Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate. The effectiveness ratings for CREATINE are as follows:
Possibly effective for…
- Athletic performance. Creatine seems to help improve rowing performance, jumping height, and soccer performance in athletes. But the effect on sprinting, cycling, or swimming performance varies. The mixed results may relate to the small sizes of the studies, the differences in creatine doses, and differences in test used to measure performance. It doesn’t seem to improve serving ability in tennis players.
- Disorders of creatine metabolism or transport. Some people have a disorder that prevents their bodies from making creatine. This can lead to low levels in the brain. Low levels in the brain can lead to decreased mental function, seizures, autism, and movement problems. Taking creatine by mouth daily for up to 3 years can increase creatine levels in the brain in children and young adults with a disorder of creatine production called guanidinoacetate methyltransferase (GAMT) deficiency. This can help improve movement and reduce seizures. But it doesn’t improve mental ability. Arginine-glycine amidinotransferase (AGAT) deficiency is another disorder that prevents the body from making creatine. In children with this condition, taking creatine for up to 8 years seems to improve attention, language, and mental performance. But taking it does not seem to improve brain creatine levels, movement, or mental function in children who have a disorder in which creatine isn’t transported properly.
- Muscle strength. There is a lot of mixed research on creatine’s ability to improve muscle strength. However, analyses of this research show that it seems to modestly improve upper body strength and lower body strength in both younger and older adults.
- Age-related muscle loss (sarcopenia ). Creatine may help improve muscle strength in older adults. It seems to work best when used along with exercise to build muscles. It doesn’t seem to help when used in lower doses, as a single dose, or when used without exercise.
Possibly ineffective for…
- Lou Gehrig’s disease (amyotrophic lateral sclerosis or ALS). Taking creatine by mouth does not seem to slow disease progression or improve survival in people with ALS.
- An inherited brain disorder that affects movements, emotions, and thinking (Huntington disease). Research suggests that taking it by mouth daily for 2 years does not improve muscle strength, coordination, or symptoms in people with Huntington’s disease.
- Low bone mass (osteopenia). Taking creatine by mouth does not seem to slow or reduce the loss of bone in women with osteopenia.
Insufficient evidence to rate effectiveness for…
- Long-term kidney disease (chronic kidney disease or CKD). Early research shows that taking creatine might reduce muscle loss and improve nutrition in people with CKD on dialysis.
- A lung disease that makes it harder to breathe (chronic obstructive pulmonary disease or COPD). Early research on the effects in people with chronic obstructive pulmonary disease (COPD) is inconsistent. Some research suggests that taking creatine daily does not improve lung function. However, other research suggests that taking creatine may improve lung function or exercise capacity.
- Heart failure and fluid build up in the body (congestive heart failure or CHF). Some early research shows that taking creatine daily for 5-10 days improves muscle strength and endurance but does not improve symptoms of heart failure. Taking lower doses daily for 6 months does not improve exercise capacity or heart failure symptoms in men.
- Depression. Early research suggests that taking creatine daily for 8 weeks enhances the effects of the antidepressant drug escitalopram in women with major depressive disorder.
- Diabetes. Early research shows that taking creatine by mouth for 5 days reduces blood sugar after eating in people with newly diagnosed diabetes. However, the effects of taking it for longer than 5 days in people with diabetes are not known.
- Fatigue. Taking creatine might improve accuracy on mental tasks in people with mental fatigue. But it doesn’t seem to help people respond more quickly.
- Fibromyalgia. Early research suggests that taking 5 grams of creatine four times daily for 5 days followed by 5 grams daily for 16 weeks improves strength in women with fibromyalgia. But it does not seem to improve aerobic exercise capacity, pain, sleep, quality of life, or mental function in people with fibromyalgia.
- An inherited disorder marked by vision loss (gyrate atrophy). Early research shows that creatine deficiency, which has been associated with this form of vision loss, can be corrected with supplements. Taking it daily for one year seems to slow eye damage and vision loss.
- High levels of homocysteine in the blood (hyperhomocysteinemia). Early research show that taking creatine for 3 weeks reduces levels of homocysteine in vegans with hyperhomocysteinemia.
- A group of inherited disorders that leads to muscle weakness and numbness in the arms and legs. Early research in people with inherited nerve damage diseases such as Charcot-Marie-Tooth Disease suggests that taking creatine by mouth daily for between one and 12 weeks has no effect on muscle strength or endurance.
- Rare, inherited disorders causing muscle weakness (idiopathic inflammatory myopathies). Early studies suggest taking creatine might produce small improvements in muscle strength in people with these conditions.
- A rare, inherited disorder that causes muscle pain and cramping (McArdle disease). Some early research suggests that taking creatine by mouth daily improves muscle function in some people with McArdle disease. However, taking higher doses of creatine seems to make muscle pain worse.
- A group of disorders that most often cause muscle weakness (mitochondrial myopathies). Early research suggests that taking creatine by mouth does not improve muscle function or quality of life in people with mitochondrial myopathies. However, creatine might improve some measures of muscle strength.
- Multiple sclerosis (MS). Early research suggests that taking creatine by mouth daily for 5 days does not improve exercise ability in people with multiple sclerosis.
