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Are there really downsides to creatine though? (Genuine question). All the advice I've seen makes it seem like it's basically just good for you even if it doesn't accomplish some specific thing. The only downside I've heard is maybe water retention?
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That's not the point. Often in medicine, the downside of using one thing is that you're not using another thing that would be safer and more effective. When people chase results from unproven therapies, often it means they're avoiding doing something else that is known to produce a result - even if the result of the alternative is not as spectacular as the unproven therapy promises to be.

But speaking of creatine itself, while not inherently toxic, consuming large doses can cause serious indirect harms, such as triggering falsely elevated kidney markers on blood tests that lead doctors to misdiagnose organ failure, unnecessarily cancel crucial medical treatments, or order invasive biopsies. Furthermore, overloading the body with creatine while taking kidney-stressing medications (like heavy doses of ibuprofen) or having an undetected renal condition can cause actual acute kidney strain, while the massive shift of water into muscle cells can trigger severe dehydration, heat exhaustion, and electrolyte imbalances during intense heat or exercise if fluid intake falls behind.

But, I don't want to belabour the point about creatine. Rather, I want to focus on the negatives stemming from NOT doing other things that ARE proven to be safe and effective. People tend to think creatine will solve a lot of their problems (for instance, they may believe it will fix their feeling of being "low energy). But by avoiding things that might actually help their problem get better, they're persisting a poor state of health.

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What are the "downsides"? It is one of the most studied substances and except in special cases like kidney issues it is totally safe.
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