Creatine

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    Creatine is among the most well-studied and effective supplements for improving exercise performance. It does this mainly by increasing energy availability during high-intensity activity. Creatine may also provide cognitive and mental health benefits in some contexts.

    Creatine is most often used for .

    What is creatine?

    Creatine (which comes from the Greek word “kreas”, meaning “meat”) is a molecule that is produced in the body from the amino acids arginine, glycine, and methionine. It's primarily made in the liver and (to a lesser extent) in the kidneys and pancreas.[1][2] Creatine stores high-energy phosphate groups in the form of phosphocreatine. These phosphate groups are donated to ADP to regenerate it to ATP, the primary energy carrier in the body.[3] Creatine’s role in energy production is particularly relevant under conditions of high energy demand, such as intense physical or mental activity.

    Creatine can be found in some animal-based foods and is most prevalent in meat and fish.[4][5] Athletes commonly take it as a powder or in capsules.

    What are creatine’s main benefits?

    The primary benefit of creatine is an improvement in strength and power output during resistance exercise. Creatine is well-researched for this purpose, and its effects are quite notable for a supplement, both in the general population,[6][7][8][9] and specifically in older adults.[10][11][12] When used in conjunction with resistance exercise, creatine may modestly increase lean mass.[7][12][11][13] In trained athletes, creatine has been reported to reduce body fat and improve some measures of anaerobic exercise performance, strength, and power output.[14][15] Creatine has also been tested for effects on anaerobic running capacity in many studies, the results of which are rather mixed but generally suggest a small improvement in performance.[16][17][18][19]

    Although creatine has been researched far less for cognitive performance and mental health than for physical performance, it may have benefits in some contexts. Creatine appears to reduce mental fatigue in some scenarios, particularly highly stressful ones involving sleep deprivation or exercise to exhaustion.[20][21] Creatine may also improve some aspects of memory, particularly for people with below-average creatine levels, such as vegetarians and older adults.[22][23] There is also some preliminary evidence to suggest that creatine may reduce symptoms of depression in individuals with major depressive disorder or bipolar disorder.[24] That said, more research is needed in these areas and on other cognitive measures before creatine can be said to be effective for cognitive performance or mental health.

    What are creatine’s main drawbacks?

    Supplementation with creatine typically results in weight gain, partly due to an increase in total body water.[25] The range of weight gain after a creatine loading phase tends to fall between 0.9 and 1.8 kg (1.98–3.96 lbs).[26][27] This may be of particular concern to individuals competing in weight-sensitive sports.

    Diarrhea can occur when too much creatine is taken at one time,[28] in which case the doses should be spread out throughout the day and taken with meals.

    Supplementation with creatine has been reported to negatively affect aerobic capacity to a small degree.[29] It has been speculated that this potential detrimental effect may be related to increases in total body water and body weight following supplementation with creatine.[30]

    How does creatine work?

    Creatine works mainly through its effects on energy metabolism. Adenosine triphosphate (ATP) is a molecule that carries energy within cells and is the main fuel source for high-intensity exercise. When cells use ATP for energy, this molecule is converted into adenosine diphosphate (ADP) and adenosine monophosphate (AMP). Creatine exists in cells in the form of creatine phosphate (or phosphocreatine), which donates a high-energy phosphate group to ADP, thus turning this molecule back into ATP.

    By increasing the overall pool of cellular phosphocreatine, supplementation with creatine can accelerate the recycling of ADP into ATP, thereby quickly replenishing cellular energy stores. This increased availability of energy can promote improvements in strength and power output.[31] The pro-energetic properties of creatine don’t just affect skeletal muscle, but nearly all body systems, including the central nervous system (which comprises the brain and spinal cord).[32]

    What are other names for Creatine

    Note that Creatine is also known as:
    • creatine monohydrate
    • creatine 2-oxopropanoate
    • a-methylguanidinoacetic acid
    Creatine should not be confused with:

    Dosage information

    There are many different forms of creatine available on the market, but creatine monohydrate is the most extensively researched and tends to be the cheapest form. Another option is micronized creatine monohydrate, which dissolves more easily in water.

    In most studies, supplementation involved an initial loading protocol of around 0.3 grams per kilogram of bodyweight per day (typically divided into four equal doses throughout the day) for 5–7 days followed by a daily maintenance dose of at least 0.03 g/kg of bodyweight. For a 180 lb (82 kg) person, this translates to a loading dose of 25 g/day and a maintenance dose of at least 2.5 g/day. The “alternative” to creatine loading involves simply taking a smaller dose (usually 3–5 g) of creatine every day.

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    Frequently asked questions

    What is creatine?

    Creatine (which comes from the Greek word “kreas”, meaning “meat”) is a molecule that is produced in the body from the amino acids arginine, glycine, and methionine. It's primarily made in the liver and (to a lesser extent) in the kidneys and pancreas.[1][2] Creatine stores high-energy phosphate groups in the form of phosphocreatine. These phosphate groups are donated to ADP to regenerate it to ATP, the primary energy carrier in the body.[3] Creatine’s role in energy production is particularly relevant under conditions of high energy demand, such as intense physical or mental activity.

    Creatine can be found in some animal-based foods and is most prevalent in meat and fish.[4][5] Athletes commonly take it as a powder or in capsules.

    Do I need to load creatine?

    Creatine loading involves taking a larger amount of creatine for the first few days of supplementation (usually around 0.3 grams per kilogram of bodyweight per day for 5–7 days) before reducing the daily dose to “maintenance” levels (at least 0.03 g/kg of bodyweight). The “alternative” to creatine loading involves simply taking a smaller dose (usually 3–5 g) of creatine every day.

    Although both loading and non-loading strategies increase muscle creatine stores, creatine loading saturates muscles with creatine within the first week of supplementation, while non-loading takes around 4 weeks.[77]

    So, in short: no, you do not need to load creatine. However, creatine loading will lead to slightly quicker benefits than non-loading, with the downside being a potentially greater risk of experiencing digestive discomfort during the loading phase.

    What is the best form of creatine?

    Several forms of creatine (other than creatine monohydrate) have been investigated, including creatine hydrochloride (creatine HCl), creatine citrate, creatine malate, “buffered” creatine (Kre-Alkalyn), and creatine ethyl ester. However, creatine monohydrate has the most scientific evidence behind it to support its efficacy and safety, and appears to be the cheapest form of creatine to purchase.[93] For these reasons, creatine monohydrate is currently the best form of creatine.

    Does caffeine counteract creatine’s ergogenic effects?

    Supplementation with either creatine or caffeine has consistently been shown to enhance exercise performance in most people, with these improvements thought to occur through separate physiological mechanisms.[57][94] However, some evidence suggests that caffeine may blunt the performance-enhancing effect of creatine.

    For example, one study found that six days of creatine loading increased the amount of torque produced by the quadriceps during a resistance exercise protocol, but adding a single dose of 5 mg of caffeine per kg of bodyweight during the final three days of the six-day creatine-loading protocol resulted in no improvement in exercise performance.[79] Another study found that supplementation with creatine on 4–5 days per week before performing resistance exercise increased quadriceps muscle thickness, but the same dose of creatine plus 3 mg of caffeine per kg of bodyweight resulted in no increases in quadriceps muscle thickness.[89] That said, the study was significantly underpowered, limiting its ability to detect small changes over time.

    One potential explanation for why caffeine may interfere with creatine’s performance-enhancing properties is the opposing effect the two substances have on muscle relaxation time. More specifically, creatine increases calcium reuptake into the sarcoplasmic reticulum (a structure in muscle cells that stores calcium) and reduces muscle relaxation time, whereas caffeine increases calcium release from the sarcoplasmic reticulum and increases muscle relaxation time.[81] Theoretically, reduced muscle relaxation time would be conducive to generating high amounts of force quickly and in rapid succession. Another potential explanation is that co-ingestion of creatine and caffeine may cause gastrointestinal distress.[80][82]

    With the above said, some studies have found that after 5–6 days of creatine loading, supplementation with caffeine before an exercise test enhanced exercise performance.[83][84] Moreover, another study found no differences between supplementation with creatine, creatine plus 300 mg caffeine anhydrous, and creatine plus coffee for changes in strength, muscular endurance, or repeated sprint performance.[82] That said, although caffeine didn’t appear to blunt creatine’s effects in this study, creatine also didn’t appear to have any beneficial effects to begin with. Additionally, studies that have investigated the acute and chronic effects of supplementation with multi-ingredient preworkout supplements containing both caffeine and creatine have reported enhanced exercise performance and muscular adaptations.[85][86][87][88] However, the preworkout supplements also contained ergogenic ingredients other than creatine and caffeine (e.g., beta-alanine), which may have confounded the results.

    Overall, the evidence suggesting that caffeine may blunt creatine’s performance-enhancing effects is weak and observed mainly in studies that implemented a creatine loading protocol or used high (5 mg/kg of bodyweight) doses of caffeine. This implies that this effect — if it exists at all — may not be relevant when creatine loading is not used or when lower doses of caffeine are taken. Until more research is available, it may be best to take caffeine after a creatine loading protocol has been completed, take lower (≤3 mg per kg of bodyweight) doses of caffeine when co-ingested with creatine, or simply take creatine and caffeine separately.

    What are the main dietary sources of creatine?

    Creatine is found in appreciable quantities in skeletal and cardiac (heart) muscles.[4][5] Therefore, meat (including poultry and fish) and meat-based products are the main dietary sources of creatine. Here are some examples of (uncooked) meats and their respective creatine content:

    • Beef, with minimal visible connective tissue: 4.5 g per kg[95]
    • Chicken: 3.4 g/kg[5]
    • Rabbit: 3.4 g/kg[5]
    • Beef heart: 2.5 g/kg[5]
    • Pork heart: 1.5 g/kg[4]

    According to the NHANES III survey, the average daily consumption of creatine from food sources among Americans aged 19-39 years is around 1.1 g for men and 0.6 g for women.[96]

    How much creatine do I need?

    Approximately 14.6 mmol of creatinine (creatine’s urinary metabolite) is lost on a daily basis in the average 70 kg healthy young man who has a creatine storage capacity of around 120 g.[97] This represents a daily creatine loss rate of 1.6%–1.7% (around 2 g),[98][99] and is the amount of creatine that has to be obtained from the diet or in supplemental form on a daily basis in order to maintain sufficient creatine levels. This value is usually around 20% lower in women and 45% lower in older adults due to lower levels of lean mass in these populations,[97][100] and higher in individuals with higher than normal levels of lean mass.[97]

    Do vegetarians get less creatine from their diet?

    In short, yes. This is because vegetarian diets lack the main dietary source of creatine — meat. With this in mind, and considering that around half of the daily need for creatine is obtained from the diet in omnivores,[101] it’s no surprise that the muscle creatine content of individuals eating a vegetarian diet tends to be lower compared to individuals eating an omnivorous diet.[102] Supplementation with creatine appears to close this gap.[103] It’s worth noting that the levels of creatine in the brain are similar between vegetarians and omnivores.[104][105]

    What are the main creatine formulations and variants?

    Creatine monohydrate is the most common form of creatine, and, unless otherwise stated, the default form of creatine used in most studies.[106] It has high intestinal absorption, with bioavailability of approximately 99% at standard doses of 5–10 g.[107][108] That said, there is evidence to suggest that high acute doses (greater than 10g) of creatine monohydrate can saturate intestinal uptake, lowering absorption and increasing fecal secretion.[109]

    This basic form of creatine comes in two variants: creatine anhydrous and micronized creatine monohydrate.

    Creatine anhydrous (anhydrous coming from the Greek “an-” meaning “without”, and “hydor” meaning “water”) is just creatine without the monohydrate. Creatine anhydrous is converted to creatine monohydrate when exposed to water.[110][111] Because it does not contain monohydrate, creatine anhydrous is 100% creatine by weight, whereas creatine monohydrate is 88% creatine and 12% monohydrate by weight.

