Creatine supplements are popular among athletes and Service Members trying to enhance their strength and muscle size. Unlike many other supplements, there is considerable evidence that taking creatine supplements might result in greater gains in body mass and strength when combined with resistance training. However, not all athletes or Service Members will experience the same benefits from consuming creatine supplements, especially those focused on endurance training. And although there are few safety concerns associated with creatine, it’s still important to use it under the guidance of a healthcare provider. 

What is creatine, and how does it work?

Creatine is a compound made in your liver, kidneys, and pancreas. You also get creatine from foods such as red meat and fish, as well as some dietary supplements. Creatine is primarily stored in your muscles in the form of phosphocreatine. Phosphocreatine is the initial energy source for all exercise and the preferred source for “explosive” movements such as lifting heavy objects, jumping, and short sprints. As such, creatine monohydrate supplements are widely used to increase strength performance. In theory, supplementing the diet with creatine monohydrate increases muscle stores of creatine, which then serve as a larger supply of immediate energy to delay fatigue and enhance performance.

Can creatine improve performance for all athletes and Service Members?

Some athletes and Service Members might benefit from creatine supplements more than others, because individuals respond differently to creatine ingestion depending on a number of factors such as diet. There are both high and low responders. For example, since creatine in the diet is predominately found in meats, vegetarians are more likely respond well to creatine supplementation because they tend to have lower levels in their muscles.

Although individual responses to creatine supplementation vary, creatine can have a positive effect on strength, power, sprint performance, and muscle mass in athletes who engage in resistance training. Evidence is limited that creatine supplements enhance aerobic performance such as endurance events. Creatine monohydrate supplements also might reduce the strength loss and minimize the exercise-induced muscle damage often experienced by athletes who participate in both strength and endurance activities. Although few side effects have been noted, one well-known side effect is an increase in body mass (weight gain). 

Is one type of creatine better than others?

The most-studied form of creatine is creatine monohydrate, but there are many other forms of creatine available in dietary supplement products on the market, including creatine ethyl ester, creatine magnesium chelate, micronized creatine, creatine hydrochloride (HCl), and creatine malate. Although these other forms are often marketed as being better absorbed by the body, minimizing water retention, or having a greater effect on performance, the research to support these effects is limited.

How is creatine typically used?

Taking creatine monohydrate in amounts as little as 3 g per day for 28 days has been found to be safe and effective at increasing creatine levels in the muscles and improving strength, although effects are gradual. More research is needed on the long-term (greater than 5 years) health effects of creatine supplementation. Many scientific studies have used “loading” doses, which start with 20 g of creatine monohydrate per day (broken up into four 5 g doses spaced evenly throughout the day) for 5–7 days, followed by a “maintenance” dose of 3–5 g per day for several weeks to months without reports of serious adverse events. People often experience weight gain early on during supplementation due to water retention.


When combined with resistance training, creatine supplementation might help some athletes and Service Members increase muscle mass and strength. However, those focused on endurance training will not experience the same improvements in performance, and the increase in body weight sometimes associated with creatine supplementation might even impair endurance.

If you choose to use creatine supplements, look for “creatine monohydrate” on the Supplement Facts panel, and choose a product that has been certified by a third-party organization. Also, use it only under the supervision of your healthcare provider. A registered dietitian (RD) who specializes in sports nutrition can provide personalized information to meet your performance goals. (Look for RDs with the credentials CSSD [Board Certified Specialist in Sports Dietetics].) Finally, for teens, be aware that there isn’t enough research to determine the safety and effectiveness of creatine supplements in those under 18.

Want this information as a shareable graphic? Check out Creatine: Just the facts.

Content current as of 27 October 2022


Avgerinos, K. I., Spyrou, N., Bougioukas, K. I., & Kapogiannis, D. (2018). Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Experimental Gerontology, 108, 166–173. doi:10.1016/j.exger.2018.04.013

Crawford, C., Boyd, C., & Deuster, P. A. (2021). Dietary supplement ingredients for optimizing cognitive performance among healthy adults: A systematic review. The Journal of Alternative and Complementary Medicine, 27(11), 940–958. doi:10.1089/acm.2021.0135

de Guingand, D. L., Palmer, K. R., Snow, R. J., Davies-Tuck, M. L., & Ellery, S. J. (2020). Risk of adverse outcomes in females taking oral creatine monohydrate: A systematic review and meta-analysis. Nutrients, 12(6), article 1780. doi:10.3390/nu12061780

de Souza e Silva, A., Pertille, A., Reis Barbosa, C. G., Aparecida de Oliveira Silva, J., de Jesus, D. V., Ribeiro, A. G. S. V., . . . de Oliveira, J. J. (2019). Effects of creatine supplementation on renal function: A systematic review and meta-analysis. Journal of Renal Nutrition, 29(6), 480–489. doi:10.1053/j.jrn.2019.05.004

Fazio, C., Elder, C. L., & Harris, M. M. (2022). Efficacy of alternative forms of creatine supplementation on improving performance and body composition in healthy subjects: A systematic review. Journal of Strength and Conditioning Research, 36(9), 2663–2670. doi:10.1519/jsc.0000000000003873

