-dose NSAIDs. Cyclosporine. Aminoglycosides.

Any case where the kidney picture is already messy enough that you do not want creatinine interpretation turning into a haunted spreadsheet.

As always, check with your doctor.

Your Move

The full myth autopsy - kidneys, hair loss, cramping, dehydration, and the "is it a steroid" nonsense - lives in Section 12 of the Complete Creatine Manual.

I also give you the language to use when a doctor, client, spouse, skeptical uncle, or creatinine-waving internet hall monitor starts yelling from the lab-value balcony.

Use code DRMIKE and grab it for $27 before this Wednesday at midnight PST

​https://creatine.miketnelson.com​

Much love,

Dr Mike

PS - Bonus myth busting for reading this far down. The hair loss panic comes mostly from one 2009 rugby study that measured DHT, not actual hair loss. That is the entire mansion built on a toothpick. Section 12 has the full autopsy, rubber gloves and all.

References

Hersch, S. M., Schifitto, G., Oakes, D., Bredlau, A.-L., Meyers, C. M., Nahin, R., Rosas, H. D., & the Huntington Study Group CREST-E Investigators. (2017). The CREST-E study of creatine for Huntington disease: A randomized controlled trial. Neurology, 89(6), 594-601.

Kreider, R. B., Gonzalez, D. E., Hines, K., Gil, A., & Bonilla, D. A. (2025). Safety of creatine supplementation: Analysis of the prevalence of reported side effects in clinical trials and adverse event reports. Journal of the International Society of Sports Nutrition, 22(1), 2488937.

Naeini, E. K., Eskandari, M., Mortazavi, M., Gholaminejad, A., & Karevan, N. (2025). Effect of creatine supplementation on kidney function: A systematic review and meta-analysis. BMC Nephrology, 26, 622.

_____________________

Mike T Nelson CISSN, CSCS, MSME, PhD
Associate Professor, Carrick Institute
Owner, Extreme Human Performance, LLC
Editorial Board Member, STRONG Fitness Mag

Mike T Nelson is a PhD and not a physician or registered dietitian. The contents of this email should not be taken as medical advice. It is not intended to diagnose, treat, cure, or prevent any health problem - nor is it intended to replace the advice of a physician. Always consult your physician or qualified health professional on any matters regarding your health.

..