    Micronized creatine monohydrate is creatine monohydrate that undergoes a mechanical process that reduces the particle size and increases the water solubility of creatine.

    Other creatine formulations include:

    • Creatine hydrochloride (Creatine HCl): This form is characterized by the creatine molecules being bound with hydrochloric acid. Creatine HCl is touted to require a lower dosage. However, this claim has not been scientifically proven and seems unlikely, since the stomach has an abundance of HCl anyway, and creatine will separate from HCl in the stomach. Thus, both creatine HCl and creatine monohydrate form free creatine in the stomach.
    • Liquid creatine: This form has been found to be less effective than creatine monohydrate.[112] The reduced effect is likely due to the passive breakdown of creatine over a period of days into creatinine, which occurs when creatine is suspended in solution.[113] This is not an issue for people preparing a creatine solution at home, since it takes a few days for creatine to start degrading into creatinine.
    • Buffered creatine (Kre-Alkalyn): This form of creatine has a higher pH level than creatine monohydrate. This is accomplished by adding alkaline powder to creatine. Buffered creatine is touted to enhance the effects of creatine monohydrate. However, this claim has not been scientifically proven. In fact, a 2012 study comparing buffered creatine to creatine monohydrate in 36 resistance-trained individuals found no significant differences between the two with regard to the accumulation of creatine in muscle tissue, training adaptations, or adverse effects.[114]
    • Creatine ethyl ester: This is an esterified form of creatine monohydrate that has been found to be less effective than creatine monohydrate for increasing muscle creatine levels and enhancing resistance training adaptations.[115]
    • Magnesium-chelated creatine: In this form of creatine, magnesium ions are attached to the creatine molecules. Limited research suggests that this form of creatine may have the same ergogenic effects as creatine monohydrate.[116]
    • Creatine nitrate: In this form of creatine, a nitrate (NO3) ion is attached to a creatine molecule. Despite creatine nitrate being more soluble in water, it doesn't appear to enhance athletic performance more than creatine monohydrate.[117]
    What happens when you stop taking creatine?

    When you stop taking creatine, your serum levels of creatine will start to drop, returning to baseline levels after around four weeks.[119][77][123] This length of time may vary slightly between individuals.[124] Assuming a daily creatinine elimination rate of 14.6 mmol/day,[97][123] the upper limit for serum creatine to return to baseline levels after stopping supplementation should be around six weeks.

    Does creatine timing relative to exercise matter?

    The timing of supplementation with creatine for improving training adaptations has only been investigated in a small number of trials.

    One 10-week trial looked at the effect of supplementation with creatine together with protein and carbohydrates both before and after resistance training (i.e., in close proximity to the workout) compared to the same supplement taken in the morning and evening (i.e., further away from the workout).[133] The researchers found that taking the supplement in close proximity to the workout increased lean mass, the cross sectional area of type 2 muscle fibers, strength, and intramuscular creatine and glycogen stores more than taking the supplement further away from the workout. This potential benefit of creatine taken in close proximity to the workout, relative to other times, may be related to an upregulation of creatine transport secondary to muscle contraction.[120]

    A handful of trials have also looked at the effect of supplementation with creatine before compared to after the workout.[134][135][136][137][138] In these trials, no differences were observed between groups for changes in body composition or strength.

    In summary, because only one trial examined the effect of taking creatine (together with protein and carbohydrate) in close proximity to, compared to further away from, resistance training sessions, it remains unclear whether there is an optimal time to supplement with creatine. At the very least, it doesn't seem to matter whether creatine is taken before vs. after resistance training sessions.

    What are creatine’s main benefits?

    The primary benefit of creatine is an improvement in strength and power output during resistance exercise. Creatine is well-researched for this purpose, and its effects are quite notable for a supplement, both in the general population,[6][7][8][9] and specifically in older adults.[10][11][12] When used in conjunction with resistance exercise, creatine may modestly increase lean mass.[7][12][11][13] In trained athletes, creatine has been reported to reduce body fat and improve some measures of anaerobic exercise performance, strength, and power output.[14][15] Creatine has also been tested for effects on anaerobic running capacity in many studies, the results of which are rather mixed but generally suggest a small improvement in performance.[16][17][18][19]

    Although creatine has been researched far less for cognitive performance and mental health than for physical performance, it may have benefits in some contexts. Creatine appears to reduce mental fatigue in some scenarios, particularly highly stressful ones involving sleep deprivation or exercise to exhaustion.[20][21] Creatine may also improve some aspects of memory, particularly for people with below-average creatine levels, such as vegetarians and older adults.[22][23] There is also some preliminary evidence to suggest that creatine may reduce symptoms of depression in individuals with major depressive disorder or bipolar disorder.[24] That said, more research is needed in these areas and on other cognitive measures before creatine can be said to be effective for cognitive performance or mental health.

    Does creatine benefit elite athletes?

    Supplementation with creatine has been found to improve physical performance (mainly power output) in athletes competing at the elite level in a host of different sports, including soccer,[47] volleyball,[48] wrestling,[16], and swimming.[49] That said, the beneficial effects of supplemental creatine appear to be less noticeable in elite athletes than in novice athletes.

    Can creatine increase your testosterone levels?
    Quick answer:

    The evidence is mixed, but the preponderance of the evidence suggests that it’s unlikely that creatine will increase your testosterone levels.

    The evidence is mixed, but the preponderance of the evidence suggests that it’s unlikely that creatine will increase your testosterone levels.

    Three randomized controlled trials conducted in healthy young men reported that supplementing with creatine for 1–3 weeks produced small increases in the levels of testosterone or dihydrotestosterone (DHT; a highly active androgen converted from testosterone).[65][66][67] One of the 3 trials looked at the effect of creatine loading (25 grams/day for 1 week) followed by a maintenance phase (5 grams/day for 2 weeks) on testosterone and DHT in 20 young, healthy rugby players. Although no effect on testosterone was found, creatine increased the levels of DHT by 12 nanograms of DHT per deciliter of blood (ng/dL).[65] The other 2 trials found that supplementation with creatine for 1 week in healthy, active young men increased the concentrations of testosterone by 57 ng/dL and 150 ng/dL.[66][67]

    Conversely, 10 other trials (involving a total of 218 participants) looking at the effect of supplemental creatine at daily doses of 3–25 grams on testosterone levels for up to 12 weeks have found no statistically significant effect.[68][69][70][65][71][72][73][74][75][76] The participants in the majority of these trials were healthy, active young men. With regard to the form of creatine used, 9 trials administered creatine monohydrate, whereas 1 trial administered creatine malate. It’s worth noting that no trials have looked at the effect of creatine on testosterone in men with abnormally low testosterone levels.

    image

    Taken together, the available evidence suggests that supplementing with creatine is unlikely to increase testosterone levels, at least in young healthy men whose testosterone levels are within the normal range.

    Does creatine reduce exercise-induced muscle damage?

    Research examining the effect of supplementation with creatine on measures associated with exercise-induced muscle damage has provided somewhat paradoxical results.

    Two 2021 meta-analyses found that creatine appears to blunt increases in the levels of creatine kinase and lactate dehydrogenase (indirect biomarkers of muscle damage), which suggests that creatine may promote recovery from muscle-damaging exercise.[139][140] However, a more recent meta-analysis found that, although acute supplementation with creatine blunted increases in the levels of creatine kinase and lactate dehydrogenase following muscle-damaging exercise, chronic supplementation with creatine resulted in larger increases in the levels of these biomarkers of muscle damage.[141] These findings suggest that creatine may promote the recovery from a single bout of muscle-damaging exercise, but that chronic supplementation may have the opposite effect.

    One possible explanation for the findings above could be that, since creatine increases training performance and capacity over time, people who supplement with creatine may work their muscles harder than they otherwise would, which could eventually result in greater cumulative muscle damage.

    With the above said, it should be kept in mind that supplementation with creatine doesn’t appear to have a consistent effect on other measures associated with exercise-induced muscle damage, including the recovery of exercise performance and muscle function, inflammatory biomarkers, range of motion, and delayed-onset muscle soreness in the hours following a muscle-damaging exercise bout.[139][140][141]

    Can creatine treat muscle disorders?

    Although curative therapies for muscle disorders are lacking, supplementation with creatine may improve the symptoms of some muscle disorders. According to a 2013 Cochrane meta-analysis, supplementation with creatine decreased symptom severity, increased muscle strength, and improved activities of daily living in individuals with muscular dystrophies.[142] However, no effects of creatine were observed in individuals with metabolic myopathies. It’s also worth noting that one trial reported an increase in muscle pain episodes and impairment in activities of daily living with creatine in individuals with glycogen storage disease type V (GSDV, also called McArdle disease).[143]

    Is creatine beneficial in Parkinson’s disease?

    Although a 2017 meta-analysis found that supplementation with creatine increased functional independence (as assessed with the Schwab and England Activities of Daily Living Scale), the size of the effect was very small (and potentially clinically irrelevant). Moreover, no effects of creatine were observed on mental health, motor symptoms, or activities of daily living as assessed with the Unified Parkinson's Disease Rating Scale (UPDRS).[144]

    Does creatine improve bone health?

    The current body of scientific evidence looking at the effects of creatine on bone health is limited and inconclusive. According to a 2018 meta-analysis, supplementation with creatine alongside resistance training in older adults was no more effective than resistance training alone for improving whole body bone mineral density (BMD) or BMD measured at the lumbar spine, hip, or femoral neck.[145] That said, a 2023 randomized controlled trial conducted in 237 postmenopausal women found that supplementation with creatine for 2 years alongside resistance training preserved the compressive and bending strength of parts of the femur.[146]

    Does creatine improve blood sugar control?

    Limited available evidence from one meta-analysis of five randomized controlled trials involving healthy adults and adults with diabetes found no effect of supplementation with creatine on fasting blood glucose levels or on the degree of insulin resistance.[147]

    What are creatine’s main drawbacks?

    Supplementation with creatine typically results in weight gain, partly due to an increase in total body water.[25] The range of weight gain after a creatine loading phase tends to fall between 0.9 and 1.8 kg (1.98–3.96 lbs).[26][27] This may be of particular concern to individuals competing in weight-sensitive sports.

    Diarrhea can occur when too much creatine is taken at one time,[28] in which case the doses should be spread out throughout the day and taken with meals.

    Supplementation with creatine has been reported to negatively affect aerobic capacity to a small degree.[29] It has been speculated that this potential detrimental effect may be related to increases in total body water and body weight following supplementation with creatine.[30]

    Can creatine cause cancer?
    Quick answer:

    The potential links between creatine and cancer are unclear. In general, evidence from in vitro studies and from studies conducted in animals suggests that creatine may have both cancer-suppressive and cancer-promoting properties,[33] whereas evidence from human research suggests a potential protective role of creatine against cancer.

    The potential links between creatine and cancer are unclear. In general, evidence from in vitro studies and from studies conducted in animals suggests that creatine may have both cancer-suppressive and cancer-promoting properties.[33]

    For example, in mouse models, both creatine and cyclocreatine (a synthetic analog of creatine) have been reported to slow down the rate of growth of subcutaneously implanted tumors.[34][35][36][37][38][39] The potential antitumor effects of cyclocreatine may require the presence of creatine kinase, through which cyclocreatine is converted to phosphocyclocreatine, which, in turn, potentially acts as an energy depleter by trapping ATP that has been released from the cell’s mitochondria or transported into the cell from outside, thereby limiting cancer cell proliferation.[36] However, because the expression of creatine kinase can vary widely depending on the type of tumor, the potential antitumor effects of cyclocreatine may also vary accordingly.[40] The potential antitumor properties of supplemental creatine may be related to its effects on cellular acidosis, inflammation, and oxidative stress,[37][39] as well as on the regulation of antitumor killer T cell immunity.[41]

    On the other hand, findings from some studies suggest that creatine may promote invasion and metastasis of certain types of cancer — including colorectal cancer, breast cancer, and pancreatic cancer — through its energy-buffering properties and modulation of cell signaling.[42][43][44]

    It’s important to highlight that the above findings are from in vitro and animal research, so their applicability to humans is currently unclear.

