Creatine is a chemical found naturally in the body. It’s also in red meat and seafood. It is often used to improve exercise performance and muscle mass.

Creatine is involved in making energy for muscles. About 95% of it is found in skeletal muscle. The majority of sports supplements in the US contain creatine. People who have lower creatine levels when they start taking creatine seem to get more benefit than people who start with higher levels.

People commonly use creatine for improving exercise performance and increasing muscle mass. It is also used for muscle cramps, fatigue, multiple sclerosis (MS), depression, and many other conditions, but there is no good scientific evidence to support most of these uses.

Creatine use is allowed by the International Olympic Committee and National Collegiate Athletic Association (NCAA).

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for CREATINE are as follows:

Possibly effective for…

• Athletic performance. Taking creatine by mouth seems to somewhat improve rowing, jumping, and soccer performance. It’s not clear if it helps with sprinting, cycling, swimming, or tennis.
• Disorders of creatine metabolism or transport. Taking creatine by mouth daily can increase creatine levels in the brain in children and young adults with conditions called GAMT deficiency or AGAT deficiency. But taking creatine doesn’t seem to improve brain creatine levels in children who have a disorder in which creatine isn’t transported properly.
• Muscle strength. Taking creatine by mouth seems to somewhat improve muscle strength in both younger and older adults. It’s not clear if applying creatine to the skin helps.
• Age-related muscle loss (sarcopenia). Taking creatine by mouth for up to 12 weeks seems to improve muscle strength in older adults. It seems to work best when used along with exercise to build muscles.

Possibly ineffective for…

• Lou Gehrig disease (amyotrophic lateral sclerosis or ALS). Taking creatine by mouth does not seem to slow disease progression or improve survival in people with ALS.
• An inherited brain disorder that affects movements, emotions, and thinking (Huntington disease). Taking creatine by mouth does not improve symptoms in people with Huntington disease.
• Low bone mass (osteopenia). Taking creatine by mouth doesn’t seem to slow or reduce bone loss in people with osteopenia.

There is interest in using creatine for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

When taken by mouth: Creatine is likely safe for most people. Doses up to 25 grams daily for up to 14 days have been safely used. Lower doses up to 4-5 grams daily for up to 18 months have also been safely used. Creatine is possibly safe when taken long-term. Doses up to 10 grams daily for up to 5 years have been safely used. Side effects might include dehydration, upset stomach, and muscle cramps.

When applied to the skin: There isn’t enough reliable information to know if creatine is safe. It might cause side effects such as redness and itching.

Special precautions & warnings:

Pregnancy and breast-feeding: There isn’t enough reliable information to know if creatine is safe to use when pregnant or breast feeding. Stay on the safe side and avoid use.

Children: Creatine is possibly safe when taken by mouth, short-term. Creatine 3-5 grams daily for 2-6 months has been taken safely in children 5-18 years of age. Creatine 2 grams daily for 6 months has been taken safely in children 2-5 years of age. Creatine 0.1-0.4 grams/kg daily for up to 6 months has been taken safely in both infants and children.

Bipolar disorder: Creatine might make mania worse in people with bipolar disorder.

Kidney disease: Creatine might make kidney disease worse in people who already have kidney disease. If you have kidney disease, speak with a healthcare professional before using creatine.

Parkinson disease: Caffeine and creatine taken together may make symptoms of Parkinson disease worse. If you have Parkinson disease and take creatine, use caffeine with caution.

It is not known if this product interacts with any medicines.

Before taking this product, talk with your health professional if you take any medications.

Caffeine

Caffeine might decrease creatine’s beneficial effects on athletic performance.

There are no known interactions with foods.

Creatine is found in foods such as meat and seafood. Creatine is also found in many different types of sports supplements. In supplements, creatine has most often been used by adults in a one-time loading dose of up to 20 grams by mouth daily for up to 7 days, followed by a maintenance dose of 2.25-10 grams daily for up to 16 weeks. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

Creatine is allowed by the International Olympic Committee and National Collegiate Athletic Association (NCAA).

2-[carbamimidoyl(methyl)amino]acetic acid, Cr, Creatin, Creatina, Créatine, Créatine Anhydre, Creatine Anhydrous, Creatine Citrate, Créatine Citrate, Creatine Ethyl Ester, Créatine Ethyl Ester, Creatine Ethyl Ester HCl, Créatine Ethyl Ester HCl, Creatine Gluconate, Creatine Hydrochloride, Créatine Kré Alkaline, Creatine Malate, Créatine Malate, Creatine Monohydrate, Créatine Monohydrate, Créatine Monohydratée, Creatine Pyroglutamate, Créatine Pyroglutamate, Creatine Pyruvate, Créatine Pyruvate, Dicreatine Malate, Dicréatine Malate, Di-Creatine Malate, Éthyle Ester de Créatine, Glycine, Kreatin, Kre-Alkalyn Pyruvate, Malate de Tricréatine, Methylguanidine Acetic Acid, N-(aminoiminométhyl)-N-Méthyl, N-(aminoiminomethyl)-N methyl glycine, N-amidinosarcosine, Phosphocreatine, Phosphocréatine, Tricreatine HCA, Tricréatine HCA, Tricreatine Malate, Tricréatine Malate.

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

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