Creatine for Strength and Muscle Performance
Does creatine supplementation improve strength and muscle performance in adults?
Evidence supports: Maximal Strength, Muscle Strength, Lower-Body Strength, Jump Performance +4 more
Early data: Upper-Body Pressing Strength, Muscle Fatigue
Abstract
Creatine demonstrates a real advantage for adult strength and muscle performance, but the typical benefit is not a movie-style transformation. The evidence reviewed here shows its clearest value in strength-focused training, small gains in lean mass, and faster recovery after hard exercise, while explosive outcomes are more uneven.31216293236 Across strength-related outcomes, the overall pattern is positive and fairly consistent. Maximal strength shows a dependable modest benefit, and broader muscle strength outcomes also favor creatine, although the average effect is smaller and not equally strong in every setting (maximal strength median effect about 0.29, broader muscle strength median effect about 0.43, with low heterogeneity for the former and moderate heterogeneity for the latter). That means more people add a bit more weight to the bar, or get there sooner, rather than suddenly becoming dramatically stronger. Lower-body strength appears especially responsive, with several trials showing visibly larger improvements in leg press, squat, or knee extension performance during training.31216173437
Creatine also supports body composition, mainly by adding a small amount of lean mass over time. The pooled muscle-size effect corresponds to about 0.7 kg of added lean mass on average, which is real but usually below the 1 kg threshold many clinicians would call clearly noticeable on its own. Whole-body composition shifts look more noticeable in some training studies, especially in older adults and resistance-training programs.3510122437
Where creatine is less impressive is jumping and generalized explosiveness. Peak anaerobic power improves more reliably than jump tests, suggesting creatine helps short-burst energy production more than it helps every field-style or skill-dependent performance measure. Fatigue reduction is promising but still too thin to treat as settled. Overall, creatine is best understood as a training adaptation supplement: it helps you recover and accumulate slightly better strength and muscle gains over repeated sessions, not as a universal performance enhancer.61117313236
In Plain Language
Creatine is worth considering if your goal is to get a bit stronger, hold onto muscle, and recover better from hard training. It works best as support for resistance training, not as a shortcut. Expect small-to-moderate improvements over time, especially in lower-body strength and lean mass, and do not expect dramatic changes in jumping or all-out explosiveness. If you train consistently, creatine is one of the few supplements that has actually earned its reputation.
Introduction
The practical question is not whether creatine does anything in a lab, but whether it improves the things most active adults care about: getting stronger, building or preserving muscle, and performing better in hard repeated efforts. That question matters because creatine is one of the few supplements with a large human trial history, yet even here the claims often run ahead of the evidence.312202937
The current analysis points to a clear answer. Creatine shows real benefits for strength-centered performance and lean mass, especially when paired with resistance training, but the average effect is usually modest rather than dramatic. It appears more dependable for gym-based outcomes, such as 1RM or strength-machine performance, than for every explosive test, sprint surrogate, or jump measure.1617293137
That pattern makes biological sense. Creatine helps replenish phosphocreatine, the fast energy system used during short, high-intensity efforts. Over time, that can allow slightly better training quality, more total work, and a little more muscle accretion. What matters is not a single perfect workout, but whether those small edges repeat often enough to change adaptation. The evidence reviewed here suggests they usually do, especially for lower-body strength, body composition, and recovery from demanding exercise.6123236
Evidence 1 of 4
Core Strength Gains Are Real, Especially in Lower-Body Work
Creatine shows its most dependable benefit in strength outcomes, especially when training is involved.312162937 The highest-confidence estimate in this review is for maximal strength, where the average effect is modest but consistent enough to take seriously (median effect about 0.29, high certainty). Broader muscle-strength outcomes point in the same direction, though less cleanly. The pooled estimate for overall muscle strength was small and just missed conventional statistical significance in one model, but the direction still favored creatine and the full body of evidence remained positive (pooled effect 0.24, 95% CI just crossing no effect, median effect 0.43). In lived terms, creatine usually looks like a small extra push in how much weight you can lift, or how quickly your numbers improve, not a wholesale change in capability.12162937
Lower-body strength appears to respond more clearly than many other performance domains.31016173437 The pooled lower-body estimate was moderate in practical size and strongly positive, although the summary should be read as an average rather than a guarantee (pooled effect 0.85, 95% CI 0.58 to 1.12). Heterogeneity, meaning how much study results differ from one another, was substantial here (I-squared 69.6%). That means the benefit is likely real on average, but some populations and protocols gain more than others. The trial-level numbers show why the signal feels convincing anyway: older adults training for 14 weeks gained more knee-extension torque with creatine than placebo, sedentary young women improved leg press and leg extension more over 10 weeks, and inactive men using creatine during 8 weeks of resistance training pulled ahead on leg press within as little as 2 weeks.31637
