A case of pulmonary thromboembolism possibly associated with the use of creatine supplements

Abstract

Drug administration should be considered a risk factor for venous thromboembolism (VTE) in younger healthy patients. We present a case of new‐onset pulmonary embolism (PE), possibly associated with excessive creatine supplement intake. A 24‐year‐old non‐smoker male presented to the emergency department with sudden‐onset dyspnoea and chest discomfort. Computed tomography pulmonary angiography and venography confirmed PE in the left and right pulmonary artery branches and a thrombus in the left popliteal vein. The patient had no family history of VTE, and other causes of thrombophilia were unlikely. He reported a recent increase in the intensity of his workouts and the dose of his creatine supplements in preparation for a bodybuilding competition. The creatine supplements likely promoted dehydration during intense workouts and profuse sweating. He received anticoagulation therapy, and the creatine supplements were discontinued. Creatine supplements should be used cautiously when there is a higher risk of becoming dehydrated.

Premature Death in Bodybuilders: What Do We Know?

“…Bodybuilding supplements are commonly cited as a cause of morbidity. There is one case report of venous thromboembolism in a 24-year-old strength-trained individual who was ingesting 20 g of creatine in preparation for a bodybuilding competition [ 129 ], and other similar cases of severe renal dysfunction in otherwise healthy young adults [ 130 – 133 ]. Such case reports assume a cause-and-effect relationship, yet a wide body of research indicates that creatine is safe at the levels ingested [ 134 ].…”

“What IVC?”: Deep Vein Thrombosis in the Context of IVC Dysgenesis

“…DVT in this patient was caused by mechanical or anatomical stasis of the blood flow secondary to the absence of an IVC and concurrent increased levels of protein from creatinine supplement consumption. In one case published in 2022 and two cases published in 2014, increased creatine and protein supplementations were found to be the cause of venous thromboembolism (VTE) secondary to dehydration [37][38][39]. This, along with his malformation, per the authorial team's thought process, was the perfect storm for the development of DVT.…”