FitProven
Evidence Breakdown
Based on 4 studies
THE BIGGER QUESTION
Whether this one statement holds is settled above. What to actually do about it is a wider question, weighed across every claim that bears on it.
- Should women take creatine? — this claim is one of 3 weighed there
Evidence map
For & against, at a glance
Meta-Analysis
Pro
Lanhers C et al. · 2015Sports MedicineSystematic review and meta-analysis of **60 randomised controlled trials** — 646 participants supplementing creatine and 651 controls, 1,297 in total — restricted to **lower-limb** strength performance in exercise lasting under 3 minutes.
The effects are real but **small**. The global lower-limb effect size was 0.235 (95% CI 0.125–0.346, p < 0.001). Stratified by exercise: squat ES 0.336 (95% CI 0.047–0.625, p = 0.023), leg press ES 0.297 (95% CI 0.098–0.496, p = 0.003), and overall quadriceps ES 0.266 (95% CI 0.150–0.381, p < 0.001). Meta-analysis of the change from baseline to end of supplementation gave similar results.
Meta-regression found **no** moderating effect of population characteristics, training protocol, or supplementary dose and duration — creatine's effect was independent of all of them. That is the opposite of a "more pronounced in untrained individuals" finding, and this paper reports nothing at all about upper-body strength: the +5.3% upper-body figure and the 53-studies/563-subjects count that previously appeared here belong to Lanhers et al. **2017**, the separate upper-limb meta-analysis (*Sports Medicine*, doi 10.1007/s40279-016-0571-4). 563 was only this paper's treatment arm, not a total.
0.85
Systematic review and meta-analysis of **60 randomised controlled trials** — 646 participants supplementing creatine and 651 controls, 1,297 in total — restricted to **lower-limb** strength performance in exercise lasting under 3 minutes. The effects are real but **small**. The global lower-limb effect size was 0.235 (95% CI 0.125–0.346, p < 0.001). Stratified by exercise: squat ES 0.336 (95% CI 0.047–0.625, p = 0.023), leg press ES 0.297 (95% CI 0.098–0.496, p = 0.003), and overall quadriceps ES 0.266 (95% CI 0.150–0.381, p < 0.001). Meta-analysis of the change from baseline to end of supplementation gave similar results. Meta-regression found **no** moderating effect of population characteristics, training protocol, or supplementary dose and duration — creatine's effect was independent of all of them. That is the opposite of a "more pronounced in untrained individuals" finding, and this paper reports nothing at all about upper-body strength: the +5.3% upper-body figure and the 53-studies/563-subjects count that previously appeared here belong to Lanhers et al. **2017**, the separate upper-limb meta-analysis (*Sports Medicine*, doi 10.1007/s40279-016-0571-4). 563 was only this paper's treatment arm, not a total.
Design Meta-Analysis (1.0) × quality 0.85 = impact 0.85
View sourceMeta-Analysis
Pro
Branch JD · 2003International Journal of Sport Nutrition and Exercise MetabolismMeta-analysis examining the effects of creatine supplementation on body composition and performance. Found significant improvements in lean body mass and strength measures across multiple studies.
0.60
Meta-analysis examining the effects of creatine supplementation on body composition and performance. Found significant improvements in lean body mass and strength measures across multiple studies.
Design Meta-Analysis (1.0) × quality 0.60 = impact 0.60
View sourceMeta-Analysis
Pro
Rawson ES & Volek JS · 2003Journal of Strength and Conditioning ResearchMeta-analysis of 22 studies found that creatine supplementation increased maximal strength by an average of 8% and repetition performance by 14% compared to placebo.
0.60
Meta-analysis of 22 studies found that creatine supplementation increased maximal strength by an average of 8% and repetition performance by 14% compared to placebo.
Design Meta-Analysis (1.0) × quality 0.60 = impact 0.60
View sourceExpert Opinion
Pro
Kreider RB et al. · 2017Journal of the International Society of Sports NutritionThe ISSN position stand on creatine, which takes positions on two separate questions — which is why it is cited by more than one claim, with opposite polarity.
**On performance.** Position statement 1: creatine monohydrate is *"the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training."* Position statement 5 says the same of the monohydrate form specifically. Quantitatively: *"After creatine loading, performance of high intensity and/or repetitive exercise is generally increased by 10–20% depending on the magnitude of increase in muscle PCr."* It also cites a meta-analysis of 357 older adults in whom creatine plus resistance training produced *"greater gains in muscle mass, strength, and functional capacity"* than training alone.