    The limited available research in humans seems to suggest a potential protective role of creatine against cancer. Specifically, according to a 2023 cross-sectional study that was performed using data from 7,344 US adults who participated in the 2017–2020 National Health and Nutrition Examination Survey (NHANES), a higher intake of dietary creatine was associated with a lower risk of cancer or malignancy, with a 1% reduction in cancer risk for every additional milligram of creatine per kilogram of body mass consumed daily.[45] Moreover, in a 2006 randomized controlled trial, supplementation with creatine in people with colorectal cancer who were undergoing chemotherapy had no effect on muscle mass, muscle function, or quality of life, but improved biomarkers of nutritional status in a subsample of participants that were undergoing less aggressive chemotherapy.[46]

    Overall, the available evidence from in vitro and animal studies suggests that creatine may suppress primary tumor growth, but promote invasion and metastasis of some types of tumor, with limited research in humans linking dietary creatine to a lower risk of cancer as well as to some minor protective effects in people undergoing mild chemotherapy for colorectal cancer.

    Is creatine safe for your kidneys?
    Quick answer:

    Short- and long-term supplementation with creatine is likely safe for people with healthy kidneys, and short-term supplementation with creatine is likely safe for people with suboptimal kidney function.

    Creatinine is a byproduct of the breakdown of creatine and phosphocreatine in the body. It is also a commonly used marker of kidney function.

    Because supplementing with creatine can increase the blood levels of creatinine, there have been some concerns about a potential negative effect of creatine on kidney function. However, beyond a harmless increase in creatinine levels, scientific reviews on both the long- and short-term safety of supplemental creatine in people with healthy kidneys have consistently found no adverse effects on kidney function with a wide range of doses.[50][51][52][53][54][55][56][57] That said, although doses of >10 g/day have been found not to impair kidney function, fewer long-term trials have assessed the safety of such high chronic daily intakes.

    Similar findings have been reported in trials looking at the effect of supplemental creatine in people with kidney disease, with trials reporting no detrimental effects on kidney function.[58][59][60] That said, long-term trials assessing the safety of supplemental creatine in people with kidney disease are lacking. Also, it’s worth keeping in mind that, because creatine can increase water retention, it could theoretically adversely affect individuals whose kidney disorder is being treated with diuretics, which cause water loss.

    Overall, the available evidence suggests that short- and long-term supplementation with creatine is likely safe for people with healthy kidneys, and that short-term supplementation with creatine is likely safe for people with suboptimal kidney function. Less is known about the effects of long-term supplementation with creatine in people with suboptimal kidney function.

    Also, it’s worth keeping in mind that, although elevated creatinine levels in response to supplementation with creatine are not indicative of kidney damage, creatine’s ability to raise creatinine levels could potentially mask underlying health issues.

    Does creatine cause hair loss?
    Quick answer:

    Although plausible, it seems unlikely that supplementing with creatine causes hair loss.

    Although plausible, it seems unlikely that supplementing with creatine causes hair loss.

    By binding to androgen receptors in susceptible hair follicles, dihydrotestosterone (DHT; a testosterone metabolite) can cause hair follicles to shrink, ultimately leading to hair loss.[61][62] That said, whether a given hair is more or less likely to fall depends on its location (in male-pattern hair loss, the crown and hairline thin first) and the person’s genetic predisposition to hair loss.[63][64]

    A proposed mechanism behind creatine’s effect on testosterone

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    image

    The idea that supplemental creatine could be linked to hair loss largely originates from the findings of a 2009 randomized controlled trial.[65] In this trial, college-aged male rugby players who took creatine monohydrate for 3 weeks experienced a 41% increase in their blood levels of DHT. The baseline DHT concentration was 0.98 nmol/L and the concentration after 3 weeks was 1.26 nmol/L, with both values being well within the normal range.

    To date, this has been the only trial testing creatine’s effects on DHT. However, 12 other trials have tested creatine’s effects on testosterone. Of these, only two trials (lasting 6 and 7 days) have reported increases in testosterone levels,[66] [67] while the remaining 10 trials (which ranged in duration from 6 days to 12 weeks) found no effect.[68][69][70][65][71][72][73][74][75][76] Importantly, 5 of these trials specifically tested creatine’s effects on free testosterone, the form of testosterone that gets converted to DHT, and found no significant increases.[68][71][73][69][75]

    Lastly, and perhaps most importantly, the effect of supplemental creatine on hair loss hasn’t been directly studied, so all we can do is make educated guesses.

    To sum up: (i) Only one trial has reported an increase in DHT levels with supplemental creatine; (ii) although DHT levels increased, they stayed well within the normal range; (iii) no other trials have looked at the effect of supplementing with creatine on DHT levels, but 10 of the 12 trials looking at the effect of supplemental creatine on testosterone, five of which also looked at free testosterone, reported no effect; and (iv) the effect of supplemental creatine on hair loss hasn’t been directly studied.

    With the above in mind, we can conclude that, although plausible, it seems unlikely that supplementing with creatine causes hair loss.

    Is creatine supplementation safe during pregnancy?

    No human studies to date have evaluated the safety of supplementation with creatine in women during pregnancy. However, studies in rodents suggest that supplemental creatine may not only be safe, but may also have positive effects on birth outcomes.

    For example, in one study conducted in mice, maternal supplementation with creatine from the midpoint of pregnancy until birth increased the creatine content of the placenta (+105%) and of some of the fetal tissues, including the brain (+3.6%), heart (+14%), kidney (+22%), and liver (+37%).[127] The increased concentration of creatine in the brain of the fetus before birth may protect the fetus from damage associated with low oxygen availability, such as during a Cesarean section.[128] Protective effects have also been observed in the offspring’s diaphragm (through preserved muscle fiber size),[129] kidneys,[130] and neural tissue (due to less oxidation in the brain and less cellular apoptosis).[131]

    Importantly, maternal supplementation with creatine (again, in mice) does not seem to affect the creatine transporter or the enzymes responsible for creatine synthesis in the newborn, which suggests that the capacity for creatine synthesis in the newborn mouse is not altered.[132]

    How does creatine work?

    Creatine works mainly through its effects on energy metabolism. Adenosine triphosphate (ATP) is a molecule that carries energy within cells and is the main fuel source for high-intensity exercise. When cells use ATP for energy, this molecule is converted into adenosine diphosphate (ADP) and adenosine monophosphate (AMP). Creatine exists in cells in the form of creatine phosphate (or phosphocreatine), which donates a high-energy phosphate group to ADP, thus turning this molecule back into ATP.

    By increasing the overall pool of cellular phosphocreatine, supplementation with creatine can accelerate the recycling of ADP into ATP, thereby quickly replenishing cellular energy stores. This increased availability of energy can promote improvements in strength and power output.[31] The pro-energetic properties of creatine don’t just affect skeletal muscle, but nearly all body systems, including the central nervous system (which comprises the brain and spinal cord).[32]

    Does caffeine counteract creatine?
    Quick answer:

    There is very little evidence that caffeine counteracts the benefits of creatine.

    Supplementation with either creatine or caffeine has consistently been shown to enhance high-intensity exercise performance in most people, and the ingredients are thought to achieve this feat via separate physiological mechanisms. There also doesn’t appear to be any pharmacokinetic interactions when caffeine or creatine are taken together; i.e., neither caffeine nor creatine affects the other’s blood levels.[78] Caffeine does not influence creatine’s ability to increase muscle phosphocreatine storage[79], which makes combined supplementation of creatine and caffeine an attractive prospect for athletes and recreational exercisers alike.

    However, there is some evidence to suggest that chronic caffeine consumption during creatine loading blunts the ergogenic (i.e., performance-enhancing) effect of creatine.[80] One notable study found that six days of creatine loading increased the amount of torque produced by the quadriceps during a resistance exercise protocol but adding a single dose of 5 mg of caffeine per kg of body weight during the final three days of the six-day creatine-loading protocol produced no improvement in exercise performance.[79]

    If caffeine does interfere with creatine’s ergogenic effect, it may be a consequence of these supplements having opposing effects on muscle relaxation time. Creatine increases calcium reuptake into the sarcoplasmic reticulum (a structure in muscle cells that stores calcium) and reduces muscle relaxation time, whereas caffeine increases calcium release from the sarcoplasmic reticulum and increases muscle relaxation time.[81] Theoretically, reduced muscle relaxation time would be conducive to generating high amounts of force quickly and in rapid succession.

    Caffeine may also blunt the ergogenic effect of creatine because co-ingestion of these ingredients has been reported to cause gastrointestinal distress in some people.[80][82]

    While these data are thought-provoking, it’s far from clear whether caffeine and creatine should be consumed separately to maximize their ergogenic effects. For instance, despite caffeine potentially diminishing creatine’s ergogenic effect when ingested during creatine loading, other studies found that after five to six days of creatine loading, supplementation with caffeine before an exercise test enhanced performance.[83][84]

    Additionally, studies that investigated the acute and chronic effects of supplementation with a multi-ingredient preworkout supplement containing both caffeine and creatine reported enhanced exercise performance and muscular adaptations.[85][86][87][88] However, these preworkout supplements also contained ergogenic ingredients other than creatine and caffeine (e.g., beta-alanine), which may have confounded the results.

    Lastly, and most recently, the results from two studies cast further uncertainty on whether one should refrain from co-ingestion of caffeine and creatine. In the first study, a 2016 randomized controlled trial, 54 physically active men supplemented with a daily loading dose of creatine, creatine plus 300 mg caffeine anhydrous (equivalent to about 3 cups of coffee), creatine plus coffee (containing 300 mg of caffeine), or placebo for five days. No differences between groups were found for changes in upper- or lower-body strength, upper- or lower-body muscular endurance, or repeated sprint performance.[82] This dose of caffeine didn’t appear to blunt creatine’s effects in this study, but creatine also didn’t appear to have any positive effects to blunt.

    In the second study, a small controlled trial published in 2022, 28 resistance-trained adults were randomly assigned to supplement with a non-loading dose of creatine monohydrate (0.1 grams per kg of body weight), caffeine (3 mg per kg of body weight), creatine plus caffeine, or placebo for four to five days per week before performing resistance exercise. After six weeks of training, there were no differences between groups for changes in upper- or lower-body strength, upper- or lower-body muscular endurance, or fat-free mass; however, the group that supplemented with creatine alone, and only that group, experienced an increase in quadriceps muscle thickness compared to baseline.[89] In this study, the creatine group did see positive effects (albeit in muscle thickness, not performance) that the caffeine + creatine group did not. However, the study was significantly underpowered, limiting its ability to detect small changes over time. The intermittent (as opposed to daily) supplementation protocol may have also influenced the results.

    The evidence indicating that co-ingestion of caffeine and creatine blunts creatine’s ergogenic effect is weak, and is seen mainly in studies that implemented a creatine loading protocol, implying that this effect — if it exists at all — may not be relevant when creatine loading is not used. Nonetheless, this level of evidence may be sufficient to lead some people to reconsider their current supplementation practices.

    In terms of practical recommendations to mitigate the potentially unfavorable interaction between caffeine and creatine, one option is to supplement caffeine before exercise and creatine after exercise.[90] If co-ingesting caffeine and creatine, it may be prudent to stick to a lower dose of caffeine (≤ 3 mg per kg of body weight), as the studies that reported a negative interaction had participants supplement with 5 mg per kg of body weight. Additionally, early studies on creatine supplementation, which had participants mix creatine with hot coffee or tea, didn’t find that these beverages inhibited creatine’s ergogenic effect;[91][92] typical cups of coffee and tea contain far less than 5 mg/kg of caffeine. Further, coffee and tea are not simply “caffeine water” and contain hundreds of other bioactive compounds, which could have influenced the results.

