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Low serum creatinine indicates: Low creatinine levels: Causes, symptoms, and treatments


Low creatinine levels: Causes, symptoms, and treatments

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Low levels of the waste product creatinine in the body could be a sign that the liver or muscles are not working as well as they should.

This MNT Knowledge Center features aims to find out what causes creatinine levels to drop, whether this is always a cause for concern, and what can be done to restore healthier levels.

When the body uses the amino acid creatine for energy, creatinine is left behind as waste. The levels of creatinine in the bloodstream or urine can be checked if there is a concern that someone may have a disease of the liver or muscles.

More often, low creatinine levels are a sign of losing muscle mass as people age, or it is a temporary condition during pregnancy or periods of illness, or due to malnutrition.

Fast facts on creatinine:

  • Creatine is an amino acid made naturally in the body, with a small amount coming from food.
  • It is used for energy in the body, made in the liver and found in muscles.
  • Lower creatinine levels in an older adult, or in someone who is slightly underweight, should not be a serious cause for concern.

Share on PinterestCreatine powder is a popular dietary supplement that may increase body mass.

The amino acid called creatine has gained popularity as a dietary supplement due to evidence that it may increase body mass, improve short-term intense exercise performance, and aid in recovery.

When creatine breaks down as it is used for energy, creatinine is created as a waste product.

Creatinine levels vary from person to person depending on factors such as body size, age, or gender, so there is no standard or ‘normal’ level.

Low creatinine levels could indicate a problem with the muscles or liver but may be due to something less serious, such as reduced muscle mass in older adults, or pregnancy.

Creatinine is always present in the bloodstream, where it is removed by the kidneys and leaves the body in urine.

Although it is a waste product, research suggests that creatinine in the body may also play a part in fighting disease, as it has been shown to stop the growth of bacteria.

Creatinine clearance is a test used by doctors that shows how well the kidneys are removing creatinine from the bloodstream.

The test is done using a timed urine sample, which means that all the urine someone passes in a set time period, such as 24 hours, is collected and tested to show how much creatinine has been removed from the body by the kidneys.

This test is most often used to judge high, rather than low creatinine levels in the body and is likely to be used alongside other tests to look at overall kidney health.

There are four key causes of low creatinine:

  • low muscle mass
  • liver problems
  • diet
  • pregnancy or illness

Low muscle mass

Levels of creatinine are often linked with muscle mass or the amount of muscle in the body, which can decrease with age or illness.

Low levels may indicate that muscles are less strong or are deteriorating, for example with a disease such as muscular dystrophy (MD).

Older adults often lose some muscle mass with age, and this is not usually a serious medical concern.

Liver problems

Creatine is made in the liver, and an unhealthy liver that is not working properly will not be able to make the normal amount of creatine.

For chronic liver disease, there can be a 50 percent reduction in the production of creatine. This means that there will be lower levels of creatinine in the blood, which can be checked with a simple blood test called a serum creatinine test.


Although creatine is made naturally in the body, a small amount comes from food, so low levels of creatinine could relate to diet.

Creatine is mostly found in meat, so those who follow a vegetarian or low-protein diet are likely to have lower levels than people who eat meat.

A prolonged period of not eating, or having an illness that prevents someone from eating, could be another cause of low levels of creatinine.


Pregnancy is often a cause of low creatinine levels, which should return to normal after a woman has given birth.

Symptoms of low creatinine will vary depending on the underlying condition but can include:

  • Low muscle mass: Lack of strength, difficulty exercising, a thin or frail body.
  • Liver disease: Inflamed liver, which may cause pain in the upper right-side of the abdomen, fatigue or nausea.
  • Diet-related: Feeling faint or dizzy, losing weight.

In the majority of cases, symptoms are unlikely to point clearly to low creatinine levels and could indicate other health problems.

A medical professional will test creatinine levels as part of a diagnosis if other symptoms are present, and a test is needed.

Usually, low creatinine means that there is too little creatine being produced in the body. This state will relate to the liver, muscles, or diet.

High levels of creatinine usually mean that there is too much creatine in the body, or that creatinine is not being filtered and removed from the body properly.

Creatinine levels often rise during intense exercise, as more creatine is burned for energy, or because someone may eat a high-protein diet.

High levels could also indicate a problem with the kidneys, as these organs get rid of waste products from the body to keep the blood clean.

Share on PinterestIf low creatinine levels indicate liver disease, then treatment may include quitting alcohol.

