Creatine

Supplement Forms/Alternate Names:

Creatine monohydrate

Introduction

Creatine is a substance in the body that helps produce energy. It can be taken as a pill or powder. Creatine has been used to improve athletic performance and muscle strength.

Dosages

10 to 20 grams once daily

What Research Shows

Likely Effective

  • Athletic performance —likely to improve muscle mass, strength, and function B1-B4
  • Muscular dystrophy —likely to improve muscle strength G1

May Be Effective

  • Mental Function —may improve short-term memory and intelligence/reasoning E1

May Not Be Effective

  • Amyotrophic Lateral Sclerosis (ALS) —may not improve symptoms A1
  • Mitochondrial disorders —may not have benefit as an intervention F1

Unlikely to Be Effective

  • Chronic Obstructive Pulmonary Disease (COPD) —unlikely to improve exercise capacity, muscle strength, or quality of life D1
  • Parkinson disease —unlikely to prevent development H1-H3

Not Enough Data to Assess

  • Cardiovascular disease C1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

It is likely safe to take creatine in small doses for a short time. Not enough studies have been done to say whether it is safe to use for a long period. It is also not known whether it is safe to take by women who are pregnant or breastfeeding.

Interactions

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse such as:

  • People with kidney or heart problems should talk to their doctors before taking creatine. It may interrupt proper function.
 

References

A. Amyotrophic Lateral Sclerosis

A1. Pastula DM, Moore DH, et al. Creatine for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev. 2012;12:CD005225.

B. Athletic Performance

B1. Cornelissen VA, Defoor JG, et al. Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial. Clin Rehabil. 2010 Nov;24(11):988-99.

B2. Devries MC, Phillips SM. Creatine supplementation during resistance training in older adults-a meta-analysis. Med Sci Sports Exerc. 2014 Jun;46(6):1194-1203.

B3. Lanhers C, Pereira B, et al. Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses. Sports Med. 2015 Sep;45(9):1285-1294.

B4. Lanhers C, Pereira B, et al. Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis. Sports Med. 2017;47(1):163-173.

C. Cardiovascular Disease

C1. Horjus DL, Oudman I, et al. Creatine and creatine analogues in hypertension and cardiovascular disease. Cochrane Database Syst Rev. 2011;(11):CD005184.

D. Chronic Obstructive Pulmonary Disease

D1. Al-Ghimlas F, Todd DC. Creatine supplementation for patients with COPD receiving pulmonary rehabilitation: a systematic review and meta-analysis. Respirology. 2010 Jul;15(5):785-795.

E. Cognitive Function

E1. Avgerinos KI, Spyrou N, et al. Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Exp Gerontol. 2018 Jul 15;108:166-173.

F. Mitochondrial Disorders

F1. Pfeffer G, Majamaa K, et al. Treatment for mitochondrial disorders. Cochrane Database Syst Rev. 2012 Apr 18;(4):CD004426.

G. Muscular Dystrophy

G1. Kley RA, Tarnopolsky MA, et al. Creatine for treating muscle disorders. Cochrane Database Syst Rev. 2013;(6):CD004760.

H. Parkinson Disease

H1. Xiao Y, Luo M, et al. Creatine for Parkinson's disease. Cochrane Database Syst Rev. 2014 Jun 17;(6):CD009646.

H2. Attia, Ahmed H, et al. Meta-Analysis of Creatine for Neuroprotection Against Parkinson’s Disease. CNS Neurol Disord Drug Targets. 2017;16(2):169-175.

H3. Mo JJ, Liu LY, et al. The effectiveness of creatine treatment for Parkinson’s disease: an updated meta-analysis of randomized controlled trials. BMC Neurol. 2017;17(1):105.

Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC