Emerging research suggests that creatine supplements may help improve symptoms of ulcerative colitis and other forms of inflammatory bowel disease.

Creatine is a naturally occurring amino acid that’s also available as an over-the-counter (OTC) supplement. It helps provide energy to tissues throughout your body, including your large intestine (colon).

Your pancreas, liver, and kidneys naturally produce creatine. You can also get it by eating certain animal proteins, such as fish and red meat. Some athletes take creatine supplements to enhance exercise performance.

While it’s not conclusive, current evidence suggests that creatine may be worth investigating as a complementary treatment for inflammatory bowel disease (IBD), including ulcerative colitis (UC).

Here’s what you need to know about creatine and UC and what important information to discuss with a doctor before taking creatine supplements.

UC is a type of IBD that affects the lining of your large intestine. It’s a chronic condition characterized by inflammation resulting from an immune system overreaction.

There’s currently no cure for UC. Treatment focuses on managing the symptoms and reducing the risk of complications.

Traditional medical treatments, such as medications, are standard. But complementary methods, such as creatine, are also being researched. Below are some of the possible ways that creatine monohydrate (the most common form of creatine) may help with UC.

Supplements may address low creatine levels in UC

UC is thought to be caused by a weakened intestinal barrier. This may be the result of several possible causes, such as an abnormal immune system reaction.

However, researchers also believe that people with UC are more likely to have low levels of creatine in their bodies than those without UC.

One 2020 study in mice suggests that creatine supplementation could potentially increase these levels and improve retention of creatine in intestinal cells. But human studies are needed to find out whether supplementation could play the same role in humans.

Creatine may improve barrier function

The authors of the same 2020 study hypothesize that low creatine levels in the body could possibly weaken the tissues lining the large intestine. In theory, this could cause a “leaky” barrier by making the barrier weaker over time. That could lead to inflammation, infections, and damage.

The authors note that creatine supplementation may help heal the damage UC causes in the large intestine, including associated ulcers.

Creatine may help reduce inflammation

UC and other forms of IBD are characterized by chronic inflammation. Some researchers suggest that creatine has anti-inflammatory effects that could possibly help treat UC.

However, while creatine may generally have anti-inflammatory effects, human studies are necessary to find out whether it has those effects on UC specifically.

Creatine may complement other UC treatments

Until health experts know more about the possible role of creatine supplements in UC prevention and treatment, researchers recommend them only as a complementary treatment.

This means a doctor might recommend creatine as part of your overall UC treatment plan. Traditional treatments for UC can include medications that reduce inflammation in your large intestine, such as immunosuppressants and corticosteroids.

A common side effect of creatine is unintentional weight gain due to water retention. If you’re concerned about this, talk with your doctor about ways you may be able to reduce possible weight gain when taking creatine.

Creatine may also have negative effects on kidney and liver function. If you have any history of kidney or liver disease, it’s important to talk with a doctor before taking creatine supplements.

Other possible (but uncommon) side effects associated with these supplements include:

Creatine is sold as an OTC supplement. Creatine monohydrate is the most common form. Less-studied forms include:

  • creatine ethyl ester
  • creatine hydrochloride
  • creatine magnesium chelate
  • creatine malate
  • micronized creatine

There’s currently no guideline for taking creatine supplements specifically for UC. One study was set to enroll human participants to compare the effects of 21 grams (g) of creatine monohydrate per day versus a placebo, but it was withdrawn in 2023.

When taking creatine to enhance exercise performance, athletes generally start with 5 g four times per day for an initial period of 5–7 days. After that, they may take a maintenance dose of 3–5 g per day.

Creatine is considered generally safe for adults to use at doses of 3 g per day for up to 4 weeks at a time. But more studies are needed to determine whether it’s safe to take creatine supplements for UC.

In particular, there’s a lack of research on using creatine for longer than 5 years at a time. This is something to consider if you’re thinking of taking creatine supplements as a long-term UC treatment.

Furthermore, as with other OTC supplements, the Food and Drug Administration does not regulate creatine supplements. If you’re interested in trying creatine, it’s important to consult your doctor to find out whether it might interact with any medications or supplements you currently take. Your doctor might also recommend a particular brand of supplements.

Since there’s no medical cure for UC, researchers are investigating possible complementary and alternative treatments for this chronic inflammatory disease of the large intestine. Creatine supplements are one possibility.

Early evidence suggests that creatine supplements may help increase the low creatine levels often seen in people with UC while helping improve the intestinal barrier. However, more human studies are needed to determine the safety and effectiveness.

Also, because creatine is sold as an OTC supplement, it’s important to check with a doctor about whether it’s safe for you to take.