Low creatinine levels may indicate various different conditions, so a doctor will use test results alongside other checks to work out what the underlying issue could be.

If low creatinine levels, alongside other symptoms, show that someone may have liver disease, treatment is likely to start with medication and lifestyle changes. These changes could include eating a more healthful diet and giving up alcohol.

If someone has a muscle disease, treatment may include physical therapy, medication, or surgery to support them to remain mobile.

How to increase creatinine levels

Gentle exercise to increase muscle mass, or increasing creatine intake in the diet may help, particularly for those on a vegetarian diet who may not be eating enough protein.

For people who do high-intensity exercise, creatine as a dietary supplement is generally considered safe. A range of creatine supplements is available for purchase online.

However, the body produces creatine naturally, and most people who eat a balanced diet and are moderately active should not need to supplement their diet.

Low creatinine levels can indicate an underlying health problem, such as liver disease, but if this is the case, it will usually present alongside other symptoms. In these instances, the condition will be best tested by a doctor.

More often, low levels of creatinine are a normal part of aging or a temporary issue that can be resolved with changes to diet.

Creatinine and Creatinine Clearance | Michigan Medicine

Test Overview

Creatinine and creatinine clearance tests measure the level of the waste product creatinine (say “kree-AT-uh-neen”) in your blood and urine. These tests tell how well your kidneys are working.

Another substance, creatine (say “KREE-uh-teen”), is formed when food is changed into energy through a process called metabolism. Creatine is broken down into creatinine. Your kidneys take creatinine out of your blood and pass it out of your body in urine.

If your kidneys are damaged and can’t work as they should, the amount of creatinine in your urine goes down while its level in your blood goes up.

Three types of tests can be done.

Blood creatinine level

The blood creatinine level shows how well your kidneys are working. A high level may mean that your kidneys aren’t working as they should. The amount of creatinine in the blood depends partly on the amount of muscle tissue you have. Men generally have higher creatinine levels than women.

Creatinine clearance

A creatinine clearance test measures how well creatinine is removed from your blood by your kidneys. This test gives better information than a blood creatinine test on how well your kidneys are working. The test is done on both a blood sample and on a sample of urine collected over 24 hours.

Blood urea nitrogen-to-creatinine ratio

This test measures the amount of urea in your blood. Urea is a waste product made when protein is broken down in your body. Urea is made in the liver and passed out of your body in the urine.

The levels of blood creatinine and blood urea nitrogen (BUN) can be used to find the BUN-to-creatinine ratio. This ratio can help your doctor check for problems, such as dehydration, that may cause abnormal BUN and creatinine levels.

Why It Is Done

These tests are done:

  • To see if your kidneys are working normally.
  • To find out if your kidney disease is changing.
  • To see how well the kidneys work in people who take medicines that can cause kidney damage.
  • To check for severe dehydration. Dehydration generally causes BUN levels to rise more than creatinine levels. This causes a high BUN-to-creatinine ratio. Kidney disease or blocked urine flow from your kidney causes both BUN and creatinine levels to rise.

How To Prepare

You may be asked to:

  • Not do any strenuous exercise for 2 days (48 hours) before having the tests.
  • Not eat more than 8 ounces of meat, especially beef, or other protein for 24 hours before the blood creatinine test and during the creatinine clearance urine test.
  • Drink plenty of fluids if you are asked to collect your urine for 24 hours. But don’t drink coffee or tea. These are diuretics that cause your body to pass more urine than normal.

If you are asked to collect urine, your doctor will give you a large container that holds about 1 gallon. You will use the container to collect your urine for 24 hours.

Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your test. Your doctor will tell you if you should stop taking any of them before the test and how soon to do it..

How It Is Done

Blood tests

A health professional uses a needle to take a blood sample, usually from the arm.

Timed urine test

You collect your urine for a period of time, such as over 4 or 24 hours. Your doctor will give you a large container that holds about 1 gallon. You will use the container to collect your urine.

  • When you first get up, you empty your bladder.

    But don’t save this urine. Write down the time you began.

  • For the set period of time, collect all your urine.

    Each time you urinate during this time period, collect your urine in a small, clean container. Then pour the urine into the large container. Don’t touch the inside of either container with your fingers.

  • Don’t get toilet paper, pubic hair, stool (feces), menstrual blood, or anything else in the urine sample.
  • Keep the collected urine in the refrigerator for the collection time.
  • Empty your bladder for the last time at or just before the end of the collection period.

