Creatine is one of the most extensively studied supplements and has been shown to increase physical performance in successive bursts of short-term, high-intensity exercise,’ says Aitken. After that initial retention period, subsequent gains are due to the increase in the workload you can handle, according to Paul Greenhaff, Ph.D., professor of muscle metabolism at the University of Nottingham in England.

In summary, based on the limited evidence, creatine supplementation appears safe and potentially beneficial for children and adolescents. Does creatine increase fat mass? In skeletal muscle, both creatine and PCr are degraded non-enzymatically to creatinine, which is exported to the blood and excreted in the urine [ 1]. Healthy kidneys filter creatinine, which would otherwise increase in the blood. Therefore, blood creatinine levels can be used as a proxy marker of kidney function. However, the amount of creatinine in the blood is related to muscle mass (i.e. males have higher blood creatinine than females) and both dietary creatine and creatinine intake [ 35]. Both blood and urinary creatinine may be increased by ingestion of creatine supplementation and creatine containing foods, such as meat. Creatine is normally not present in urine, but can reach very high levels (>10 g/day) during creatine supplementation [ 49]. There appears to be an unsubstantiated perspective that if the kidneys are “forced” to excrete higher than normal levels of creatine or creatinine, some sort of kidney “overload” will take place, causing kidney damage and/or renal dysfunction. In reality, transient increases in blood or urinary creatine or creatinine due to creatine supplementation are unlikely to reflect a decrease in kidney function. Additionally, one must exercise caution when using blood creatinine and estimated creatinine clearance/glomerular filtration rate in individuals who consume high meat intake or supplement with creatine. In a review of creatine supplementation studies, Persky and Rawson [ 50] found no increase in serum creatinine in 12 studies, 8 studies showed an increase that remained within the normal range, and only 2 studies showed an increase above normal limits (although not different from the control group in one study).Creatine isn’t just found in supplements,” Brown says. "It’s actually found in beef, pork, and salmon." In summary, there is growing body of evidence showing that creatine supplementation, particularly when combined with exercise, provides musculoskeletal and performance benefits in older adults. Is creatine only useful for resistance / power type activities? Balestrino M, Adriano E. Beyond sports: Efficacy and safet Creatine can help improve blood sugar management, so if you are using medication known to affect blood sugar, you should discuss creatine use with a doctor ( 24). Over the long term, studies show that body weight may continue to increase to a greater extent in creatine users than in people who do not take creatine. This weight gain is due to increased muscle growth — not increased body fat ( 11, 12).

Creatine monohydrate powder has been the most extensively studied and commonly used form of creatine in dietary supplements since the early 1990s [ 2, 125]. Creatine monohydrate was used in early studies to assess bioavailability, determine proper dosages, and assess the impact of oral ingestion of creatine on blood creatine and intramuscular creatine stores [ 35, 60, 182]. These studies indicated that orally ingested creatine monohydrate (e.g., 3–5 g/day) increases blood concentrations of creatine for 3-4 hours after ingestion thereby facilitating the uptake of creatine into tissue through diffusion and creatine transporters [ 1, 183, 184]. Additionally, it is well established that ~99% of orally ingested creatine monohydrate is either taken up by tissue or excreted in the urine as creatine through normal digestion [ 60, 185, 186]. Short-term loading with creatine monohydrate (e.g., consuming 5 g, 4 times daily for 5-7 days) has been reported to increase intramuscular creatine stores by 20–40% and exercise performance capacity by 5–10% [ 2, 125]. Creatine monohydrate supplementation during training (e.g., 5–25 g/day for 4–12 weeks) has been reported to promoted gains in muscle mass, strength, and exercise capacity [ 2, 125]. Despite the known efficacy, safety, and low cost of creatine monohydrate; a number of different forms of creatine have been marketed as more effective with fewer anecdotally reported adverse effects [ 187]. These marketing efforts have fueled speculation that creatine monohydrate is not the most effective or safest form of creatine to consume. This notion is clearly refuted by understanding the well-known physio-chemical properties of creatine monohydrate, as well as current creatine supplementation literature. There is a small body of research that has investigated the effects of creatine supplementation in younger females. For example, Vandenberghe et al. [ 176] showed that creatine supplementation (20 g/day for 4 days followed by 5 g/day thereafter) during 10 weeks of resistance training significantly increased intramuscular concentrations, muscle mass and strength compared to placebo in females (19-22 yrs). In elite female soccer players (22 ± 5 yrs), creatine supplementation (20 g/day for 6 days) improved sprint and agility performance compared to placebo [ 177]. Hamilton et al. [ 178] showed that creatine supplementation (25 g for 7 days) augmented upper-body exercise capacity in strength-trained females (21-33 yrs) compared to placebo (19-29 yrs). Furthermore, in college-aged females (20 yrs), creatine supplementation (0.5 g/kg of fat-free mass for 5 days) improved knee extension muscle performance compared to placebo [ 179]. In contrast, not all data show improved performance in females [ 89, 160, 161]. Additionally, Smith-Ryan et al. [ 180] reported no significant effects of creatine loading on neuromuscular properties of fatigue in young adult females. It is important to evaluate the benefit to risk ratio; as noted elsewhere in this document, there are minimal risks associated with creatine supplementation, particularly when it is evaluated against the potential benefits in females. Rare creatine-metabolizing syndromes. In children with the certain creatine deficiency syndromes, oral creatine supplements might improve some symptoms. Creatine does show promise in athletic training, particularly for high-intensity movements such as sprinting, studies show. For example, a 2013 study of 16 amateur swimmers found that those who took creatine supplements had a lower heart rate and blood lactate levels (a measure of tired muscles) after swimming sprints compared with athletes who took a placebo. These results were measured after the participants took the supplements for six days, according to the paper published in the Journal of Sports Medicine and Physical Fitness. Some small studies have shown creatine increases lean muscle mass, strength and speed.However, if you’re a larger-than-average person, or don’t notice benefits with 5 grams per day, you can use 10 grams of creatine daily for maintenance instead. The Bottom Line Creatine. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Nov. 13, 2020. Long-term studies suggest that there are no negative effects associated with supplementing with creatine in healthy individuals,’ adds Roberts. ‘While there have been side effects noted, this is largely dependent on an individual’s dosing strategy, pre-existing health conditions, and overall response to supplementing creatine.’ Maternal creatine supplementation during pregnancy in pre-clinical animal studies have demonstrated a protective effect against fetal death and organ damage associated with intrapartum hypoxia [ 164, 165]. Reduced creatine levels in late pregnancy have also been associated with low fetal growth [ 165]. There is additional data that metabolic demand from the placenta during gestation further lowers the creatine pool of the mother [ 166], which may be associated with low birth weight and pre-term birth. Creatine supplementation during pregnancy has been shown to enhance neuronal cell uptake of creatine and support mitochondrial integrity in animal offspring, thereby reducing brain injury induced by intrapartum asphyxia [ 167, 168]. Although there are no human studies evaluating the effects of creatine supplementation during pregnancy, creatine could provide a safe, low-cost nutritional interventional for reducing intra- and post-partum complications associated with cellular energy depletion [ 169]. This may be more important if the female is vegetarian, or unable to consume meat due to nausea or taste preferences (i.e. meat contains about 0.7 g of creatine/6 oz serving [ 54];).