    Is there such a thing as a creatine non-responder?
    Quick answer:

    Yes, there is, in fact, such a thing as a creatine non-responder!

    In general, oral supplementation of creatine increases muscle creatine content by 15%–20%, which is more than a 20 millimolar (mM) increase. Individuals who get a response of this magnitude are considered creatine responders.[118][77][119][120] Creatine non-responders are individuals whose muscle creatine content increases by less than 10 mM after prolonged supplementation with creatine,[121] while creatine quasi-responders are individuals whose muscle creatine content increases by 10–20 mM.[121]

    Non-response to supplemental creatine is thought to explain instances in which not all participants benefit from supplementing with creatine in trials.[122]

    Does creatine affect growth hormone levels?

    Limited evidence suggests that a single dose of creatine at rest may increase growth hormone secretion in the hours following supplementation, with a high degree of variability between individuals (38%–128%).[125] On the other hand, creatine loading (but not a lower daily dose to maintain elevated creatine levels) may blunt exercise-induced growth hormone secretion.[126]

    Update History

    Big page update

    major

    We modified the following FAQs:

    1. Creatine & cancer: we added more studies to elaborate on our answer. The conclusions have changed from “no link” to “potential protective effects from studies in humans” and “potential cancer-promoting and cancer-suppressive effects based on in vitro and animal studies”.
    2. Creatine & testosterone: we expanded on this relationship a bit, but there are no changes to the conclusions of the FAQ.
    3. Creatine & kidney health: We added an additional small paragraph, but the conclusions of the FAQ have not changed.
    4. Creatine & hair loss: we reworded some of the paragraph for clarity, but the conclusions of the FAQ have not changed.
    5. Creatine non-responders: we reworded for clarity, but the conclusions of the FAQ have not changed.

    Additionally, we changed the following outcomes in the database:

    1. "Weight" has been changed to from "large increase" to "small increase".
    2. "Total body water" has been changed from "moderate increase" to "small increase"
    3. "Testosterone" has been changed from "small increase" to "no effect".
    4. "Metabolic rate" has changed from "moderate increase" to "small increase".

    Finally, we added three new meta-analyses to the database related to creatine's effect on exercise-induced muscle damage.

    Reviewed By

    Handful of small changes

    minor

    We adjusted the wording and content of the overview, dosage information, and the FAQ about reducing exercise-induced muscle damage. None of these changes affect the take-home concepts on the page.

    Reviewed By

    Research Breakdown

    References

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    112. ^Astorino TA, Marrocco AC, Gross SM, Johnson DL, Brazil CM, Icenhower ME, Kneessi RJIs running performance enhanced with creatine serum ingestion?J Strength Cond Res.(2005-Nov)
    113. ^Gill ND, Hall RD, Blazevich AJCreatine serum is not as effective as creatine powder for improving cycle sprint performance in competitive male team-sport athletes.J Strength Cond Res.(2004-May)
    114. ^Jagim AR, Oliver JM, Sanchez A, Galvan E, Fluckey J, Riechman S, Greenwood M, Kelly K, Meininger C, Rasmussen C, Kreider RBA buffered form of creatine does not promote greater changes in muscle creatine content, body composition, or training adaptations than creatine monohydrate.J Int Soc Sports Nutr.(2012-Sep-13)
    115. ^Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DSThe effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levelsJ Int Soc Sports Nutr.(2009 Feb 19)
    116. ^Selsby JT, DiSilvestro RA, Devor STMg2+-creatine chelate and a low-dose creatine supplementation regimen improve exercise performanceJ Strength Cond Res.(2004 May)
    117. ^Galvan E, Walker DK, Simbo SY, Dalton R, Levers K, O'Connor A, Goodenough C, Barringer ND, Greenwood M, Rasmussen C, Smith SB, Riechman SE, Fluckey JD, Murano PS, Earnest CP, Kreider RBAcute and chronic safety and efficacy of dose dependent creatine nitrate supplementation and exercise performanceJ Int Soc Sports Nutr.(2016 Mar 31)
    118. ^Casey A, Constantin-Teodosiu D, Howell S, Hultman E, Greenhaff PLCreatine ingestion favorably affects performance and muscle metabolism during maximal exercise in humans.Am J Physiol.(1996-Jul)
    119. ^Febbraio MA, Flanagan TR, Snow RJ, Zhao S, Carey MFEffect of creatine supplementation on intramuscular TCr, metabolism and performance during intermittent, supramaximal exercise in humans.Acta Physiol Scand.(1995-Dec)
    120. ^Robinson TM, Sewell DA, Hultman E, Greenhaff PLRole of submaximal exercise in promoting creatine and glycogen accumulation in human skeletal muscleJ Appl Physiol (1985).(1999 Aug)
    121. ^Syrotuik DG, Bell GJAcute creatine monohydrate supplementation: a descriptive physiological profile of responders vs. nonrespondersJ Strength Cond Res.(2004 Aug)
    122. ^Hadjicharalambous M, Kilduff LP, Pitsiladis YPBrain serotonin and dopamine modulators, perceptual responses and endurance performance during exercise in the heat following creatine supplementationJ Int Soc Sports Nutr.(2008 Sep 30)
    123. ^Preen D, Dawson B, Goodman C, Beilby J, Ching SCreatine supplementation: a comparison of loading and maintenance protocols on creatine uptake by human skeletal muscle.Int J Sport Nutr Exerc Metab.(2003-Mar)
    124. ^Rawson ES, Persky AM, Price TB, Clarkson PMEffects of repeated creatine supplementation on muscle, plasma, and urine creatine levels.J Strength Cond Res.(2004-Feb)
    125. ^Schedel JM, Tanaka H, Kiyonaga A, Shindo M, Schutz YAcute creatine loading enhances human growth hormone secretionJ Sports Med Phys Fitness.(2000 Dec)
    126. ^Peyrebrune MC, Stokes K, Hall GM, Nevill MEEffect of creatine supplementation on training for competition in elite swimmersMed Sci Sports Exerc.(2005 Dec)
    127. ^Zoe Ireland, Hayley Dickinson, Rod Snow, David W WalkerMaternal creatine: does it reach the fetus and improve survival after an acute hypoxic episode in the spiny mouse (Acomys cahirinus)?Am J Obstet Gynecol.(2008 Apr)
    128. ^Adcock KH, Nedelcu J, Loenneker T, Martin E, Wallimann T, Wagner BPNeuroprotection of creatine supplementation in neonatal rats with transient cerebral hypoxia-ischemia.Dev Neurosci.(2002)
    129. ^Cannata DJ, Ireland Z, Dickinson H, Snow RJ, Russell AP, West JM, Walker DWMaternal creatine supplementation from mid-pregnancy protects the diaphragm of the newborn spiny mouse from intrapartum hypoxia-induced damage.Pediatr Res.(2010-Nov)
    130. ^Ellery SJ, Ireland Z, Kett MM, Snow R, Walker DW, Dickinson HCreatine pretreatment prevents birth asphyxia-induced injury of the newborn spiny mouse kidney.Pediatr Res.(2013-Feb)
    131. ^Ireland Z, Castillo-Melendez M, Dickinson H, Snow R, Walker DWA maternal diet supplemented with creatine from mid-pregnancy protects the newborn spiny mouse brain from birth hypoxia.Neuroscience.(2011-Oct-27)
    132. ^Dickinson H, Ireland ZJ, Larosa DA, O'Connell BA, Ellery S, Snow R, Walker DWMaternal dietary creatine supplementation does not alter the capacity for creatine synthesis in the newborn spiny mouse.Reprod Sci.(2013-Sep)
    133. ^Paul J Cribb, Alan HayesEffects of supplement timing and resistance exercise on skeletal muscle hypertrophyMed Sci Sports Exerc.(2006 Nov)
    134. ^Antonio J, Ciccone VThe effects of pre versus post workout supplementation of creatine monohydrate on body composition and strengthJ Int Soc Sports Nutr.(2013 Aug 6)
    135. ^Candow DG, Zello GA, Ling B, Farthing JP, Chilibeck PD, McLeod K, Harris J, Johnson SComparison of creatine supplementation before versus after supervised resistance training in healthy older adults.Res Sports Med.(2014)
    136. ^Candow DG, Vogt E, Johannsmeyer S, Forbes SC, Farthing JPStrategic creatine supplementation and resistance training in healthy older adults.Appl Physiol Nutr Metab.(2015-Jul)
    137. ^Forbes SC, Krentz JR, Candow DGTiming of creatine supplementation does not influence gains in unilateral muscle hypertrophy or strength from resistance training in young adults: a within-subject design.J Sports Med Phys Fitness.(2021-Sep)
    138. ^Dinan NE, Hagele AM, Jagim AR, Miller MG, Kerksick CMEffects of creatine monohydrate timing on resistance training adaptations and body composition after 8 weeks in male and female collegiate athletes.Front Sports Act Living.(2022)
    139. ^Yue Jiaming, Mohammad Hossein RahimiCreatine supplementation effect on recovery following exercise-induced muscle damage: A systematic review and meta-analysis of randomized controlled trialsJ Food Biochem.(2021 Oct)
    140. ^Bethany Northeast, Tom CliffordThe Effect of Creatine Supplementation on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention TrialsInt J Sport Nutr Exerc Metab.(2021 Feb 24)
    141. ^Kenji Doma, Akhilesh Kumar Ramachandran, Daniel Boullosa, Jonathan ConnorThe Paradoxical Effect of Creatine Monohydrate on Muscle Damage Markers: A Systematic Review and Meta-AnalysisSports Med.(2022 Feb 26)
    142. ^Kley RA, Tarnopolsky MA, Vorgerd MCreatine for treating muscle disorders.Cochrane Database Syst Rev.(2013-Jun-05)
    143. ^Vorgerd M, Zange J, Kley R, Grehl T, Hüsing A, Jäger M, Müller K, Schröder R, Mortier W, Fabian K, Malin JP, Luttmann AEffect of high-dose creatine therapy on symptoms of exercise intolerance in McArdle disease: double-blind, placebo-controlled crossover studyArch Neurol.(2002 Jan)
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    146. ^Chilibeck PD, Candow DG, Gordon JJ, Duff WRD, Mason R, Shaw K, Taylor-Gjevre R, Nair B, Zello GAA 2-Year Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health.Med Sci Sports Exerc.(2023-May-05)
    147. ^Delpino FM, Figueiredo LMDoes creatine supplementation improve glycemic control and insulin resistance in healthy and diabetic patients? A systematic review and meta-analysis.Clin Nutr ESPEN.(2022-Feb)