    Add this urine to the large container. Then write down the time.

How long the test takes

The urine test will take 24 hours. The blood test will take a few minutes.

How It Feels

Blood test

When a blood sample is taken, you may feel nothing at all from the needle. Or you might feel a quick sting or pinch.

Urine test

This test usually doesn’t cause any pain or discomfort.


Risks of a blood test

There is very little chance of having a problem from this test. When a blood sample is taken, a small bruise may form at the site.

Urine test

There are no known risks from having this test.


These tests give information about how well your kidneys are working. The creatinine clearance value is found from the amounts of creatinine in the urine and blood and from the amount of urine you pass in 24 hours. This value is the amount of blood cleared of creatinine per minute, based on your body size.


Each lab has a different range for what’s normal. Your lab report should show the range that your lab uses for each test. The normal range is just a guide. Your doctor will also look at your results based on your age, health, and other factors. A value that isn’t in the normal range may still be normal for you.

Blood creatinine, creatinine clearance, and BUN-to-creatinine ratios can be measured.

High values

  • High creatinine blood levels can be caused by:

    • Serious kidney damage or chronic kidney disease. Kidney damage can be caused by a life-threatening infection, shock, cancer, or low blood flow to the kidneys.
    • Dehydration.
    • Muscle injury and conditions. These include crush injuries, burns, rhabdomyolysis, muscular dystrophy, polymyositis, and strenuous exercises.
    • Shock. This is low blood pressure with many causes including severe bleeding and very severe infection.
  • High creatinine clearance levels can be caused by carbon monoxide poisoning and pregnancy.
  • High BUN-to-creatinine ratios occur with sudden (acute) kidney problems. This may be caused by shock or severe dehydration. A very high BUN-to-creatinine ratio may be caused by bleeding in the digestive tract.

Low values

  • Low blood creatinine levels can mean lower muscle mass caused by a disease, such as muscular dystrophy, or by aging. Low levels can also mean some types of severe liver disease or a diet very low in protein. Pregnancy can also cause low levels.
  • Low creatinine clearance levels can mean you have chronic kidney disease or serious kidney damage. Kidney damage can be from conditions such as a life-threatening infection, shock, cancer, low blood flow to the kidneys, or urinary tract blockage. Other conditions, such as heart failure and dehydration, can also cause low clearance levels.
  • Low BUN-to-creatinine ratios may be linked with a diet low in protein, a severe muscle injury called rhabdomyolysis, pregnancy, cirrhosis, or syndrome of inappropriate antidiuretic hormone secretion (SIADH). SIADH sometimes occurs with lung disease, cancer, diseases of the central nervous system, or the use of certain medicines.


Current as of:
December 17, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Kathleen Romito MD – Family Medicine
Adam Husney MD – Family Medicine
Caroline S. Rhoads MD – Internal Medicine

Current as of: December 17, 2020

Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Kathleen Romito MD – Family Medicine & Adam Husney MD – Family Medicine & Caroline S. Rhoads MD – Internal Medicine

Creatinine tests – Mayo Clinic


A creatinine test is a measure of how well your kidneys are performing their job of filtering waste from your blood.

Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy kidneys filter creatinine out of the blood. Creatinine exits your body as a waste product in urine.

A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the kidneys are working.

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Why it’s done

Your doctor or other health care provider may order a creatinine test for the following reasons:

  • To make a diagnosis if you have signs or symptoms of kidney disease
  • To screen for kidney disease if you have diabetes, high blood pressure or other conditions that increase the risk of kidney disease
  • To monitor kidney disease treatment or progression
  • To monitor for side effects of drugs that may include kidney damage or altered kidney function
  • To monitor the function of a transplanted kidney

How you prepare

A standard blood test is used to measure creatinine levels in your blood (serum creatinine). Your doctor may ask you not to eat (fast) overnight before the test.

For a creatinine urine test, you may need to collect urine over 24 hours in containers provided by the clinic.

For either test, you may need to avoid eating meat for a certain period before the test. If you take a creatine supplement, you’ll likely need to stop use.

What you can expect

For a serum creatinine test, a member of your health care team takes a blood sample by inserting a needle into a vein in your arm.

For a urine test, you’ll need to provide a single sample in the clinic or collect samples at home over 24 hours and return them to the clinic.


Results from creatinine in blood or urine are measured and interpreted in many ways, including the following:

Serum creatinine level

Creatinine usually enters your bloodstream and is filtered from the bloodstream at a generally constant rate. The amount of creatinine in your blood should be relatively stable. An increased level of creatinine may be a sign of poor kidney function.

