Creatine: What the Research Says and If It’s Right for You

Creatine is one of the most researched dietary supplements in existence, yet it remains surrounded by myths and misconceptions. Whether you’ve heard it’s only for bodybuilders, damages kidneys, or causes water retention – here’s what the science says.

Key Takeaways

• One of the safest and most extensively studied supplements available (Antonio et al., 2021)
• Consistently improves strength, power, and muscle growth when combined with training (Wang et al., 2024; Kreider et al., 2017)
• Emerging research suggests benefits for healthy ageing, brain health, and cognitive performance (Forbes et al., 2022)
• May be particularly beneficial during perimenopause and menopause (Smith-Ryan et al., 2025; Smith-Ryan et al., 2021)
• Creatine monohydrate is the most effective and best-studied form (Kreider et al., 2017)
• For most people, 3–5 g/day is sufficient, though optimal dose depends on your goal (Candow et al., 2024)
• Current evidence does not support the claim that creatine causes kidney damage in healthy individuals (Longobardi et al., 2025; Antonio et al., 2021)

What Is Creatine?

Creatine is a naturally occurring compound synthesised from three amino acids – arginine, glycine, and methionine – primarily in the liver and kidneys, with approximately 95% stored in skeletal muscle (Antonio et al., 2021).

Creatine is also obtained from food, particularly red meat and seafood. Because plant foods contain little to no creatine, vegetarians and vegans tend to have lower stores and often experience greater responses to supplementation (Kreider et al., 2017).

How Does It Work?

Creatine helps regenerate adenosine triphosphate (ATP), the molecule cells use for energy. During high-intensity efforts – lifting, sprinting, jumping – ATP depletes rapidly. Phosphocreatine acts as a rapid energy reserve, sustaining performance and supporting recovery between efforts (Kreider et al., 2017).

What Does the Research Show?

Exercise Performance and Muscle Growth

Creatine consistently improves strength and power across a wide range of populations (Kreider et al., 2017). A 2024 systematic review and meta-analysis found significant improvements in upper-body strength (+4.43 kg) and lower-body strength (+11.35 kg) when creatine was combined with resistance training compared to training alone (Wang et al., 2024). Research also suggests creatine may reduce muscle damage and soreness and support glycogen replenishment during recovery (Kreider et al., 2017).

Creatine and Strength Gains in Women

It is worth noting that the Wang et al. (2024) meta-analysis included only two female-only studies with 40 participants, making it underpowered to draw firm conclusions about women. Despite the limited number of female-only studies, the available evidence is encouraging. A meta-analysis in older females found creatine combined with resistance training significantly increased upper-body strength, with both upper- and lower-body strength gains significant in studies lasting at least 24 weeks (dos Santos et al., 2021). Smith-Ryan et al. (2021) confirm substantial evidence that creatine is effective for increasing strength and power in both trained and untrained females.

Healthy Ageing

As we age, maintaining muscle mass and strength is critical for mobility, independence, and metabolic health. Research suggests creatine supplementation helps preserve muscle mass, improve strength, and enhance physical function in older adults – particularly when combined with resistance training (Candow et al., 2021). Some studies also report improvements in bone health, though findings are less consistent than those for muscle (Smith-Ryan et al., 2021).

Brain Health and Cognitive Function

Creatine is stored in the brain, where it plays an energy-buffering role. Supplementation may improve memory and information-processing speed, particularly when the brain is under metabolic stress – such as during sleep deprivation, mental fatigue, or ageing (Forbes et al., 2022). Benefits appear most pronounced in older adults and vegetarians, who have lower baseline brain creatine stores (Forbes et al., 2022).

Perimenopause and Menopause

Declining oestrogen is associated with losses in muscle mass, bone density, and cognitive function. Creatine is receiving growing attention as a targeted strategy during this life stage (Smith-Ryan et al., 2025; Smith-Ryan et al., 2021). The strongest evidence supports muscle mass preservation when combined with resistance training (dos Santos et al., 2021). Research is also exploring potential roles in bone health and mood, though human trials remain limited (Smith-Ryan et al., 2025).

Creatine is not a treatment for perimenopausal symptoms, but it may be a useful addition alongside resistance training, adequate nutrition, quality sleep, and stress management.

Is Creatine Safe?

More than three decades of research have not established a link between creatine and kidney dysfunction in healthy individuals (Longobardi et al., 2025; Antonio et al., 2021). Concerns arise largely from confusion between creatine (the supplement) and creatinine (a kidney waste marker). Supplementation does raise creatinine levels on blood tests, but this reflects increased muscle mass and creatine turnover – not kidney damage (Antonio et al., 2021).

