"Is creatine bad for your heart" is three questions searched as one: whether it changes cholesterol, whether it changes heart rate and rhythm, and whether it changes the heart itself. Each has a different amount of evidence behind it. Cholesterol has been pooled; heart rate and structure have a handful of small trials; and long-term cardiac events have exactly one trial large enough to count them, which did not test them.
The short version
| Question | Best evidence | What it shows |
|---|---|---|
| Cholesterol and triglycerides | 2026 meta-analysis, 8 RCTs | No significant change; certainty very low to low |
| Heart structure | 1 echocardiography trial, 18 adults, 28 days | No change |
| Heart rate | Same trial; FDA reports | Max exercise heart rate −3.7%; 13 reports of raised rate |
| Blood pressure | Six controlled studies, days to weeks | No change — the six blood-pressure studies |
| Serious cardiac events over years | NET-PD LS-1, 1,741 people, ~4 years | 48 v 38 events, never tested |
| Heart failure | Small trials, 1990s–2012 | Mixed; nothing clinical |
Cholesterol: pooled, and flat
The most complete answer is a 2026 systematic review and meta-analysis that searched seven databases to June 2025 and pooled 8 randomised placebo-controlled trials (Gimenez et al., Front Nutr 2026, PMID 42180567):
| Lipid | Mean difference, creatine v placebo | 95% CI |
|---|---|---|
| Total cholesterol | +2.9 mg/dL | −7.4 to +13.2 |
| LDL cholesterol | +4.1 mg/dL | −2.6 to +10.7 |
| HDL cholesterol | −0.7 mg/dL | −3.9 to +2.6 |
| Triglycerides | +8.0 mg/dL | −13.7 to +29.6 |
None of the four differences is significant, and the review graded its own evidence very low (total cholesterol, triglycerides) to low (LDL, HDL), citing weaknesses in randomisation and reporting. That combination matters: the pooled data neither show a benefit nor exclude a modest shift.
The older claim that creatine lowers cholesterol comes mainly from one trial (Earnest et al., Clin Sci 1996, PMID 8774269). Thirty-four men and women aged 32–70 with total cholesterol above 200 mg/dL took 5 g of creatine with 1 g of glucose daily for 5 days, then twice daily for 51 days, or a glucose placebo. Within the creatine group, triglycerides (from 194 mg/dL) and VLDL fell by 23% and 22% at weeks 4 and 8 and stayed 26% lower four weeks after stopping. LDL, HDL and the cholesterol-to-HDL ratio did not differ between groups. It is a within-group result in 34 people, and the later trials pooled above did not reproduce a lipid effect. The 2011 type 2 diabetes trial that lowered HbA1c also found the lipid profile unchanged against placebo (PMID 20881878).
Heart structure and heart rate
Only one trial in healthy adults has looked at the heart directly (Murphy et al., J Sci Med Sport 2005, PMID 16248471). Eighteen adults took creatine (20 g a day for seven days, then 10 g a day for 21) or placebo, with echocardiography, blood pressure and exercise testing before, at day 7 and at day 28.
- Echocardiography: no change in any measure in either group.
- Blood pressure: no change.
- Heart rate: maximum heart rate during exercise fell 3.7% from start to finish in the creatine group; submaximal oxygen use fell 4.8–11.4% at fixed cycling loads.
Twenty-eight days in eighteen people says nothing about years of use. It is, however, the only direct measurement of the heart in healthy creatine users found for this page, and it points away from a short-term structural effect. Heart-rate variability and resting heart rate have been recorded as side measures in a few exercise trials since, without a trial designed around them.
The one trial big enough to count heart events
NET-PD Long-term Study 1 gave 10 g of creatine monohydrate a day or placebo to 1,741 people with early Parkinson disease across 45 sites and was stopped for futility on its Parkinson outcome after a median of about four years (JAMA 2015, PMID 25668262; NCT00449865). Its posted results list every serious adverse event by body system. We summed the cardiac ones on 2 November 2026:
| Serious cardiac event (posted terms) | Creatine (n = 874) | Placebo (n = 867) |
|---|---|---|
| Myocardial infarction | 12 | 8 |
| Atrial fibrillation | 9 | 4 |
| Cardiac arrest | 7 | 4 |
| Coronary artery disease | 4 | 3 |
| Congestive cardiac failure | 3 | 1 |
| Cardio-respiratory arrest | 3 | 1 |
| Bradycardia | 0 | 4 |
| All 25 cardiac terms combined | 48 | 38 |
| Any serious adverse event, all systems | 315 | 347 |
Read this carefully, because it is easy to over-read in either direction.
