Creatine

ByLaura Shane-McWhorter, PharmD, University of Utah College of Pharmacy
Reviewed/Revised Jan 2023
View Patient Education

(See also Overview of Dietary Supplements.)

Claims

Creatine is said to improve physical and athletic performance and to reduce muscle fatigue.

Evidence

Some evidence suggests creatine is effective at increasing work done in a short duration with maximal effort (eg, sprinting, rowing, weightlifting). A small 6-week study in 22 physically active adults also showed creatine ingestion during resistance training sessions may improve muscle strength (1). Creatine has proven therapeutic use in muscle phosphorylase deficiency (glycogen storage disease type V [McArdle disease]) and gyrate atrophy of the choroid and retina; early data also suggest possible effects in Parkinson disease and amyotrophic lateral sclerosis.

Numerous clinical trials have demonstrated that creatine supplementation is well tolerated and may increase muscle mass. The effects can be seen in normal healthy people as well as a means of aiding in the treatment of muscle disorders and improving physical function and quality of life in patients with muscle disorders or osteoarthritis (2-4).

Adverse Effects

Creatine may cause weight gain (possibly because of an increase in muscle mass) and spurious increases in serum creatinine levels. Minor gastrointestinal symptoms, headache, dehydration, irritability and aggression, edema, electrolyte imbalance, and muscle cramps have been reported anecdotally.

Drug Interactions

References

  1. 1. Mills S, Candow DG, Forbes SC, et al: Effects of creatine supplementation during resistance training sessions in physically active young adults. Nutrients 12(6):1880, 2020. doi:10.3390/nu12061880

  2. 2. Kley RA, Tarnopolsky MA, Vorgerd M: Creatine for treating muscle disorders. Cochrane Database Syst Rev (6):CD004760, 2013. doi: 10.1002/14651858.CD004760.pub4

  3. 3. Branch JD: Effect of creatine supplementation on body composition and performance: a meta-analysis. Int J Sport Nutr Exerc Metab 13(2):198-226, 2003. doi:10.1123/ijsnem.13.2.198

  4. 4. Neves M Jr, Gualano B, Roschel H, et al: Beneficial effect of creatine supplementation in knee osteoarthritis. Med Sci Sports Exerc 43(8):1538-1543, 2011. doi: 10.1249/MSS.0b013e3182118592

More Information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  1. National Institutes of Health (NIH), National Center for Complementary and Integrative Health: Dietary Supplements Marketed for Weight Loss, Bodybuilding, and Sexual Enhancement: What the Science Says

Drugs Mentioned In This Article
quizzes_lightbulb_red
Test your KnowledgeTake a Quiz!
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID