Understanding Creatine's Role in GLP-1 Therapy

Creatine on GLP-1 Therapy (Ozempic/Wegovy/Zepbound): What It Can—and Can’t—Do

Last updated: January 12, 2026

Reading time: ~7 minutes

GLP-1 medications can produce meaningful weight loss, but some of that loss may include lean mass (muscle and other fat-free tissue). In the STEP 1 semaglutide trial, a DXA substudy showed weight loss was driven mostly by fat mass, with a smaller lean-mass reduction. (New England Journal of Medicine)
This is where many people ask: Should I take creatine while on GLP-1 therapy?

This article explains how creatine fits into a muscle-preservation strategy (and where expectations should stay realistic), plus a simple dosing guide and a 12-week training template.

Important: This is educational information, not medical advice. If you have kidney disease, are pregnant/breastfeeding, or take prescription medications, consult your clinician.

• GLP-1 therapy can reduce weight substantially; some lean mass loss can occur, especially with rapid weight loss. (New England Journal of Medicine)

• Creatine monohydrate is one of the most studied performance supplements; it can help support strength and repeated high-intensity efforts, especially alongside resistance training. (Taylor & Francis Online)

• Creatine is not a “muscle-loss shield.” The foundation is still strength training + adequate protein + consistency.

• Creatine can raise serum creatinine in labs without necessarily indicating kidney damage; interpretation should be clinical (especially if you’re monitoring kidney markers). (PubMed)

What GLP-1 therapy changes (and why muscle can drop)

GLP-1 receptor agonists (like semaglutide, found in Wegovy/Ozempic) reduce appetite and energy intake. With faster weight loss, it’s common for the body to lose a combination of fat and lean mass. STEP 1’s DXA substudy reported larger reductions in fat mass than lean mass, improving the lean-to-fat ratio overall—but lean mass still decreased in absolute terms. (New England Journal of Medicine)

Why it matters: less lean mass can mean lower strength, lower “daily energy,” and a harder time maintaining your new body weight long-term—especially if you stop the medication.

Where creatine fits (realistic expectations)

Creatine doesn’t “burn fat” and it doesn’t magically build muscle without training. What it can do is support training output—more reps, better power across repeated sets—so your strength program has a better chance of working while you’re in a calorie deficit. NIH’s Office of Dietary Supplements summarizes creatine as helpful for repeated short bursts of intense activity (like lifting) and generally safe at recommended doses for most healthy people. (Office of Dietary Supplements)

What creatine can help with

• Training performance (lifting quality): more capacity for short, intense work. (Office of Dietary Supplements)

• Strength and hypertrophy support with resistance training: meta-analyses show creatine + lifting can improve muscle outcomes versus lifting alone (effects vary by population and program). (PubMed)

What creatine will NOT do

• It won’t prevent muscle loss if you don’t train.

• It won’t replace adequate protein and sleep.

• It won’t guarantee “no loose skin,” “no fatigue,” or “no weakness” on GLP-1.

How to take creatine on GLP-1 (simple protocol)

Creatine monohydrate is the form used in most of the research and the default choice for cost-effectiveness.

Dose

• 3–5 g daily, every day (including rest days). This aligns with commonly referenced evidence-based guidance for ongoing use. (Taylor & Francis Online)

Timing

• Take it any time of day. Pick the time you can stick to.

Loading phase (optional)

A loading phase (e.g., ~20 g/day for ~5–7 days) is not required for most people. If your stomach is sensitive (common on GLP-1), skipping loading is often the more tolerable choice.

If GLP-1 nausea is an issue

• Split the dose: 3 g + 3 g (or similar) with meals.

• Mix fully and drink slowly.

Hydration

Maintain steady fluid intake, especially if you lift. Creatine increases intramuscular water content; dehydration plus hard training is a bad combo.

Safety notes (read this if you track labs)

Creatine is widely studied and is generally considered safe within recommended doses for healthy adults. (Taylor & Francis Online)

Creatinine vs kidney function

Creatine supplementation can increase serum creatinine, which may look alarming on basic labs, but it does not automatically equal kidney damage. A 2025 meta-analysis evaluated kidney markers (including serum creatinine and GFR) across studies and provides context on how these values may shift. (PubMed)
Earlier meta-analytic work also found no evidence of renal damage in studied amounts/durations in healthy populations. (PubMed)

Practical advice: If you monitor kidney markers, ask your clinician to interpret the full panel (e.g., eGFR, BUN, urinalysis) in context rather than reacting to creatinine alone.

The 12-week “keep muscle” plan while on GLP-1 (template)

Your goal is simple: keep lifting heavy enough to give your body a reason to hold muscle.

Weekly schedule (3 days/week)

Day A (Lower + push):

• Squat or leg press: 3×5–8

• Romanian deadlift: 3×6–10

• Bench press or dumbbell press: 3×5–10

• Calf raises: 2×10–15

Day B (Pull + hinge):

• Deadlift variation or hip hinge: 3×3–6

• Lat pulldown or pull-ups: 3×6–10

• Row (machine/dumbbells): 3×6–12

• Biceps curls: 2×10–12

Day C (Full body):

• Split squat: 3×8–10

• Overhead press: 3×6–10

• Chest-supported row: 3×8–12

• Farmer carry: 3×30–60 seconds

Progression rule: When you hit the top of the rep range with good form for all sets, add a small amount of weight next week.

Minimum cardio (for health, not punishment)

2–3 sessions/week of 20–30 minutes easy/moderate walking or cycling.

Protein and recovery (high-level)

Rapid appetite reduction can make it harder to eat enough protein. Prioritize protein at each meal, and don’t “save” all your food for one sitting.

FAQ

Can I take creatine while on Ozempic/Wegovy/Zepbound?

Often yes for healthy adults, but check with your clinician if you have kidney disease or complex medications. Creatine monohydrate is one of the most studied supplements in sport and performance. 

Does GLP-1 cause muscle loss?

Weight loss can include some lean mass loss. In STEP 1’s DXA substudy, semaglutide reduced fat mass more than lean mass, improving body composition overall, but lean mass still decreased in absolute terms. (New England Journal of Medicine)

Will creatine prevent muscle loss on GLP-1?

No guarantee. Creatine supports training output; resistance training remains the main lever.

Do I need a loading phase?

Usually not—especially if GLP-1 side effects make large doses hard to tolerate.

What if creatine upsets my stomach on GLP-1?

Split dose (3 g + 3 g), take with food, and avoid large single servings.

References (short list)

• STEP 1 trial (semaglutide 2.4 mg, NEJM, 2021). (New England Journal of Medicine)

• STEP 1 body composition DXA substudy (Journal of the Endocrine Society, 2021). (PMC)

• Liraglutide + exercise for weight loss maintenance (NEJM, 2021). (New England Journal of Medicine)

• ISSN Position Stand on creatine (2017). (Taylor & Francis Online)

• NIH Office of Dietary Supplements: creatine summary (consumer/health professional). (Office of Dietary Supplements)

• Creatine and kidney function meta-analysis (2025). (PubMed)

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