    Examine Database References

    1. Muscle Creatine Content - Banerjee B, Sharma U, Balasubramanian K, Kalaivani M, Kalra V, Jagannathan NREffect of creatine monohydrate in improving cellular energetics and muscle strength in ambulatory Duchenne muscular dystrophy patients: a randomized, placebo-controlled 31P MRS studyMagn Reson Imaging.(2010 Jun)
    2. Duchenne Muscular Dystrophy Symptoms - Tarnopolsky MA, Mahoney DJ, Vajsar J, Rodriguez C, Doherty TJ, Roy BD, Biggar DCreatine monohydrate enhances strength and body composition in Duchenne muscular dystrophyNeurology.(2004 May 25)
    3. Power Output - Kley RA, Tarnopolsky MA, Vorgerd MCreatine for treating muscle disorders.Cochrane Database Syst Rev.(2013-Jun-05)
    4. Power Output - Arciero PJ, Hannibal NS 3rd, Nindl BC, Gentile CL, Hamed J, Vukovich MDComparison of creatine ingestion and resistance training on energy expenditure and limb blood flowMetabolism.(2001 Dec)
    5. Power Output - Jonathan P Little, Scott C Forbes, Darren G Candow, Stephen M Cornish, Philip D ChilibeckCreatine, arginine alpha-ketoglutarate, amino acids, and medium-chain triglycerides and endurance and performanceInt J Sport Nutr Exerc Metab.(2008 Oct)
    6. Power Output - Spillane M, Schoch R, Cooke M, Harvey T, Greenwood M, Kreider R, Willoughby DSThe effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levelsJ Int Soc Sports Nutr.(2009 Feb 19)
    7. Power Output - Branch JDEffect of creatine supplementation on body composition and performance: a meta-analysisInt J Sport Nutr Exerc Metab.(2003 Jun)
    8. Power Output - Chilibeck PD, Magnus C, Anderson MEffect of in-season creatine supplementation on body composition and performance in rugby union football playersAppl Physiol Nutr Metab.(2007 Dec)
    9. Power Output - Sakkas GK, Mulligan K, Dasilva M, Doyle JW, Khatami H, Schleich T, Kent-Braun JA, Schambelan MCreatine fails to augment the benefits from resistance training in patients with HIV infection: a randomized, double-blind, placebo-controlled studyPLoS One.(2009)
    10. Power Output - Burke DG, Chilibeck PD, Parise G, Candow DG, Mahoney D, Tarnopolsky MEffect of creatine and weight training on muscle creatine and performance in vegetariansMed Sci Sports Exerc.(2003 Nov)
    11. Power Output - Manjarrez-Montes de Oca R, Farfán-González F, Camarillo-Romero S, Tlatempa-Sotelo P, Francisco-Argüelles C, Kormanowski A, González-Gallego J, Alvear-Ordenes IEffects of creatine supplementation in taekwondo practitionersNutr Hosp.(2013 Mar-Apr)
    12. Power Output - Gotshalk LA, Kraemer WJ, Mendonca MA, Vingren JL, Kenny AM, Spiering BA, Hatfield DL, Fragala MS, Volek JSCreatine supplementation improves muscular performance in older womenEur J Appl Physiol.(2008 Jan)
    13. Power Output - Kerksick CM, Wilborn CD, Campbell WI, Harvey TM, Marcello BM, Roberts MD, Parker AG, Byars AG, Greenwood LD, Almada AL, Kreider RB, Greenwood MThe effects of creatine monohydrate supplementation with and without D-pinitol on resistance training adaptationsJ Strength Cond Res.(2009 Dec)
    14. Power Output - Kilduff LP, Pitsiladis YP, Tasker L, Attwood J, Hyslop P, Dailly A, Dickson I, Grant SEffects of creatine on body composition and strength gains after 4 weeks of resistance training in previously nonresistance-trained humansInt J Sport Nutr Exerc Metab.(2003 Dec)
    15. Power Output - Dos Santos EEP, de Araújo RC, Candow DG, Forbes SC, Guijo JA, de Almeida Santana CC, Prado WLD, Botero JPEfficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis.Nutrients.(2021-Oct-24)
    16. Power Output - Forbes SC, Candow DG, Ostojic SM, Roberts MD, Chilibeck PDMeta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults.Nutrients.(2021-Jun-02)
    17. Power Output - Wu Y, Hu X, Chen LEffects of Creatine in Trained Athletes: A Meta-analysis of 21 Randomized Placebo-Controlled Trials.Am J Ther.(2020)
    18. Power Output - Philip D Chilibeck, Mojtaba Kaviani, Darren G Candow, Gordon A ZelloEffect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysisOpen Access J Sports Med.(2017 Nov 2)
    19. Body Fat - Forbes SC, Candow DG, Krentz JR, Roberts MD, Young KCChanges in Fat Mass Following Creatine Supplementation and Resistance Training in Adults ≥50 Years of Age: A Meta-Analysis.J Funct Morphol Kinesiol.(2019-Aug-23)
    20. Weight - Kutz MR, Gunter MJCreatine monohydrate supplementation on body weight and percent body fatJ Strength Cond Res.(2003 Nov)
    21. Weight - Kilduff LP, Lewis S, Kingsley MI, Owen NJ, Dietzig REReliability and detecting change following short-term creatine supplementation: comparison of two-component body composition methodsJ Strength Cond Res.(2007 May)
    22. Fatigue Resistance - Eric S Rawson, Michael J Stec, Sara J Frederickson, Mary P MilesLow-dose creatine supplementation enhances fatigue resistance in the absence of weight gainNutrition.(2011 Apr)
    23. Power Output - Faager G, Söderlund K, Sköld CM, Rundgren S, Tollbäck A, Jakobsson PCreatine supplementation and physical training in patients with COPD: a double blind, placebo-controlled studyInt J Chron Obstruct Pulmon Dis.(2006)
    24. Power Output - Tarnopolsky M, Martin JCreatine monohydrate increases strength in patients with neuromuscular diseaseNeurology.(1999 Mar 10)
    25. Power Output - Chilibeck PD, Stride D, Farthing JP, Burke DGEffect of creatine ingestion after exercise on muscle thickness in males and femalesMed Sci Sports Exerc.(2004 Oct)
    26. Power Output - Carter JM, Bemben DA, Knehans AW, Bemben MG, Witten MSDoes nutritional supplementation influence adaptability of muscle to resistance training in men aged 48 to 72 yearsJ Geriatr Phys Ther.(2005)
    27. Power Output - Kendall KL, Smith AE, Graef JL, Fukuda DH, Moon JR, Beck TW, Cramer JT, Stout JREffects of four weeks of high-intensity interval training and creatine supplementation on critical power and anaerobic working capacity in college-aged menJ Strength Cond Res.(2009 Sep)
    28. Power Output - Hoffman J, Ratamess N, Kang J, Mangine G, Faigenbaum A, Stout JEffect of creatine and beta-alanine supplementation on performance and endocrine responses in strength/power athletesInt J Sport Nutr Exerc Metab.(2006 Aug)
    29. Power Output - Bazzucchi I, Felici F, Sacchetti MEffect of short-term creatine supplementation on neuromuscular functionMed Sci Sports Exerc.(2009 Oct)
    30. Power Output - Camic CL, Hendrix CR, Housh TJ, Zuniga JM, Mielke M, Johnson GO, Schmidt RJ, Housh DJThe effects of polyethylene glycosylated creatine supplementation on muscular strength and powerJ Strength Cond Res.(2010 Dec)
    31. Power Output - Eckerson JM, Bull AA, Moore GAEffect of thirty days of creatine supplementation with phosphate salts on anaerobic working capacity and body weight in menJ Strength Cond Res.(2008 May)
    32. Power Output - Bemben MG, Witten MS, Carter JM, Eliot KA, Knehans AW, Bemben DAThe effects of supplementation with creatine and protein on muscle strength following a traditional resistance training program in middle-aged and older menJ Nutr Health Aging.(2010 Feb)
    33. Power Output - Antonio J, Ciccone VThe effects of pre versus post workout supplementation of creatine monohydrate on body composition and strengthJ Int Soc Sports Nutr.(2013 Aug 6)
    34. Power Output - Candow DG, Chilibeck PD, Burke DG, Mueller KD, Lewis JDEffect of different frequencies of creatine supplementation on muscle size and strength in young adultsJ Strength Cond Res.(2011 Jul)
    35. Power Output - Trent J Herda, Travis W Beck, Eric D Ryan, Abbie E Smith, Ashley A Walter, Michael J Hartman, Jeffrey R Stout, Joel T CramerEffects of creatine monohydrate and polyethylene glycosylated creatine supplementation on muscular strength, endurance, and power outputJ Strength Cond Res.(2009 May)
    36. Power Output - Volek JS, Ratamess NA, Rubin MR, Gómez AL, French DN, McGuigan MM, Scheett TP, Sharman MJ, Häkkinen K, Kraemer WJThe effects of creatine supplementation on muscular performance and body composition responses to short-term resistance training overreachingEur J Appl Physiol.(2004 May)
    37. Power Output - Rawson ES, Volek JSEffects of creatine supplementation and resistance training on muscle strength and weightlifting performanceJ Strength Cond Res.(2003 Nov)
    38. Power Output - Netreba I, Shenkman BS, Popov DV, Tarasova OS, Vdovina AB, Khotchenkov VP, Stekhanova TN, Vinogradova OLCreatine as a metabolic controller of skeletal muscles structure and function in strength exercises in humansRoss Fiziol Zh Im I M Sechenova.(2006 Jan)
    39. Power Output - Ferguson TB, Syrotuik DGEffects of creatine monohydrate supplementation on body composition and strength indices in experienced resistance trained womenJ Strength Cond Res.(2006 Nov)
    40. Power Output - Saremi A, Gharakhanloo R, Sharghi S, Gharaati MR, Larijani B, Omidfar KEffects of oral creatine and resistance training on serum myostatin and GASP-1Mol Cell Endocrinol.(2010 Apr 12)
    41. Power Output - Law YL, Ong WS, GillianYap TL, Lim SC, Von Chia EEffects of two and five days of creatine loading on muscular strength and anaerobic power in trained athletesJ Strength Cond Res.(2009 May)
    42. Power Output - Koçak S, Karli UEffects of high dose oral creatine supplementation on anaerobic capacity of elite wrestlersJ Sports Med Phys Fitness.(2003 Dec)
    43. Power Output - Graef JL, Smith AE, Kendall KL, Fukuda DH, Moon JR, Beck TW, Cramer JT, Stout JRThe effects of four weeks of creatine supplementation and high-intensity interval training on cardiorespiratory fitness: a randomized controlled trialJ Int Soc Sports Nutr.(2009 Nov 12)
    44. Power Output - Chia-Lun Lee, Jung-Charng Lin, Ching-Feng ChengEffect of caffeine ingestion after creatine supplementation on intermittent high-intensity sprint performanceEur J Appl Physiol.(2011 Aug)
    45. Power Output - Cramer JT, Stout JR, Culbertson JY, Egan ADEffects of creatine supplementation and three days of resistance training on muscle strength, power output, and neuromuscular functionJ Strength Cond Res.(2007 Aug)
    46. Power Output - Selsby JT, DiSilvestro RA, Devor STMg2+-creatine chelate and a low-dose creatine supplementation regimen improve exercise performanceJ Strength Cond Res.(2004 May)
    47. Power Output - Del Favero S, Roschel H, Artioli G, Ugrinowitsch C, Tricoli V, Costa A, Barroso R, Negrelli AL, Otaduy MC, da Costa Leite C, Lancha-Junior AH, Gualano BCreatine but not betaine supplementation increases muscle phosphorylcreatine content and strength performanceAmino Acids.(2011 Jul 9)
