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Creatine

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amino acid derivativeentity:supplement:creatine

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Creatineentity:ingredient:creatine

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Creatine monohydratecompound

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Creatine monohydratecreatine form

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Evidence source: NIH ODS evidence synthesis
Linked references: 3 identified
Human evidence: Human evidence not identified in the frozen metadata
Randomized trials: Randomized trials not identified in the frozen metadata
Reviews and meta-analyses: Systematic reviews or meta-analyses not identified in the frozen metadata
Evidence recency: 2010–2017
Source-described consistency: Not characterized in these source blocks
MEDucated evidence rating: Not assigned

Reference counts describe frozen source associations; a larger count does not establish stronger evidence.

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Evidence types identified

Study type could not be determined3

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No explicit limitation phrase was identified in these imported source blocks.

Classified references

Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Salomons GS, Jakobs C, Wyss M. Creatine. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements, 2nd ed. New York, NY: Informa Healthcare;2010:202-207.
Study type could not be determined · Population basis: unknown · Directness: not assessed
Cooper R, Naclerio F, Allgrove J, Jimenez A. Creatine supplementation with specific view to exercise/sports performance: an update. J Int Soc Sports Nutr. 2012,9:33. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed

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Creatine is one of the most thoroughly studied and widely used dietary supplements to enhance exercise and sports performance [112]. Creatine is produced endogenously and obtained from the diet in small amounts. It helps generate ATP and thereby supplies the muscles with energy, particularly for short-term events [113]. Creatine might improve muscle performance in four ways: by increasing stores of phosphocreatine used to generate ATP at the beginning of intense exercise, accelerating the re-synthesis of phosphocreatine after exercise, depressing the degradation of adenine nucleotides and the accumulation of lactate, and/or enhancing glycogen storage in skeletal muscles [113].

The liver and kidneys synthesize about 1 g/day creatine from the amino acids glycine, arginine, and methionine [114]. Animal-based foods, such as beef (2 g/lb), pork (2.3 g/lb), and salmon (2 g/lb), also contain creatine. A person weighing 154 pounds has about 120 g creatine and phosphocreatine in his or her body, almost all in the skeletal and cardiac muscles [112]. However, it is only when users consume much greater amounts of creatine over time as a dietary supplement that it could have ergogenic effects. Metabolized creatine is converted into the waste product creatinine, which is eliminated from the body through the kidneys.

Source-described amount

Where did MEDucated get this?

Dietary Supplements for Exercise and Athletic Performance — Fact Sheet for Health Professionals

NIH Office of Dietary Supplements. Government health-professional reference material imported without MEDucated medical review.

Source section: Creatine
ODS revision: April 1, 2024
Retrieved: 2026-08-10T22:07:07.072Z
Source fingerprint: 7a77ecb53239a7de4420bcdd7894f04b8efeeedb8c8517ad2569ff5f1278e764
Cited reference numbers: 112, 113, 114

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Evidence source: NIH ODS evidence synthesis
Linked references: 9 identified
Human evidence: Human evidence not identified in the frozen metadata
Randomized trials: Randomized trials not identified in the frozen metadata
Reviews and meta-analyses: Systematic reviews or meta-analyses not identified in the frozen metadata
Evidence recency: 1997–2017
Source-described consistency: Not characterized in these source blocks
MEDucated evidence rating: Not assigned

Reference counts describe frozen source associations; a larger count does not establish stronger evidence.

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Evidence types identified

Study type could not be determined9

Source-described limitations

No explicit limitation phrase was identified in these imported source blocks.