**On safety.** Position statement 2 holds that there is no compelling scientific evidence that short- or long-term creatine monohydrate use (up to 30 g/day for 5 years) has any detrimental effect on otherwise healthy individuals; on kidneys specifically it finds no support for renal dysfunction, citing an absence of effect on creatinine clearance, glomerular filtration rate, tubular resorption and glomerular membrane permeability.
Carried as expert opinion, not primary evidence: it is a consensus statement, it was funded by the supplement industry's trade association, and the author list is commercially entangled. Weigh it accordingly on **both** claims — including the one where its conclusion happens to be right.
0.04
The ISSN position stand on creatine, which takes positions on two separate questions — which is why it is cited by more than one claim, with opposite polarity. **On performance.** Position statement 1: creatine monohydrate is *"the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training."* Position statement 5 says the same of the monohydrate form specifically. Quantitatively: *"After creatine loading, performance of high intensity and/or repetitive exercise is generally increased by 10–20% depending on the magnitude of increase in muscle PCr."* It also cites a meta-analysis of 357 older adults in whom creatine plus resistance training produced *"greater gains in muscle mass, strength, and functional capacity"* than training alone. **On safety.** Position statement 2 holds that there is no compelling scientific evidence that short- or long-term creatine monohydrate use (up to 30 g/day for 5 years) has any detrimental effect on otherwise healthy individuals; on kidneys specifically it finds no support for renal dysfunction, citing an absence of effect on creatinine clearance, glomerular filtration rate, tubular resorption and glomerular membrane permeability. Carried as expert opinion, not primary evidence: it is a consensus statement, it was funded by the supplement industry's trade association, and the author list is commercially entangled. Weigh it accordingly on **both** claims — including the one where its conclusion happens to be right.
Design Expert Opinion (0.2) × quality 0.20 = impact 0.04
View sourceMeta-Analysis
Pro
Lanhers C et al. · 2015Sports MedicineSystematic review and meta-analysis of **60 randomised controlled trials** — 646 participants supplementing creatine and 651 controls, 1,297 in total — restricted to **lower-limb** strength performance in exercise lasting under 3 minutes.
The effects are real but **small**. The global lower-limb effect size was 0.235 (95% CI 0.125–0.346, p < 0.001). Stratified by exercise: squat ES 0.336 (95% CI 0.047–0.625, p = 0.023), leg press ES 0.297 (95% CI 0.098–0.496, p = 0.003), and overall quadriceps ES 0.266 (95% CI 0.150–0.381, p < 0.001). Meta-analysis of the change from baseline to end of supplementation gave similar results.
Meta-regression found **no** moderating effect of population characteristics, training protocol, or supplementary dose and duration — creatine's effect was independent of all of them. That is the opposite of a "more pronounced in untrained individuals" finding, and this paper reports nothing at all about upper-body strength: the +5.3% upper-body figure and the 53-studies/563-subjects count that previously appeared here belong to Lanhers et al. **2017**, the separate upper-limb meta-analysis (*Sports Medicine*, doi 10.1007/s40279-016-0571-4). 563 was only this paper's treatment arm, not a total.
0.85
Systematic review and meta-analysis of **60 randomised controlled trials** — 646 participants supplementing creatine and 651 controls, 1,297 in total — restricted to **lower-limb** strength performance in exercise lasting under 3 minutes. The effects are real but **small**. The global lower-limb effect size was 0.235 (95% CI 0.125–0.346, p < 0.001). Stratified by exercise: squat ES 0.336 (95% CI 0.047–0.625, p = 0.023), leg press ES 0.297 (95% CI 0.098–0.496, p = 0.003), and overall quadriceps ES 0.266 (95% CI 0.150–0.381, p < 0.001). Meta-analysis of the change from baseline to end of supplementation gave similar results. Meta-regression found **no** moderating effect of population characteristics, training protocol, or supplementary dose and duration — creatine's effect was independent of all of them. That is the opposite of a "more pronounced in untrained individuals" finding, and this paper reports nothing at all about upper-body strength: the +5.3% upper-body figure and the 53-studies/563-subjects count that previously appeared here belong to Lanhers et al. **2017**, the separate upper-limb meta-analysis (*Sports Medicine*, doi 10.1007/s40279-016-0571-4). 563 was only this paper's treatment arm, not a total.
Design Meta-Analysis (1.0) × quality 0.85 = impact 0.85
View sourceMeta-Analysis
Pro
Branch JD · 2003International Journal of Sport Nutrition and Exercise MetabolismMeta-analysis examining the effects of creatine supplementation on body composition and performance. Found significant improvements in lean body mass and strength measures across multiple studies.
0.60
Meta-analysis examining the effects of creatine supplementation on body composition and performance. Found significant improvements in lean body mass and strength measures across multiple studies.
Design Meta-Analysis (1.0) × quality 0.60 = impact 0.60
View sourceMeta-Analysis
Pro
Rawson ES & Volek JS · 2003Journal of Strength and Conditioning ResearchMeta-analysis of 22 studies found that creatine supplementation increased maximal strength by an average of 8% and repetition performance by 14% compared to placebo.
0.60
Meta-analysis of 22 studies found that creatine supplementation increased maximal strength by an average of 8% and repetition performance by 14% compared to placebo.
Design Meta-Analysis (1.0) × quality 0.60 = impact 0.60
View sourceExpert Opinion
Pro
Kreider RB et al. · 2017Journal of the International Society of Sports NutritionThe ISSN position stand on creatine, which takes positions on two separate questions — which is why it is cited by more than one claim, with opposite polarity.
**On performance.** Position statement 1: creatine monohydrate is *"the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training."* Position statement 5 says the same of the monohydrate form specifically. Quantitatively: *"After creatine loading, performance of high intensity and/or repetitive exercise is generally increased by 10–20% depending on the magnitude of increase in muscle PCr."* It also cites a meta-analysis of 357 older adults in whom creatine plus resistance training produced *"greater gains in muscle mass, strength, and functional capacity"* than training alone.
**On safety.** Position statement 2 holds that there is no compelling scientific evidence that short- or long-term creatine monohydrate use (up to 30 g/day for 5 years) has any detrimental effect on otherwise healthy individuals; on kidneys specifically it finds no support for renal dysfunction, citing an absence of effect on creatinine clearance, glomerular filtration rate, tubular resorption and glomerular membrane permeability.
Carried as expert opinion, not primary evidence: it is a consensus statement, it was funded by the supplement industry's trade association, and the author list is commercially entangled. Weigh it accordingly on **both** claims — including the one where its conclusion happens to be right.
0.04
The ISSN position stand on creatine, which takes positions on two separate questions — which is why it is cited by more than one claim, with opposite polarity. **On performance.** Position statement 1: creatine monohydrate is *"the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training."* Position statement 5 says the same of the monohydrate form specifically. Quantitatively: *"After creatine loading, performance of high intensity and/or repetitive exercise is generally increased by 10–20% depending on the magnitude of increase in muscle PCr."* It also cites a meta-analysis of 357 older adults in whom creatine plus resistance training produced *"greater gains in muscle mass, strength, and functional capacity"* than training alone. **On safety.** Position statement 2 holds that there is no compelling scientific evidence that short- or long-term creatine monohydrate use (up to 30 g/day for 5 years) has any detrimental effect on otherwise healthy individuals; on kidneys specifically it finds no support for renal dysfunction, citing an absence of effect on creatinine clearance, glomerular filtration rate, tubular resorption and glomerular membrane permeability. Carried as expert opinion, not primary evidence: it is a consensus statement, it was funded by the supplement industry's trade association, and the author list is commercially entangled. Weigh it accordingly on **both** claims — including the one where its conclusion happens to be right.
Design Expert Opinion (0.2) × quality 0.20 = impact 0.04
View sourceTap any node to expand its detail.
Evidence
PRO (4)
PRO Meta-Analysisn=12970.85 Lanhers C, Pereira B et al. (2015)
Creatine improved lower-limb strength: global lower-limb effect size 0.235 (95% CI 0.125-0.346, p < 0.001), squat 0.336, leg press 0.297, overall quadriceps 0.266
Systematic review and meta-analysis of 60 randomised controlled trials — 646 participants supplementing creatine and 651 controls, 1,297 in total — restricted to lower-limb strength performance in exercise lasting under 3 minutes.
The effects are real but small. The global lower-limb effect size was 0.235 (95% CI 0.125–0.346, p < 0.001). Stratified by exercise: squat ES 0.336 (95% CI 0.047–0.625, p = 0.023), leg press ES 0.297 (95% CI 0.098–0.496, p = 0.003), and overall quadriceps ES 0.266 (95% CI 0.150–0.381, p < 0.001). Meta-analysis of the change from baseline to end of supplementation gave similar results.
Meta-regression found no moderating effect of population characteristics, training protocol, or supplementary dose and duration — creatine's effect was independent of all of them. That is the opposite of a "more pronounced in untrained individuals" finding, and this paper reports nothing at all about upper-body strength: the +5.3% upper-body figure and the 53-studies/563-subjects count that previously appeared here belong to Lanhers et al. 2017, the separate upper-limb meta-analysis (Sports Medicine, doi 10.1007/s40279-016-0571-4). 563 was only this paper's treatment arm, not a total.