Serum creatinine is reported as milligrams of creatinine to a deciliter of blood (mg/dL) or micromoles of creatinine to a liter of blood (micromoles/L). The typical range for serum creatinine is:

  • For adult men, 0.74 to 1.35 mg/dL (65.4 to 119.3 micromoles/L)
  • For adult women, 0.59 to 1.04 mg/dL (52.2 to 91.9 micromoles/L)

Glomerular filtration rate (GFR)

The measure of serum creatinine may also be used to estimate how quickly the kidneys filter blood (glomerular filtration rate). Because of variability in serum creatinine from one person to another, the GFR may provide a more accurate reading on kidney function.

The formula for calculating GFR takes into account the serum creatinine count and other factors, such as age and sex. A GFR score below 60 suggests kidney disease. The range of scores below 60 may be used to monitor treatment and disease progression.

Creatinine clearance

Creatinine clearance is a measure of how well the kidneys filter creatinine out of the bloodstream for excretion in urine.

Creatinine clearance is usually determined from a measurement of creatinine in a 24-hour urine sample and from a serum sample taken during the same time period. However, shorter time periods for urine samples may be used. Accurate timing and collection of the urine sample is important.

Creatinine clearance is reported as milliliters of creatinine per minute per body surface area (mL/min/BSA). The typical range for men, 19 to 75 years old, is 77 to 160 mL/min/BSA.

The typical range, by age, for creatinine clearance in women is as follows:

  • 18 to 29 years: 78 to 161 mL/min/BSA
  • 30 to 39 years: 72 to 154 mL/min/BSA
  • 40 to 49 years: 67 to 146 mL/min/BSA
  • 50 to 59 years: 62 to 139 mL/min/BSA
  • 60 to 72 years: 56- to 131 mL/min/BSA

Standard measures have not been determined for older adults.

Results lower than the typical range for your age group may be a sign of poor kidney function or conditions that affect blood flow to your kidneys.

Albumin/creatinine ratio

Another interpretation of urine creatinine count is called the albumin/creatinine ratio. Albumin is a protein in blood. Healthy kidneys generally don’t filter it out of the blood, so there should be little to no albumin found in the urine.

Albumin/creatinine ratio describes how much albumin is in a urine sample relative to how much creatinine there is. The results are reported as the number of milligrams (mg) of albumin for every gram (g) of creatinine. Results indicating a healthy kidney are:

  • For adult men, less than 17 mg/g
  • For adult women, less than 25 mg/g

A higher than typical result may be a sign of kidney disease. In particular, the result may indicate a complication of diabetes called diabetic nephropathy, or diabetic kidney disease.

Your doctor or other health care provider will discuss the results of a creatinine test with you and help you understand what the information means for a diagnosis or treatment plan.

Feb. 25, 2021

Low Creatinine Levels – Symptoms, Causes, And Treatments + Diet Tips

Creatinine is the chemical waste product of an amino acid called creatine that is produced and stored by the liver. Creatinine levels are usually an indication of normal muscle metabolism. It usually enters your blood after it is broken down. Your kidneys then remove it from your bloodstream before creatinine finally exits your body through urine. This entire process is responsible for maintaining normal creatinine levels in your body.

The normal levels of creatinine usually vary for different body sizes and muscle mass. The normal range of creatinine level for men is within 0.6 and 1.2 mg/dl, whereas for women, it is between 0.5 and 1.1 mg/dl (1). Any levels lower or higher than this could be an indication of deteriorating muscles.

Low creatinine levels could be an indication of loss of muscle mass that can occur due to various reasons. To know more about what could trigger this loss and how you can restore your creatinine levels to normal, continue reading.

Let us now take a look at the signs and symptoms of low creatinine levels.

Symptoms And Causes Of Low Creatinine

The signs and symptoms of low creatinine levels are usually associated with an underlying medical condition. They include:

  • Muscle diseases like muscular dystrophy that can lead to symptoms like muscle weakness, stiffened muscles, pain, and reduced movement.
  • Liver diseases or poor functioning of the liver can also interfere with the production of creatine, thereby causing low creatinine levels. This may lead to symptoms like jaundice, abdominal swelling and pain, swelling, and pale/tar-colored/bloody stool.
  • Low creatinine levels can also be caused due to loss of water from your body (dehydration). This could either be due to an excess of water intake, pregnancy, or even due to certain medications.

