Creatine is buzzing all around the internet right now, from every direction. I swear I can’t go online and not see someone pushing creatine on consumers and trying to sell you their brand of “the best creatine on the market”.

But is creatine necessary and useful for everyone? What about those with sensitive guts, leaky gut, GERD, or rosacea?? I needed answers, so I went to work digging for clues to that question. What did I find? That there is not much research to answer my question is what I found.

SO why is everyone pushing creatine, and what IS it exactly?

“A compound formed in protein metabolism and present in much living tissue. It is involved in the supply of energy for muscular contraction.

The monohydrate form of creatine similar or identical to endogenous creatine produced in the liver, kidneys, and pancreas. Creatine, in phosphate form, helps supply energy to muscle cells for contraction. After intense effort, when ATP deposits are depleted, creatine phosphate donates phosphate groups toward the fast synthesis of ATP. Dietary supplementation with creatine may improve muscle wasting associated with cancer and other chronic diseases ” – NIH

Athletes and those who are focused on performance have been using creatine to help boost performance for many years, but there has been a resurgence in the past couple years and a boom of influencers promoting it. I even saw a creator who is in the autoimmune community promoting a brand today—which what spurred me to write this.

Who is creatine NOT for? Is it safe for those with GI issues like leaky gut? Roscea or HSV that causes cold sores?

While I couldn’t find any research to give me a definitive answer, I came across several Reddit threads of people claiming that they noticed more cold sore outbreaks, as well as reflux. Of course, these are personal reports, not clinical trials — but they can still give us clues.

In one study on mice I found, scientists saw I decrease in outbreaks over genital herpes when creatine was introduced—but not in humans. It is really hard to determine since there are some people who claim an “antacid ” effect from creatine, while others claim it exacerbated their symptoms.

What about rosacea? This is a topic I could find ZERO answers on. But to me it makes sense that it could potentially cause flare ups in some people because of the nitric oxide production creatine causes. That vasodilation is great for delivering oxygen and nutrients to muscles, but in someone with rosacea, it may translate into facial flushing, heat, or redness.

I’ve experience this with other supplements. For example, L-glutamine is recommended for repairing the gut but it caused my rosacea to flare up to the point my face felt like it was on fire and was beet red. That is my body’s way of saying “this doesn’t work for me”, so I immediately stopped using it even though it was recommended to me to help repair my gut.

So what is the bottom line on creatine?

My opinion is that if you are a sensitive individual, or experience cold sores, reflux or rosacea, to be cautious and start VERY small. Everyone’s body is different, and will react differently to any kind of supplement. What works well for sone, may not for others. It’s also wise to ask your primary care physician before starting any supplement, since they know your health history as well as any medications you may take. They can help you decide if creatine is a good fit — or if there’s a better option for your goals.

The following tips are based on what we know from creatine research, sports nutrition best practices, and real-world experiences — but they aren’t guaranteed to prevent symptoms. Use them as a starting point, then adjust based on your body’s feedback:

• Choose pure creatine monohydrate with no added flavors, sweeteners, or fillers.
• Start with 1–2 grams per day instead of a large “loading phase.”
• Take it with food and a full glass of water to support digestion.
• Include lysine-rich foods if you’re prone to cold sores. Beans are a great way to get lysine in.
• Track your skin, digestion, and energy for a few weeks before increasing your dose.

If you notice any new or worsening symptoms after starting creatine, stop taking it and give your body time to settle before deciding whether to try again. Sometimes that pause is all you need to know whether something is a good fit — or not.

Right now, there isn’t enough targeted research to say for sure whether creatine is “safe” or “unsafe” for these specific conditions — which makes your own experience the most important guide. Listen to your body, and if something feels off, it’s okay to stop. This is how I test everything, because you know your body best, and can tell when something doesn’t feel right.

At the end of the day, supplements like creatine can be incredibly helpful for some people — and not worth the risk for others. The key is listening to your body and paying attention to your own body’s signals, making changes that feel right for YOU. It’s not the person promoting this supplement who will be feeling the negative effects so be your own advocate.

If you’ve tried creatine and have reflux, rosacea, or cold sores, I’d love to hear your experience in the comments. Your story might help someone else make a more informed decision. And if you want more deep dives like this on supplements and sensitive systems, make sure you’re subscribed so you don’t miss the next one.

See you next time

Shauna