- The cardiac counts lean towards creatine — 48 against 38, about 5.5% against 4.4% if each event were a different person, which the posting does not guarantee.
- No statistical test of them was published, and with event counts this small a difference of ten could be chance. The trial was powered for a Parkinson outcome, not for heart events.
- Overall serious events ran the other way: 315 people on creatine against 347 on placebo had any serious adverse event.
- The population was older adults with Parkinson disease on 10 g a day, twice the amount on most supplement labels.
What this trial establishes is that the question is not closed by "no evidence of harm". It is the only long, large, randomised record of creatine and heart events, and its numbers have not been analysed for that purpose.
Heart failure: creatine studied as a treatment
On the hypothesis that energy supply in muscle is part of what limits people with heart failure, several groups tested creatine in them in the 1990s and 2000s. A 1998 trial gave 20 g a day for five days and found forearm muscle endurance at 75% of maximum grip improved, with less ammonia and lactate per contraction (Andrews et al., Eur Heart J 1998, PMID 9597411). A 2012 trial gave 33 men with class II–IV heart failure 5 g a day or maltodextrin for six months and found no difference in peak oxygen uptake, anaerobic threshold or six-minute walk distance (Carvalho et al., Arq Bras Cardiol 2012, PMID 22735863). No trial shows a cardiac benefit, and none was large enough to show harm.
What the FDA's reports hold
CAERS, the FDA's reporting system for foods and supplements, held 210 reports naming a product with "creatine" in its brand name on 2 November 2026. Thirty-two list a heart-related reaction, filed between 2004 and 2025:
| Reports | |
|---|---|
| Any heart-related reaction | 32 |
| A creatine product is the only suspect | 16 |
| Creatine product suspected alongside others (pre-workouts, fat burners, multi-packs) | 11 |
| Creatine only a concomitant product | 5 |
| Naming a raised or rapid heart rate | 13 |
| Naming myocardial infarction | 4 |
| Naming atrial fibrillation | 3 |
| Outcome recorded as death | 2 |
A single-suspect report shows that someone linked a heart symptom to a creatine product, not that the product caused it; the database cannot give a rate because nobody counts how many people use creatine without filing anything. Several of the 16 single-suspect products are themselves multi-ingredient "creatine" formulas. Brand names from the reports are not printed here.
What is not established
- Whether years of creatine use changes cardiac risk in healthy adults. No trial has been designed for it.
- Whether NET-PD's 48 v 38 cardiac events is a real difference. Never tested; small counts.
- Whether creatine affects heart rhythm. No trial has used continuous monitoring as an outcome.
- Whether creatine changes cholesterol at all. Pooled data say no significant change, at very low to low certainty.
Who should ask a cardiologist first
Anyone with coronary disease, heart failure, an arrhythmia including atrial fibrillation, a pacemaker or defibrillator, or anyone on heart medication. Some creatine labels say the same: the 1st Phorm warning names heart disease. People taking drugs dosed by kidney blood tests have a second reason, set out on creatine and medications.
Related reading: creatine side effects, creatine kinase (a heart and muscle blood marker, not the supplement), creatine and caffeine, is creatine bad for you?.
Sources and dates
- Gimenez FVM et al. Does creatine affect lipid profile? Systematic review and meta-analysis of randomized placebo-controlled trials. Front Nutr 2026;13:1787009. PMID 42180567, abstract read 2026-11-02.
- Earnest CP et al. Clin Sci (Lond) 1996;91(1):113–8. PMID 8774269.
- Gualano B et al. Med Sci Sports Exerc 2011. PMID 20881878.
- Murphy AJ et al. Effects of creatine supplementation on aerobic power and cardiovascular structure and function. J Sci Med Sport 2005;8(3):305–13. PMID 16248471.
- NET-PD LS-1: Writing Group for the NINDS Exploratory Trials in Parkinson Disease Investigators. JAMA 2015;313(6):584–93. PMID 25668262. Posted serious adverse events, cardiac organ system, ClinicalTrials.gov API v2 NCT00449865, read and summed 2026-11-02.
- Andrews R et al. Eur Heart J 1998;19(4):617–22. PMID 9597411.
- Carvalho AP et al. Arq Bras Cardiol 2012;99(1):623–9. PMID 22735863.
- FDA CAERS via openFDA food/event,
products.name_brand:creatine, 210 reports downloaded 2026-11-02; the 32 heart-related reports classified by product role.