Current evidence does not support a link between creatine supplementation and cancer. While creatine can theoretically form heterocyclic amines when cooked at high temperatures in meat, supplemental creatine consumed in powder or liquid form does not follow the same metabolic pathway. Experimental studies have in fact suggested possible anticancer properties, though human trials are lacking (Longobardi et al., 2025).

Contrary to common belief, creatine does not impair hydration or thermoregulation and may help maintain body temperature during exercise. Research also suggests creatine may reduce – not increase – the incidence of muscle cramps (Longobardi et al., 2025; Antonio et al., 2021).

Practical considerations:

• People with pre-existing kidney disease or are pregnant should seek medical advice before supplementing
• Serum creatinine will rise on blood tests – this does not indicate kidney damage if taking creatine (Antonio et al., 2021). Flag this with your GP if kidney function is being monitored

Which Type Should You Choose?

Despite the wide range of products available, creatine monohydrate remains the gold standard (Kreider et al., 2017).

Creapure® vs. generic: Creapure® is a German-manufactured creatine monohydrate with verified ≥99.9% purity and independent third-party testing. It is not more effective than other high-quality creatine monohydrate products – the distinction lies in manufacturing assurance and traceability, not physiological benefit (Antonio et al., 2021). Whether choosing Creapure® or a reputable generic, look for independent third-party certification such as HASTA or Informed Sport – the two programs recommended by Sport Integrity Australia.

How Much Should You Take?

The right dose depends on what you’re trying to achieve (Candow et al., 2024):

For muscle health, an alternative to absolute dosing is 0.1 g/kg/day – a relative approach that accounts for body size and may be more appropriate for older adults or those at either end of the weight spectrum (Candow et al., 2024).

3 g/day is the practical minimum to maintain elevated muscle creatine stores over time – 2 g/day has been shown to be insufficient in some research (Candow et al., 2024).

Taking creatine post-exercise alongside carbohydrates and/or protein (e.g., in a post-workout shake) may modestly enhance uptake into muscle cells via an insulin-mediated mechanism (Kreider et al., 2017). Consistency matters more than precise timing.

Troubleshooting, Cautions and Who May Not Benefit

GI discomfort at 3–5 g/day

The most common culprit is product quality, not creatine itself. Impurities in lower-grade products are more likely to cause bloating, nausea, or loose stools than pure creatine (Antonio et al., 2021). Practical steps that resolve symptoms in most cases:

• Switch to a high-purity, third-party tested product (Creapure® or Informed Sport/HASTA certified equivalent)
• Take with food rather than on an empty stomach
• Ensure thorough mixing before drinking – undissolved powder is a common irritant
• Split the dose (e.g., 1.5 g twice daily rather than 3 g at once)

Who should seek advice before supplementing

• People with pre-existing kidney or liver disease – not because creatine is established as harmful, but because evidence in these populations is limited and individual assessment is warranted (Longobardi et al., 2025)
• Individuals taking nephrotoxic medications or medications affecting fluid balance
• Anyone with a history of kidney stones – creatine raises urinary creatinine, which may warrant monitoring in this group

Who may experience less benefit

• High meat consumers already have near-saturated creatine stores and may see smaller performance gains than vegetarians or vegans (Antonio et al., 2021)
• Non-responders – approximately 25–30% of people show little response to creatine supplementation, likely due to already high baseline muscle creatine levels (Candow et al., 2024)
• Those not engaging in resistance or high-intensity exercise will see more modest benefits, as the strongest evidence is exercise-dependent

What to watch for

• Weight gain of ~1–2 kg in the first 1–2 weeks is normal – this is intramuscular water retention, not fat. The evidence suggests creatine does not lead to water retention over longer periods of time.
• Serum creatinine will rise on blood tests – this is expected and does not indicate kidney damage (Antonio et al., 2021). Flag this with your GP if kidney function is being monitored
• If symptoms persist after switching products and adjusting dose, discontinue and seek advice from an Accredited Practising Dietitian or your GP.

Who Might Benefit Most?

• Individuals performing strength training, sprinting, or other high-intensity exercise
• Those building or maintaining muscle mass
• Vegetarians and vegans, who typically have lower creatine stores (Kreider et al., 2017)
• Older adults wanting to preserve strength, mobility, and independence (Candow et al., 2021)
• Women during perimenopause and menopause, particularly when combined with resistance training (Smith-Ryan et al., 2025; Smith-Ryan et al., 2021)
• Those experiencing high cognitive demands, mental fatigue, or disrupted sleep (Forbes et al., 2022)

Frequently Asked Questions

Do I need to cycle creatine?

No. There is no evidence that cycling on and off provides any benefit.

Should I take it every day?

Yes. Daily consistency is more important than timing.

Can women take creatine?

Yes, and the benefits extend to exercise performance, muscle preservation, healthy ageing, and cognitive health (Smith-Ryan et al., 2021; dos Santos et al., 2021).

Can I take creatine without exercising?

Potentially. While the strongest evidence relates to exercise, emerging research supports possible benefits for healthy ageing and cognitive function (Forbes et al., 2022; Candow et al., 2021).

Can I mix creatine with coffee?

Yes. Current evidence does not suggest coffee meaningfully reduces creatine effectiveness, provided you consume it promptly after mixing.

Bottom Line

Creatine monohydrate is one of the few dietary supplements with a genuinely robust evidence base. Benefits for strength, power, recovery, and muscle mass are well established, with emerging evidence for healthy ageing, perimenopause, and cognitive health. The right dose depends on your goal – 3–5 g/day suits most people for muscle health, while bone and brain benefits may require higher doses (Candow et al., 2024). For most healthy adults it is safe, affordable, and effective.

If you’re unsure whether creatine is right for you, speak with an Accredited Practising Dietitian.

References

Antonio, J., Candow, D. G., Forbes, S. C., Gualano, B., Jagim, A. R., Kreider, R. B., Rawson, E. S., Smith-Ryan, A. E., VanDusseldorp, T. A., Willoughby, D. S., & Ziegenfuss, T. N. (2021). Common questions and misconceptions about creatine supplementation: What does the scientific evidence really show? Journal of the International Society of Sports Nutrition, 18(1), 13. https://doi.org/10.1186/s12970-021-00412-w

Candow, D. G., Forbes, S. C., Chilibeck, P. D., Cornish, S. M., Antonio, J., & Kreider, R. B. (2021). Effectiveness of creatine supplementation on aging muscle and bone: Focus on falls prevention and inflammation. Journal of Clinical Medicine, 10(1), 133. https://doi.org/10.3390/jcm10010133

Candow, D. G., Ostojic, S. M., Forbes, S. C., & Antonio, J. (2024). Does one dose of creatine supplementation fit all? Advanced Exercise and Health Science, 1(1). https://doi.org/10.1016/j.aehs.2024.05.002

dos Santos, E. E. P., de Araújo, R. C., Candow, D. G., Forbes, S. C., Guijo, J. A., de Almeida Santana, C. C., Prado, W. L. D., & Botero, J. P. (2021). Efficacy of creatine supplementation combined with resistance training on muscle strength and muscle mass in older females: A systematic review and meta-analysis. Nutrients, 13(11), 3757. https://doi.org/10.3390/nu13113757

Forbes, S. C., Cordingley, D. M., Cornish, S. M., Gualano, B., Roschel, H., Ostojic, S. M., Rawson, E. S., Roy, B. D., Prokopidis, K., Giannos, P., & Candow, D. G. (2022). Effects of creatine supplementation on brain function and health. Nutrients, 14(5), 921. https://doi.org/10.3390/nu14050921

Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (2017). International Society of Sports Nutrition position stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1), 18. https://doi.org/10.1186/s12970-017-0173-z

Longobardi, I., Solis, M. Y., Roschel, H., & Gualano, B. (2025). A short review of the most common safety concerns regarding creatine ingestion. Frontiers in Nutrition, 12, 1682746. https://doi.org/10.3389/fnut.2025.1682746

Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Creatine supplementation in women’s health: A lifespan perspective. Nutrients, 13(3), 877. https://doi.org/10.3390/nu13030877

Smith-Ryan, A. E., DelBiondo, G. M., Brown, A. F., Kleiner, S. M., Tran, N. T., & Ellery, S. J. (2025). Creatine in women’s health: Bridging the gap from menstruation through pregnancy to menopause. Journal of the International Society of Sports Nutrition, 22(1). https://doi.org/10.1080/15502783.2025.2502094

Wang, Z., Qiu, B., Li, R., Han, Y., Petersen, C., Liu, S., Zhang, Y., Liu, C., Candow, D. G., & Del Coso, J. (2024). Effects of creatine supplementation and resistance training on muscle strength gains in adults <50 years of age: A systematic review and meta-analysis. Nutrients, 16(21), 3665. https://doi.org/10.3390/nu16213665