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Ct9.5
Creatine Research
Likely helpsHigh safety
70 peer-reviewed studies
What the evidence says
Likely helps
Creatine appears to help in 13 of 16 studies with measurable effects — the evidence leans clearly favourable.
Most evidence is from high-quality meta-analyses and randomised trials published 2007–2026 with a typical study size of 57 participants.
Based on 70 studies · 23 meta-analyses · 30 RCTs · 13,758 total participants
Confidence
High
What the studies found
13helped2unclear1didn't help· 54 more without graded effect data
Endurance & exercise performanceIncreases power output and repeated-sprint performance · 2-4 weeks
Probably helps18 studies
Lean body mass & muscle growth5-15% strength gains · 2-4 weeks
Likely helps16 studies
Cognitive functionImproves working memory and cognitive performance, especially under stress · 4-8 weeks
Likely helps15 studies
Therapeutic & clinical
Probably helps15 studies
Safety profile
Mostly mechanism / observational9 studies
RecoveryFaster muscle recovery · 1-2 weeks
Mostly mechanism / observational7 studies
By the numbers
Pulled from 42 studies with measurable effects
Likely real effects
80%
across studies
People studied
14k
typical study: 57 people
Strongest designs
53
23 pooled, 30 randomised
Showed benefit
81%
13/16 studies
How long studies ran
1–4 weeks
3
1–3 months
3
3+ months
4
Populations Studied
General population6
Older adults2
Females taking oral creatine monohydrate1
Healthy individuals, with greater benefits in older adults (66-76 years)1
Active research area
56 studies in the last 5 years · Latest meta-analysis: 2026
200720162026
1Meta-Analysisn=608 · large study2026
In postmenopausal women, creatine, particularly ≥ 5 g·day⁻¹ with RT, yields small but meaningful gains in lean mass and strength without evidence of harm.
Naddafha S et al. · Journal of the International Society of Sports Nutrition (2026)
Lean mass (k = 5; n = 338) favored creatine: mean difference (MD) + 0.37 kg (95% CI + 0.05 to + 0.69; I² = 25%; τ² = 0.01; 95% PI -0.10 to + 0.84).
Leg-press 1RM (k = 3; n = 111) improved with creatine: MD + 7.5 kg (95% CI + 2.2 to + 12.8; I² = 0%).
In postmenopausal women, creatine, particularly ≥ 5 g·day⁻¹ with RT, yields small but meaningful gains in lean mass and strength without evidence of harm.
Current evidence does not support robust additive effects of nutritional supplementation on muscle mass or bone health when combined with exercise in women across reproductive stages.
Chen KH et al. · International journal of medical sciences (2026)
The combined intervention showed no significant effects on muscle mass measures: skeletal muscle mass (g=0.065, 95% CI: -0.353 to 0.482, p=0.762), appendicular lean mass (g=0.197, 95% CI: -0.177 to 0.571, p=0.302), or fat-free mass (g=0.069, 95% CI: -0.110 to 0.249, p=0.447).
Significant improvements occurred in bench press (g=0.279, 95% CI: 0.008 to 0.550, p=0.043) and handgrip strength (g=0.412, 95% CI: 0.039 to 0.786, p=0.031).
No significant effects emerged for bone mineral content (g=0.195, 95% CI: -0.281 to 0.671, p=0.421) or bone mineral density (g=0.087, 95% CI: -0.129 to 0.303, p=0.430).
5Adverse outcomes in females taking creatineMeta-AnalysisCited 21×n=951 · large study2020
However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.
de Guingand DL et al. · Nutrients (2020)
Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%).
No statistically significant difference was reported in measures of renal or hepatic function.
In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females.
7VO2maxMeta-AnalysisCited 9×n=424 · medium study2023
Creatine supplementation has a negative effect on VO2max, regardless of the characteristics of training, supplementation, or population characteristics.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2008864 .