Feuerbacher, J. F., von Schöning, V., Melcher, J., Notbohm, H. L., Freitag, N., & Schumann, M. (2021). Short-term creatine loading improves total work and repetitions to failure but not load–velocity characteristics in strength-trained men. Nutrients, 13(3), article 826. doi:10.3390/nu13030826

Forbes, S. C., Krentz, J. R., & Candow, D. G. (2021). Timing of creatine supplementation does not influence gains in unilateral muscle hypertrophy or strength from resistance training in young adults: A within-subject design. The Journal of Sports Medicine and Physical Fitness, 61(9), 1219–1225. doi:10.23736/s0022-4707.20.11668-2

Gras, D., Lanhers, C., Bagheri, R., Ugbolue, U. C., Coudeyre, E., Pereira, B., . . . Dutheil, F. (2021). Creatine supplementation and VO2max: A systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition(3 Dec), 1–12. doi:10.1080/10408398.2021.2008864

Jiaming, Y., & Rahimi, M. H. (2021). Creatine supplementation effect on recovery following exercise‐induced muscle damage: A systematic review and meta‐analysis of randomized controlled trials. Journal of Food Biochemistry, 45(10), artlcle e13916. doi:10.1111/jfbc.13916

Jurado-Castro, J. M., Campos-Pérez, J., Vilches-Redondo, M. Á., Mata, F., Navarrete-Pérez, A., & Ranchal-Sanchez, A. (2021). Morning versus evening intake of creatine in elite female handball players. International Journal of Environmental Research and Public Health, 19(1), article 393. doi:10.3390/ijerph19010393

Kaviani, M., Shaw, K., & Chilibeck, P. D. (2020). Benefits of creatine supplementation for vegetarians compared to omnivorous athletes: A systematic review. International Journal of Environmental Research and Public Health, 17(9), article 3041. doi:10.3390/ijerph17093041

Kreider, R. B., & Stout, J. R. (2021). Creatine in health and disease. Nutrients, 13(2), article 447. doi:10.3390/nu13020447

Lanhers, C., Pereira, B., Naughton, G., Trousselard, M., Lesage, F.-X., & Dutheil, F. (2015). Creatine supplementation and lower limb strength performance: A systematic review and meta-analyses. Sports Medicine, 45(9), 1285–1294. doi:10.1007/s40279-015-0337-4

Lanhers, C., Pereira, B., Naughton, G., Trousselard, M., Lesage, F.-X., & Dutheil, F. (2016). Creatine supplementation and upper limb strength performance: A systematic review and meta-analysis. Sports Medicine, 47(1), 163–173. doi:10.1007/s40279-016-0571-4

Mielgo-Ayuso, J., Calleja-Gonzalez, J., Marqués-Jiménez, D., Caballero-García, A., Córdova, A., & Fernández-Lázaro, D. (2019). Effects of creatine supplementation on athletic performance in soccer players: A systematic review and meta-analysis. Nutrients, 11(4), article 757. doi:10.3390/nu11040757

Mills, S., Candow, D. G., Forbes, S. C., Neary, J. P., Ormsbee, M. J., & Antonio, J. (2020). Effects of creatine supplementation during resistance training sessions in physically active young adults. Nutrients, 12(6), article 1880. doi:10.3390/nu12061880

Northeast, B., & Clifford, T. (2021). The effect of creatine supplementation on markers of exercise-induced muscle damage: A systematic review and meta-analysis of human intervention trials. International Journal of Sport Nutrition and Exercise Metabolism, 31(3), 276–291. doi:10.1123/ijsnem.2020-0282

Turnes, T., Cruz, R. S. O., Caputo, F., & De Aguiar, R. A. (2019). The impact of preconditioning strategies designed to improve 2000-m rowing ergometer performance in trained rowers: A systematic review and meta-analysis. International Journal of Sports Physiology and Performance, 14(7), 871–879. doi:10.1123/ijspp.2019-0247

Vicente-Salar, N., Fuster-Muñoz, E., & Martínez-Rodríguez, A. (2022). Nutritional ergogenic aids in combat sports: A systematic review and meta-analysis. Nutrients, 14(13), article 2588. doi:10.3390/nu14132588

Vicente-Salar, N., Santos-Sánchez, G., & Roche, E. (2020). Nutritional ergogenic aids in racquet sports: A systematic review. Nutrients, 12(9), article 2842. doi:10.3390/nu12092842

Wu, Y., Hu, X., & Chen, L. (2020). Effects of creatine in trained athletes: A meta-analysis of 21 randomized placebo-controlled trials. American Journal of Therapeutics, 27(5), e519–e523. doi:10.1097/mjt.0000000000000974

Zajac, A., Golas, A., Chycki, J., Halz, M., & Michalczyk, M. M. (2020). The effects of long-term magnesium creatine chelate supplementation on repeated sprint ability (RAST) in elite soccer players. Nutrients, 12(10), article 2961. doi:10.3390/nu12102961