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Creatine

Creatine is among the most well-researched and effective supplements. It can help with exercise performance by rapidly producing energy during intense activity. Creatine may also provide cognitive benefits but more research is needed in that area.

Our evidence-based analysis on creatine features 746 unique references to scientific papers.

Research analysis led by Kamal Patel .
Reviewed by
Examine.com Team
Last Updated:

Summary of Creatine

Primary Information, Benefits, Effects, and Important Facts

This is a quick summary of creatine. For full references, please see our complete Scientific Research section

What is creatine?

Creatine is a molecule that's produced in the body from amino acids. It's primarily made in the liver and to a lesser extent in the kidneys and pancreas. It stores high-energy phosphate groups in the form of phosphocreatine which are donated to ADP, regenerating it to ATP, the primary energy carrier in the body. This 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 foods and is most prevalent in meat and fish. Athletes commonly take it as a powder or in capsules.

What are creatine’s benefits?

The primary benefit of creatine is an improvement in strength and power output during resistance exercise. For this purpose, creatine is well-researched, and the effects are quite notable for a supplement. When used in conjunction with resistance exercise, creatine may modestly increase lean mass. It has also been tested for anaerobic running capacity in many studies, the results of which are fairly mixed but generally suggest a small improvement in performance.

While creatine has been researched far less for cognitive performance than physical performance, it may have benefits in some contexts. A reduction in mental fatigue has been observed in various scenarios such as demanding mental activity, sleep deprivation, and traumatic brain injury. Creatine may improve working memory, though likely only for those with below-average creatine levels such as vegetarians and the elderly. We need more research in these areas and other cognitive measures before creatine can be said to be effective.

What are creatine’s side effects and drawbacks?

When taken without sufficient water, stomach cramping can occur. Diarrhea and nausea can occur when too much creatine is taken at once, in which case doses should be spread out throughout the day and taken with meals.

Is creatine safe?

Most of the supposed dangers of creatine are unfounded. Due to the bad reputation of performance-enhancing drugs, it has been wrongfully equated with the worst examples. It also increases levels of creatinine in the body, which are a marker of poor kidney function. However, the increase in creatinine isn't due to kidney damage, but simply more creatinine being produced. There is a lack of long-term studies in people with reduced kidney function, however, so caution could still be taken in that instance. Besides the minor gastrointestinal issues from excessive creatine, it is unlikely to be unsafe or bad for you.

Evidence-Based Recommendation on Creatine

Creatine is very safe, and has been proven to increase power ouput (which lets you build more muscle). Do note that it can cause bloating, but this is purely water weight.

There is promising yet very preliminary evidence for certain neurological benefits.

Taking into account efficacy, safety, and cost, creatine is among the surest supplement bets.

Considering creatine to help achieve your health goals?

Learn how to best use creatine in these goal-oriented Supplement Guides:

  • Memory & Focus

  • Muscle Gain & Exercise Performance

  • Seniors

  • Skin & Hair

  • Vegetarians & Vegans

Want the unbiased truth about creatine?

We've created a fact sheet that neatly summarizes the scientific research on creatine.

How to Take Creatine

Recommended dosage, active amounts, other details

There are many different forms of creatine available on the market, but creatine monohydrate is the cheapest and most effective. Another option is micronized creatine monohydrate, which dissolves in water more easily and can be more practical.

Creatine monohydrate can be supplemented through a loading protocol. To start loading, take 0.3 grams per kilogram of bodyweight per day for 5–7 days, then follow with at least 0.03 g/kg/day either for three weeks (if cycling) or indefinitely (without additional loading phases).

For a 180 lb (82 kg) person, this translates to 25 g/day during the loading phase and 2.5 g/day afterward, although many users take 5 g/day due to the low price of creatine and the possibility of experiencing increased benefits. Higher doses (up to 10 g/day) may be beneficial for people with a high amount of muscle mass and high activity levels or for those who are non-responders to the lower 5 g/day dose.

Stomach cramping can occur when creatine is supplemented without sufficient water. Diarrhea and nausea can occur when too much creatine is supplemented at once, in which case doses should be spread out over the day and taken with meals.

What is the best form of creatine?

There is no best form - creatine monohydrate is just as effective as other forms.