    48. Power Output - Volek JS, Mazzetti SA, Farquhar WB, Barnes BR, Gómez AL, Kraemer WJPhysiological responses to short-term exercise in the heat after creatine loadingMed Sci Sports Exerc.(2001 Jul)
    49. Power Output - Kenji Doma, Akhilesh Kumar Ramachandran, Daniel Boullosa, Jonathan ConnorThe Paradoxical Effect of Creatine Monohydrate on Muscle Damage Markers: A Systematic Review and Meta-AnalysisSports Med.(2022 Feb 26)
    50. Power Output - Bethany Northeast, Tom CliffordThe Effect of Creatine Supplementation on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention TrialsInt J Sport Nutr Exerc Metab.(2021 Feb 24)
    51. Power Output - Mielgo-Ayuso J, Calleja-Gonzalez J, Marqués-Jiménez D, Caballero-García A, Córdova A, Fernández-Lázaro DEffects of Creatine Supplementation on Athletic Performance in Soccer Players: A Systematic Review and Meta-Analysis.Nutrients.(2019-Mar-31)
    52. Power Output - Lanhers C, Pereira B, Naughton G, Trousselard M, Lesage FX, Dutheil FCreatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis.Sports Med.(2017-Jan)
    53. Power Output - Charlotte Lanhers, Bruno Pereira, Geraldine Naughton, Marion Trousselard, François-Xavier Lesage, Frédéric DutheilCreatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-AnalysesSports Med.(2015 Sep)
    54. Muscle Creatine Content - Watt KK, Garnham AP, Snow RJSkeletal muscle total creatine content and creatine transporter gene expression in vegetarians prior to and following creatine supplementationInt J Sport Nutr Exerc Metab.(2004 Oct)
    55. Muscle Creatine Content - Nelson AG, Arnall DA, Kokkonen J, Day R, Evans JMuscle glycogen supercompensation is enhanced by prior creatine supplementationMed Sci Sports Exerc.(2001 Jul)
    56. Muscle Creatine Content - Thompson CH, Kemp GJ, Sanderson AL, Dixon RM, Styles P, Taylor DJ, Radda GKEffect of creatine on aerobic and anaerobic metabolism in skeletal muscle in swimmersBr J Sports Med.(1996 Sep)
    57. Muscle Creatine Content - Jeffrey J Brault, Theodore F Towse, Jill M Slade, Ronald A MeyerParallel increases in phosphocreatine and total creatine in human vastus lateralis muscle during creatine supplementationInt J Sport Nutr Exerc Metab.(2007 Dec)
    58. Muscle Creatine Content - McConell GK, Shinewell J, Stephens TJ, Stathis CG, Canny BJ, Snow RJCreatine supplementation reduces muscle inosine monophosphate during endurance exercise in humansMed Sci Sports Exerc.(2005 Dec)
    59. Muscle Creatine Content - van Loon LJ, Oosterlaar AM, Hartgens F, Hesselink MK, Snow RJ, Wagenmakers AJEffects of creatine loading and prolonged creatine supplementation on body composition, fuel selection, sprint and endurance performance in humansClin Sci (Lond).(2003 Feb)
    60. Weight - Murphy AJ, Watsford ML, Coutts AJ, Richards DAEffects of creatine supplementation on aerobic power and cardiovascular structure and functionJ Sci Med Sport.(2005 Sep)
    61. Weight - Eckerson JM, Stout JR, Moore GA, Stone NJ, Nishimura K, Tamura KEffect of two and five days of creatine loading on anaerobic working capacity in womenJ Strength Cond Res.(2004 Feb)
    62. Weight - Eckerson JM, Stout JR, Moore GA, Stone NJ, Iwan KA, Gebauer AN, Ginsberg REffect of creatine phosphate supplementation on anaerobic working capacity and body weight after two and six days of loading in men and womenJ Strength Cond Res.(2005 Nov)
    63. Weight - Walter AA, Smith AE, Herda TJ, Ryan ED, Moon JR, Cramer JT, Stout JREffects of creatine loading on electromyographic fatigue threshold in cycle ergometry in college-age menInt J Sport Nutr Exerc Metab.(2008 Apr)
    64. Weight - Smith AE, Walter AA, Herda TJ, Ryan ED, Moon JR, Cramer JT, Stout JREffects of creatine loading on electromyographic fatigue threshold during cycle ergometry in college-aged womenJ Int Soc Sports Nutr.(2007 Nov 26)
    65. Weight - Hoffman JR, Stout JR, Falvo MJ, Kang J, Ratamess NAEffect of low-dose, short-duration creatine supplementation on anaerobic exercise performanceJ Strength Cond Res.(2005 May)
    66. Anaerobic Capacity - Kinugasa R, Akima H, Ota A, Ohta A, Sugiura K, Kuno SYShort-term creatine supplementation does not improve muscle activation or sprint performance in humansEur J Appl Physiol.(2004 Mar)
    67. Anaerobic Capacity - Havenetidis K, Bourdas DCreatine supplementation: effects on urinary excretion and anaerobic performanceJ Sports Med Phys Fitness.(2003 Sep)
    68. Fatigue Resistance - Stout JR, Cramer JT, Mielke M, O'Kroy J, Torok DJ, Zoeller RFEffects of twenty-eight days of beta-alanine and creatine monohydrate supplementation on the physical working capacity at neuromuscular fatigue thresholdJ Strength Cond Res.(2006 Nov)
    69. Fatigue Resistance - Stout JR, Sue Graves B, Cramer JT, Goldstein ER, Costa PB, Smith AE, Walter AAEffects of creatine supplementation on the onset of neuromuscular fatigue threshold and muscle strength in elderly men and women (64 - 86 years)J Nutr Health Aging.(2007 Nov-Dec)
    70. Fatigue Resistance - Damien Gras, Charlotte Lanhers, Reza Bagheri, Ukadike Chris Ugbolue, Emmanuel Coudeyre, Bruno Pereira, Marek Zak, Jean-Baptiste Bouillon-Minois, Frédéric DutheilCreatine supplementation and VO 2 max: a systematic review and meta-analysisCrit Rev Food Sci Nutr.(2021 Dec 3)
    71. Muscular Endurance - Armentano MJ, Brenner AK, Hedman TL, Solomon ZT, Chavez J, Kemper GB, Salzberg D, Battafarano DF, Christie DSThe effect and safety of short-term creatine supplementation on performance of push-upsMil Med.(2007 Mar)
    72. Muscular Endurance - Ayoama R, Hiruma E, Sasaki HEffects of creatine loading on muscular strength and endurance of female softball playersJ Sports Med Phys Fitness.(2003 Dec)
    73. Heart Rate - Dabidi Roshan V, Babaei H, Hosseinzadeh M, Arendt-Nielsen LThe effect of creatine supplementation on muscle fatigue and physiological indices following intermittent swimming boutsJ Sports Med Phys Fitness.(2013 Jun)
    74. Satellite Cell Recruitment - Olsen S, Aagaard P, Kadi F, Tufekovic G, Verney J, Olesen JL, Suetta C, Kjaer MCreatine supplementation augments the increase in satellite cell and myonuclei number in human skeletal muscle induced by strength trainingJ Physiol.(2006 Jun 1)
    75. Aerobic Exercise Metrics - Reardon TF, Ruell PA, Fiatarone Singh MA, Thompson CH, Rooney KBCreatine supplementation does not enhance submaximal aerobic training adaptations in healthy young men and womenEur J Appl Physiol.(2006 Oct)
    76. IGF-1 - Burke DG, Candow DG, Chilibeck PD, MacNeil LG, Roy BD, Tarnopolsky MA, Ziegenfuss TEffect of creatine supplementation and resistance-exercise training on muscle insulin-like growth factor in young adultsInt J Sport Nutr Exerc Metab.(2008 Aug)
    77. IGF-1 - Louise Deldicque, Magali Louis, Daniel Theisen, Henri Nielens, Mischaël Dehoux, Jean-Paul Thissen, Michael J Rennie, Marc FrancauxIncreased IGF mRNA in human skeletal muscle after creatine supplementationMed Sci Sports Exerc.(2005 May)
    78. Skeletal Muscle Atrophy - Johnston AP, Burke DG, MacNeil LG, Candow DGEffect of creatine supplementation during cast-induced immobilization on the preservation of muscle mass, strength, and enduranceJ Strength Cond Res.(2009 Jan)
    79. Muscle Damage - Cooke MB, Rybalka E, Williams AD, Cribb PJ, Hayes ACreatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individualsJ Int Soc Sports Nutr.(2009 Jun 2)
    80. Hydration (Total Body Water) - Nicholas Sculthorpe, Fergal Grace, Peter Jones, Iain FletcherThe effect of short-term creatine loading on active range of movementAppl Physiol Nutr Metab.(2010 Aug)
    81. Growth Hormone - Schedel JM, Tanaka H, Kiyonaga A, Shindo M, Schutz YAcute creatine loading enhances human growth hormone secretionJ Sports Med Phys Fitness.(2000 Dec)
    82. Creatinine - Deminice R, Rosa FT, Franco GS, Jordao AA, de Freitas ECEffects of creatine supplementation on oxidative stress and inflammatory markers after repeated-sprint exercise in humansNutrition.(2013 Sep)
    83. Muscle Damage - Santos RV, Bassit RA, Caperuto EC, Costa Rosa LFThe effect of creatine supplementation upon inflammatory and muscle soreness markers after a 30km raceLife Sci.(2004 Sep 3)
    84. Anaerobic Capacity - Javierre C, Barbany JR, Bonjorn VM, Lizárraga MA, Ventura JL, Segura RCreatine supplementation and performance in 6 consecutive 60 meter sprintsJ Physiol Biochem.(2004 Dec)
    85. Anaerobic Capacity - Fukuda DH, Smith AE, Kendall KL, Dwyer TR, Kerksick CM, Beck TW, Cramer JT, Stout JRThe effects of creatine loading and gender on anaerobic running capacityJ Strength Cond Res.(2010 Jul)
    86. Anaerobic Capacity - Ahmun RP, Tong RJ, Grimshaw PNThe effects of acute creatine supplementation on multiple sprint cycling and running performance in rugby playersJ Strength Cond Res.(2005 Feb)
    87. Anaerobic Capacity - Glaister M, Lockey RA, Abraham CS, Staerck A, Goodwin JE, McInnes GCreatine supplementation and multiple sprint running performanceJ Strength Cond Res.(2006 May)
    88. Anaerobic Capacity - Wright GA, Grandjean PW, Pascoe DDThe effects of creatine loading on thermoregulation and intermittent sprint exercise performance in a hot humid environmentJ Strength Cond Res.(2007 Aug)
    89. Swimming Performance Metrics - Mujika I, Chatard JC, Lacoste L, Barale F, Geyssant ACreatine supplementation does not improve sprint performance in competitive swimmersMed Sci Sports Exerc.(1996 Nov)
    90. Weight - Smith AE, Fukuda DH, Ryan ED, Kendall KL, Cramer JT, Stout JErgolytic/ergogenic effects of creatine on aerobic powerInt J Sports Med.(2011 Dec)
    91. Weight - Fuld JP, Kilduff LP, Neder JA, Pitsiladis Y, Lean ME, Ward SA, Cotton MMCreatine supplementation during pulmonary rehabilitation in chronic obstructive pulmonary diseaseThorax.(2005 Jul)
    92. Weight - Deacon SJ, Vincent EE, Greenhaff PL, Fox J, Steiner MC, Singh SJ, Morgan MDRandomized controlled trial of dietary creatine as an adjunct therapy to physical training in chronic obstructive pulmonary diseaseAm J Respir Crit Care Med.(2008 Aug 1)
    93. Exercise Capacity (with Heart Conditions) - Al-Ghimlas F, Todd DCCreatine supplementation for patients with COPD receiving pulmonary rehabilitation: a systematic review and meta-analysisRespirology.(2010 Jul)
    94. Subjective Well-Being - McMorris T, Harris RC, Swain J, Corbett J, Collard K, Dyson RJ, Dye L, Hodgson C, Draper NEffect of creatine supplementation and sleep deprivation, with mild exercise, on cognitive and psychomotor performance, mood state, and plasma concentrations of catecholamines and cortisolPsychopharmacology (Berl).(2006 Mar)
