Creatine Research
54 peer-reviewed studies · Evidence score: 9.5/10
Nutritional Supplementation Combined with Exercise for Musculoskeletal Health in Women: A Systematic Review and Meta-Analysis Evaluating Proteins, Amino Acids, and Creatine across Reproductive Stages
Chen KH et al. • International journal of medical sciences (2026)
Current evidence does not support robust additive effects of nutritional supplementation on muscle mass or bone health when combined with exercise in women across reproductive stages.
- The combined intervention showed no significant effects on muscle mass measures: skeletal muscle mass (g=0.065, 95% CI: -0.353 to 0.482, p=0.762), appendicular lean mass (g=0.197, 95% CI: -0.177 to 0.571, p=0.302), or fat-free mass (g=0.069, 95% CI: -0.110 to 0.249, p=0.447).
- Significant improvements occurred in bench press (g=0.279, 95% CI: 0.008 to 0.550, p=0.043) and handgrip strength (g=0.412, 95% CI: 0.039 to 0.786, p=0.031).
- No significant effects emerged for bone mineral content (g=0.195, 95% CI: -0.281 to 0.671, p=0.421) or bone mineral density (g=0.087, 95% CI: -0.129 to 0.303, p=0.430).
Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: a systematic review and meta-analysis
Naddafha S et al. • Journal of the International Society of Sports Nutrition (2026)
In postmenopausal women, creatine, particularly ≥ 5 g·day⁻¹ with RT, yields small but meaningful gains in lean mass and strength without evidence of harm.
- Lean mass (k = 5; n = 338) favored creatine: mean difference (MD) + 0.37 kg (95% CI + 0.05 to + 0.69; I² = 25%; τ² = 0.01; 95% PI -0.10 to + 0.84).
- Leg-press 1RM (k = 3; n = 111) improved with creatine: MD + 7.5 kg (95% CI + 2.2 to + 12.8; I² = 0%).
- In postmenopausal women, creatine, particularly ≥ 5 g·day⁻¹ with RT, yields small but meaningful gains in lean mass and strength without evidence of harm.
Creatine supplementation protocols with or without training interventions on body composition: a GRADE-assessed systematic review and dose-response meta-analysis
Pashayee-Khamene F et al. • Journal of the International Society of Sports Nutrition (2024)
Creatine supplementation has a small effect on body mass and estimates of fat-free mass and body fat percentage.
- Creatine supplementation increased body mass (WMD: 0.86 kg; 95% CI: 0.76 to 0.96, I2 = 0%) and fat-free mass (WMD: 0.82 kg; 95% CI: 0.57 to 1.06, I2 = 0%) while reducing body fat percentage (WMD: -0.28 %; 95% CI: -0.47 to -0.09; I2 = 0%).
- Creatine supplementation has a small effect on body mass and estimates of fat-free mass and body fat percentage.
- These findings were more robust when combined with resistance training.
Creatine supplementation and lower limb strength performance
Lanhers C et al. • Sports Medicine (2015)
Creatine supplementation significantly increases lower limb strength, with greater effects seen in trained individuals.
- Significant strength improvements in legs
- Effects enhanced with resistance training
- Safe for long-term use
Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis
de Guingand DL et al. • Nutrients (2020)
However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.
- Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%).
- No statistically significant difference was reported in measures of renal or hepatic function.
- In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females.
Creatine supplementation and memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials
Prokopidis K et al. • Nutrition Reviews (2023)
Creatine supplementation improved measures of memory compared with placebo, with significant benefits in older adults.
- Significant improvement in memory (SMD = 0.29)
- Greater benefits in older adults (66-76 years)
- Supports brain health across lifespan
Creatine supplementation and VO(2)max: a systematic review and meta-analysis
Gras D et al. • Critical reviews in food science and nutrition (2023)
Creatine supplementation has a negative effect on VO2max, regardless of the characteristics of training, supplementation, or population characteristics.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2008864 .
- We included 19 RCTs for a total of 424 individuals (mean age 30 years old, 82% men).
- Participants in both groups were engaged in exercise interventions in most studies (80%).
