The Pros and Cons of Creatine, According to a Nutrition Coach

As a fitness enthusiast, you may find yourself in the sports supplements aisle from time to time. Whether you’re browsing for supplements for muscle growth or performance, you may be wondering if you should shell out for a tub of creatine? If you’re heavily into weightlifting or bodybuilding, the answer is: maybe. Here, I’ll help you decide by breaking down the pros and cons of creatine, with the scientific evidence to back it all up.

What Is Creatine?

Creatine is an amino acid that your body already has. It’s stored in your skeletal muscles and brain. Increasing your creatine levels may help with muscle performance and brain health. 

You can take creatine supplementation or eat animal-based protein sources, like red meat, to build up your creatine levels. Vegans and vegetarians can eat foods containing amino acids arginine, glycine, and methionine — the precursors to creatine synthesis. It is difficult to get enough through food, so many athletes turn to creatine supplements. (1)

There are many types of creatine on the market, but research indicates that creatine monohydrate is the most effective. (1)

How Does Creatine Work?

When you ingest creatine through food or a dietary supplement, your body stores it as creatine phosphate in your muscle cells. Creatine phosphate is a type of phosphagen that can increase energy storage. Phosphocreatine can directly impact the stored energy known as ATP (adenosine triphosphate). 

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Your muscle cells have a natural supply of ATP, but it burns out after a few seconds. Keeping your creatine stores full allows your body to quickly create and replenish ATP. If you can recover quicker between sets, you have more energy for high-intensity exercises like heavy deadlifts and can crank out a few more quality reps.

It’s only a few extra seconds of energy, but consistently pulling off a couple more heavy reps in your sessions week after week can lead to longer-term gains.

Creatine Benefits

The International Society of Sports Nutrition (ISSN) states that, based on the available research, creatine is a safe and ergonomic aid for improving exercise performance, increasing muscle strength, and packing on lean muscle mass. (3)

Creatine doesn’t work by itself — all studies note that you have to pair it with a solid resistance training program. Let’s explore the potential benefits of creatine.

It Seems to Help Build Muscle

When trying to build muscle, you probably already know you have to follow a hypertrophy program, eat enough calories and protein, sleep, and wait. Research strongly suggests that creatine offers a boost in muscle growth.

Research indicates it may also work by increasing the growth hormone IGF-1 and proteins that help stimulate muscle protein synthesis. (4)(5)

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Here are the findings from major studies and reviews on people across ages and genders.

• A large review of clinical trials from 2012 to 2021 found that creatine increased muscle growth in young and older adults, though younger adults had more significant gains. For older adults, some studies found it particularly increased muscle mass in their legs. (6)
• A 2022 meta-analysis of studies on over 1,000 people compared the effects of creatine supplementation on people doing resistance training, mixed exercise, and no exercise. Those who did resistance training added two pounds of lean body mass; the other groups did not. (7)
• Creatine supplementation may help older adults build muscle and prevent muscle loss. In some cases, it works without resistance training. (8)
• People assigned female at birth may have 70 to 80 percent lower creatine stores than people assigned male at birth. Some research suggests that those who are assigned female at birth may particularly benefit from creatine supplementation to increase muscle mass and strength. It may also help preserve bone health and prevent muscle loss for post-menopausal people. (9) Studies have not been done on whether hormone replacement therapy (HRT) impacys this. 

It Seems to Help Increase Muscle Strength

Studies find that higher phosphocreatine levels may yield strength gains in people across different ages, fitness levels, and genders. It works by boosting ATP, which increases your power output and shortens your recovery time. You can do more volume in each session, helping to increase strength over time. (10)

• A 2020 study followed young adults doing resistance training five times a week for six weeks. One group took creatine, and the other took a placebo. The creatine group increased their muscle strength in the chest press and leg press, as well as endurance in the leg press and total-body strength. The placebo group did not. That doesn’t mean you can’t get stronger without creatine, of course — but it might take longer. (11) 
• That 2012 to 2021 review on muscle growth I talked about earlier also found that young adults taking creatine while resistance training increased their muscle strength and exercise performance. (6)
• A systematic review of studies on 700 older adults taking creatine while resistance training twice a week found that they all increased their lean body mass and improved muscle strength on the leg and chest press. (12)
• A systematic review of 60 studies found that creatine supplementation increased leg strength in exercises lasting less than three minutes in all genders, ages, and fitness levels. (13)

It Seems to Improve Athletic Performance

Here is how ATP plays into athletic performance. More ATP (and quicker replenishment of it) can increase maximal strength (lifting heavy slowly), power output (lifting any load more quickly), and the ability to tolerate a higher training volume. (10)

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These benefits of creatine can apply to both exercise performance in the gym and other types of sports performance.

• Since creatine increases exercise capacity, this applies to other high-intensity activities besides weightlifting and powerlifting. These include plyometrics, agility, and sprinting. Research suggests improving your skills in these three areas helps improve sports performance in tennis, rugby, soccer, swimming, football, and track and field. (10)
• One review of 300 studies found that short-term creatine supplementation (20 grams of creatine per day for five to seven days, which is a very high dosage) may improve maximal strength and power, increase the volume of work and muscle contractions during resistance training, improve sprinting performance, and increase work achieved during sprint workouts. This review notes that not all studies find significant gains, but most do. (14)
• Clinical trials on young adults taking creatine found it improved their sports performance in canoeing, soccer, plyometrics, and resistance training. (6)
• Some evidence suggests it can also improve endurance in long-duration aerobic exercise. Creatine, carbohydrates, and protein may help replenish glycogen stores faster than carbohydrates alone, leading to better recovery for endurance athletes. (15)

It Seems to Boost Brain Health 

Creatine may have another health benefit outside of the gym (though it also applies there) — potentially better brain health. The benefits of creatine for brain health may be due to 20 percent of your body’s creatine getting stored in your brain. (16)

• Creatine supplementation can increase brain creatine, improving brain function, neurological performance, and cognitive processing. (17)
• Better brain function also contributes to athletic performance. Many sports require quick reaction time, decision-making, and motor control. Research finds that creatine also reduces mental fatigue. Sleep-deprived and stressed athletes may see the most benefits on brain function from creatine. (16)
• A study on older adults aged 68 to 85 took 20 grams of creatine every day for seven days and had improved memory. (16)
• Ongoing research has been investigating whether creatine can improve brain health for people with neurodegenerative diseases like muscular dystrophy and Parkinson’s disease, but no health benefits have been found. (18)

Drawbacks of Creatine

Initially, reports stated the potential side effects of creatine supplementation included muscle cramps, spasms, strains, poor kidney function, gastrointestinal upset, and overheating. Now, research indicates it mainly comes down to bloating. (19)

Here’s how it works, as well as two other potential drawbacks.

It May Cause Bloating

The main creatine side effect is temporary weight gain caused by short-term water retention when you begin creatine use. Individuals who do a creatine loading phase by taking 20 to 25 grams of creatine per day for five to seven days experience more water retention at first as their muscle cells fill with water — which may show up as bloating. (19)

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It Has Unknown Effects on People With Kidney Disease

Regarding the kidney damage claim, research now shows that creatine supplementation is safe for healthy individuals without kidney disease. People with kidney disease or other health conditions should consult with a healthcare provider before trying creatine. (15)

Dietary Supplements are Not FDA-Approved

The U.S. Food and Drug Administration (FDA) does not need to approve dietary supplements, including creatine, for sale. They do not need to be proven to be safe or effective. That doesn’t mean creatine is dangerous, but it is certainly something to keep in mind. (20) 

Overall Pros and Cons of Creatine

Pros of Creatine	Cons of Creatine
When combined with resistance training (and adequate nutrition), creatine may help people of different ages and genders build muscle.	The main side effect of creatine is that it may initially cause bloating due to short-term water retention, leading to temporary weight gain.
Creatine may help increase muscle strength; many studies focus on the leg press and chest press.	Though creatine is now considered safe for people without kidney disease, its effects on people with kidney disease are unknown.
Creatine may help older adults prevent muscle loss.	Creatine is not FDA-approved.
Since creatine increases ATP, it can help improve athletic performance in the gym and sports.
Creatine may boost brain health and cognitive function.

Frequently Asked Questions

As with anything you hear about in the weight room, you probably have questions about creatine supplements. Here’s the quick, dirty, and research-backed scoop.

Editor’s Note: The content on BarBend is meant to be informative in nature, but it should not be taken as medical advice. When starting a new training regimen and/or diet, it is always a good idea to consult with a trusted medical professional. We are not a medical resource. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. They are not substitutes for consulting a qualified medical professional.

References

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2. Dunn J, Grider MH. Physiology, Adenosine Triphosphate. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. 
3. Buford TW, Kreider RB, Stout JR, Greenwood M, Campbell B, Spano M, Ziegenfuss T, Lopez H, Landis J, Antonio J. International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. 2007 Aug 30;4:6. 
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