Classified references

American College of Sports Medicine, American Dietetic Association, Dietitians of Canada. American College of Sports Medicine position stand: Nutrition and athletic performance. Med Sci Sports Exerc 2009:709-31. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Salomons GS, Jakobs C, Wyss M. Creatine. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements, 2nd ed. New York, NY: Informa Healthcare;2010:202-207.
Study type could not be determined · Population basis: unknown · Directness: not assessed
Cooper R, Naclerio F, Allgrove J, Jimenez A. Creatine supplementation with specific view to exercise/sports performance: an update. J Int Soc Sports Nutr. 2012,9:33. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Kreider RB. Effects of creatine supplementation on performance and training adaptations. Mol Cell Biochem 2003;244:89-94. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Volek JS, Kraemer WJ, Bush JA, Boetes M, Incledon T, Clark KL, Lynch JM. Creatine supplementation enhances muscular performance during high-intensity resistance exercise. J Am Diet Assoc 1997;97:765-70. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Skare O-C, Skadberg O, Wisnes AR. Creatine supplementation improves sprint performance in male sprinters. Scand J Med Sci Sports 2001;11:96-102. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Larson-Meyer DE, Hunter GR, Trowbridge CA, Turk JC, Ernest JM, Torman SL, Harbin PA. The effect of creatine supplementation on muscle strength and body composition during off-season training in female soccer players. J Strength Cond Res 2000;14:434-442.
Study type could not be determined · Population basis: unknown · Directness: not assessed
Operation Supplement Safety. Creatine supplements.
Study type could not be determined · Population basis: unknown · Directness: not assessed

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Studies in both laboratory and sports settings have found that short-term creatine supplementation (for 5 to 7 days) in both men and women often significantly increases strength (e.g., for bench presses) and power (e.g., for cycling), work involving multiple sets of maximal effort muscle contractions, and sprinting and soccer performance [112,115]. In one example, a study randomized 14 healthy, resistance-trained men (age 19–29 years) to receive 25 g creatine monohydrate or a placebo for 6–7 days [116]. Participants taking the supplement had significant improvements in peak power output during all five sets of jump squats and in repetitions during all five sets of bench presses on three occasions. In another study, 18 well-trained male sprinters age 18–24 years received either 20 g/day creatine or a placebo for 5 days [117]. Compared with those taking the placebo, participants taking the creatine improved their performance in both 100-meter sprints and six intermittent 60-m sprints.

Study doseSource-described amount

Supplementation with creatine over weeks or months helps training adaptations to structured, increased workloads over time. For example, in a randomized study of 14 female collegiate soccer players during the off-season, those who received creatine (15 g/day for 1 week and then 5 g/day for 12 weeks) had significantly greater increases in muscle strength, as measured by bench press and full-squat maximal strength testing, but not lean tissue compared with participants who took a placebo [118].

Study doseSource-described amount

Individuals have varied responses to creatine supplementation, based on factors such as diet and the relative percentages of various muscle fiber types [114,119]. Vegetarians, for example, with their lower muscle creatine content, might have greater responses to supplementation than meat eaters. Overall, creatine enhances performance during repeated short bursts of high-intensity, intermittent activity, such as sprinting and weight lifting, where energy for this predominantly anaerobic exercise comes mainly from the ATP-creatine phosphate energy system [38,114].

Creatine supplementation seems to be of little value for endurance sports, such as distance running or swimming, that do not depend on the short-term ATP-creatine phosphate system to provide short-term energy, and it leads to weight gain that might impede performance in such sports [113,114]. Furthermore, in predominantly aerobic exercise lasting more than 150 seconds, the body relies on oxidative phosphorylation as the primary energy source, a metabolic pathway that does not require creatine [114].

Where did MEDucated get this?

Dietary Supplements for Exercise and Athletic Performance — Fact Sheet for Health Professionals

NIH Office of Dietary Supplements. Government health-professional reference material imported without MEDucated medical review.

Source section: Efficacy
ODS revision: April 1, 2024
Retrieved: 2026-08-10T22:07:07.072Z
Source fingerprint: 7a77ecb53239a7de4420bcdd7894f04b8efeeedb8c8517ad2569ff5f1278e764
Cited reference numbers: 112, 115, 116, 117, 118, 38, 114, 119, 113

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Source attribution does not imply NIH or ODS endorsement of MEDucated.

Potential benefits studied

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Known risks and safety considerations

Imported NIH ODS source content is available for this topic. MEDucated has preserved the source wording and has not converted it into personalized guidance.