- Using changes in VO2max, VO2max increased in both groups but increased less after creatine supplementation than placebo (effect size [ES] = -0.32, 95%CI = -0.51 to -0.12, p = 0.002).
Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis
Dos Santos EEP et al. • Nutrients (2021)
However, given the level of evidence, future high-quality studies are needed to confirm these findings.
- Overall, Cr significantly increased measures of upper-body strength (7 studies, n = 142, p = 0.04), with no effect on lower-body strength or measures of muscle mass.
- Sub-analyses revealed that both upper-body (4 studies, n = 97, p = 0.05) and lower-body strength (4 studies, n = 100, p = 0.03) were increased by Cr, compared to placebo in studies ≥ 24 weeks in duration.
- In conclusion, older females supplementing with Cr experience significant gains in muscle strength, especially when RT lasts for at least 24 weeks in duration.
The Effects of Creatine Supplementation Combined with Resistance Training on Regional Measures of Muscle Hypertrophy
Burke R et al. • Nutrients (2023)
Evidence supports a small positive effect of creatine supplementation on muscle hypertrophy when combined with resistance training.
- Small but positive effect on muscle growth
- Benefits seen across muscle groups
- Complements resistance training effects
Effects of Creatine Supplementation and Resistance Training on Muscle Strength Gains in Adults <50 Years of Age: A Systematic Review and Meta-Analysis
Wang Z et al. • Nutrients (2024)
In conclusions, creatine supplementation with resistance training enhances upper- and lower-body muscle strength in adults aged < 50, with greater benefits likely to be seen in males than females.
- In comparison with a placebo, creatine supplementation combined with resistance training significantly increased upper-body (WMD = 4.43 kg, p < 0.001) and lower-body strength (WMD = 11.35 kg, p < 0.001).
- Subgroup analyses showed a trend for greater upper-body strength improvements for males on creatine compared with females on creatine (p = 0.067, Q = 3.366).
- Additionally, males who consumed creatine combined with resistance training significantly increased both upper- and lower-body strength, whereas females showed no significant gains.
Effects of creatine supplementation on cognitive function
Avgerinos KI et al. • Experimental Gerontology (2018)
Creatine supplementation improves short-term memory and reasoning, particularly under stress conditions.
- Improves cognitive function under stress
- Benefits memory in sleep-deprived individuals
- May support brain health in aging
The Effect of Creatine Supplementation on Resistance Training-Based Changes to Body Composition: A Systematic Review and Meta-analysis
Desai I et al. • Journal of strength and conditioning research (2024)
Concurrent carbohydrate ingestion did not enhance the hypertrophy benefits of creatine.Copyright © 2024 National Strength and Conditioning Association.
- Our primary outcome was lean body mass (LBM); secondary outcomes were body fat percentage (%) and body fat mass (kg).
- Fifty-two percentages of the studies had low risk, 41% some concerns, and 7% high risk of bias.
- Compared with resistance training (RT) alone, creatine supplementation increased LBM by 1.14 kg (95% CI 0.69 to 1.59), and reduced body fat percentage by -0.88% (95% CI -1.66 to -0.11) and body fat mass by -0.73 kg (95% CI -1.34 to -0.11).
Biomarkers of mitochondrial dysfunction in autism spectrum disorder: A systematic review and meta-analysis
Frye RE et al. • Neurobiology of disease (2024)
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- Significant elevations (all p < 0.01) in the prevalence of lactate (17%), pyruvate (41%), alanine (15%) and creatine kinase (9%) were found in ASD.
- Individuals with ASD had significant differences (all p < 0.01) with moderate to large effect sizes (Cohen's d' ≥ 0.6) compared to controls in mean pyruvate, lactate-to-pyruvate ratio, ATP, and creatine kinase.
- The fact that alterations in mitochondrial metabolism may be found during pregnancy and early in the life of individuals who eventually develop ASD provides promise for early life predictive biomarkers of ASD.
Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise in Physically Active Participants: A Systematic Review, Meta-Analysis, and Meta-Regression
Moore E et al. • Sports medicine (Auckland, N.Z.) (2023)
CWI is effective for promoting recovery from acute strenuous exercise in physically active populations compared with other common recovery methods.