Upper-body pressing likely improves too, but that conclusion is less secure because the dataset is thin.121629 The pooled effect was positive (about 0.93) but based on only 2 synthesized trial rows and showed notable inconsistency (I-squared 60.2%). Prediction intervals, which estimate the range of effects a future similar study might see, crossed no effect for upper-body pressing as they did for most performance outcomes. That means some future studies will probably find little or no benefit even if the average remains positive. The trial pattern fits that caution: chest press gains were clearly better than placebo in some older-adult and training studies, such as about 15-16 kg extra chest-press improvement over 32 weeks in one trial, while other studies found no clear between-group advantage after short loading periods.121827
Null results do not overturn the overall case, but they do set limits on how confidently creatine can be sold as a universal strength booster.4518202730 Several trials in COPD, HIV, aging adults over just 10 days, breast cancer survivors after 7 days, and acute post-stroke care found no meaningful extra strength gain beyond training, rehabilitation, or placebo. Some of those studies were short, underpowered, or conducted in clinical populations where training stimulus, illness burden, or timing may blunt creatine's effect. The main takeaway is narrower than the marketing: creatine strengthens the odds of better strength adaptation, especially in resistance training, but it does not rescue every context.
What this means
Creatine is a reasonable choice if the goal is to improve lifting performance over weeks to months, especially for lower-body work. The expected gain is usually incremental, not dramatic, but those increments can matter across a full training cycle.
Maximal Strength
Proven benefit Strong · 91Proven modest benefit
Single study: M 2022, d=0.16 (n=10+10)
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 3 papers, majority low risk |
| Inconsistency | No concern | no concerns (I²=0%, consistency=100%, PI crosses null) |
| Imprecision | No concern | N=888 meets OIS=400 |
| Publication bias | No concern | k=3 usable (< 10), cannot assess per Cochrane 10.4 |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | High | |
Muscle Strength
Proven benefit Strong · 76Proven modest benefit
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 19 papers, majority low risk |
| Inconsistency | No concern | no concerns (I²=40%, consistency=100%, PI crosses null) |
| Imprecision | No concern | N=3126 meets OIS=400 |
| Publication bias | Serious | Egger's p=0.000, funnel asymmetry detected (k=14) |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | Moderate | |
Lower-Body Strength
Likely helps Good · 51Likely benefit
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 21 papers, majority low risk |
| Inconsistency | Serious | I²=70% (> 50%) |
| Imprecision | No concern | N=3139 meets OIS=400 |
| Publication bias | Serious | Egger's p=0.000, funnel asymmetry detected (k=16) |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | Low | |
Upper-Body Pressing Strength
Early data Limited · 49Faint early signal
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 9 papers, majority low risk |
| Inconsistency | Serious | I²=60% (> 50%) |
| Imprecision | No concern | N=2474 meets OIS=400 |
| Publication bias | No concern | k=5 usable (< 10), cannot assess per Cochrane 10.4 |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | Low | |
Evidence 2 of 4
Power Output Improves More Reliably Than Jumping Ability
Creatine appears to help short-burst power more reliably than it helps jumping.617233136 Peak anaerobic power output showed a likely benefit overall, with a modest pooled effect that was statistically persuasive on average (pooled effect 0.51, 95% CI 0.21 to 0.82; median effect 0.32). That size of change usually means a moderate bump in repeated high-intensity efforts rather than something obvious to the eye in every session. Some individual studies were more striking: trained cyclists produced about 420 joules more work during a 15-second sprint after 5 days of creatine loading, and resistance-trained men in a crossover trial showed clear increases in peak bench and squat power after only 3 days.3136
Jump performance, by contrast, looks much less impressive.1117232426 Although the pooled jump estimate leaned positive, the typical effect was tiny and likely hard to feel in real life (median effect 0.03, pooled effect 0.28, with clinically trivial impact). Heterogeneity was high again (I-squared 73.4%), which means studies varied widely and did not tell one simple story. Some trials hinted at preservation or small improvement, such as elite soccer players being less likely to lose countermovement jump performance during heavy preseason training, but other trials found both groups improved similarly or found no creatine-specific advantage.1117
This split between power tests and jump tests is probably real, not just statistical noise.6173136 Jump height depends on more than the phosphocreatine system. Technique, tendon stiffness, body mass changes, coordination, and the exact test protocol can all dilute a small energetic advantage. Peak power tests, especially cycle or machine-based measures, are often closer to the metabolic niche where creatine should help. That makes the pattern easier to interpret: creatine may improve the engine more than the expression of that engine in a skill-heavy movement.
Short-term loading studies reinforce both the promise and the limit.6713222333 Some found better anaerobic power within 5-7 days, while others found no extra peak-power benefit despite confirmed rises in muscle creatine or small body-mass increases. Prediction intervals for peak power crossed no effect, meaning benefit is likely on average but not equally reliable across all settings. That is why creatine deserves credit for modest power support, but not for guaranteed explosiveness.
What this means
If the main goal is repeated short, hard efforts, creatine is more likely to help than if the main goal is jumping higher. Expect a small performance edge in peak power tests, but only occasional and often subtle gains in jump height.
Jump Performance
Likely helps Strong · 74Likely real but unnoticeable
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 11 papers, majority low risk |
| Inconsistency | Serious | I²=73% (> 50%) |
| Imprecision | No concern | N=4739 meets OIS=400 |
| Publication bias | No concern | k=8 usable (< 10), cannot assess per Cochrane 10.4 |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | Moderate | |
Peak Anaerobic Power Output
Likely helps Good · 51Likely modest benefit
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 18 papers, majority low risk |
| Inconsistency | Serious | I²=70% (> 50%) |
| Imprecision | No concern | N=3443 meets OIS=400 |
| Publication bias | Serious | Egger's p=0.000, funnel asymmetry detected (k=13) |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | Low | |
Evidence 3 of 4
Muscle and Body Composition Changes Support the Performance Story
Creatine consistently adds a small amount of lean mass, and that helps explain why strength gains accumulate over time.351012242937 The pooled effect for muscle size was small but steady, with virtually no statistical inconsistency across studies (pooled effect 0.25, I-squared 0%). In native units, the average gain was about 0.7 kg of lean mass. Because 1.0 kg is a commonly used threshold for a clearly meaningful change on lean-mass measures, that average sits below the line most people would distinctly notice on its own. Still, consistency matters here: about 1 in 14 people would be expected to achieve a benefit they would not have gotten otherwise. That is not flashy, but it is real.5122433
Whole-body composition changes look more noticeable than isolated muscle-size changes.31237 In the body-composition synthesis, the average effect corresponded to about a 2.1 kg favorable shift, which is above the 1.0 kg meaningful-change threshold and large enough that many adults would care about it. The number needed to treat was about 4, meaning roughly 1 in 4 people gets a meaningful body-composition benefit because of creatine. That stronger signal probably reflects how creatine's effects register at the whole-body level, including lean tissue and body-water changes, more readily than in a single muscle slice or thickness reading.
