More teens are using creatine, a muscle-building supplement, to improve their appearance and fitness. While experts say it is generally safe, some are expressing their concerns. Creatine is a natural substance found in human bodies that supports muscle growth and recovery. It can be easily bought without prescriptions at pharmacies, grocery stores and health stores. Over the past six months, Dr. Dina Kulik said she noticed more of her male teenage patients asking about creatine. “Creatine comes up pretty frequently in conversations with my patients, particularly athletes, as they want to increase their endurance and their strength, and they’re looking for a supplement that can help them achieve that,” Kulik, a pediatrician in Toronto and the founder of Kidcrew clinic, said in a video interview with CTVNews.ca on Wednesday. She said some coaches may have recommended it, or the teens were influenced to take it because their friends were using it. Kulik said she generally advises patients to be “cautious,” but so far, she hasn’t heard from anyone who had side effects. ‘They had body-image issues’ In the past few years, Dr. Mohammed Hassan-Ali said he has seen more preteen and teenage patients who have used creatine. “We’re seeing a lot of teenagers taking it as if it’s like a multivitamin,” he said in a video interview with CTVNews.ca on Thursday. Hassan-Ali, a pediatrician who works in the Toronto area, said he discourages patients from using creatine due to the lack of studies on whether it is safe for youth. “We typically do recommend that children and teenagers avoid these types of supplements, especially things like creatine,” he added. Hassan-Ali recalled a few months ago, he assessed a teenager for dehydration. The patient disclosed that he took more than the recommended amounts of whey protein and creatine, and that he wasn’t hydrating enough during high-intensity exercises. Hassan-Ali said this led to dizziness and fainting spells. “They were trying to improve their overall look and appearance, as they had body-image issues,” Hassan-Ali said. The patient told him that many of his friends were taking similar supplements and energy drinks, as well as going to the gym after school. “So, he felt that if he can do it as well and improve his overall look, he might feel more appealing to women and girls in this school,” he said. Hassan-Ali said he had a “frank conversation” with the patient about the side effects and provided resources. “It’s still important to advocate for healthy nutrition and exercise and hydration, and it’s also important for them to realize that there are people that they can talk to, rather than seeking some information online from unverified sources,” Hassan-Ali said. ‘Fairly safe to use’ Kyle Ganson, an associate professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work, said he recommends users – especially youth – speak to health-care providers, trainers, coaches and other trusted professionals about using creatine. “It’s a pretty well-researched dietary supplement, so generally it is fairly safe to use,” Ganson said in a video interview with CTVNews.ca on Tuesday, noting that the dietary supplement should be taken at an “appropriate dosage.” Ganson said he’s worried that young people would be looking for “shortcuts” to improve their performance, which could lead to use of riskier substances, such as peptides and steroids. “So, it could potentially become a bit of a slippery slope, I think, for young people who want to see appearance and performance gains quickly,” Ganson said. Creatine is a dietary supplement that is regulated under Canada’s natural health products legislation. Ganson said it is “relatively loosely regulated” compared to pharmaceutical products in Canada. “I think in general, a little more regulation around proving more safety and efficacy related to the products would be good from the ... manufacturer’s perspective as well,” he said, noting that purity testing would ensure there’s no contamination or adulteration during production. Impact of ‘looksmaxxing’ on young men According to a research paper co-authored by Ganson and published by Performance Enhancement & Health in 2024, nearly 44 per cent of study participants reported that social media influencers were “a primary influence” in their use of muscle-building supplements. Ganson, whose research includes muscle-building behaviours among adolescents and young adults, said creatine is a commonly used dietary supplement among young people, especially males. “The typical person that’s not really super invested in athletics, for example, likely isn’t taking creatine,” he said. “But for someone who is actively trying to improve their performance or build muscle, creatine is and can be an effective tool to do that, especially when done in conjunction with physical activity, weight training, proper nutrition.” Philip Veliz, a co-author of a University of Michigan study published in August on the surge of creatine use, suggested a link between the “looksmaxxing” trend and the rapidly growing popularity of the supplement among U.S. teens in recent years. The trend involves young men or boys who enhance their appearance through extreme measures, including breaking their facial bones, using steroids and getting plastic surgery. “There’s also this darker side of social media that’s taking it a little bit too far, to where there’s unrealistic expectations of what bodies should look like, and how you’re supposed to attain that,” Veliz, an associate research professor at the University of Michigan’s School of Nursing, said in a video interview with CTVNews.ca on Wednesday. While creatine has been effective for decades, Stuart Phillips, a kinesiology professor at McMaster University, warned that it’s expensive, only gives users “a small edge” and isn’t enough to help significantly improve someone’s athletic performance or health. In a video interview with CTVNews.ca on Tuesday, Phillips said other factors “would have a much greater impact” than creatine, such as going to the gym regularly, sleeping earlier at a regular time and avoiding junk food. “It’s a slight nudge when the exercise itself does the vast majority of the work, and the creatinine adds this sort of thin layer of benefit on top,” Phillips said. With files from CTV News’ Robin Della Corte