As you already know, the breakdown of muscle tissues produces creatinine. Therefore, low levels of this chemical waste (creatinine) could be an indication of low muscle mass – a risk factor for low creatinine levels.

Malnutrition and a low-protein or low-meat diet are some of the common causes of low muscle mass (2).

To determine your creatinine levels, your doctor or healthcare provider may use multiple diagnostic tests.

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One of the options to determine your creatinine levels is a serum creatinine test that can help measure the creatinine levels in your bloodstream.

Another option is a creatinine urine test that will test your urine to determine your creatinine levels.

Once the diagnostic test reveals your creatinine levels, your doctor will suggest a treatment plan. Low creatinine levels may need further diagnostic tests to rule out a muscular disease (if any). A muscle biopsy or a muscle enzyme test may be conducted to look for muscle damage.

Once the cause of your low creatinine levels is determined, your doctor will discuss the treatment options available to treat your condition.

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Medical Treatments

If you are found to have an underlying muscle disease, your treatment will be focused on combating the condition and alleviating its symptoms. Some of the options to treat muscle diseases include taking corticosteroids that can help in strengthening your muscles or therapy to improve the quality of your remaining life (3).

Low creatinine levels that occur due to pregnancy are usually normalized after delivery.

If your low creatinine levels are not due to an underlying muscle disease, medical intervention may not be necessary.

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Other Treatment Options

If the low creatinine levels are not a result of muscle disease, your doctor may recommend a few ways that can help in increasing and strengthening your muscle mass to normalize your creatinine levels without medications.

They may ask you to increase your level of physical activity or do strength training exercises regularly to increase your muscle mass.

You can also try:
  • Walking
  • Swimming
  • Aerobics
  • Biking
  • Weightlifting

If your doctor doubts that your low muscle mass is a result of malnutrition or extreme weight loss or dieting, you may be asked to modify your diet to rebuild the lost muscles. Listed below are some diet tips that can help increase your creatinine levels by increasing your muscle mass.

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Diet For Low Creatinine Levels

Start by eating 5-6 small but healthy meals daily. Your diet must consist of protein-rich foods like lean meat, seafood, milk, cheese, yogurt, cottage cheese, and soy. Vegetarians are more likely to be protein-deficient that non-vegetarians. Hence, they should consume alternative sources of protein to make up for it. Avoid alcohol as it can accelerate muscle loss (4).

You can also practice some muscle-building exercises to improve your muscle mass.

Note: You may take supplements (like creatine monohydrate) to improve creatinine levels in your body. Good creatinine levels help enhance athletic performance, keep your muscles and bones healthy as your age, and improve brain health.

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Exercises To Improve Low Muscle Mass

Some exercises that can help improve muscle mass are (5):

  • Lifting weights
  • Squats
  • Lunges
  • Pull-ups
  • Pulldowns
  • Military press
  • Seated dumbbell press
  • Bench press
  • Leg raises
  • Weighted abdominal crunches

While some of these exercises, like squats and lunges, can be done right at home, you may need to go to a gym to do the others.

Here are some tips that can help prevent muscle loss.

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Prevention Tips

  • Follow a healthy diet that contains important nutrients, like vitamin D.
  • Workout regularly.
  • Get sufficient sleep.
  • Don’t cut down on your carbohydrate intake.
  • Limit your alcohol intake.
  • Drink enough water to prevent dehydration.

Low creatinine levels are usually easy to restore, especially when they are not caused by an underlying medical issue. The tips and exercises discussed will help improve your muscle mass in the long run. However, it is best to stick to the treatment plan provided by your doctor if your low creatinine levels are due to an underlying muscular disease.

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Expert’s Answers For Readers’ Questions

What is the creatinine level for kidney failure?

The normal serum creatinine levels are supposed to be 0.5-1.1 mg/dl in women, and 0.6-1.2 mg/dl in men. Creatinine levels higher than this could be an indication of kidney damage.

Is a creatinine level of 1.2 bad?

A serum creatinine level of 1.2 mg/dl is clinically insignificant.

What is the best thing to drink for your kidneys?

Water is one of the best drinks for promoting the health of your kidneys. Other drinks include fruit juices like cranberry juice and lemon juice that can help in detoxifying your kidneys and preventing the formation of kidney stones.

What does low creatinine indicate?

Low levels of creatinine may indicate muscle loss or an underlying medical condition like muscular dystrophy.