- Muscle breakdown. Taking creatine by mouth daily does not seem to increase muscle mass or strength in men with muscle loss due to HIV. However, taking it seems to help maintain muscle mass and reduce the loss of muscle strength that is associated with having to wear a cast.
- Muscle cramps. Early research shows that taking creatine by mouth before hemodialysis treatments seems to reduce muscle cramps.
- A group of inherited disorders that cause muscle weakness and muscle loss (muscular dystrophy). Early research on the use of creatine by mouth in people with muscular dystrophy is not clear. Some evidence shows that muscle strength and fatigue seem to improve after taking creatine daily for 8-16 weeks. However, other research suggests that it provides no benefit for people with muscular dystrophy.
- Pauses in breathing may be followed by low heart rate and low oxygen levels in newborns. Early research shows that giving creatine to premature infants does not improve breathing problems while sleeping.
- Injury to the brain, spine, or nerves (neurological trauma). Early research shows that taking creatine by mouth daily for 7 days increases the ability to exercise by increasing lung function in people with a spinal cord injury. However, other research shows that creatine does not improve wrist muscle or hand function. Early research also shows that taking it by mouth daily for 6 months reduces amnesia following a traumatic brain injury in children.
- Osteoarthritis. Early research suggests that taking creatine by mouth daily in combination with strengthening exercises improves physical functioning in postmenopausal women with knee osteoarthritis.
- Parkinson’s disease. Early research suggests that taking creatine twice daily for 12-18 months slows the progression of Parkinson’s disease in people who have not yet started conventional medicines.
- Recovery after surgery. Early research shows that taking creatine daily doesn’t improve recovery of muscle strength after surgery.
- An inherited disorder the affects brain development in girls (Rett syndrome). Early research suggests that taking creatine daily for 6 months can slightly improve symptoms in females with Rett syndrome.
- Rheumatoid arthritis (RA). Early research shows that taking creatine by mouth daily increases lean muscle mass and may improve muscle strength, but does not improve physical functioning in adults with rheumatoid arthritis. In children, taking a specific supplement containing creatine and fatty acids twice daily for 30 days might reduce pain and swelling. But the effects of creatine alone are not clear.
- Schizophrenia. Early research shows that taking creatine by mouth daily for 2 months does not improve symptoms or mental function in people with schizophrenia.
- An inherited disorder that causes muscle weakness and wasting (spinal muscular atrophy). Early research suggests that children with muscle loss in the spine do not benefit from taking creatine by mouth.
- Aging skin.
- Bipolar disorder.
- Other conditions.
More evidence is needed to rate the effectiveness for these uses.
Side Effects Of Creatine
When taken by mouth: Creatine is LIKELY SAFE when taken by mouth, short-term. Doses up to 25 grams daily for up to 14 days have been safely used. Lower doses up to 4-5 grams taken daily for up to 18 months have also been safely used. Creatine is POSSIBLY SAFE when taken by mouth, long-term. Doses up to 10 grams daily for up to 5 years have been safely used in research.
Many people who use creatine gain weight. This is because it causes the muscles to hold water, not because it actually builds muscle.
Warnings & Precautions
- Pregnancy and breast-feeding: There isn’t enough reliable information to know if it is safe to use when pregnant or breastfeeding. Stay on the safe side and avoid use.
- Children: Creatine is POSSIBLY SAFE in children when taken by mouth, short-term. Creatine 3-5 grams daily for 2-6 months has been taken safely in children 5-18 years of age. 2 grams daily for 6 months has been taken safely in children 2-5 years of age. Additionally, 0.1-0.4 grams/kg daily for up to 6 months has been taken safely in both infants and children.
- Bipolar disorder: There have been cases of manic episodes in people with bipolar disorder who took creatine daily for 4 weeks. It might make mania worse in people with bipolar disorder.
- Kidney disease: There is some concern that creatine might make kidney disease worse in people who already have kidney disease. If you have kidney disease, speak with a healthcare professional before using creatine.
- Parkinson’s disease: Caffeine and creatine taken together may make Parkinson’s disease get worse faster. If you have Parkinson’s disease and take it, use caffeine with caution.
Dosage Of Creatine
The following doses have been studied in scientific research:
- For athletic performance: Many different dosing regimens have been used; however, most use a short-term “loading dose” followed by a long-term maintenance dose. Loading doses are typically 20 grams daily for 4-7 days. Maintenance doses are typically 2-10 grams daily.
- For muscle strength: Many different dosing regimens have been used; however, most use a short-term “loading dose” followed by a long-term maintenance dose. The most common loading doses are typically around 20 grams daily for 5-7 days. Maintenance doses ranging from 1 to 27 grams daily have also been used.
- Age-related muscle loss (sarcopenia): Many different dosing regimens have been used; however, most use a short-term “loading dose” followed by a long-term maintenance dose. Loading doses are typically 20 grams daily for 4-7 days. Maintenance doses are typically 2-10 grams daily. Older adults seem to experience benefits from creatine supplementation only when it is combined with resistance training.
- For disorders of creatine metabolism or transport: Doses of 400-800 mg per kg of body weight have been taken daily for up to 8 years. Also, 4-8 grams of creatine has been taken daily for up to 25 months.
Consult your doctor or pharmacist.
All information has been provided courtesy of MedLinePlus from the National Library of Medicine and from the FDA.