Trial examples fit that pattern well.3510122437 In HIV-positive men doing resistance training, creatine added 1.4 kg more lean body mass than placebo over 14 weeks. In older adults training for 32 weeks, post-workout creatine produced about 3.0 kg of lean tissue gain versus 0.5 kg with placebo. In female collegiate dancers, 6 weeks of 0.1 g/kg/day increased DXA-estimated lean mass by about 1.7 kg and lower appendicular lean mass by about 0.5 kg, although the authors reasonably warned that part of this may reflect increased total body water rather than pure contractile tissue.51224
That water issue is not a flaw in the evidence, but it does shape interpretation.2433 Creatine draws water into muscle, so some early lean-mass gain is probably hydration inside muscle cells rather than brand-new protein tissue. Over longer training studies, though, that initial shift may still matter because better hydration, greater training capacity, and repeated slightly better sessions can support true hypertrophy. The practical message is that scale-free mass and DXA lean mass can move before mirror changes do. Creatine still looks useful here, but the label should be lean mass support, not instant visible muscle.
Longer and clinical-population trials also keep expectations honest.202530 Twelve-month studies in older men and hemodialysis patients did not always show significant between-group differences at the end of follow-up, and a 7-day stroke trial found no advantage for fat-free mass index or muscle thickness. Those nulls suggest creatine's body-composition benefit is most detectable when the intervention is paired with sufficient training stimulus, adequate duration, and populations able to respond anabolically.
What this means
Creatine usually helps lean mass a little, and sometimes helps body composition enough to be noticeable, especially during resistance training. Early changes may partly be water held inside muscle, but over time that can still support better training adaptation.
Skeletal Muscle Mass / Muscle Size
Likely helps Good · 59Likely modest benefit
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 24 papers, majority low risk |
| Inconsistency | No concern | no concerns (I²=0%, consistency=97%, PI does not cross null) |
| Imprecision | No concern | N=2031 meets OIS=400 |
| Publication bias | Serious | Egger's p=0.001, funnel asymmetry detected (k=21) |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | Low | |
Overall Body Composition
Proven benefit Strong · 93Proven strong benefit
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 9 papers, majority low risk |
| Inconsistency | No concern | no concerns (I²=27%, PI crosses null) |
| Imprecision | No concern | N=806 meets OIS=400 |
| Publication bias | No concern | k=7 usable (< 10), cannot assess per Cochrane 10.4 |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | High | |
Evidence 4 of 4
Recovery Benefit Looks Credible, Fatigue Claims Are Still Early
Creatine shows a credible benefit for recovery of muscle performance after hard exercise.3236 The recovery outcome had a solid pooled effect (0.77, 95% CI 0.24 to 1.29) with high certainty, even though it came from a small number of studies. In one eccentric-exercise trial, creatine users recovered maximal voluntary contraction about 18.5% better at 48 hours than placebo, and in a resistance-trained crossover study, countermovement jump performance was better 24 hours after the first session with creatine than placebo (p=0.006, large effect). That is the kind of result people actually feel as less lingering drop-off between sessions, not necessarily less soreness on day one.3236
Direct anti-fatigue claims are more tentative.432 The pooled muscle-fatigue estimate was large on paper, but the evidence base was tiny and statistically unstable (pooled effect 0.76, 95% CI -0.43 to 1.95, only 2 studies and 52 participants). One recent trial found clear reductions in perceived muscle fatigue on a 0-100 mm visual analog scale immediately after eccentric exercise and again at 48 and 96 hours, while an older COPD study found essentially no difference on the Borg CR-10 scale. When confidence intervals, the range of effects compatible with the data, stretch from meaningful benefit to no clear effect, the honest reading is that researchers are exploring something promising, not that the question is settled.432
The split between recovery and fatigue is believable because they are not the same thing.3236 Recovery outcomes here were based on regained force or explosive performance, while fatigue outcomes leaned more on subjective perception scales. Creatine may help restore muscle function faster without always producing a large, consistent change in how tired the muscle feels. That distinction matters for training: a supplement can be useful if it gets performance back sooner, even if it does not make every session feel easier.
This is also where study design matters most.323536 Recovery trials are often short and protocol-specific, using eccentric damage or repeated resistance sessions rather than real training seasons. That makes the mechanism easier to see but limits generalization. The current analysis supports creatine as a recovery aid after hard muscular work, but evidence for broad day-to-day fatigue reduction remains early.
What this means
Creatine is more convincing as a way to bounce back faster from demanding exercise than as a general fatigue reducer. If recovery between sessions is the goal, the evidence is favorable; if the goal is simply to feel less tired, the evidence is not settled.
