We Asked a Doctor If Creatine Really Works Like a Steroid

Creatine has become a staple supplement for people who want to improve exercise performance and recovery. Still, some online chatter claims that creatine is a steroid and warns people to avoid it.

We asked Pieter Cohen, MD, an associate professor of medicine at Harvard Medical School and general internist at Cambridge Health Alliance, to clarify whether creatine supplements qualify as steroids.

*This interview has been edited and condensed for clarity.

Q: Is creatine actually a steroid?

Cohen: I wouldn’t consider creatine a steroid. Creatine is just a few linked amino acid precursors and acts much more like a micro-protein. It really has nothing to do with steroids like testosterone. The whole mechanism route, the way testosterone works, and its side effects, are completely different. 

Taking creatine or testosterone could make you stronger in specific situations, and I think this overlapping end result may create some confusion. I’m not saying that creatine will have the same effects as testosterone at all, but in terms of trying to help muscle strength, they’re both working on that same thing. 

Just remember that creatine and testosterone have very different mechanisms and safety profiles. I wouldn’t think about creatine as a steroid at all. Instead, think about creatine as an amino acid or a very small protein.

Is Creatine Safe Because It’s Naturally Occurring?

Creatine is quite safe. Some people experience gastrointestinal side effects, nausea, or headaches with creatine. But, creatine doesn’t have any of the dangerous side effects—like aggression, irritability, or sexual dysfunction—that are associated with steroids.

However, the reason creatine is safe is not that it is “naturally occurring.” Snake venom is naturally occurring, so whether or not something is “natural” has no effect on its safety.

Caffeine is also naturally occurring, extremely safe at normal doses, and frequently sold in supplements. But a teaspoon of pure caffeine could kill you. It’s all about the dosage.

Even though supplements may have “naturally occurring” ingredients, they are not well-regulated for ingredient quality or quantity before they are sold. You should check third-party verifiers, like USP, NSF, or NSF Certified for Sport, to ensure that the label actually matches what is in the supplement.

Does Creatine Actually Improve Workouts?

Taking creatine supplements on their own won’t do anything to improve strength. You have to take creatine with significant exercise to see some gains.

The great majority of ingredients sold as sports supplements have no proven benefit to improve strength, endurance, or anything else. But creatine is really an exceptional ingredient since it actually has some proven benefits. 

However, just because creatine is a safe supplement to try does not mean it is good to experiment with other types of sports supplements. I do not recommend taking pre-workouts or “natural” muscle-building supplements.