Creatine is a naturally occurring compound produced in the liver, kidneys, and pancreas, primarily stored in skeletal muscle tissue. It functions as a rapid energy source, helping to regenerate adenosine triphosphate (ATP), the body’s primary energy currency during short bursts of high-intensity activity like sprinting or weightlifting. Creatine is also consumed through the diet, mainly from red meat and fish, and is widely available as a supplement, typically as creatine monohydrate. High school athletes often consider using creatine to gain a competitive edge, prompting scrutiny into its safety and efficacy for a developing population.
The Science of Creatine in Adolescent Physiology
The primary concern regarding creatine use in high school athletes stems from the lack of long-term safety data in populations under 18. Most research confirming creatine’s safety has been conducted on healthy adults, and these findings cannot be directly applied to a body still undergoing puberty and growth. Adolescence involves rapid changes in skeletal muscle mass and hormonal levels, making the effects of supplementation on developmental processes largely unknown.
While short-term studies report no adverse events, the potential for long-term health risks remains a significant knowledge gap. There is a theoretical concern that creatine metabolism, which occurs in the kidneys and liver, could place an undue strain on these developing organs. Although no evidence of kidney damage has been found in healthy individuals taking creatine, the supplement can transiently increase serum creatinine levels, which complicates medical assessment of kidney function.
Creatine is an osmotically active substance, meaning it pulls water into the muscles, which contributes to an increase in lean body mass. This rapid body composition change raises theoretical risks regarding the effect on developing growth plates and musculoskeletal development, requiring further investigation. While this osmotic effect traditionally raised concerns about dehydration and thermoregulation, recent reviews suggest that creatine, when taken at recommended dosages, does not appear to hinder the body’s ability to dissipate heat or negatively affect fluid balance.
Performance Efficacy and Acute Side Effects
The motivation for high school athletes to use creatine is the expectation of improved performance, but the evidence for consistent, significant benefits in this specific age group is limited. Studies conducted on adolescents often feature small sample sizes and are of short duration, making it difficult to draw definitive conclusions about its effectiveness in youth sports. While creatine may offer benefits for quick, explosive movements, its impact on long-term strength gains or sports requiring endurance is often inconclusive in this population.
Acute, short-term side effects are frequently reported by users, especially when following aggressive initial “loading” protocols. The most common adverse effects include gastrointestinal distress, such as stomach cramps, diarrhea, and nausea. The osmotic effect of creatine also leads to water retention, which typically results in a temporary increase in body weight.
The response to creatine supplementation is highly variable among individuals, and this variability may be more pronounced in minors whose bodies are still maturing. For an adolescent with a well-developed training program and an optimized diet, the marginal performance benefit gained may not justify the potential risks and common side effects. The lack of robust evidence means that the cost-benefit analysis often leans toward caution for this age group.
Guidance from Athletic Organizations and Nutritional Alternatives
Major medical and athletic organizations generally advise against creatine use for individuals under 18 due to the uncertainty surrounding its long-term effects on a developing body. The American Academy of Pediatrics, for instance, does not recommend creatine or other performance supplements for minors, primarily because of the lack of sufficient long-term safety data. High school athletic associations typically follow this guidance, discouraging the use of such supplements among their student-athletes.
Limited regulatory oversight is an important factor in supplement use. Dietary supplements are not subjected to the same rigorous Food and Drug Administration (FDA) approval process as prescription medications before they are marketed. This means that the purity and potency of products can vary, and there is a risk that supplements may be contaminated with undeclared, potentially harmful, or banned substances.
For high school athletes seeking to enhance their performance and body composition safely, the most effective strategy is a food-first approach. Optimizing dietary intake of natural creatine sources, such as red meat and certain fish, can help maximize muscle stores without the risks associated with supplements. Focusing on proper nutrition, adequate sleep, and a structured strength and conditioning program remains the safest and most proven path for achieving athletic goals during adolescence.