    95. Subjective Well-Being - McMorris T, Harris RC, Howard AN, Langridge G, Hall B, Corbett J, Dicks M, Hodgson CCreatine supplementation, sleep deprivation, cortisol, melatonin and behaviorPhysiol Behav.(2007 Jan 30)
    96. Fatigue Symptoms - Watanabe A, Kato N, Kato TEffects of creatine on mental fatigue and cerebral hemoglobin oxygenationNeurosci Res.(2002 Apr)
    97. Cognition - Rae C, Digney AL, McEwan SR, Bates TCOral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trialProc Biol Sci.(2003 Oct 22)
    98. Cognition - Benton D, Donohoe RThe influence of creatine supplementation on the cognitive functioning of vegetarians and omnivoresBr J Nutr.(2011 Apr)
    99. Cognition - Rawson ES, Lieberman HR, Walsh TM, Zuber SM, Harhart JM, Matthews TCCreatine supplementation does not improve cognitive function in young adultsPhysiol Behav.(2008 Sep 3)
    100. Cognition - McMorris T, Mielcarz G, Harris RC, Swain JP, Howard ACreatine supplementation and cognitive performance in elderly individualsNeuropsychol Dev Cogn B Aging Neuropsychol Cogn.(2007 Sep)
    101. Memory - Prokopidis K, Giannos P, Triantafyllidis KK, Kechagias KS, Forbes SC, Candow DGEffects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials.Nutr Rev.(2023-Mar-10)
    102. Alertness - Pan JW, Takahashi KCerebral energetic effects of creatine supplementation in humansAm J Physiol Regul Integr Comp Physiol.(2007 Apr)
    103. Oxygen Uptake - Kingsley M, Cunningham D, Mason L, Kilduff LP, McEneny JRole of creatine supplementation on exercise-induced cardiovascular function and oxidative stressOxid Med Cell Longev.(2009 Sep-Oct)
    104. Power Output - Burke LM, Pyne DB, Telford RDEffect of oral creatine supplementation on single-effort sprint performance in elite swimmersInt J Sport Nutr.(1996 Sep)
    105. Power Output - Silva AJ, Machado Reis V, Guidetti L, Bessone Alves F, Mota P, Freitas J, Baldari CEffect of creatine on swimming velocity, body composition and hydrodynamic variablesJ Sports Med Phys Fitness.(2007 Mar)
    106. Power Output - Anomasiri W, Sanguanrungsirikul S, Saichandee PLow dose creatine supplementation enhances sprint phase of 400 meters swimming performanceJ Med Assoc Thai.(2004 Sep)
    107. Power Output - Juhász I, Györe I, Csende Z, Rácz L, Tihanyi JCreatine supplementation improves the anaerobic performance of elite junior fin swimmersActa Physiol Hung.(2009 Sep)
    108. Power Output - Theodorou AS, Havenetidis K, Zanker CL, O'Hara JP, King RF, Hood C, Paradisis G, Cooke CBEffects of acute creatine loading with or without carbohydrate on repeated bouts of maximal swimming in high-performance swimmersJ Strength Cond Res.(2005 May)
    109. Swimming Performance Metrics - Mendes RR, Pires I, Oliveira A, Tirapegui JEffects of creatine supplementation on the performance and body composition of competitive swimmersJ Nutr Biochem.(2004 Aug)
    110. Swimming Performance Metrics - Selsby JT, Beckett KD, Kern M, Devor STSwim performance following creatine supplementation in Division III athletesJ Strength Cond Res.(2003 Aug)
    111. Swimming Performance Metrics - Leenders NM, Lamb DR, Nelson TECreatine supplementation and swimming performanceInt J Sport Nutr.(1999 Sep)
    112. Swimming Performance Metrics - Peyrebrune MC, Stokes K, Hall GM, Nevill MEEffect of creatine supplementation on training for competition in elite swimmersMed Sci Sports Exerc.(2005 Dec)
    113. Swimming Performance Metrics - Dawson B, Vladich T, Blanksby BAEffects of 4 weeks of creatine supplementation in junior swimmers on freestyle sprint and swim bench performanceJ Strength Cond Res.(2002 Nov)
    114. Swimming Performance Metrics - Theodorou AS, Cooke CB, King RF, Hood C, Denison T, Wainwright BG, Havenetidis KThe effect of longer-term creatine supplementation on elite swimming performance after an acute creatine loadingJ Sports Sci.(1999 Nov)
    115. Swimming Performance Metrics - D. Sheikholeslami Vatania, H. Farajib, R. Sooric, M. MogharnasidThe effects of creatine supplementation on performance and hormonal response in amateur swimmersScience and Sports.()
    116. Anaerobic Capacity - Mero AA, Keskinen KL, Malvela MT, Sallinen JMCombined creatine and sodium bicarbonate supplementation enhances interval swimmingJ Strength Cond Res.(2004 May)
    117. Hydration (Total Body Water) - Weiss BA, Powers MECreatine supplementation does not impair the thermoregulatory response during a bout of exercise in the heatJ Sports Med Phys Fitness.(2006 Dec)
    118. Hydration (Total Body Water) - Easton C, Turner S, Pitsiladis YPCreatine and glycerol hyperhydration in trained subjects before exercise in the heatInt J Sport Nutr Exerc Metab.(2007 Feb)
    119. Hydration (Total Body Water) - Watson G, Casa DJ, Fiala KA, Hile A, Roti MW, Healey JC, Armstrong LE, Maresh CMCreatine use and exercise heat tolerance in dehydrated menJ Athl Train.(2006 Jan-Mar)
    120. Hydration (Total Body Water) - Lopez RM, Casa DJ, McDermott BP, Ganio MS, Armstrong LE, Maresh CMDoes creatine supplementation hinder exercise heat tolerance or hydration status? A systematic review with meta-analysesJ Athl Train.(2009 Mar-Apr)
    121. Muscle Creatine Content - Hadjicharalambous M, Kilduff LP, Pitsiladis YPBrain serotonin and dopamine modulators, perceptual responses and endurance performance during exercise in the heat following creatine supplementationJ Int Soc Sports Nutr.(2008 Sep 30)
    122. Amyotrophic Lateral Sclerosis Symptoms - Pastula DM, Moore DH, Bedlack RSCreatine for amyotrophic lateral sclerosis/motor neuron diseaseCochrane Database Syst Rev.(2012 Dec 12)
    123. Amyotrophic Lateral Sclerosis Symptoms - Shefner JM, Cudkowicz ME, Schoenfeld D, Conrad T, Taft J, Chilton M, Urbinelli L, Qureshi M, Zhang H, Pestronk A, Caress J, Donofrio P, Sorenson E, Bradley W, Lomen-Hoerth C, Pioro E, Rezania K, Ross M, Pascuzzi R, Heiman-Patterson T, Tandan R, Mitsumoto H, Rothstein J, Smith-Palmer T, MacDonald D, Burke D; NEALS ConsortiumA clinical trial of creatine in ALSNeurology.(2004 Nov 9)
    124. Amyotrophic Lateral Sclerosis Symptoms - Mazzini L, Balzarini C, Colombo R, Mora G, Pastore I, De Ambrogio R, Caligari MEffects of creatine supplementation on exercise performance and muscular strength in amyotrophic lateral sclerosis: preliminary resultsJ Neurol Sci.(2001 Oct 15)
    125. Amyotrophic Lateral Sclerosis Symptoms - Groeneveld GJ, Veldink JH, van der Tweel I, Kalmijn S, Beijer C, de Visser M, Wokke JH, Franssen H, van den Berg LHA randomized sequential trial of creatine in amyotrophic lateral sclerosisAnn Neurol.(2003 Apr)
    126. Amyotrophic Lateral Sclerosis Symptoms - Rosenfeld J, King RM, Jackson CE, Bedlack RS, Barohn RJ, Dick A, Phillips LH, Chapin J, Gelinas DF, Lou JSCreatine monohydrate in ALS: effects on strength, fatigue, respiratory status and ALSFRSAmyotroph Lateral Scler.(2008 Oct)
    127. Amyotrophic Lateral Sclerosis Symptoms - Drory VE, Gross DNo effect of creatine on respiratory distress in amyotrophic lateral sclerosisAmyotroph Lateral Scler Other Motor Neuron Disord.(2002 Mar)
    128. Kidney Function - Groeneveld GJ, Beijer C, Veldink JH, Kalmijn S, Wokke JH, van den Berg LHFew adverse effects of long-term creatine supplementation in a placebo-controlled trialInt J Sports Med.(2005 May)
    129. Parkinson's Disease Symptoms - Writing Group for the NINDS Exploratory Trials in Parkinson Disease (NET-PD) Investigators, Kieburtz K, Tilley BC, Elm JJ, Babcock D, Hauser R, Ross GW, Augustine AH, Augustine EU, Aminoff MJ, Bodis-Wollner IG, Boyd J, Cambi F, Chou K, Christine CW, Cines M, Dahodwala N, Derwent L, Dewey RB Jr, Hawthorne K, Houghton DJ, Kamp C, Leehey M, Lew MF, Liang GS, Luo ST, Mari Z, Morgan JC, Parashos S, Pérez A, Petrovitch H, Rajan S, Reichwein S, Roth JT, Schneider JS, Shannon KM, Simon DK, Simuni T, Singer C, Sudarsky L, Tanner CM, Umeh CC, Williams K, Wills AMEffect of creatine monohydrate on clinical progression in patients with Parkinson disease: a randomized clinical trialJAMA.(2015 Feb 10)
    130. Parkinson's Disease Symptoms - Bender A, Koch W, Elstner M, Schombacher Y, Bender J, Moeschl M, Gekeler F, Müller-Myhsok B, Gasser T, Tatsch K, Klopstock TCreatine supplementation in Parkinson disease: a placebo-controlled randomized pilot trialNeurology.(2006 Oct 10)
    131. Parkinson's Disease Symptoms - Mo JJ, Liu LY, Peng WB, Rao J, Liu Z, Cui LLThe effectiveness of creatine treatment for Parkinson's disease: an updated meta-analysis of randomized controlled trials.BMC Neurol.(2017-Jun-02)
    132. Parkinson's Disease Symptoms - Xiao Y, Luo M, Luo H, Wang JCreatine for Parkinson's disease.Cochrane Database Syst Rev.(2014-Jun-17)
    133. Power Output - Hass CJ, Collins MA, Juncos JLResistance training with creatine monohydrate improves upper-body strength in patients with Parkinson disease: a randomized trialNeurorehabil Neural Repair.(2007 Mar-Apr)
    134. Depression Symptoms - Kondo DG, Sung YH, Hellem TL, Fiedler KK, Shi X, Jeong EK, Renshaw PFOpen-label adjunctive creatine for female adolescents with SSRI-resistant major depressive disorder: a 31-phosphorus magnetic resonance spectroscopy studyJ Affect Disord.(2011 Dec)
    135. Depression Symptoms - Lyoo IK, Yoon S, Kim TS, Hwang J, Kim JE, Won W, Bae S, Renshaw PFA randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorderAm J Psychiatry.(2012 Sep)
    136. Depression Symptoms - Roitman S, Green T, Osher Y, Karni N, Levine JCreatine monohydrate in resistant depression: a preliminary studyBipolar Disord.(2007 Nov)
    137. Food Intake - Gualano B, Novaes RB, Artioli GG, Freire TO, Coelho DF, Scagliusi FB, Rogeri PS, Roschel H, Ugrinowitsch C, Lancha AH JrEffects of creatine supplementation on glucose tolerance and insulin sensitivity in sedentary healthy males undergoing aerobic trainingAmino Acids.(2008 Feb)
    138. Total cholesterol - Gualano B, Ugrinowitsch C, Artioli GG, Benatti FB, Scagliusi FB, Harris RC, Lancha AH JrDoes creatine supplementation improve the plasma lipid profile in healthy male subjects undergoing aerobic trainingJ Int Soc Sports Nutr.(2008 Oct 3)
    139. Total cholesterol - Schilling BK, Stone MH, Utter A, Kearney JT, Johnson M, Coglianese R, Smith L, O'Bryant HS, Fry AC, Starks M, Keith R, Stone MECreatine supplementation and health variables: a retrospective studyMed Sci Sports Exerc.(2001 Feb)
    140. Insulin - van Loon LJ, Murphy R, Oosterlaar AM, Cameron-Smith D, Hargreaves M, Wagenmakers AJ, Snow RCreatine supplementation increases glycogen storage but not GLUT-4 expression in human skeletal muscleClin Sci (Lond).(2004 Jan)
    141. Insulin - Rooney KB, Bryson JM, Digney AL, Rae CD, Thompson CHCreatine supplementation affects glucose homeostasis but not insulin secretion in humansAnn Nutr Metab.(2003)