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Structural characterization

Evidence profile

No overall rating assigned

Evidence source: NIH ODS evidence synthesis
Linked references: 8 identified
Human evidence: Human evidence not identified in the frozen metadata
Randomized trials: Randomized trials not identified in the frozen metadata
Reviews and meta-analyses: Systematic reviews or meta-analyses not identified in the frozen metadata
Evidence recency: 1985–2017
Source-described consistency: Not characterized in these source blocks
MEDucated evidence rating: Not assigned

Reference counts describe frozen source associations; a larger count does not establish stronger evidence.

Inspect technical evidence details

Evidence types identified

Study type could not be determined8

Source-described limitations

No explicit limitation phrase was identified in these imported source blocks.

Classified references

Thomas DT, Erdman KA, Burke LM, MacKillop M. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. J Acad Nutr Diet 2016;116:501-28. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. J Int Soc Sports Nutr 2014;11:20. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Salomons GS, Jakobs C, Wyss M. Creatine. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements, 2nd ed. New York, NY: Informa Healthcare;2010:202-207.
Study type could not be determined · Population basis: unknown · Directness: not assessed
Cooper R, Naclerio F, Allgrove J, Jimenez A. Creatine supplementation with specific view to exercise/sports performance: an update. J Int Soc Sports Nutr. 2012,9:33. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Schilling BK, Stone MH, Utter A, Kearney JT, Johnson M, Coglianese R, Smith L, O'Bryant HS, Fry AC, Starks M, Keith R, Stone ME. Creatine supplementation and health variables: a retrospective study. Med Sci Sports Exerc 2001;33:183-8. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Poortmans JR, Francaux M. Long-term oral creatine supplementation does not impair renal function in healthy athletes. Med Sci Sports Exerc 1999;31:1108-10. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Vannas-Sulonen K, Sipila I, VannasA, Simell O, Rapola J. Gyrate atrophy of the choroid and retina: a five-year follow-up of creatine supplementation. Ophthalmology 1985;92:1719-27. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed

Studies have found no consistent set of side effects from creatine use, except that it often leads to weight gain, because it increases water retention and possibly stimulates muscle protein synthesis [112,113]. Several studies have found that supplemental creatine monohydrate, when used for a strength-training program, can lead to a 1–2 kg increase in total body weight in a month [73].

Creatine is considered safe for short-term use by healthy adults [12,112,113,114]. In addition, evidence shows that use of the product for several years is safe [112,120-122]. Anecdotal reactions to creatine use include nausea, diarrhea and related gastrointestinal distress, muscle cramps, and heat intolerance. Creatine supplementation may reduce the range of motion of various parts of the body (such as the shoulders, ankles, and lower legs) and lead to muscle stiffness and resistance to stretching [114]. Adequate hydration while taking creatine might minimize these uncommon risks [113].

Where did MEDucated get this?

Dietary Supplements for Exercise and Athletic Performance — Fact Sheet for Health Professionals

NIH Office of Dietary Supplements. Government health-professional reference material imported without MEDucated medical review.

Source section: Safety
ODS revision: April 1, 2024
Retrieved: 2026-08-10T22:07:07.072Z
Source fingerprint: 7a77ecb53239a7de4420bcdd7894f04b8efeeedb8c8517ad2569ff5f1278e764
Cited reference numbers: 73, 112, 113, 12, 114, 120, 121, 122

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Source attribution does not imply NIH or ODS endorsement of MEDucated.

Side effects

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Food and nutrient interactions

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Typical forms

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Pregnancy and lactation considerations

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Laboratory and test considerations

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Regulatory information

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Imported NIH ODS source content is available for this topic. MEDucated has preserved the source wording and has not converted it into personalized guidance.

Source-backed preview

Structural characterization

Evidence profile

No overall rating assigned

Evidence source: NIH ODS evidence synthesis
Linked references: 8 identified
Human evidence: Human evidence not identified in the frozen metadata
Randomized trials: Randomized trials not identified in the frozen metadata
Reviews and meta-analyses: Systematic reviews or meta-analyses not identified in the frozen metadata
Evidence recency: 2010–2017
Source-described consistency: Not characterized in these source blocks
MEDucated evidence rating: Not assigned

Reference counts describe frozen source associations; a larger count does not establish stronger evidence.

Inspect technical evidence details

Evidence types identified

Study type could not be determined8

Source-described limitations

No explicit limitation phrase was identified in these imported source blocks.

