Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?

J Int Soc Sports Nutr. 2021 Feb 8;18(1):13. doi: 10.1186/s12970-021-00412-w.


Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine 'loading-phase' required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.

Keywords: Adverse Effects; Anecdotal; Research; Safety; Social Media.

Publication types

  • Review

MeSH terms

  • Adiposity / drug effects
  • Adolescent
  • Adult
  • Alopecia / chemically induced
  • Body Water / drug effects
  • Child
  • Creatine / administration & dosage
  • Creatine / adverse effects*
  • Creatine / chemistry
  • Creatine / metabolism
  • Dehydration / chemically induced
  • Dietary Supplements / adverse effects*
  • Female
  • Humans
  • Kidney / drug effects
  • Kidney Diseases / chemically induced
  • Male
  • Muscle Cramp / chemically induced
  • Muscle, Skeletal / drug effects
  • Sex Factors
  • Sports Nutritional Physiological Phenomena
  • Testosterone / metabolism
  • Testosterone Congeners / pharmacology


  • Testosterone Congeners
  • Testosterone
  • Creatine