Creatine: what the research shows

This is information, not a recommendation. We do not advise you to take anything. Under 18 or with an eating disorder, including a past one: this text is not aimed at you, and you will find places to turn to under When to get medical advice. During pregnancy or breastfeeding, with kidney disease or on medication, ask a doctor first.

What creatine is

Creatine is found mainly in red meat and fish, and about 95% of it in the body sits in skeletal muscle. Depending on muscle mass, the body has to replace about 1 to 3 g a day. Roughly half comes from food, and the body makes the rest.^[2]

Creatine is not a must. You can lose weight and train without ever thinking about it.

What may be said in the EU

The EU Register lists exactly two authorised claims for creatine.^[3] Here they are word for word, with their conditions:^[4]

Authorised claim	Condition
“Creatine increases physical performance in successive bursts of short-term, high intensity exercise”	Only for foods that provide 3 g of creatine a day and target adults performing high intensity exercise. The beneficial effect is obtained with 3 g of creatine a day^[4]
“Daily creatine consumption can enhance the effect of resistance training on muscle strength in adults over the age of 55.”	Only for foods targeting adults over 55 who do regular resistance training. The beneficial effect is obtained with 3 g of creatine a day together with resistance training at least three times a week for several weeks, at an intensity of at least 65% to 75% of the one-repetition maximum, with a load that can be increased over time^[4]

Claims about attentiveness, memory, endurance, energy reserves and muscle building are not authorised.^[3] Everything below that goes beyond this is the state of research, not a permitted product claim.

Which amounts studies used

Approach	Amount	What was measured
Without loading	3 g a day for 28 days	Muscle creatine rose by about 20%^[1]
With loading	20 g a day for 6 days	A similar rise, only faster^[1]
Usual range in reviews	3 to 5 g a day, or 0.1 g/kg	Described there as well tolerated^[1]
Assessment by authorities	3 g a day	Judged unlikely to pose a concern for healthy adults, excluding pregnant and breastfeeding women^[5]

These are figures from studies, not a dose for you. Authorities have only assessed the 3 g a day.^[5]

According to a review, loading is not necessary. Single servings above 10 g can cause diarrhoea.^[1]

Which forms were studied

Form	State of research
Monohydrate	The most studied. A review of 17 trials found no consistent advantage for other forms over placebo, and only 3 trials compared them directly with monohydrate^[6]
Buffered creatine	No advantage over monohydrate in a study with 36 trained people^[7]
Hydrochloride	Two small studies with 40 young athletes each disagree: one found no advantage,^[8] the other better results than with monohydrate^[9]
Ethyl ester	Breaks down to creatinine in the lab.^[10] A case report describes raised blood values as a result.^[11] The study with 40 athletes still saw better results^[9]
Orotate, phosphate, magnesium chelate	A review names open safety questions for these forms^[5]

In liquid, creatine slowly turns into creatinine, especially with heat and acid.^[1]

Performance and muscle

An analysis of 69 trials with 1,937 people found small advantages for creatine with resistance training in bench press, squat, jump height and sprint power. Handgrip and leg press showed no difference, and in women and older adults the effects were smaller or not detectable in several measures.^[12]

In adults under 50, an analysis of 12 trials found on average 1.14 kg more lean mass with resistance training than with training alone.^[13] Lean mass includes water. Where muscle was measured directly with imaging, the advantage was very small.^[14]

For older adults there is an analysis of 22 trials with 721 people, also with resistance training, showing more lean mass and strength.^[15] In postmenopausal women, an analysis of 7 trials with 608 people found small gains, mostly from 5 g a day with resistance training. At 3 g or less without resistance training, nothing was measurable.^[16]

Training remains the decisive part in all these studies. Creatine came on top.

Creatine while losing weight: water on the scale

Creatine draws water into the cell. A loading phase of 20 g a day typically raises body weight by 1 to 3 kg, mostly through water.^[1]

13 young footballers took part in a 7-day trial with 0.3 g/kg. In the creatine group, body water rose by 2.3 litres on average and weight by 1.0 kg.^[17]
In 32 trained people, body water rose over 4 weeks with loading, but its distribution between cells and surroundings stayed the same.^[18]
In 15 vegans and vegetarians, 7 days of 0.3 g/kg brought about 1.6 kg more weight in the creatine group, but no better sprint performance.^[19]

Over longer periods the results are mixed. Several studies found no rise in body water relative to muscle mass.^[1] The studies showed no increase in body fat.^[1]

For your weight this means: a jump in the first few days says nothing about fat. Compare averages over weeks, see Why the scales go up and down.

There is little on creatine during a diet. In a study with 64 adults aged 45 to 65, participants took 2 × 5 g of creatine or placebo for 12 weeks, some of them with exercise and a diet. Lean mass rose in the creatine groups, but the researchers treat some individual results as preliminary only.^[20] No randomised trial has yet tested creatine alongside weight-loss injections.^[21]

Creatine has no authorised claim on weight.^[3] Losing weight depends on a calorie deficit, not on this powder.

What about the brain?

An analysis of 16 trials with 492 people found better memory scores with moderate certainty, while the other areas stayed uncertain.^[22] Another found the difference in memory mainly in older adults aged 66 to 76, not in younger people.^[23]

The largest single study so far, with 123 people and 5 g a day for 6 weeks, points to a small effect at most, and side effects were reported more often with creatine than with placebo.^[24] There is no authorised claim.^[3] More under Creatine and sleep loss.

Myths checked

Claim	What the research says
“Creatine is a steroid”	No, creatine has a completely different chemical structure^[1]
“Creatine harms the kidneys”	In the studies, mostly in healthy people, blood creatinine rises, but estimated kidney function did not differ in two analyses.^[25]^[26] Randomised long-term studies over more than 1 year are still called for.^[26] This does not apply to kidney disease
“Creatine causes hair loss”	In 38 trained men, 12 weeks at 5 g a day showed no differences in hair or hormones.^[27] An older study with 20 rugby players found more DHT but did not examine hair^[28]
“Creatine dehydrates you and causes cramps”	A review of 10 studies found no drawbacks for fluid balance.^[29] Muscle cramps are occasionally named as a side effect^[5]
“Creatine makes you fat”	Weight can rise through water, more fat did not show up^[1]
“It is only for men”	Women were studied less often, and effects were smaller in several measures^[12]
“You have to load first”	No, stores also rise with 3 g a day, only more slowly^[1]

Safety and when to ask

Kidney disease: The data come mostly from healthy people. Talk to your doctor first.^[25]
Blood tests: Say that you take creatine, because creatinine can rise without the kidneys working any worse.^[26]
Pregnancy and breastfeeding: The official assessments exclude both groups,^[5] and research here is still mostly in animals.^[30]
Under 18: We do not recommend creatine for young people. There are only a few small, short studies.^[31]^[32]
Eating disorder, including a past one: Products for weight or muscle can add pressure. You will find places to turn to under When to get medical advice.
Stomach and gut: Many people do not tolerate large single amounts well.^[1]

The app does not replace medical advice.