Creatine is one of the most popular and commonly used sports supplements available today. According to the International Society of Sports Nutrition, creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes in terms of increasing high-intensity exercise capacity and lean body mass during training. Recent opinions by the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine on nutrition for athletic performance all drew similar conclusions. 1, 18, 19, 20

Aside from improving exercise performance, a number of health-boosting proprieties and clinical applications of creatine supplementation have been studied. These studies provide a large body of evidence that creatine may play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, improving mental performance, decreasing fatigue, and protecting cardiovascular health. In addition, creatine may represent a potential adjunctive therapeutic supplement to treat a number of diseases including neurodegenerative diseases (e.g., muscular dystrophy, Parkinson’s, Huntington’s disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia and depression.18



Short-term creatine supplementation has been found to increase maximal power/strength by 5–15%, increase work performed during sets of maximal effort muscle contractions by 5–15%, and increase work performed during repetitive sprint performance by 5–15%. 1, 4, 18

Meanwhile, long-term creatine supplementation has been reported to improve the overall quality of training, leading to 5 to 15% greater gains in strength and performance. 1, 4, 18

Potential ergogenic benefits of creatine supplementation: 1-13, 18, 19, 20

  • Increased single and repetitive sprint performance,
  • Increased work performed during sets of maximal effort muscle contractions,
  • Increased muscle mass & strength adaptations during training,
  • Enhanced glycogen synthesis,
  • Increased anaerobic threshold,
  • Possible enhancement of aerobic capacity via greater shuttling of ATP from mitochondria,
  • Increased work capacity,
  • Enhanced recovery,
  • Greater training tolerance.

In addition, studies indicate that creatine supplementation may increase body mass by about 1 to 2 kg in the first week of loading, while in longer term, subjects taking creatine supplements typically gain about twice as much body mass and/or fat free mass than non-supplemented subjects. 1, 4, 13


Creatine is involved in brain and neural function and bioenergetics. Its effects on neurological and cognitive function have been extensively investigated. 13, 14, 15, 16, 17 It has been found that higher brain creatine is associated with improved neuropsychological performance, and creatine supplementation has been shown to increase brain creatine and phosphocreatine. 21

A controlled trial led by researchers at the University of Sydney found that oral creatine supplementation (5 grams/day for six weeks) improved intelligence test scores, and working memory performance. 14

Studies have demonstrated that cognitive processing, that is either experimentally (following sleep deprivation) or naturally (due to aging) impaired, can be improved with creatine supplementation. 21 In a study published in Neuroscience Research, creatine supplementation (8 grams/day for 5 days) reduced mental fatigue when subjects repeatedly perform a simple mathematical calculation. 15



In two separate studies specifically designed to assess the safety of creatine supplementation, researchers found that American collegiate football players supplementing with creatine experienced less incidence of cramping, heat illness/dehydration, muscle tightness, muscle strains/pulls, non-contact injuries and total injuries/missed practices than those not taking creatine. 18, 22, 23

In a study published in the Journal of the International Society of Sports Nutrition, researchers found an improved rate of recovery of knee extensor muscle function after injury. 24

In addition, it has been found that creatine may exert a beneficial effect even after an injury has happened. Researchers showed that creatine supplementation attenuated the loss in muscle mass and strength during periods of physical inactivity and immobilization. 25



Elevated LDL-cholesterol and triglyceride levels are considered independent risk factors for cardiovascular disease. In this regard, creatine supplementation has been reported to help lower cholesterol and triglyceride levels. 18, 26, 27

In a study from Texas Woman’s University, men and women ranging in age from 32 to 70 years. received either a creatine supplement (5 g of creatine) or placebo for 56 days. Significant reductions in plasma total cholesterol, triacylglycerols and VLDL-hoclesterol occurred within the creatine group. 26

Another risk factors for cardiovascular disease is elevated homocysteine levels. Studies of the general population have suggested that high homocysteine levels are associated with cardiovascular morbidity and mortality. According to some new evidence creatine supplementation may reduce homocysteine levels, and may help with cardiovascular protection. 18, 28


A growing body of evidence supports the notion that creatine supplementation may improve health status and daily functioning in aging individuals. In this regard, the position stand of the International Society of Sport Nutrition lists the following potential benefits of creatine supplementation: 18

  • reduced cholesterol and triglyceride levels,
  • reduced fat accumulation in the liver,
  • reduced homocysteine levels,
  • improved antioxidant capacity,
  • enhanced glycemic control,
  • slower tumor growth in some types of cancers,
  • increased strength and/or muscle mass,
  • minimized bone loss,
  • improved functional capacity in patients with osteoarthritis and fibromyalgia,
  • improved cognitive function,
  • in some instances, improved mood, and anti-depressant effect. 18


In addition creatine has been shown to have beneficial effects on Parkinson’s disease, Huntington’s disease, Alzheimer’s disease, mitochondria-related diseases, muscular dystrophies, amyotrophic lateral sclerosis, ischemic stroke, epilepsy, brain or spinal cord injuries. 29-58


Regarding the safety of creatine, the updated position stand of the International Society of Sports Nutrition concluded that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. 18


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