Creatine
Creatine is a naturally occurring compound found in small amounts in foods like red meat and fish and is also produced by the body. It is stored primarily in muscle cells, where it helps regenerate ATP, the main energy source used during short, high-intensity activities. Because of this role, creatine is commonly used as a supplement to improve strength, power, and exercise performance. It is also studied for potential benefits in muscle recovery, aging, and certain neurological conditions.
-
This page summarizes anecdotal reports and community observations, not medical evidence. Reports may be incomplete, biased or inaccurate and are not medical advice or recommendations. “Risk” here refers to how frequently severe or prolonged symptom worsening is reported, not to proven causation or population-wide probability. Individual responses vary widely, and absence of issues in some users does not rule out significant reactions in others.
-
Within PFS/PSSD/PAS communities, creatine is discussed in relation to its potential interactions with androgen signaling pathways. There is human data suggesting creatine supplementation can increase DHT in some individuals, which suggests creatine may influence androgen signaling. Since many people with PFS/PSSD/PAS describe instability around androgen signaling, neurosteroids (e.g., allopregnanolone), and downstream nervous-system tone, creatine's effects on cellular energy buffering (phosphocreatine/ATP dynamics) and potential DHT modulation may interact with pathways that are already dysregulated in these conditions.
-
Reports of Flares and Sometimes Lasting Worsening (for PFS/PSSD/PAS):
Among individuals who already have PFS/PSSD/PAS, creatine is approached with moderate caution as it is cited in community reports as preceding symptom worsening, with accounts describing both acute exacerbations and longer-lasting declines in baseline. Although the severity and duration of these reactions vary between individuals, reports within this subgroup show a largely consistent direction toward worsening rather than improvement. In light of this pattern, many within the community view creatine as carrying a meaningful risk for those with established PFS/PSSD/PAS, even in the absence of controlled data.
For individuals without these conditions, creatine is widely used and generally well tolerated at standard doses, though individual reactions still vary.
Evidence basis: General sports nutrition literature; a limited number of human findings suggesting possible DHT changes in some contexts; anecdotal reports (online forums, self-reports); no controlled studies examining PFS/PSSD/PAS-specific outcomes.
-
Flare ( Reported, Often Reversible)
Crash / Baseline Drop (Reported)
Flare ( Reported, Often Reversible)
Crash / Baseline Drop (Reported)
Public comments reflect individual experiences and opinions. They are not medical advice and may not be accurate or representative.