Creatine and GLP-1 Medications: What the Research Shows

The short answer: creatine monohydrate is one of the best-studied supplements for strength and lean mass, but the benefit comes when it is paired with resistance training. No randomized trial has yet reported whether it protects muscle in people taking Zepbound, Wegovy or another GLP-1 medicine, so it is an option to discuss with your clinician, not a proven add-on. Protein and strength training come first.

Losing a lot of weight on a GLP-1 medicine usually means losing some lean mass along with fat. In a body-composition substudy of the Zepbound trial SURMOUNT-1, about 25% of the weight lost was lean mass (Look et al., 2025). Patients often ask whether creatine can help. This article sets out what the research shows, what it does not, and how to use creatine more safely if you and your clinician decide to try it. Our article on muscle loss on GLP-1 medications explains the bigger picture.

What creatine is, and how it differs from creatinine

Creatine, usually sold as creatine monohydrate, is a compound your muscles use to regenerate ATP, the fast energy that powers short, intense efforts such as lifting. Taking it raises the amount stored in muscle, which can let you do a little more work in each training session. Over weeks, that extra work is thought to add up to more strength and lean mass.

Creatine is not creatinine. Creatinine is a waste product that your kidneys filter, and a high blood level can signal reduced kidney function. Taking creatine is not the same as ingesting creatinine, but, as explained below, it can nudge a creatinine blood test upward. That matters if you have lab work.

What the research shows

Almost all research on creatine comes from healthy adults who were not taking GLP-1 medicines. Taken together, the studies below point the same way: creatine plus resistance training does better than resistance training alone, by a modest amount.

Study	Who and how long	What it found
Wang et al., 2024 (23 trials)	Healthy adults under 50 doing resistance training for 4 to 12 weeks	Upper-body strength gains were 4.43 kg greater and lower-body strength gains were 11.35 kg greater with creatine than with placebo.
Delpino et al., 2022 (35 trials, 1,192 people)	Randomized trials in adults, analyzed by exercise type, sex and age	Lean body mass rose 1.10 kg more with creatine during resistance training. Without exercise the gain was 0.03 kg, with no clear effect. Men gained 1.46 kg; the 0.29 kg gain in women was not statistically significant.
Chilibeck et al., 2017 (22 trials, 721 people)	Adults 50 and older (average ages 57 to 70) doing resistance training	Lean tissue mass rose 1.37 kg more with creatine. Chest-press and leg-press strength also improved more.
Pinto et al., 2016	Older adults, 12 weeks of resistance training	Lean mass increased more with creatine (P = 0.02). Strength and bone measures did not differ between groups.
Burke et al., 2023 (10 trials)	Healthy adults, at least 6 weeks of training	A very small effect on direct measures of muscle size, favoring creatine. The statistical ranges included zero, so the result is small and uncertain.

Is it just water weight? Partly. Creatine draws water into muscle cells, and body scans count that water as lean mass, so some of the early gain is water. The studies that measured muscle size directly (Burke) or strength (Wang, Chilibeck) suggest that some of the benefit is real muscle and strength, but it is modest. Creatine is a boost to training, not a substitute for it.

Does creatine help if you take a GLP-1 medicine?

We do not know yet. As far as we can find, no randomized trial of creatine in people taking GLP-1 medicines has reported results. One is registered: a University of Saskatchewan study of adults who are starting a GLP-1 medicine and doing 12 weeks of resistance training, with either creatine or placebo (NCT07625202; completion expected in 2027). Until results are in, everything above comes from people who were not taking these drugs, and the findings may not carry over.

Creatine also needs training to do much. In the analysis above, people who took it without exercising gained no meaningful lean mass. If you are not lifting yet, start there. The federal Dietary Guidelines for Americans 2025–2030 give a general protein goal of 1.2 to 1.6 grams per kilogram of body weight per day, and our eating guide for Zepbound and Wegovy shows how to reach it. Our dumbbell alternatives article covers strength training at home.

If you decide to try it: dose and timing

• Dose: 3 to 5 grams of creatine monohydrate once a day, or about 0.1 gram per kilogram of body weight, is the amount most studies used (Antonio et al., Chilibeck et al.).
• Loading: most of the older-adult trials started with about 20 grams a day for 5 to 7 days before dropping to the daily dose. Others used a fixed daily dose. Because stomach upset was reported in some trials and nausea is common on GLP-1 medicines, a steady daily dose without a loading phase is the simpler choice for most of our patients.
• How: take it with food and fluids, at the same time each day. Choose plain creatine monohydrate, the form with the most research behind it, from a brand that uses independent third-party testing, since supplements are not regulated like medicines.

Safety, kidneys and blood tests

In healthy adults, studies at standard doses have not found kidney harm. Five of the older-adult trials in the Chilibeck analysis measured liver or kidney function and found no adverse effects, and a 3-month randomized trial in healthy young men taking about 10 grams a day found no sign of kidney dysfunction (Eur J Appl Physiol, 2008). A 2021 expert review calls creatine relatively well tolerated at recommended doses. Most of this research is in healthy people, though, so two points matter more if you take a GLP-1 medicine.

