Creatine and Cancer Safety: Gabrielle Raucci Discusses Timing and Benefits

Creatine has long been a staple in sports nutrition, recognized as one of the most well-studied supplements for increasing lean body mass and enhancing exercise performance. However, for patients navigating a cancer diagnosis, the decision to supplement is not always straightforward.

Gabrielle Raucci, RD, an outpatient clinical oncology dietitian with the OSF HealthCare Cancer Institute, warned in an interview with Oncology Nursing News that while creatine offers significant recovery benefits, its use during active treatment can present serious risks.

The "Red Light" During Active Treatment

For patients currently undergoing chemotherapy, immunotherapy, or targeted therapies, Raucci classifies creatine as a "red light." The primary concern involves the potential for the supplement to interfere with the efficacy of medical interventions.

"There's some data that shows some negative side effects with taking creatine during active treatment and saying that it could potentially interfere actually with the treatment," Raucci said. She further emphasized that clinicians must be cautious about anything that could "alter the tumors," calling such a possibility a "really big red flag."

Beyond treatment interference, creatine supplementation can complicate the clinical monitoring of kidney health. When the body processes creatine, it produces a byproduct called creatinine. Because oncologists use creatinine levels in the blood to assess how well the kidneys are handling toxic treatments, a supplement-induced "bump" in these levels could lead to inaccurate clinical assessments.

A "Green Light" for Cancer Survivors

The clinical perspective shifts significantly once a patient enters survivorship. Raucci noted that the "main complaint" she receives from patients is the feeling that they have "lost so much muscle mass in such a short period" during their cancer journey.

For those who have completed chemotherapy, radiation, and surgery, creatine becomes a viable tool for physical restoration. "Usually it's about a month after treatment where I'll give them that green light and say, 'Let's go ahead and start this supplement and see if we can really build your lean body mass up after the treatment,'" Raucci explained.

When combined with resistance training, the supplement helps survivors regain the strength lost during the grueling months of therapy.

Best Practices and Administration

When supplementation is deemed safe by the care team, Raucci recommends creatine monohydrate as the most effective form. While the supplement is available in pills or gummies, she advises that the powder form is superior for efficacy.

Despite the benefits for survivors, Raucci stresses that no patient should start a regimen without professional oversight. Even for those who have taken the supplement for years, she insists on a multidisciplinary review. "Let's chat with your medical oncologist. Let's chat with the pharmacy and see what they're saying there," she advised, ensuring that all supplements are cross-referenced with the patient's current medications and overall organ function.