Is Creatine Bad for Gout? Creatine, Creatinine and Uric Acid

TL;DR

• Creatine is not a purine, pure creatine monohydrate adds no purines, and no study has linked it to gout flares.
• Its effect on uric acid is barely studied: one small trial saw a larger rise during hard training (placebo rose too), and a 21-month study found no clinically significant changes in blood markers.
• It can nudge serum creatinine up, which can make your kidneys look worse on paper. Tell your doctor, especially if you have kidney disease.

Creatine is not known to be bad for gout. It isn’t a purine, pure creatine powder contains no purines, and there’s no research linking it to gout flares. The two real caveats are that almost no one has studied it in people with gout, and that it can change the kidney blood test your doctor relies on.

Most of the worry comes from three similar-sounding words: creatine, creatinine and purine. Once they’re untangled, the picture gets much clearer.

Creatine vs. Creatinine vs. Purines: What’s the Difference?

	What it is	Where it comes from	Why it matters for gout
Creatine	An energy buffer stored mostly in muscle	Made in the liver and kidneys from arginine and glycine; also in meat and fish; supplements	Not a purine; doesn’t become uric acid
Creatinine	The waste product of creatine breakdown	About 1–2% of muscle creatine converts to it each day	Used to estimate kidney function, which affects uric acid clearance and medication doses
Purines	Building blocks of DNA, RNA and ATP	Your own cells, plus meat, seafood, beer	Broken down into uric acid

About 95% of the body’s creatine sits in skeletal muscle, according to the International Society of Sports Nutrition’s position stand. A body needs to replace roughly 1 to 3 g a day, and about half normally comes from food. A pound of uncooked beef or salmon provides about 1–2 g.

That food source is worth noticing. Beef and salmon are also high in purines (Urica’s chart lists raw sirloin at about 110 mg and raw salmon at about 250 mg per 100 g; published salmon analyses range from about 120 to 260 mg). A creatine supplement delivers the creatine without the purines, so for someone with gout it’s arguably a cleaner source than eating extra beef.

Does Creatine Raise Uric Acid?

There’s very little direct evidence, and what exists points in different directions.

• A 2012 trial in 26 elite handball players added creatine (20 g a day for five days, then 5 g a day) or placebo to 32 days of resistance training. Uric acid rose in every group: from 4.6 to 7.4 mg/dL with creatine, 4.4 to 6.7 mg/dL with placebo and 5.1 to 6.7 mg/dL in players who took nothing, though only the creatine group’s rise was statistically significant, and it was significantly larger than the no-supplement group’s. The authors attributed the rise to the metabolic stress of intense resistance training, which they suggested creatine may amplify.
• A 2003 study of 98 college football players followed creatine users for up to 21 months. Across a 69-item panel of blood and urine markers, there were no clinically significant differences between users and non-users.
• A 2014 study of 12 athletes taking 12 g a day for 15 days found that purine breakdown products in the blood (hypoxanthine plus uric acid) tended to be lower before running, though not significantly.

Two takeaways. First, hard training itself can raise uric acid, as the placebo group in the handball trial showed. Second, nobody has tested creatine in people with gout or high uric acid. If you start taking it, a urate test a couple of months in will tell you more than the research can. See our uric acid levels chart for how to read the result.

Why Does Creatine Affect Kidney Blood Tests?

Creatine turns into creatinine at a steady rate, so taking more creatine can raise the creatinine in your blood. Labs use creatinine to calculate eGFR, the standard estimate of kidney function. A higher creatinine therefore makes your kidneys look like they’re filtering less, even when they aren’t.

The research on this is fairly consistent:

• A 2026 meta-analysis of 20 randomized trials found that creatine raised serum creatinine by about 0.13 mg/dL on average, with no significant difference in blood urea or eGFR.
• A 2023 review concluded that when kidney function is measured with methods that don’t depend on creatinine, such as measured GFR or cystatin C, creatine supplements haven’t been shown to harm the kidneys.

This matters more for gout than for most people. Kidney function guides gout care: the American College of Rheumatology’s 2020 guideline, for example, advises considering even lower starting doses of allopurinol in chronic kidney disease. An unexplained creatinine bump could lead to confusion, extra tests or a more cautious dose. The fix is simple: tell your doctor you take creatine, and ask whether a cystatin C test would give a clearer picture.

What If You Already Have Kidney Disease?

This is where caution is warranted. The studies showing no kidney harm were mostly in healthy people. The 2023 review said further studies in people with pre-existing kidney disease are still needed, and the ISSN notes that some researchers suggest people with kidney disease consult their physician before taking creatine.

Gout and chronic kidney disease often travel together, and each can make the other worse. See gout and kidney disease for how they interact. If your eGFR is reduced, make creatine a conversation with your nephrologist or rheumatologist rather than a solo decision.

Does Creatine Dehydrate You?

The evidence says no. Creatine draws a little water into muscle. The ISSN notes that loading can cause short-term fluid retention of about half a liter to a liter, which is why the scale often moves up early on. Studies in athletes found creatine users reported no more, and sometimes fewer, cramps and heat-related illnesses than non-users.

Hydration still matters for gout, though, especially when you train hard. Sweat losses concentrate uric acid, and your kidneys need water to clear it. See dehydration and gout flares.

How to Take Creatine If You Have Gout

• Choose plain creatine monohydrate. Skip “pre-workout” blends with added sugar, and check the label for extras you don’t need.
• Skip the loading phase if you prefer. The ISSN notes that 3–5 g a day raises muscle creatine stores over 3–4 weeks without a high-dose loading week.
• Tell your doctor before your next blood test, and mention it whenever your kidney function is checked.
• Recheck your urate after a couple of months to see whether anything changed for you.
• Drink water around training, and ease into new, intense programs, since hard training can raise uric acid.
• Watch your overall protein sources. If you pair creatine with a shake, see is protein powder bad for gout.
• Talk to your doctor first if you have kidney disease or take several medicines.

The Bottom Line

Creatine isn’t a purine, pure creatine adds no purines, and there’s no evidence linking it to gout flares. Its effect on uric acid is barely studied: one small trial saw a larger rise during intense training, while a 21-month study found no clinically meaningful changes. The clearest real-world effect is on kidney blood tests, where creatine can raise creatinine and make kidney function look worse than it is. If you have gout and want to take creatine, use plain monohydrate at a modest dose, stay hydrated, recheck your urate, and keep your doctor informed, especially if your kidney function is already reduced.

Sources

• Kreider RB et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine (2017)
• Longobardi I et al. Is it time for a requiem for creatine supplementation-induced kidney failure? A narrative review (Nutrients 2023)
• Tsiaras A et al. The effect of creatine supplementation on kidney function: a systematic review and meta-analysis of randomized controlled trials (Journal of Renal Nutrition 2026)
• Percário S et al. Effects of creatine supplementation on oxidative stress profile of athletes (Journal of the International Society of Sports Nutrition 2012)
• Kreider RB et al. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes (Molecular and Cellular Biochemistry 2003)

This article is for informational purposes only and is not medical advice. Talk to your rheumatologist or healthcare provider about your specific situation.