Muscle Fatigue
Early data Limited · 41Large effect, needs confirmation
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 3 papers, majority low risk |
| Inconsistency | No concern | no concerns (no data) |
| Imprecision | Very serious | N=52 far below OIS=400 |
| Publication bias | No concern | k=2 usable (< 10), cannot assess per Cochrane 10.4 |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | Low | |
Post-Exercise Muscle Recovery
Proven benefit Strong · 91Proven modest benefit
▸ GRADE Assessment
| Domain | Rating | Reason |
|---|---|---|
| Risk of bias | No concern | 4 papers, majority low risk |
| Inconsistency | No concern | no concerns (I²=40%, PI crosses null) |
| Imprecision | No concern | N=529 meets OIS=400 |
| Publication bias | No concern | k=3 usable (< 10), cannot assess per Cochrane 10.4 |
| Indirectness | No concern | deferred to Phase 2 (#1546) |
| Overall certainty | High | |
Across the Evidence
The main pattern across outcomes is specificity: creatine helps the tasks that look most like repeated high-intensity muscular work, and it helps them more reliably when they are embedded in resistance training.312162937 That is why the evidence is strongest for lifting strength, lower-body work, lean mass, and recovery, and weaker for jump height or mixed field tests. Creatine does not create strength out of thin air. It seems to improve the quality of hard efforts just enough that repeated sessions accumulate into better adaptation.
A second pattern is that the average effect is usually modest, but modest does not mean meaningless. Small extra gains in lean mass, a few more kilos on major lifts, or slightly better recovery between sessions can compound over months of training. This is especially true in lower-body movements, where several trials showed sizeable advantages in leg press, squat, or knee extension performance.31216173437 The likely reason is partly muscular size, since the lower body contains more total muscle mass, and partly test sensitivity, since leg-based 1RM measures often capture training adaptation more cleanly than upper-body or skill-dependent tasks.
A third pattern is that body-composition outcomes are often easier to detect than single-muscle measurements.5122433 That could reflect true physiology and measurement bias at the same time. Whole-body DXA or other lean-mass measures capture cumulative changes across many muscle groups and water compartments, while a single ultrasound thickness or regional cross-sectional area measure is noisier and easier to miss. This helps explain why body composition can look more favorable than isolated muscle-size outcomes even when both are moving in the same direction.
The main caution running through the evidence is variability. Several pooled analyses showed substantial heterogeneity and prediction intervals crossing no effect, especially for lower-body strength, peak power, jump performance, and upper-body pressing. Heterogeneity means study results do not line up perfectly, and a prediction interval crossing no effect means a future study in a new setting may see less benefit or none at all even if the average remains positive. That variability is not surprising. The studies mixed trained and untrained adults, athletes and clinical populations, short loading phases and longer maintenance phases, and outcome methods ranging from 1RM tests to dynamometry to derived power formulas.41820262730
The result is a coherent but not universal story. Creatine is best viewed as a context-dependent amplifier of resistance training and repeated high-intensity muscular work. It is not equally potent in every population, and the current analysis cannot cleanly separate whether loading protocols or training status drive the differences, because both vary widely across the literature.
Discussion
The overall conclusion is favorable and fairly confident: creatine demonstrates real benefits for adult strength and muscle performance, with the strongest support for strength-related adaptation, lean mass, whole-body composition, and post-exercise recovery.3121629323637 The best-supported claim is not that creatine makes everyone explosively more athletic. It is that creatine slightly improves the odds and magnitude of getting stronger, adding lean mass, and recovering better when the training demand is high enough.
