The use of creatine and the development of deep vein thrombosis. A scoping review

Deep vein thrombosis (DVT) is the development of blood clots in the deep veins of the extremities, classically described secondary to periods of inactivity. In some reports, creatine supplementation in the context of dehydration has been demonstrated to increase the likelihood of the development of DVTs in patients who were otherwise healthy. The purpose of this study is to conduct a scoping review of incidences of DVTs related to creatine supplementation and urge future research to investigate the mechanism of this adverse effect. Following the standard PRISMA guidelines for scoping reviews, the authors searched PubMed and Google Scholar using the terms “deep vein thrombosis”, “DVT”, and “creatine intake or supplementation.” All relevant articles were included if they described an association between DVT and creatine supplementation. Once included, each study was qualitatively analyzed for relevant information. Any dispute of the articles for inclusion or exclusion were discussed until consensus was achieved. Four articles were included within this review from the case report and case series literature. While these articles reaffirmed the overall safety of creatine, there is an emphasis on ensuring adequate hydration in those taking this supplement. This should provoke further research into the role that creatine and other exercise supplements might play in provoking deep venous thrombosis. This evidence has the potential to change the advice of healthcare professionals to ensure they stress the importance of adequate hydration with the use of workout supplements.