Something changed in high school locker rooms and weight rooms between 2019 and 2024. Steroid use among American teenagers — long a concern for coaches, parents, and pediatricians — did not increase, and in some metrics declined. What surged in its place was creatine: legal, affordable, heavily promoted on social media, and used by nearly one in six American teenage boys by 2024.
A study tracking more than 870,000 adolescents over two decades, reported by HealthDay on May 20, 2026, found that creatine use among adolescents climbed from 6.29% overall in 2019 to 9.68% in 2024. Among boys, usage doubled — from 8.71% to 16.57%. Among girls, it more than doubled, from 1.22% to 3.27%. The researchers, who analyzed data from the Monitoring the Future survey tracking 8th, 10th, and 12th graders across the United States, found that the shift toward creatine tracked with the decline in steroid use — suggesting a behavioral substitution toward legal, over-the-counter alternatives that promise similar body composition benefits without the legal and health stigma of anabolic steroids.
As Earth.com reported in its coverage of the Monitoring the Future analysis: "Fewer teens turn to banned substances, like steroids. More now choose legal supplements that promise performance gains, like creatine. Social media trends, online fitness communities, and easy access to products all shape these choices."
Lead researcher Philip Veliz commented: "What surprised me was that steroid use did not increase over the past five years among adolescents. This is a positive finding, but additional research is needed."
What Is Creatine — and What Does It Do?
Creatine monohydrate is a naturally occurring compound produced by the body from three amino acids (L-arginine, glycine, and L-methionine) primarily in the liver and kidneys. It is also found in red meat and seafood. The body stores most creatine in skeletal muscle, the heart, and the brain, where it serves as a substrate for rapid ATP (energy) resynthesis during short-burst, high-intensity activities.
Supplementing with creatine increases the total creatine and phosphocreatine stores in muscle — typically by 15–40% — which can delay fatigue during maximal-effort activities lasting 10 seconds or less, increase power output in resistance training, accelerate recovery between sets, and support lean muscle mass gains over time. According to the International Society of Sports Nutrition (ISSN), creatine monohydrate is among the most well-researched and effective ergogenic aids available.
Creatine is not a steroid, hormone, or controlled substance. It is classified as a dietary supplement in the United States and can be purchased without prescription at essentially any pharmacy, grocery store, or online retailer. Standard dosing involves either a "loading phase" (20 grams/day for 5–7 days) or a maintenance approach (3–5 grams/day), though loading is not required for eventual saturation of muscle creatine stores.
| Creatine Use Among U.S. Adolescents — Key Data | Detail |
| HealthDay / study publication date | May 20, 2026 |
| KFF Health News Morning Breakout flagged | June 17, 2026 |
| Study dataset | Monitoring the Future Survey — 870,000+ adolescents over 20 years |
| Creatine use among all teens — 2019 | 6.29% |
| Creatine use among all teens — 2024 | 9.68% |
| Creatine use among teen boys — 2019 | 8.71% |
| Creatine use among teen boys — 2024 | 16.57% (doubled) |
| Creatine use among teen girls — 2019 | 1.22% |
| Creatine use among teen girls — 2024 | 3.27% (more than doubled) |
| Primary driver cited | Social media trends; "looksmaxxing" culture; legal/affordable status |
| Concurrent trend | Steroid use declined among teens in same period |
| Adolescent-specific safety studies available | Extremely limited (5 studies met PRISMA criteria in April 2026 Cureus systematic review) |
| Medical consensus on adolescent use | Caution warranted; no pediatric dosing guidelines established; adult evidence not directly extrapolatable |
The Safety Evidence — What We Know and What We Don't
The most comprehensive recent evaluation of creatine safety in adolescents — a systematic review published in Cureus in April 2026 using PRISMA guidelines — identified only five studies meeting eligibility criteria for pediatric and adolescent creatine safety research published between 2015 and 2025. The review found no clinically meaningful changes in kidney function, liver function, or cardiometabolic markers across those five studies.
However, the limitations of this evidence base are significant and must not be minimized:
The five studies are short-term. Most covered only a few weeks to a few months of use. Creatine use among today's teenagers may begin in early high school and continue for years — a duration for which essentially no safety data exists in adolescent populations.
The studies involve supervised, structured use. The adolescents in these studies used creatine under research protocols with specific dosing, monitoring, and dietary guidance. This is categorically different from the unsupervised use of creatine by teenagers based on social media recommendations and peer-to-peer advice.