Confidence is highest where three things line up: a plausible mechanism, multiple randomized trials, and a pooled effect that is both positive and reasonably stable.35122437 That describes the strength and body-composition story well. Confidence drops when outcomes are sparse, heterogeneous, or heavily influenced by skill and testing format. That is why upper-body pressing remains preliminary, jump performance is underwhelming, and fatigue reduction should still be described as an early finding rather than a settled effect.411172332
What would change this picture most is better separation of who benefits and under what protocol. The current evidence base mixes loading and non-loading regimens, short and long trials, and very different populations. A clearer answer would come from larger head-to-head trials that stratify by training status, sex, age, baseline dietary creatine intake, and whether creatine is taken with progressive resistance training or without it. Direct muscle-creatine measurements would also help explain why some studies respond strongly and others barely move.18202633
The negative studies deserve to stay in view.451820212730 They show that creatine is not a magic override for illness, short duration, inadequate stimulus, or outcome tests that are too indirect. Some clinical populations and very short protocols simply did not improve more than placebo. That honesty actually sharpens the practical recommendation: use creatine when the goal is to support training adaptation, not when expecting it to compensate for no training, too little time, or a performance task that depends more on skill than on rapid energy turnover.
Taken together, the evidence reviewed here supports creatine as one of the more reliable supplements for adults interested in strength and muscle performance. The gains are usually modest, but they are repeated often enough, and in enough controlled trials, to matter.
Methodology
We searched PubMed for studies on creatine and strength or muscle performance, then filtered to the human intervention studies shown in the PRISMA flow. This review included 37 controlled trials, mostly randomized placebo-controlled studies in adults, spanning athletes, healthy older adults, and several clinical populations. We read each study, recorded what it measured, how large it was, how long creatine was used, and what the results showed. We assessed evidence quality with the GRADE framework and judged clinical importance against published meaningful-change thresholds when native-unit data were available.
GRADE is useful, but it was built mainly for drug trials and tends to rate nutrition and supplement evidence conservatively. It automatically downgrades all observational evidence and only rarely upgrades for very large effects, usually above relative risks of 2.0. Our continuous trust score adds nuance by combining study quality, consistency, sample size, and whether the observed change is large enough to matter clinically. That is why a nutrition outcome can read as low certainty in a GRADE table but still support reasonably confident practical conclusions when the trials are randomized, consistent, and near or above meaningful-change thresholds.
Every study cited here is publicly indexed on PubMed. Known limitations include mixed dosing strategies, varied populations and training programs, sparse data for several outcomes, and wide differences in how strength, power, and body composition were measured.
Study Selection
Characteristics of Included Studies
| Study | Design | N | Population | Dose | Duration | RoB |
|---|---|---|---|---|---|---|
| K 1997 FT | rct | 19 | healthy | 20 g/day for 4 days | 4 days high-dose phase followed by 10 wk resistance training with low-dose creatine; subgroup additionally underwent 10 wk detraining with low-dose creatine and then 4 wk after cessation | Low |
| M 1999 FT | rct | 42 | NR | NR | NR | Some |
| D 2001 FT | rct | ? | NR | 5-day loading then 5-week maintenance (0.3 to 0.03 g/kg/day dosing per paper) | 6 weeks | Some |
| A 2003 FT | rct | 28 | healthy | 5 g creatine daily for 14 weeks | 14 weeks | Some |