- CWI is effective for promoting recovery from acute strenuous exercise in physically active populations compared with other common recovery methods.
- Published in Sports medicine (Auckland, N.Z.) (2023)
- Further research warranted to confirm findings
Ergogenic Aids to Improve Physical Performance in Female Athletes: A Systematic Review with Meta-Analysis
López-Torres O et al. • Nutrients (2022)
More studies are needed in female athletes that measure the effects of different EAs on sports performance, such as beetroot juice, beta-alanine or sodium phosphate, as the studies to date are scarce and there are many types of EA that need to be further considered in this population, such as creatine and taurine.
- A random-effects model and the standardized mean differences (SMD) ± 95% confidence intervals (CI) were reported.
- Aerobic tests could be improved with the use of taurine, caffeine, and beta-alanine.
- No conclusive effects of beetroot juice, polyphenols, or creatine in improving aerobic performance were shown.
Nutritional Ergogenic Aids in Combat Sports: A Systematic Review and Meta-Analysis
Vicente-Salar N et al. • Nutrients (2022)
Caffeine is the only NEA that has shown strong evidence for performance enhancement in combat sports.
- In this regard, abilities including the number of attacks, reaction time, handgrip strength, power and TTE, among others, were improved.
- Buffering supplements such as sodium bicarbonate, sodium citrate and beta-alanine may have a promising role in high and intermittent exertion during combat, but more studies are needed in grappling combat sports to confirm their efficacy during sustained isometric exertion.
- Other NEAs, including creatine, beetroot juice or glycerol, need further investigation to strengthen the evidence for performance enhancement in combat sports.
Creatine in Health and Disease
Kreider RB et al. • Nutrients (2021)
Based on this analysis, it can be concluded that creatine supplementation has several health and therapeutic benefits throughout the lifespan.
- Moreover, increasing availability of creatine in tissue may enhance cellular metabolism and thereby lessen the severity of injury and/or disease conditions, particularly when oxygen availability is compromised.
- This systematic review assesses the peer-reviewed scientific and medical evidence related to creatine's role in promoting general health as we age and how creatine supplementation has been used as a nutritional strategy to help individuals recover from injury and/or manage chronic disease.
- Additionally, it provides reasonable conclusions about the role of creatine on health and disease based on current scientific evidence.
Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults
Forbes SC et al. • Nutrients (2021)
Finally, creatine supplementation only on resistance training days significantly increased measures of lean tissue mass and strength vs. placebo.
- Finally, creatine supplementation only on resistance training days significantly increased measures of lean tissue mass and strength vs. placebo.
- Subanalyses showed that creatine-loading followed by lower-dose creatine (≤5 g/day) increased chest press strength vs. placebo.
- Higher-dose creatine (>5 g/day), with and without a creatine-loading phase, produced significant gains in leg press strength vs. placebo.
Creatine supplementation effect on recovery following exercise-induced muscle damage: A systematic review and meta-analysis of randomized controlled trials
Jiaming Y et al. • Journal of food biochemistry (2021)
But, due to high heterogeneity and the medium risk of bias for articles, we suggest that these results are taken into account and the facts are interpreted with caution by the readers.© 2021 Wiley Periodicals LLC.
- Weighted mean difference (WMD), 95% confidence interval (CI), and random-effects model, were applied for estimating the overall effect.
- Pooled data showed that creatine significantly reduced creatine kinase (CK) concentration overall (WMD = -30.94; 95% CI: -53.19, -8.69; p = .006) and at three follow-up times (48, 72, and 96 hr) in comparison with placebo.
- In contrast, effects were not significant in lactate dehydrogenase (LDH) concentration overall (WMD = -5.99; 95% CI: -14.49, 2.50; p = .167), but creatine supplementation leaded to a significant reduction in LDH concentrations in trials with 48 hr measurement of LDH.
International Society of Sports Nutrition position stand: creatine supplementation and exercise
Kreider RB et al. • Journal of the International Society of Sports Nutrition (2017)
Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes for increasing high-intensity exercise capacity and lean body mass.
- Increases strength by 5-15%
- Enhances muscle mass gains
- Improves high-intensity exercise performance