Does Creatine Show Up On Drug Tests?

Testing the concentration of substances in urine can reveal many interesting things. For example, through urine results, you know whether a person has used drugs or not. However, a urine sample can represent many substances and these substances sometimes interact with each other.

Therefore, the possibility of errors in urine testing is entirely possible.

Accordingly, many funny and sad cases when the recruitment and sports industry in the United States stipulates that if the urine test result has a Creatinine level below <20 mg/dL, it is considered cheating [1], although supplementing creatine during training to increase endurance and alertness before competition is allowed.

So, does the Creatinine level in urine affect the results of a drug test?

What Does a Drug Test for Creatinine Mean?

Creatinine is a waste product from the process of protein metabolism into creatine and creatine phosphate, which occurs continuously inside the body. This substance is stored in skeletal muscle in a high-energy phosphorylated form and excreted in the urine.

Normally, urine always has a certain amount of Creatinine available and remains stable regardless of the time of day when tested (Ropero-Miller et al., 2000).

In terms of gender, in women, the normal Creatinine concentration is 0.5-1.1 mg/dL or 44-97 μmol/L (SI units) and in men it is 0.6-1.2 mg/dL or 53-106 μmol/L (SI units). In addition, the level of Creatinine in urine according to age is also slightly different when 0.5-1.0 mg/dL for adolescents, 0.3-0.7 mg/dL for children, 0.2-1.2 mg/dL for infants.

At the same time, the current health status also affects the concentration of this substance, for example, those with kidney failure will have Creatinine levels >4 mg/dL [3].

Therefore, the Creatinine test is often understood to determine the level of Creatinine in urine, low or high, or there is any abnormality suggesting that the sample may have been diluted or manipulated before undergoing the comprehensive metabolic panel (CMP) or basic metabolic panel (BMP).

This helps evaluate the integrity of the sample and ensure more reliable testing outcomes.

You may also read:

• How Long Does Creatine Take to Work?
• Is Creatine Good for Runners? How to Choose Creatine for Runners?

Does Creatine Show Up On Drug Tests?

Creatine has received much attention since the early 1960s as a safe dietary and exercise supplement that can increase endurance for short-term, high-intensity exercise [2].

Many people are concerned about whether taking Creatine will lead to false positive drug test results. For example, in the topic Effects of creatine use on urine drug test detection, Michael Reilly demonstrates that the level of dilution of marijuana in urine that the test does not recognize is 500g/ml of urine.

However, drinking such a large amount of water after taking Creatine, 24–36 hours before the test, which can still be easily detected by experienced urine testing professionals.*

Fortunately, the answer is no. Creatine does not usually show up on standard drug tests and always remains at normal levels as mentioned above.

Furthermore, drug tests are specifically designed to detect illegal or controlled substances—not naturally occurring compounds like creatine. Creatine is also not banned in sports; in fact, it's widely accepted as a legal performance supplement.

However, testing personnel may still refer to the creatinine concentration in urine and compare it to standard reference values. This helps determine whether the sample has been diluted or manipulated in an attempt to mask substance use.

In this context, creatinine levels serve as an indicator of the sample's integrity rather than proof of drug use. Thereby, hoping to change the results of determining substances in urine, confirming drug use or not. In other words, Creatinine concentration can be used to assess the integrity of urine (to ensure the sample is not diluted) [4].

This point is also supported by Ton Mahurin, a Quora user who contributed to the discussion on the topic “Does creatine supplementation help pass a urine drug test?”

According to him, creatine is a natural waste product that is consistently present in urine due to the body’s daily protein metabolism. Therefore, whether or not someone is supplementing with creatine, it has minimal impact on drug test results.*

I’ve provided you with some perspectives from real users; however, these personal anecdotes are shared for informational purposes only and should not be considered a substitute for professional advice or medical diagnosis.

Read more: 13 Best Creatine Supplements for Strength and Performance

Can Creatine Cause You To Fail A Drug Test?

