What are the benefits of creatine?
Executive summary
Creatine is a well-studied dietary supplement that reliably improves short-duration, high-intensity exercise capacity and supports gains in lean muscle mass when combined with resistance training, with expanding but still preliminary evidence for cognitive and clinical benefits; safety data in healthy adults are reassuring while some caution is advised for people with kidney disease or specific medications [1][2][3].
1. Athletic performance and short, intense efforts
The clearest and most consistent benefit is ergogenic: creatine increases intramuscular phosphocreatine (PCr) stores, speeding ATP resynthesis during short, maximal efforts and thereby improving strength, sprinting power, and repeated high-intensity work capacity—an effect recognized by sport nutrition authorities and supported across populations from youth to older adults [1][4][5].
2. Muscle mass, training adaptations and recovery
When paired with resistance training, creatine supplementation leads to greater increases in lean body mass and strength than training alone, likely through multiple mechanisms including increased cellular hydration, reduced protein breakdown, glycogen augmentation and satellite cell signaling; it may also accelerate recovery between intense exercise bouts and blunt exercise-induced muscle damage [1][5][4].
3. Who benefits most — diet, age and sex considerations
People who consume little dietary creatine from animal sources—vegetarians and vegans—tend to show larger relative gains because baseline muscle creatine is lower, and older adults facing age-related sarcopenia may gain functional benefit when creatine supplements accompany resistance exercise, though magnitude varies across studies [6][7][8].
4. Emerging cognitive and neurological signals
A growing body of research points to cognitive benefits in specific contexts: creatine can raise brain creatine/PCr levels over weeks and has shown improvements in working memory, attention and resilience to sleep deprivation in some trials, while small pilot studies and animal work suggest potential roles in brain injury, dementia and mood—promising but not yet definitive for broad clinical use [9][10][11].
5. Potential clinical and other health effects
Beyond performance and cognition, investigators are exploring therapeutic roles in conditions ranging from traumatic brain injury to neurodegenerative diseases and metabolic health; meta-analyses and narrative reviews note potential benefits for sarcopenia and some neurological outcomes, yet many clinical applications remain investigational and require larger, longer trials to establish efficacy and dosing [1][8][7].
6. Safety, side effects and practical caveats
Extensive research finds creatine monohydrate well tolerated in healthy adults with minimal adverse effects—transient GI upset, bloating or weight gain from water retention are most reported—and typical maintenance dosing is 3–5 g/day after optional loading, but people with kidney disease or those on nephrotoxic drugs should consult clinicians because trials excluded many at‑risk groups and specific safety questions persist for some populations [8][3][12].
7. Limits of the evidence and competing narratives
While sports science consensus calls creatine the most effective ergogenic supplement for high‑intensity work, not all athletic tasks benefit (endurance events can show mixed effects) and cognitive/therapeutic claims are heterogeneous in design, dose and populations studied; media enthusiasm sometimes oversells tentative findings, so distinguishing robust performance data from preliminary clinical signals is essential [4][11][13].