Weighted 0.85 — 60 RCTs and 1297 participants (646 creatine, 651 control), with no funding used and no conflicts declared -- large, independent and well powered. The effect sizes are small (global lower-limb ES ~0.24), so this supports "creatine reliably produces a small strength benefit", not a large one. Covers LOWER limb strength only; it says nothing about upper-body strength. The body text has been corrected: it previously described Lanhers et al. 2017, the separate upper-limb meta-analysis (doi 10.1007/s40279-016-0571-4), including its 53-studies/563-subjects count and its +5.3% upper-body figure, neither of which appears in this paper.
Funding: none declared
Sports Medicine
PRO Meta-Analysis0.60 Branch JD (2003)
Small but significant effect sizes favouring creatine: body composition ES 0.17 +/- 0.03, ATP-PCr tasks (30 s or less) ES 0.24 +/- 0.02, glycolytic tasks ES 0.19 +/- 0.05; largest for lean body mass after short-term loading and for repetitive upper-body laboratory tasks; no benefit for running or swimming
Meta-analysis examining the effects of creatine supplementation on body composition and performance. Found significant improvements in lean body mass and strength measures across multiple studies.
Weighted 0.60 — k=100 studies from 96 papers, all randomised and placebo-controlled — broad and directly on point. sample_size is omitted because the paper reports effect-size counts, not a pooled participant total. Discounted to 0.60 because it is a 2003 synthesis using pre-PRISMA methods with no formal risk-of-bias appraisal, the constituent trials are small and short, and the effect sizes it finds are themselves small. Funding could not be verified, so the field is omitted.
International Journal of Sport Nutrition and Exercise Metabolism
PRO Meta-Analysis0.60 Rawson ES, Volek JS (2003)
Creatine supplementation increased maximal strength by ~8% and repetition performance by ~14% versus placebo
Meta-analysis of 22 studies found that creatine supplementation increased maximal strength by an average of 8% and repetition performance by 14% compared to placebo.
Weighted 0.60 — k=22 studies; the pooled participant total is not reported, so precision cannot be judged. An early (2003) synthesis by pre-modern standards — no risk-of-bias assessment, no heterogeneity statistics and no publication-bias analysis are reported, and the constituent trials are small. The effect it describes has been replicated repeatedly since, which is why it is not scored lower, but as a meta-analysis it is dated. Funding could not be verified (paywalled).
Journal of Strength and Conditioning Research
PRO Expert OpinionCONFLICTED0.20 Kreider RB, Kalman DS et al. (2017)
Two positions. On performance: creatine monohydrate is 'the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training', with high-intensity performance 'generally increased by 10-20%' after loading. On safety: no compelling evidence that up to 30 g/day for five years harms otherwise healthy people, and specifically no support for renal dysfunction -- creatinine clearance, glomerular filtration rate, tubular resorption and glomerular membrane permeability all unaffected
The ISSN position stand on creatine, which takes positions on two separate questions — which is why it is cited by more than one claim, with opposite polarity.
On performance. Position statement 1: creatine monohydrate is "the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training." Position statement 5 says the same of the monohydrate form specifically. Quantitatively: "After creatine loading, performance of high intensity and/or repetitive exercise is generally increased by 10–20% depending on the magnitude of increase in muscle PCr." It also cites a meta-analysis of 357 older adults in whom creatine plus resistance training produced "greater gains in muscle mass, strength, and functional capacity" than training alone.
On safety. Position statement 2 holds that there is no compelling scientific evidence that short- or long-term creatine monohydrate use (up to 30 g/day for 5 years) has any detrimental effect on otherwise healthy individuals; on kidneys specifically it finds no support for renal dysfunction, citing an absence of effect on creatinine clearance, glomerular filtration rate, tubular resorption and glomerular membrane permeability.
Carried as expert opinion, not primary evidence: it is a consensus statement, it was funded by the supplement industry's trade association, and the author list is commercially entangled. Weigh it accordingly on both claims — including the one where its conclusion happens to be right.
Weighted 0.20 — Not a systematic review -- a consensus position stand with no inclusion criteria, no pooled sample and no risk-of-bias appraisal, so it carries no independent evidential weight (sample_size omitted by design). It was written at the REQUEST of, and funded by, the supplement industry's trade association, and the author list is deeply commercially entangled: the lead author is a university-approved advisor to a creatine seller (Nutrabolt), two are ISSN founders, and others include a supplement-company chief science officer, a supplement-company CEO, and multiple supplement patent-holders. An industry-funded safety reassurance is precisely the configuration warranting most caution -- though in this instance its conclusion is independently corroborated by trial evidence.
Funding: Council for Responsible Nutrition (the dietary-supplement industry trade association) — the funder profits from this result.
Journal of the International Society of Sports Nutrition