In healthy individuals, standard-dose creatine is generally reported as safe in many studies and sports nutrition position statements; however, that does not mean it is risk-free for everyone. People with kidney disease, older age, uncontrolled hypertension/diabetes, a single kidney, high dehydration risk, or kidney-impacting medications should be more cautious and seek clinical guidance. Creatine use can slightly raise measured serum creatinine without indicating kidney damage—context matters. Best practice is baseline testing, periodic monitoring, adequate hydration, and managing comorbid risks. If symptoms like swelling, reduced urine output, or rising blood pressure occur, stop supplementation and seek medical evaluation.