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Human Effect Matrix

The Human Effect Matrix looks at human studies (it excludes animal and in vitro studies) to tell you what effects creatine has on your body, and how strong these effects are.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Strong Very High See all 18 studies
Creatine supplementation is the reference compound for increasing muscular creatine levels; there is variability in this increase, however, with some nonresponders.
grade-a Strong Very High See all 66 studies
Creatine is the reference compound for power improvement, with numbers from one meta-analysis to assess potency being "Able to increase a 12% improvement in strength to 20% and able to increase a 12% increase in power to 26% following a training regiment using creatine monohydrate".
grade-a Strong Very High See all 28 studies
Appears to have a large effect on increasing overall weight due to water retention in persons who respond to creatine supplementation. Degree of increase is variable.
grade-a Notable Moderate See all 12 studies
Creatine supplementation usually increases serum creatinine levels during the loading phase (but usually not during maintenance), since creatinine is the breakdown product of creatine. This is not indicative of kidney damage.
grade-a Notable Very High See all 9 studies
Appears to be quite notable due to the increase in water weight in skeletal muscle tissue following creatine supplementation.
grade-a Minor High See all 19 studies
Appears to increase anaerobic cardiovascular capacity, not to a remarkable degree however.
grade-a Minor Very High See all 20 studies
Does appear to have inherent lean mass building properties, but a large amount of research is confounded with water weight gains (difficult to assess potency).
grade-a - Very High See all 13 studies
In otherwise healthy persons given creatine supplementation, there is no significant beneficial nor negative influence on kidney function.
grade-a - Moderate See all 17 studies
No reliable improvement in swimming performance. Acute supplementation prior to short sprint tests (50-100 m) may reduce time by around 2%.
grade-b Notable High See all 7 studies
400 mg/kg/day in children and adolescents subject to traumatic brain injury reduces fatigue frequency from around 90% down to near 10%. Fatigue is also reduced, though to a lesser degree, in cases of sleep deprivation.
grade-b Minor Low See all 4 studies
No apparent influence on fasting blood glucose, but an 11-22% reduction in the postprandial spike.
grade-b Minor Low See all 3 studies
There is limited evidence in favor of improvements in bone mineral density.
grade-b Minor Moderate See all 8 studies
Small degree of fatigue reduction during exercise, but appears unreliable.
grade-b Minor Low See all 3 studies
A minor reduction has been observed.
grade-b Minor Moderate See all 6 studies
Not overly protective, but there appears to be a degree of protection.
grade-b Minor High See all 3 studies
Somewhat effective.
grade-b Minor Moderate See all 11 studies
The influence of creatine on well being and general happiness is usually dependent on it treating a disease state; there does not appear to be a per se benefit to well being.
grade-b Minor High See all 6 studies
Degree of testosterone spike is not overly notable, although it appears to be present
grade-b Minor High See all 3 studies
Preliminary evidence seems to support a minor to moderate benefit with regard to Myotonic Dystrophy type II (DM2) and a mild benefit or none with regard to DM1.
grade-b Minor Low See all 6 studies
Improvements in VO2 max are not wholly reliable, and appear to be low in magnitude.
grade-b - Very High See all 7 studies
Does not appear to confer any apparent benefit to prolonged cardiovascular exercise.
grade-b - Very High See all 4 studies
Does not appear to significantly influence blood pressure.
grade-b - High See all 3 studies
No inherent benefit to omnivore cognition appears apparent, but it may benefit cognition in the sleep deprived.
grade-b - Very High See all 4 studies
No effect on cortisol changes associated with sleep deprivation.
grade-b - Very High See all 3 studies
Although there may be a small reduction of power output (typical of creatine), the main parameter of interest (cardiorespiratory output) is mostly unaffected by creatine supplementation.
grade-b - Very High See all 3 studies
The main parameter of interest with exercise in COPD (cardiovascular capacity and aerobic exercise) is wholly unaffected with supplementation, although power output still can be increased.
grade-b - Very High See all 9 studies
Creatine reliably increases lean mass (water at first, then muscle with more prolonged supplementation) but does not appear to significantly alter fat mass.
grade-b - Very High See all 3 studies
No known influence on heart rate.
grade-b - Very High See all 5 studies
Insufficient evidence to support a role of creatine in increasing IGF-1
grade-b - Very High See all 3 studies
No effect on fasting insulin.
grade-b - Moderate See all 6 studies
No apparent reduction or increase in lactate in swimmers after sprinting exercises.
grade-b - Very High See all 7 studies
No known influence on circulating liver enzymes, suggesting no liver toxicity in humans.
grade-b - Very High See all 7 studies
No effect on healthy people or on disease states characterized by impaired lung function.
grade-b - High See all 4 studies
No effect on overall cholesterol levels in otherwise healthy males.
grade-b - Very High See all 6 studies
Short term usage may increase power output like usual, but prolonged supplementation of creatine has failed to alter the deterioration of muscle and lung function. While no reduction in mortality has been noted statistically, two studies have noted a trend towards reductions in mortality suggesting an unknown protective effect.
grade-b - High See all 3 studies
No effect on cardiovascular exercise performance and lung and heart functions, the main parameters of concern when treating COPD.
grade-c Notable Very High See all 3 studies