Gras D et al. · Critical reviews in food science and nutrition (2023)
Noticeable benefit
← WorseNo effectBetter →
Likely real
We included 19 RCTs for a total of 424 individuals (mean age 30 years old, 82% men).
Participants in both groups were engaged in exercise interventions in most studies (80%).
Using changes in VO2max, VO2max increased in both groups but increased less after creatine supplementation than placebo (effect size [ES] = -0.32, 95%CI = -0.51 to -0.12, p = 0.002).
However, given the level of evidence, future high-quality studies are needed to confirm these findings.
Dos Santos EEP et al. · Nutrients (2021)
Overall, Cr significantly increased measures of upper-body strength (7 studies, n = 142, p = 0.04), with no effect on lower-body strength or measures of muscle mass.
Sub-analyses revealed that both upper-body (4 studies, n = 97, p = 0.05) and lower-body strength (4 studies, n = 100, p = 0.03) were increased by Cr, compared to placebo in studies ≥ 24 weeks in duration.
In conclusion, older females supplementing with Cr experience significant gains in muscle strength, especially when RT lasts for at least 24 weeks in duration.
10Muscle strength gainsMeta-AnalysisCited 18×n=20 · very small study2024
In conclusions, creatine supplementation with resistance training enhances upper- and lower-body muscle strength in adults aged < 50, with greater benefits likely to be seen in males than females.
Wang Z et al. · Nutrients (2024)
Noticeable benefit
← WorseNo effectBetter →
Likely real
In comparison with a placebo, creatine supplementation combined with resistance training significantly increased upper-body (WMD = 4.43 kg, p < 0.001) and lower-body strength (WMD = 11.35 kg, p < 0.001).
Subgroup analyses showed a trend for greater upper-body strength improvements for males on creatine compared with females on creatine (p = 0.067, Q = 3.366).
Additionally, males who consumed creatine combined with resistance training significantly increased both upper- and lower-body strength, whereas females showed no significant gains.
Concurrent carbohydrate ingestion did not enhance the hypertrophy benefits of creatine.
Desai I et al. · Journal of strength and conditioning research (2024)
Noticeable benefit
← WorseNo effectBetter →
Our primary outcome was lean body mass (LBM); secondary outcomes were body fat percentage (%) and body fat mass (kg).
Fifty-two percentages of the studies had low risk, 41% some concerns, and 7% high risk of bias.
Compared with resistance training (RT) alone, creatine supplementation increased LBM by 1.14 kg (95% CI 0.69 to 1.59), and reduced body fat percentage by -0.88% (95% CI -1.66 to -0.11) and body fat mass by -0.73 kg (95% CI -1.34 to -0.11).
12Performance enhancement in combat sportsMeta-AnalysisCited 14×2022
Caffeine is the only NEA that has shown strong evidence for performance enhancement in combat sports.
Vicente-Salar N et al. · Nutrients (2022)
In this regard, abilities including the number of attacks, reaction time, handgrip strength, power and TTE, among others, were improved.
Buffering supplements such as sodium bicarbonate, sodium citrate and beta-alanine may have a promising role in high and intermittent exertion during combat, but more studies are needed in grappling combat sports to confirm their efficacy during sustained isometric exertion.
Other NEAs, including creatine, beetroot juice or glycerol, need further investigation to strengthen the evidence for performance enhancement in combat sports.
13Physical performance in female athletesMeta-AnalysisCited 19×2022
More studies are needed in female athletes that measure the effects of different EAs on sports performance, such as beetroot juice, beta-alanine or sodium phosphate, as the studies to date are scarce and there are many types of EA that need to be further considered in this population, such as creatine and taurine.
López-Torres O et al. · Nutrients (2022)
A random-effects model and the standardized mean differences (SMD) ± 95% confidence intervals (CI) were reported.
Aerobic tests could be improved with the use of taurine, caffeine, and beta-alanine.
No conclusive effects of beetroot juice, polyphenols, or creatine in improving aerobic performance were shown.