Classified references

Thomas DT, Erdman KA, Burke LM, MacKillop M. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. J Acad Nutr Diet 2016;116:501-28. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Australian Institute of Sport. ABCD Classification System. 2017.
Study type could not be determined · Population basis: unknown · Directness: not assessed
Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. J Int Soc Sports Nutr 2014;11:20. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Salomons GS, Jakobs C, Wyss M. Creatine. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements, 2nd ed. New York, NY: Informa Healthcare;2010:202-207.
Study type could not be determined · Population basis: unknown · Directness: not assessed
Cooper R, Naclerio F, Allgrove J, Jimenez A. Creatine supplementation with specific view to exercise/sports performance: an update. J Int Soc Sports Nutr. 2012,9:33. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed
Operation Supplement Safety. Creatine supplements.
Study type could not be determined · Population basis: unknown · Directness: not assessed
Jager R, Purpura M, Shao A, Inoue T, Kreider RB. Analysis of the efficacy, safety, and regulatory status of novel forms of creatine. Amino Acids 2011;40:1369-83. [PubMed abstract]
Study type could not be determined · Population basis: unknown · Directness: not assessed

Read imported source wording

In a position statement, the AND, DoC, and ACSM advise that creatine enhances performance of cycles of high-intensity exercise followed by short recovery periods and improves training capacity [12]. In its position statement, the ISSN states that creatine monohydrate is the most effective nutritional supplement currently available for enhancing capacity for high-intensity exercise and lean body mass during exercise [112]. The ISSN contends that athletes who supplement with creatine have a lower incidence of injuries and exercise-related side effects compared to those who do not take creatine [112]. The Australian Institute of Sport supports the use of creatine for improving sports performance in suitable athletic competitions under the direction of an expert in sports medicine, but it notes that more research might be required to understand how the supplement should be used for best results [29].

A typical protocol for creatine supplementation in adults, regardless of sex or body size, consists of a loading phase for 5–7 days, when users consume 20 g/day creatine monohydrate in four portions of 5 g, followed by a maintenance phase of 3–5 g/day [112-114]. In some studies, the loading dose is based on body weight (e.g., 0.3 g/kg) [114]. Another creatine supplementation protocol consists of taking single doses of about 3–6 g/day (0.03–0.1 g/kg body weight) for 3 to 4 weeks, without a loading phase, to produce ergogenic effects [112,114,119].

Source intake rangeSource-described amount

Creatine monohydrate, which is 88% creatine by weight, is the most widely used and studied form [112,114,123]. Other, usually more expensive, forms of creatine (e.g., creatine ethyl ester, creatine alpha-ketoglutarate, and buffered forms of creatine) have not been proven to have superior ability to creatine monohydrate for enhancing muscle creatine levels, digestibility, product stability, or safety [73,112,123].

Where did MEDucated get this?

Dietary Supplements for Exercise and Athletic Performance — Fact Sheet for Health Professionals

NIH Office of Dietary Supplements. Government health-professional reference material imported without MEDucated medical review.

Source section: Implications for use
ODS revision: April 1, 2024
Retrieved: 2026-08-10T22:07:07.072Z
Source fingerprint: 7a77ecb53239a7de4420bcdd7894f04b8efeeedb8c8517ad2569ff5f1278e764
Cited reference numbers: 12, 29, 112, 113, 114, 119, 73, 123

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Fixture ID: fixture:supplement:creatine:ods-evidence-preview
Fixture revision: source-revision:nih-ods:exercise-athletic-performance-health-professional:2026-08-10.7a77ecb53239
Content classification: source backed demonstration
Medical review: not medically reviewed
Evidence classification: unknown other
External source metadata: Not available for this internal identity fixture

Imported government source

Dietary Supplements for Exercise and Athletic Performance — Fact Sheet for Health Professionals

NIH Office of Dietary Supplements

Fixture ID: fixture:supplement:creatine:ods-evidence-preview
Fixture revision: source-revision:nih-ods:exercise-athletic-performance-health-professional:2026-08-10.7a77ecb53239
Content classification: source backed demonstration
Medical review: not medically reviewed
Evidence classification: government reference
External source metadata: Available in source inspection