    142. Muscle Creatine Content - Robinson TM, Sewell DA, Hultman E, Greenhaff PLRole of submaximal exercise in promoting creatine and glycogen accumulation in human skeletal muscleJ Appl Physiol (1985).(1999 Aug)
    143. Muscle Creatine Content - Op 't Eijnde B, Ursø B, Richter EA, Greenhaff PL, Hespel PEffect of oral creatine supplementation on human muscle GLUT4 protein content after immobilizationDiabetes.(2001 Jan)
    144. Testosterone - van der Merwe J, Brooks NE, Myburgh KHThree weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby playersClin J Sport Med.(2009 Sep)
    145. Fasting Glucose - Delpino FM, Figueiredo LMDoes creatine supplementation improve glycemic control and insulin resistance in healthy and diabetic patients? A systematic review and meta-analysis.Clin Nutr ESPEN.(2022-Feb)
    146. Glycemic Control - Gualano B, DE Salles Painneli V, Roschel H, Artioli GG, Neves M Jr, De Sá Pinto AL, Da Silva ME, Cunha MR, Otaduy MC, Leite Cda C, Ferreira JC, Pereira RM, Brum PC, Bonfá E, Lancha AH JrCreatine in type 2 diabetes: a randomized, double-blind, placebo-controlled trialMed Sci Sports Exerc.(2011 May)
    147. Kidney Function - Gualano B, de Salles Painelli V, Roschel H, Lugaresi R, Dorea E, Artioli GG, Lima FR, da Silva ME, Cunha MR, Seguro AC, Shimizu MH, Otaduy MC, Sapienza MT, da Costa Leite C, Bonfá E, Lancha Junior AHCreatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trialEur J Appl Physiol.(2011 May)
    148. Oxygen Uptake - Zoeller RF, Stout JR, O'kroy JA, Torok DJ, Mielke MEffects of 28 days of beta-alanine and creatine monohydrate supplementation on aerobic power, ventilatory and lactate thresholds, and time to exhaustionAmino Acids.(2007 Sep)
    149. Anaerobic Capacity - Okudan N, Gokbel HThe effects of creatine supplementation on performance during the repeated bouts of supramaximal exerciseJ Sports Med Phys Fitness.(2005 Dec)
    150. Muscular Dystrophy Symptoms - Tarnopolsky M, Mahoney D, Thompson T, Naylor H, Doherty TJCreatine monohydrate supplementation does not increase muscle strength, lean body mass, or muscle phosphocreatine in patients with myotonic dystrophy type 1Muscle Nerve.(2004 Jan)
    151. Muscular Dystrophy Symptoms - Walter MC, Reilich P, Lochmüller H, Kohnen R, Schlotter B, Hautmann H, Dunkl E, Pongratz D, Müller-Felber WCreatine monohydrate in myotonic dystrophy: a double-blind, placebo-controlled clinical studyJ Neurol.(2002 Dec)
    152. Creatinine - Kornblum C, Schröder R, Müller K, Vorgerd M, Eggers J, Bogdanow M, Papassotiropoulos A, Fabian K, Klockgether T, Zange JCreatine has no beneficial effect on skeletal muscle energy metabolism in patients with single mitochondrial DNA deletions: a placebo-controlled, double-blind 31P-MRS crossover studyEur J Neurol.(2005 Apr)
    153. Creatinine - Mayhew DL, Mayhew JL, Ware JSEffects of long-term creatine supplementation on liver and kidney functions in American college football playersInt J Sport Nutr Exerc Metab.(2002 Dec)
    154. Kidney Function - Gualano B, Ugrinowitsch C, Novaes RB, Artioli GG, Shimizu MH, Seguro AC, Harris RC, Lancha AH JrEffects of creatine supplementation on renal function: a randomized, double-blind, placebo-controlled clinical trialEur J Appl Physiol.(2008 May)
    155. Kidney Function - Gualano B, Ferreira DC, Sapienza MT, Seguro AC, Lancha AH JrEffect of short-term high-dose creatine supplementation on measured GFR in a young man with a single kidneyAm J Kidney Dis.(2010 Mar)
    156. Oxidative Stress Biomarkers - Rahimi RCreatine supplementation decreases oxidative DNA damage and lipid peroxidation induced by a single bout of resistance exerciseJ Strength Cond Res.(2011 Dec)
    157. Power Output - Hespel P, Op't Eijnde B, Van Leemputte M, Ursø B, Greenhaff PL, Labarque V, Dymarkowski S, Van Hecke P, Richter EAOral creatine supplementation facilitates the rehabilitation of disuse atrophy and alters the expression of muscle myogenic factors in humansJ Physiol.(2001 Oct 15)
    158. Muscle Damage - Bassit RA, Pinheiro CH, Vitzel KF, Sproesser AJ, Silveira LR, Curi REffect of short-term creatine supplementation on markers of skeletal muscle damage after strenuous contractile activityEur J Appl Physiol.(2010 Mar)
    159. Muscle Damage - Rawson ES, Conti MP, Miles MPCreatine supplementation does not reduce muscle damage or enhance recovery from resistance exerciseJ Strength Cond Res.(2007 Nov)
    160. Creatine Kinase - Yue Jiaming, Mohammad Hossein RahimiCreatine supplementation effect on recovery following exercise-induced muscle damage: A systematic review and meta-analysis of randomized controlled trialsJ Food Biochem.(2021 Oct)
    161. Upper Body Strength - Christiano R R Alves, Bianca M Santiago, Fernanda R Lima, Maria C G Otaduy, Ana Luisa Calich, Aline C C Tritto, Ana Lúcia de Sá Pinto, Hamilton Roschel, Cláudia C Leite, Fabiana B Benatti, Eloisa Bonfá, Bruno GualanoCreatine supplementation in fibromyalgia: a randomized, double-blind, placebo-controlled trialArthritis Care Res (Hoboken).(2013 Sep)
    162. Fibromyalgia Symptoms - Avi Leader, Daniella Amital, Alan Rubinow, Howard AmitalAn open-label study adding creatine monohydrate to ongoing medical regimens in patients with the fibromyalgia syndromeAnn N Y Acad Sci.(2009 Sep)
    163. Huntington's Disease Symptoms - Verbessem P, Lemiere J, Eijnde BO, Swinnen S, Vanhees L, Van Leemputte M, Hespel P, Dom RCreatine supplementation in Huntington's disease: a placebo-controlled pilot trialNeurology.(2003 Oct 14)
    164. Huntington's Disease Symptoms - Andreas Bender, Dorothee P Auer, Thomas Merl, Ralf Reilmann, Phillip Saemann, Alexander Yassouridis, Julia Bender, Adolf Weindl, Matthias Dose, Thomas Gasser, Thomas KlopstockCreatine supplementation lowers brain glutamate levels in Huntington's diseaseJ Neurol.(2005 Jan)
    165. Muscular Dystrophy Symptoms - Schneider-Gold C, Beck M, Wessig C, George A, Kele H, Reiners K, Toyka KVCreatine monohydrate in DM2/PROMM: a double-blind placebo-controlled clinical study. Proximal myotonic myopathyNeurology.(2003 Feb 11)
    166. Bilirubin - Roy BD, de Beer J, Harvey D, Tarnopolsky MACreatine monohydrate supplementation does not improve functional recovery after total knee arthroplastyArch Phys Med Rehabil.(2005 Jul)
    167. Low-density lipoprotein (LDL) - Earnest CP, Almada AL, Mitchell TLHigh-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and womenClin Sci (Lond).(1996 Jul)
    168. Anaerobic Capacity - Perret C, Mueller G, Knecht HInfluence of creatine supplementation on 800 m wheelchair performance: a pilot studySpinal Cord.(2006 May)
    169. Dizziness - George Sakellaris, George Nasis, Maria Kotsiou, Maria Tamiolaki, Giorgos Charissis, Athanasios EvangeliouPrevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot studyActa Paediatr.(2008 Jan)
    170. Functionality in Elderly or Injured - Cañete S, San Juan AF, Pérez M, Gómez-Gallego F, López-Mojares LM, Earnest CP, Fleck SJ, Lucia ADoes creatine supplementation improve functional capacity in elderly womenJ Strength Cond Res.(2006 Feb)
    171. Bone Mineral Density - Chilibeck PD, Chrusch MJ, Chad KE, Shawn Davison K, Burke DGCreatine monohydrate and resistance training increase bone mineral content and density in older menJ Nutr Health Aging.(2005 Sep-Oct)
    172. Bone Mineral Density - Scott C Forbes, Philip D Chilibeck, Darren G CandowCreatine Supplementation During Resistance Training Does Not Lead to Greater Bone Mineral Density in Older Humans: A Brief Meta-AnalysisFront Nutr.(2018 Apr 24)
    173. Alertness - Cook CJ, Crewther BT, Kilduff LP, Drawer S, Gaviglio CMSkill execution and sleep deprivation: effects of acute caffeine or creatine supplementation - a randomized placebo-controlled trialJ Int Soc Sports Nutr.(2011 Feb 16)
    174. Uric Acid - Cancela P, Ohanian C, Cuitiño E, Hackney ACCreatine supplementation does not affect clinical health markers in football playersBr J Sports Med.(2008 Sep)
    175. Homocysteine - Korzun WJOral creatine supplements lower plasma homocysteine concentrations in humansClin Lab Sci.(2004 Spring)
    176. Lean Mass - Norman K, Stübler D, Baier P, Schütz T, Ocran K, Holm E, Lochs H, Pirlich MEffects of creatine supplementation on nutritional status, muscle function and quality of life in patients with colorectal cancer--a double blind randomised controlled trialClin Nutr.(2006 Aug)
    177. Muscle Creatine Content - Jacques R Poortmans, Alain Kumps, Pierre Duez, Aline Fofonka, Alain Carpentier, Marc FrancauxEffect of oral creatine supplementation on urinary methylamine, formaldehyde, and formateMed Sci Sports Exerc.(2005 Oct)
    178. Kidney Function - Taes YE, Delanghe JR, De Bacquer D, Langlois M, Stevens L, Geerolf I, Lameire NH, De Vriese ASCreatine supplementation does not decrease total plasma homocysteine in chronic hemodialysis patientsKidney Int.(2004 Dec)
    179. Mitochondrial Cytopathies Symptoms - A Borchert, E Wilichowski, F HanefeldSupplementation with creatine monohydrate in children with mitochondrial encephalomyopathiesMuscle Nerve.(1999 Sep)
    180. Anaerobic Capacity - Cornish SM, Chilibeck PD, Burke DGThe effect of creatine monohydrate supplementation on sprint skating in ice-hockey playersJ Sports Med Phys Fitness.(2006 Mar)
    181. Exercise Capacity (with Heart Conditions) - Kuethe F, Krack A, Richartz BM, Figulla HRCreatine supplementation improves muscle strength in patients with congestive heart failurePharmazie.(2006 Mar)
    182. Exercise Tolerance - Vorgerd M, Zange J, Kley R, Grehl T, Hüsing A, Jäger M, Müller K, Schröder R, Mortier W, Fabian K, Malin JP, Luttmann AEffect of high-dose creatine therapy on symptoms of exercise intolerance in McArdle disease: double-blind, placebo-controlled crossover studyArch Neurol.(2002 Jan)
    183. Exercise Tolerance - Vorgerd M, Grehl T, Jager M, Muller K, Freitag G, Patzold T, Bruns N, Fabian K, Tegenthoff M, Mortier W, Luttmann A, Zange J, Malin JPCreatine therapy in myophosphorylase deficiency (McArdle disease): a placebo-controlled crossover trialArch Neurol.(2000 Jul)
    184. DNA methylation - Freilinger M, Dunkler D, Lanator I, Item CB, Mühl A, Fowler B, Bodamer OAEffects of creatine supplementation in Rett syndrome: a randomized, placebo-controlled trialJ Dev Behav Pediatr.(2011 Jul-Aug)
    185. Cystic Fibrosis Symptoms - Christian P Braegger, Uwe Schlattner, Theo Wallimann, Anna Utiger, Friederike Frank, Beat Schaefer, Claus W Heizmann, Felix H SennhauserEffects of creatine supplementation in cystic fibrosis: results of a pilot studyJ Cyst Fibros.(2003 Dec