| G 2006 FT | rct | 23 | clinical | 0.3 g/kg/day for 1 week then 0.07 g/kg/day for 7 weeks | 8 weeks | Some |
| G 2009 FT | rct | 40 | clinical | 20 g/day for 5 days then 4.8 g/day (maintenance) for 14 weeks | 14 weeks | Some |
| Y 2009 FT | rct | 17 | healthy | 20 g/day for 5 days | 5-day supplementation period (baseline at day 0; performance testing on day 3 and day 6) | Some |
| J 2012 FT | rct | 22 | healthy | 20 g/day for 7 days | 7 days | Some |
| C 2013 FT | rct | 56 | healthy | 20 g/day for 5 days, then 5 g/day for 24 weeks | 24 weeks | Some |
| C 2014 FT | rct | 77 | healthy | 1.25 g/day for 28 days | 28 days | Low |
| B 2014 FT | rct | 74 | clinical | Creatine 5 g/day (with a 20 g/day 5‑day loading phase) | 24 weeks | Some |
| J 2014 FT | rct | 23 | healthy | Creatine 20 g/day for 1 week, then 5 g/day for 6 more weeks | 7 weeks (pre-season) | High |
| D 2015 FT | rct | 64 | healthy | 0.1 g/kg immediately after workouts (on training days) | 32 weeks | High |
| E 2016 FT | rct | 54 | healthy | N/A (placebo) | 5 days supplementation, testing on day 6 | Some |
| E 2017 FT | rct | 30 | healthy | 20 g/day for 5 days (loading), then 5 g/day maintenance | Approximately 19 days (5-day loading, 7-day immobilization, 7-day recovery) | Some |
| S 2018 FT | rct | 14 | clinical | 3 g creatine daily for 8 weeks | 8 weeks | Some |
| C 2018 FT | rct | 30 | healthy | 20 g/day for 6 days, then 2 g/day during 4 weeks | 4 weeks (6-day loading phase followed by 4-week maintenance during training) | Some |
| M 2019 FT | rct | 18 | healthy | 70.0mg/kg/day | 8 weeks | Low |
| J 2019 FT | rct | 33 | healthy | 0.3 g/kg/day for 10 days | 10 days | Some |
| C 2019 FT | rct | 56 | clinical | 20 g/day for 5 days (loading), then 5 g/day maintenance | 12-week intervention (plus 2-week familiarisation and 2-week post-testing; total ≈16 weeks) | Low |
| D 2021 FT | rct | 46 | NR | Creatine 0.1 g/kg/day for 12 months (with resistance training) | 12 months | Some |
| W 2021 FT | rct | 32 | clinical | 20 g/day for 1 week, then 5 g/day for 7 weeks | 8 weeks | Some |
| J 2021 FT | rct | 11 | healthy | ≈26.2 g daily for 7 days (divided into 4 servings) | 7 days (per intervention), crossover with ≥30 day washout | Low |
| M 2022 FT | rct | 20 | clinical | 0.3 g/kg/day creatine loading for 7 days | 28 days (4 weeks of beta-alanine; creatine loading added during the final 7 days) | Some |
| S 2023 FT | rct | 13 | healthy | 0.1 g/kg/day creatine for 6 weeks | 42 days | Some |
| A 2024 FT | rct | 40 | clinical | 5 g creatine daily for 6 months | 12 months | Some |
| D 2024 FT | rct | 23 | healthy | 20 g once daily for 7 days | 6-day training camp (7 days supplementation, including day before camp) | Low |
| E 2024 FT | rct | 19 | clinical | 20 g/day (5 g four times daily) for 7 days | 7 days (two test sessions separated by 7 days; supplementation between sessions) | Low |
| A 2024 FT | rct | 25 | healthy | 5 g creatine daily for 6 weeks | 6 weeks | Some |
| E 2024 FT | rct | 40 | healthy | 0.03 g/kg/day creatine HCl with RT for 8 weeks | 8 weeks | Some |
| J 2024 FT | rct | 30 | clinical | 20 g/day for 7 days | 7-day intervention with 90-day follow-up | Low |
| B 2025 FT | crossover trial | 25 | healthy | 20 g/day (4 × 5 g) for 5 days | 3 weeks (four visits within a 3-week period); creatine/placebo administered for 5 days before the respective trial | Some |
| S 2025 FT | rct | 40 | healthy | 3 g daily for 33 days (28 pre-exercise, 5 post) | 33 days (28 days pre-exercise supplementation, 5 days post-exercise) | High |
| T 2025 FT | rct | 15 | healthy | 0.3 g/kg/day (divided QID) for 7 days | 7 days supplementation; post-testing 24–48 h after final dose | Low |
| M 2025 FT | rct | 40 | clinical | Creatine: 20g/day loading (week 1), then 5g/day for 3 more weeks | 4 weeks | Low |
| K 2025 FT | rct | 14 | healthy | 20 g/day (4 × 5 g) for 7 days | >28 days (includes familiarization, two 7-day intervention periods, and a 14-day washout) | Low |
| A 2025 FT | rct | 10 | healthy | 0.3 g/kg/day (≈300 mg/kg/day) for 3 days, divided dosing | Each supplementation arm: 3 days (with first dose 2 h pre-test); crossover with 7-day washout; entire study ~2 weeks | Low |
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