Depression symptoms seem to improve noticeably. This improvement is probably related to serotonin (creatine supplementation appears to enhance SSRI therapy). Possible gender differences (a greater efficacy in females) require further study.
grade-c Notable - See study
Degree of improvement is somewhat more potent than other supplemental options, and may be related to the improvements in glycemic control seen with creatine.
grade-c
Notable
- See all 4 studies
During exercise, creatine supplementation can suppress growth hormone secretion: up to 35% during loading; up to 5% during maintenance. At rest, creatine supplementation can spike growth hormone by up to 83±45%. This bidirectional effect is similar to that of arginine supplementation.
grade-c Notable - See study
The reduction in circulating Myostatin, while notable (17%), is of uncertain practical relevance.
grade-c Minor - See study
A possible increase in cell mass. Evidence is limited.
grade-c Minor Very High See 2 studies
Appears to be reliable in increasing cognition in vegetarians, but is based on limited evidence and not yet compared to a reference drug.
grade-c Minor - See study
An increase in DHT independent of an increase in testosterone has been noted, but the study requires replication due to some potential issues (its location, the lack of biological plausibility, etc.).
grade-c Minor Moderate See 2 studies
Creatine supplementation appears to reduce exercise-induced DNA damage. This is potentially promising with regard to cancer prevention.
grade-c Minor - See study
The effect of creatine supplementation on DNA methylation cannot be properly assessed due to a lack of comparisons with other agents.
grade-c Minor Moderate See 2 studies
Possibly an effect, but the less reliable effects of creatine in the older population (which seem to respond less) seems to manifest here.
grade-c Minor Very High See 2 studies
Appears to be somewhat effective in diabetics for improving glycemic control.
grade-c Minor - See study
Decrease in homocysteine (biomarker of inflammatory cardiovascular disease) was present, but not to a remarkable magnitude
grade-c Minor - See study
Creatine supplementation appears to induce myonuclei proliferation, to a degree unknown relative to other agents.
grade-c Minor - See study
Compared to reference drugs, creatine had no significant effect.
grade-c Minor Very High See 2 studies
There appears to be a mild therapeutic effect of creatine supplementation (2-5g) to boys with DMD, mostly related to an improvement in handgrip strength and body composition with some parent-rated improvements.
grade-c
Minor
- See 2 studies
Two trials have shown differing effects, for reasons currently unknown.
grade-c Minor - See study
Functionality seems to improve, although not to a remarkable degree.
grade-c Minor Very High See 2 studies
The cognitive dysfunction associated with prolonged sleep deprivation can be attenuated, to a small degree, with prior creatine loading.
grade-c Minor Very High See 2 studies
A minor reduction has been observed.
grade-c - - See study
No significant alterations in plasma adrenaline are seen with creatine supplementation during sleep deprivation.
grade-c - - See 2 studies
grade-c - - See study
grade-c - - See study
No effect on attention during sleep deprivation.
grade-c - - See all 3 studies
grade-c - - See study
grade-c - - See study
grade-c - - See study
No significant alterations in plasma dopamine are seen with creatine supplementation during sleep deprivation.
grade-c - - See 2 studies
grade-c - Very High See 2 studies
No effect on food intake.
grade-c - - See study
grade-c - - See 2 studies
grade-c - - See 2 studies
grade-c - - See study
grade-c - - See study
No effect on the insulin secretion in response to a test meal.
grade-c - - See study
No effect on insulin sensitivity.
grade-c - - See 2 studies
grade-c - Very High See 2 studies
No effect on short-term recall during sleep deprivation.
grade-c - - See study
grade-c - - See study
No significant alterations in plasma noradrenaline are seen with creatine supplementation during sleep deprivation.
grade-c - - See study
There is no significant influence on protein losses in the urine (proteinuria).
grade-c - - See study
Insufficient evidence to support a role in schizophrenia.
grade-c - Very High See 2 studies
The study that noted a prevention of lean mass loss did not distinguish between water and muscle, while the study that measured muscle mass specifically failed to find a protective effect during limb immobilization.
grade-c - - See study
grade-c - - See all 3 studies
grade-c - - See study
grade-c - Very High See 2 studies
No effect on the training volume of swimmers.
grade-c - Very High See 2 studies
There is insufficient evidence to support a rehabilitative role of creatine supplementation.
grade-c - Very High See 2 studies
There is insufficient evidence to support an improvement in the symptoms of Parkinson’s.
grade-c - - See all 3 studies
grade-c - - See all 4 studies
grade-c - - See study
grade-d Notable - See study
Dizziness as a side-effect of traumatic brain injury is reduced with 400 mg/kg/day.
grade-d Notable - See study
400 mg/kg/day in children and adolescents subject to traumatic brain injury reduces headache frequency from around 90% down to near 10%.
grade-d Minor Very High See 2 studies
Increases in alertness tend to be during sleep deprivation or stress, rather than outright increases in alertness. Not overly potent
grade-d Minor Very High See 2 studies
One study has found that creatine can increase blood flow to the calf and leg when combined with resistance training in healthy men. Creatine alone was found to have no effect.
grade-d Minor - See study
Uncertain practical relevance.
grade-d Minor - See study
One study, that needs to be replicated, noted a reduction in range of motion.
grade-d - - See study
grade-d - - See study
An increase in well-being and muscular strength has been noted in youth, but the main parameters under investigation (lung and chest symptoms) seemed unaffected.