Adults' safety profile does not automatically transfer. The creatine safety literature in adults is extensive and generally reassuring for healthy individuals without pre-existing kidney or liver conditions. But adolescence involves ongoing development of the kidneys, liver, endocrine system, and musculoskeletal structure. The question is not whether creatine is safe in healthy adults — it is well-established that it is. The question is whether the same conclusion applies to actively developing bodies, and the honest answer is that the research to answer that question does not yet exist at scale.
Orlando Health Arnold Palmer Hospital for Children notes: "There is virtually no scientific evidence to assess the safety or effectiveness of creatine in adolescents. There have been some reports of liver and kidney problems associated with creatine use as well as dehydration, muscle cramps and compartment syndrome. Remember, though, these studies were conducted in adults."
The creatinine confounding problem. Creatine supplementation elevates serum creatinine — the standard kidney function marker — by a mechanism that is independent of actual kidney damage (creatine is non-enzymatically converted to creatinine in muscle). This means creatine use can falsely elevate creatinine levels and mask early kidney injury signals. A January 2026 case report published in Cureus (DOI: 10.7759/cureus.100875) documented an adolescent who presented with acute kidney injury and rhabdomyolysis, in whom creatine supplementation complicated the clinical picture precisely because creatinine elevation from creatine use obscured the severity of renal function changes.
Who Should Not Take Creatine and What Parents Should Know
The strongest medical consensus is clear that certain adolescent subgroups should not take creatine under any circumstances without direct physician supervision:
- Teens with pre-existing kidney conditions (including those not yet known to have kidney problems — rare but undetected renal conditions are not uncommon in adolescents)
- Teens with diabetes or prediabetes — creatine can affect kidney filtration markers and blood glucose management in unpredictable ways in individuals with glucose dysregulation
- Teens on diuretics or medications that affect kidney function
- Teens who are dehydrated, participating in hot-weather activities, or engaged in weight-cutting practices (as in wrestling, judo, or rowing) — creatine increases intramuscular water retention and can worsen dehydration in individuals already volume-depleted
For parents navigating this conversation with teenagers who want to use creatine: the ISSN's position stands that creatine may be appropriate for serious adolescent athletes who are well-informed and supervised. The critical phrase is "supervised." An unsupervised 15-year-old purchasing a 5-kilogram tub of creatine based on a YouTube influencer's recommendation, without knowing their kidney baseline, without guidance on hydration, and without awareness of drug interactions, is a meaningfully different scenario than a monitored clinical study.
The conversation with a teenager's pediatrician is not optional — it is the appropriate first step before any performance supplement use.
Frequently Asked Questions
How much has creatine use among teens increased?
A study of 870,000+ U.S. adolescents (Monitoring the Future data) found creatine use doubled among teen boys, from 8.71% to 16.57% between 2019 and 2024. Among girls, use more than doubled, from 1.22% to 3.27%.
Is creatine safe for teenagers?
The honest answer is: we don't know with certainty. The adult safety evidence is generally reassuring for healthy individuals. But only five studies met rigorous criteria for pediatric-specific safety evaluation in a recent systematic review, and those studies involved short-term supervised use — not the years of unsupervised use typical of today's teen supplement users.
What are the main concerns about teen creatine use?
The absence of long-term adolescent safety data; the confounding of standard kidney function testing (creatine elevates creatinine independently of kidney damage); undetected pre-existing conditions that could interact with creatine; and the context of unsupervised use based on social media recommendations rather than medical guidance.
Should my teenager take creatine?
Discuss this with your teenager's pediatrician or sports medicine physician before starting. Teens with any kidney issues, diabetes, or who participate in dehydrating sports or weight-cutting should not take creatine without direct medical supervision. Even healthy teens who are supervised and well-informed should understand that the pediatric evidence base remains very limited compared to the adult literature.
What is "looksmaxxing" and how is it driving creatine use?
"Looksmaxxing" is an online trend — particularly popular on TikTok and Reddit — focused on optimizing physical appearance through legal means, including supplements, skincare, and specific training protocols. Creatine is prominently featured in looksmaxxing content as a way to increase visible muscle mass. The trend is driving uptake among teenagers who may not otherwise have been interested in athletic performance supplements
