Physio Hub:
Evidence-Based Article
Creatine and Performance: What the Research Really Says
A Practical Guide for Athletes and Active Adults
Creatine is one of the most studied supplements in sports performance — and one of the few with consistent evidence behind it. Many athletes use creatine to improve strength, power, and muscle recovery, but there are still questions about safety, dosage, and who should (or shouldn’t) take it.
Here is a simple, evidence-based breakdown to help you decide whether creatine could be beneficial for your training.
What Does Creatine Actually Do?
Creatine is stored in your muscles as phosphocreatine, which helps regenerate ATP — your body’s fastest energy source.
In short:
Creatine helps you produce more energy during short, intense efforts.
Research consistently shows benefits for:
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short bursts of max effort
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heavy lifting
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sprinting
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power-based sports
Studies have demonstrated improvements in:
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strength
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power output
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lean body mass
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training volume
Creatine may also help with:
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cellular hydration
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muscle recovery
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protein synthesis
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neurological function
Interestingly, creatine is effective not only for younger athletes but also for older adults, improving strength and lean mass across age groups.
However, individual response varies — some people (“non-responders”) experience minimal changes.
Is Creatine Safe? What Are the Risks?
For healthy individuals:
Creatine monohydrate is overwhelmingly considered safe in research.
Multiple studies (Guingand 2020, Poortmans 2000, Kim 2011) show:
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no significant negative effects
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no kidney damage in healthy users
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good safety profile even with long-term use
However — caution is necessary for individuals with kidney disease.
People with:
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chronic kidney disease
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high risk of renal dysfunction
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medical conditions affecting fluid balance
should avoid creatine unless approved by a physician.
Possible short-term side effects:
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bloating or water retention
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mild stomach discomfort (often dose-related)
But overall, creatine remains one of the safest and best-supported sports supplements available.
How Much Creatine Should You Take?
The most common and well-researched protocol:
1. Loading Phase (optional)
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0.3 g/kg/day
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For 5–7 days
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Quickly saturates muscle stores
Example:
70 kg person → 21 g/day split into 3–4 doses
2. Maintenance Phase
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0.03 g/kg/day (≈ 3–5 g/day for most people)
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Maintains elevated muscle creatine levels
If you prefer not to load:
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simply take 3–5 g/day
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muscles will saturate in 3–4 weeks instead of one week
Timing
Research suggests timing isn’t critical, though:
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post-workout creatine may slightly accelerate initial uptake
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consistency matters more than timing
Bottom Line
Creatine monohydrate is:
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one of the most proven supplements for strength and power
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generally safe for healthy individuals
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effective across age groups
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inexpensive and easy to use
It may not be suitable for people with kidney issues, and individual responses vary.
If you’re considering creatine:
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evaluate your training goals
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start with a simple 3–5 g/day routine
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consult a healthcare professional if you have medical conditions
Used properly, creatine can be a powerful tool for performance, recovery, and muscle growth.
< Recommendation by Our Experts>
✔ Best for: High-intensity training, strength, power, sprint work
✔ Dosage: 3–5 g/day of creatine monohydrate (loading optional)
✔ Safety: Avoid or proceed cautiously if you have kidney issues
✔ Goal: Support strength, muscle gain, and training performance
✔ Tip: Take consistently — timing matters less than daily use
< Reference >
- Wax B, Kerksick CM, Jagim AR, Mayo JJ, Lyons BC, Kreider RB. Creatine for Exercise and Sports Performance, with Recovery Considerations for Healthy Populations. Nutrients. 2021;13(6):1915. doi:3390/nu13061915
- Cooper R, Naclerio F, Allgrove J, Jimenez A. Creatine supplementation with specific view to exercise/sports performance: an update. Journal of the International Society of Sports Nutrition. 2012;9(1):33. doi:1186/1550-2783-9-33
- Demant T, Rhodes E. Effects of Creatine Supplementation on Exercise Performance: Sports Medicine. 1999;28(1):49-60. doi:2165/00007256-199928010-00005
- Williams MH, Branch JD. Creatine Supplementation and Exercise Performance: An Update. Journal of the American College of Nutrition. 1998;17(3):216-234. doi:1080/07315724.1998.10718751
- Farshidfar F, Pinder MA, Myrie SB. Creatine Supplementation and Skeletal Muscle Metabolism for Building Muscle Mass- Review of the Potential Mechanisms of Action. CPPS. 2017;18(12). doi:2174/1389203718666170606105108
- Chilibeck P, Kaviani M, Candow D, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. OAJSM. 2017;Volume 8:213-226. doi:2147/OAJSM.S123529
- De Guingand DL, Palmer KR, Snow RJ, Davies-Tuck ML, Ellery SJ. Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis. Nutrients. 2020;12(6):1780. doi:3390/nu12061780
- Poortmans JR, Francaux M. Adverse Effects of Creatine Supplementation: Fact or Fiction? Sports Medicine. 2000;30(3):155-170. doi:2165/00007256-200030030-00002
- Kim HJ, Kim CK, Carpentier A, Poortmans JR. Studies on the safety of creatine supplementation. Amino Acids. 2011;40(5):1409-1418. doi:1007/s00726-011-0878-2
- Davani-Davari D, Karimzadeh I, Ezzatzadegan-Jahromi S, Sagheb MM. Potential Adverse Effects of Creatine Supplement on the Kidney in Athletes and Bodybuilders. Iran J Kidney Dis. 2018;12(5):253-260.