In theory, Creatine does not affect drug test results and most of the tests show this to be true. However, there are some cases where drug test results are affected while taking Creatine supplements. This often comes from the habit of drinking enough water, even more water than usual when using Creatine supplements.

Without adequate water intake, the body has difficulty absorbing this nutrient, which can lead to dehydration. On the other hand, drinking excessive amounts of water dilutes the urine—a factor that may cause false test results.

Gaurav Agartaniya, a user on the Quora platform, also mentioned this issue in his analysis column "Is taking creatine good for one's health?"*

The Role of Creatine in Detecting Urine Sample Manipulation

The concentration of creatinine in urine can be the “key” for the examiner to determine whether a positive drug test sample is eligible for acceptance.

In other words, based on the concentration of this substance in urine, the drug test sample will be considered valid or not, and at the same time, it is possible to detect attempts to manipulate the sample by diluting or replacing it with a substance other than urine (or synthetic urine).

To illustrate this, many individuals, in order to not detect their drug use, try to drink a lot of water (or other liquid) to change the compounds in the urine.

However, they do not know that when doing so, the Creatinine level will change as if it were diluted beyond the allowed level - indicating that they attempted to alter the composition of the urine through manipulation. And of course, this urine test result is not accepted.

Therefore, before determining whether the test result is accurate or not, the examiner also compares the Creatinine level on that sample with the normal level.

If Creatinine is too low or there is no Creatinine (of synthetic urine), the sample may be flagged for further evaluation or considered potentially invalid depending on testing protocols.

In addition, an important note is that many individuals are using Creatinine supplements and are quite worried about whether the drug test results after using this substance are accurate.

In fact, the product does increase Creatinine levels but not too high (beyond normal levels, to the point of not accepting drug test results). Therefore, creatine supplementation is generally considered safe, but users should inform testing staff for clarity.

These insights are supported by various studies, though individual responses may vary:

Simon Franz et al. (2022) gave 18 participants 1.3 liters of water and 0.2 liters of orange juice respectively but did not supplement Creatine.

The same amount of water with 20 grams of creatine added and the same amount of water with 20 grams of creatine added were incubated in orange juice at room temperature for 4 days (the acidic environment helps convert creatine to creatine).

The third case had the highest creatine level (up to 28.3 mg/dL), indicating that creatine or creatinine supplementation significantly increases urinary creatinine levels, which can interfere with drug testing results [5].

Needleman (1992) stated that any creatinine value in a random urine sample <10 mg/dL contributes to the confirmation of urine dilution [6].

What Steps to Take if You Use Creatine and Face Drug Testing?

To ensure accurate positive drug test results, without having to waste time doing it over and over again, you should:

• Temporarily stop using products containing Creatine before the test date (contact the testing staff for the exact time).
• Limit drinking too much water (any type of water from filtered water to juice, soup, etc.) and only keep the necessary level (about 6 glasses of water/day) [7].
• Use a home creatinine test kit to monitor your levels several days before testing.

Other Compounds That Could Affect Drug Test Accuracy

Along with that, some other substances can also have a negative impact on the results of drug tests:

• Caffeine
• Weight loss drugs
• Antidepressants
• Vitamin B supplements
• Poppy seeds (because they contain small amounts of opium)
• Some herbal supplements
• Some cold and flu medications

Therefore, before taking the test, you should contact the specialist performing the test about nutrition and lifestyle to ensure the results are correct, not wasting time and money doing it too many times.

Conclusion

Creatine itself does not cause a positive drug test result. However, behaviors commonly associated with its use—particularly drinking excessive amounts of water to support creatine absorption—can unintentionally dilute the urine sample.

This dilution may lower creatinine levels below acceptable thresholds, leading the test to be rejected or flagged as invalid.

Therefore, while creatine is not a banned or detectable substance in standard drug screenings, improper usage practices surrounding it can still interfere with the accuracy of your test results.