Studies Excluded from Consideration

  • Confounded with the inclusion of CoQ10[2]

  • Confounded with glycerol[3]

Things To Know & Note

Primary Function:

Also Known As

creatine monohydrate, creatine 2-oxopropanoate, a-methylguanidinoacetic acid

Do Not Confuse With

creatinine (metabolite), cyclocreatine (analogue), creatinol O-phosphate (analogue)

Goes Well With

  • There have been some anecdotal reports of a subtle but noticeable stimulatory effect on alertness, but this may be a placebo effect.

  • There have been some anecdotal reports of restlessness when creatine is supplemented less than an hour before falling asleep.

  • The water retention usually seen with higher loading doses can exceed five pounds (more than two kilograms). Lower doses may cause less water retention. While water mass is not muscle mass (though both count as lean mass), prolonged creatine supplementation results in an increased rate of muscle growth.

  • Hyperhydration strategies (creatine plus glycerol) appear inefficacious as drug-masking strategies.[1]

Want the unbiased truth about creatine?

We've created a fact sheet that neatly summarizes the scientific research on creatine.

Frequently Asked Questions about Creatine

Does creatine cause hair loss?
It’s plausible, but unlikely. One RCT linked creatine supplementation to an increase in DHT — an androgen involved in hair loss — but this RCT has never been replicated.
Is creatine safe for your kidneys?
In people with healthy kidneys, long-term creatine supplementation is safe, but there are no long-term creatine studies in people with kidney issues. For these people, using a low dose of creatine (if any) would be prudent.
Can creatine increase your testosterone levels?
There is no convincing evidence that creatine can increase your testosterone levels.
What is creatine nitrate?
Creatine nitrate is simply a more water-soluble version of creatine. It is not more potent than regular creatine monohydrate.
Is creatine safe?
Creatine is absolutely safe.
What beneficial compounds are primarily found in animal products?
What is the best form of creatine?
Creatine monohydrate is the cheapest form of creatine. It is also the form whose benefits are best supported by the evidence.
When should I take creatine?
You should take creatine at any given time - you do not need to time it, nor do you need to cycle creatine.
Does caffeine counteract creatine?
There is very little evidence that caffeine counteracts the benefits of creatine.
Do you need to cycle creatine?
You do not need to cycle creatine.
Can creatine cause cancer?
There is no evidence that creatine can cause cancer or has any link to cancer.
Do I need to load creatine?
You do not need to load creatine. it can be used as diagnosis to see if you 'respond' to creatine or to get slightly quicker benefits but in the long run loading is not a requirement of creatine supplementation. No harm in it either, except perhaps digestive discomfort
Is creatine a steroid?
Creatine is not a steroid. It bears no relation to a steroid structurally or in its actions.
What happens if I go off of creatine?
Does creatine benefit elite athletes?
Creatine benefits all exercise for all individuals when it is strength based. However, this benefit does appear to be less noticeable to elite athletes than it does to novice athletes.

Research Breakdown on Creatine

Click here to see all 746 references.