14Health and therapeutic benefitsSystematic ReviewCited 136×2021
Based on this analysis, it can be concluded that creatine supplementation has several health and therapeutic benefits throughout the lifespan.
Kreider RB et al. · Nutrients (2021)
Moreover, increasing availability of creatine in tissue may enhance cellular metabolism and thereby lessen the severity of injury and/or disease conditions, particularly when oxygen availability is compromised.
This systematic review assesses the peer-reviewed scientific and medical evidence related to creatine's role in promoting general health as we age and how creatine supplementation has been used as a nutritional strategy to help individuals recover from injury and/or manage chronic disease.
Additionally, it provides reasonable conclusions about the role of creatine on health and disease based on current scientific evidence.
But, due to high heterogeneity and the medium risk of bias for articles, we suggest that these results are taken into account and the facts are interpreted with caution by the readers.
Jiaming Y et al. · Journal of food biochemistry (2021)
Noticeable benefit
← WorseNo effectBetter →
Likely real
Weighted mean difference (WMD), 95% confidence interval (CI), and random-effects model, were applied for estimating the overall effect.
Pooled data showed that creatine significantly reduced creatine kinase (CK) concentration overall (WMD = -30.94; 95% CI: -53.19, -8.69; p = .006) and at three follow-up times (48, 72, and 96 hr) in comparison with placebo.
In contrast, effects were not significant in lactate dehydrogenase (LDH) concentration overall (WMD = -5.99; 95% CI: -14.49, 2.50; p = .167), but creatine supplementation leaded to a significant reduction in LDH concentrations in trials with 48 hr measurement of LDH.
17High-intensity exercise capacity and lean body massSystematic ReviewCited 469×2017
Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes for increasing high-intensity exercise capacity and lean body mass.
Kreider RB et al. · Journal of the International Society of Sports Nutrition (2017)
In conclusion, creatine supplementation with a loading dose of 20⁻30 g/day, divided 3⁻4 times per day, ingested for 6 to 7 days, and followed by 5 g/day for 9 weeks or with a low dose of 3 mg/kg/day for 14 days presents positive effects on improving physical performance tests related to anaerobic metabolism, especially anaerobic power, in soccer players.
Mielgo-Ayuso J et al. · Nutrients (2019)
Huge benefit
← WorseNo effectBetter →
Likely real
A final meta-analysis was performed using the random effects model and pooled standardized mean differences (SMD) (Hedges's g).
However, creatine supplementation showed beneficial effects on anaerobic performance tests (SMD, 1.23; 95% CI, 0.55⁻1.91; p <0.001).
Concretely, creatine demonstrated a large and significant effect on Wingate test performance (SMD, 2.26; 95% CI, 1.40⁻3.11; p <0.001).
Retention of muscle mass and strength is integral to healthy aging.
Devries MC et al. · Medicine and science in sports and exercise (2014)
Cr + RT increased total body mass (P = 0.004) and fat-free mass (P < 0.0001) with no effect on fat mass as compared with RT alone.
Cr + RT increased chest press (P = 0.004) and leg press (P = 0.02) one-repetition maximum to a greater extent than RT alone, with no difference in the effect on knee extension or biceps curl one-repetition maximum, isokinetic or isometric knee extension peak torque.
Cr + RT had a greater effect than RT alone on the 30-s chair stand test (P = 0.03).
20Endurance performanceMeta-AnalysisCited 18×n=13 · very small study2023
Creatine monohydrate supplementation was shown to be ineffective on endurance performance in a trained population.
Fernández-Landa J et al. · Sports medicine (Auckland, N.Z.) (2023)
No clear effect
← WorseNo effectBetter →
Could be chance
Further, after excluding the studies not evenly distributed around the base of the funnel plot, the results were similar (pooled standardized mean difference = - 0.07 [95% confidence interval - 0.27 to 0.13]; I2 = 0%; p = 0.49).
Creatine monohydrate supplementation was shown to be ineffective on endurance performance in a trained population.