It can raise a blood creatinine test

Your body converts some creatine to creatinine, so supplements can raise serum creatinine slightly without any kidney damage. That can make a routine blood test look like kidney function has fallen. Tell any clinician who orders blood work that you take creatine. If the numbers are unclear, another marker, cystatin C, can be checked. In the 3-month trial above, cystatin C did not rise with creatine.

Dehydration is the bigger concern

GLP-1 medicines can cause vomiting, diarrhea and reduced drinking, and their labels warn about acute kidney injury from fluid loss. The Zepbound label tells prescribers to monitor kidney function in patients who have side effects that could lead to volume depletion. If you are vomiting, have diarrhea or cannot keep fluids down, pause creatine and call us. Our hydration guide explains how to stay ahead of fluid loss.

Other effects

Creatine can cause short-term water retention and bloating when you start, which may raise the number on the scale for a while. Track your waist, your strength and how your clothes fit, not the scale alone. Stomach upset and muscle cramps were reported in a few of the older-adult trials.

Ask us before starting if you have

• Kidney disease, or lab results showing reduced kidney function.
• Medicines that can harm the kidneys.
• Frequent vomiting or diarrhea, or trouble drinking enough fluid.

Common questions

Is creatine the same as creatinine?

No. Creatine is a supplement your muscles use for energy. Creatinine is a waste product your kidneys filter. Creatine supplements can raise a creatinine blood test slightly, which is why you should tell your clinician you take them.

Will creatine help me keep muscle on Zepbound or Wegovy?

It is not proven. Creatine plus strength training builds strength and lean mass in healthy adults, but no randomized trial has yet reported results in people taking GLP-1 medicines. Protein and resistance training are the proven steps.

Will creatine make me gain weight?

It can add a little water weight early on. That is not fat. If the scale rises after you start, check your waist and strength before assuming your weight loss has stalled.

Do I need a loading phase?

No. Many trials used one, and others used a steady daily dose. A daily 3 to 5 grams without loading is simpler and is easier on the stomach for most people.

Is creatine safe for my kidneys?

In healthy adults at standard doses, studies have not found kidney harm. If you have kidney disease, take medicines that affect the kidneys, or are dehydrated from vomiting or diarrhea, talk to your clinician first.

Does creatine work without exercise?

Not in any meaningful way. In the largest analysis above, people who took creatine without exercising gained no clear lean mass.

What should I do first to protect muscle?

Eat enough protein, spread across the day, and lift or do resistance exercise two to three times a week. See our eating guide and our article on muscle loss on GLP-1 medications.

The bottom line

Creatine is a well-studied supplement that modestly improves strength and lean mass when combined with resistance training. Whether it helps people taking GLP-1 medicines keep muscle has not been tested yet. If you want to try it, use plain monohydrate at 3 to 5 grams a day, tell your clinician so your kidney labs are read correctly, drink enough fluid, and pause it if you are vomiting or dehydrated.

How BeLite can help

If you are thinking about adding creatine, we can review your protein intake, your strength-training plan, your fluid intake and your kidney lab results, and decide together whether it makes sense. See the medicines we prescribe on our Our Medications page, including Zepbound and Wegovy.

Last medically reviewed: November 5, 2026. This article is for general education and is not a substitute for medical advice.

References

1. Wang Z, Qiu B, Li R, et al. Effects of creatine supplementation and resistance training on muscle strength gains in adults <50 years of age: a systematic review and meta-analysis. Nutrients. 2024;16(21):3665. mdpi.com
2. Delpino FM, et al. Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: a systematic review and meta-analysis of randomized clinical trials. Nutrition. 2022;103-104:111791. PubMed
3. Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med. 2017;8:213-226. PubMed Central
4. Pinto CL, Botelho PB, Carneiro JA, Mota JF. Impact of creatine supplementation in combination with resistance training on lean mass in the elderly. J Cachexia Sarcopenia Muscle. 2016. doi:10.1002/jcsm.12094
5. Burke R, Piñero A, Coleman M, et al. The effects of creatine supplementation combined with resistance training on regional measures of muscle hypertrophy: a systematic review with meta-analysis. Nutrients. 2023;15(9):2116. PubMed Central
6. Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021;18(1). jissn.biomedcentral.com
7. Effects of creatine supplementation on renal function: a randomized, double-blind, placebo-controlled clinical trial. Eur J Appl Physiol. 2008;103(1):33-40. PubMed
8. Look M, Dunn JP, Kushner RF, et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27:2720-2729. PubMed
9. Eli Lilly and Company. Zepbound (tirzepatide) prescribing information, section 5.3, Acute Kidney Injury Due to Volume Depletion (revised 8/2026). DailyMed
10. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2025–2030 (released January 7, 2026). Full document (copy hosted by NMSU Extension)
11. University of Saskatchewan. Creatine Supplementation During GLP-1a Therapy. ClinicalTrials.gov NCT07625202. ClinicalTrials.gov