Creatine

Overview

Creatine is an amino acid located mostly in your body’s muscles as well as in the brain. Most people get creatine through seafood and red meat — though at levels far below those found in synthetically made creatine supplements. The body’s liver, pancreas and kidneys also can make about 1 gram of creatine per day.

Your body stores creatine as phosphocreatine primarily in your muscles, where it’s used for energy. As a result, people take creatine orally to improve athletic performance and increase muscle mass.

People also use oral creatine to treat certain brain disorders, neuromuscular conditions, congestive heart failure and other conditions. Topical creatine might be used to treat aging skin.

Evidence

Research on creatine use for specific activities and conditions shows:

• Strength, muscle size and performance. Oral creatine use might allow an athlete to do more work during reps or sprints, leading to greater gains in strength, muscle mass and performance. Creatine is often used by athletes involved in high-intensity intermittent activities that require a rapid recovery during training and competition.
• Injury prevention. Oral creatine might reduce the frequency of dehydration, muscle cramping, and injuries to the muscles, bones, ligaments, tendons and nerves.
• Rare creatine-metabolizing syndromes. In children with the certain creatine deficiency syndromes, oral creatine supplements might improve some symptoms.
• Cognition and brain health. Creatine supplementation might improve performance during cognitive tasks, especially in older adults.
• Sarcopenia and bone health. Creatine supplementation might help counteract age-related declines in skeletal muscle and bone mineral density.
• Heart failure. There isn’t enough evidence to recommend use of oral creatine as a heart failure treatment.
• Skin aging. Early research suggests that a cream containing creatine and other ingredients applied to the face every day for six weeks might reduce skin sag and wrinkles in men. Another study suggests that a cream containing creatine and folic acid improves sun damage and reduces wrinkles.

People who have low levels of creatine — such as vegetarians — appear to benefit most from creatine supplements.

Our take

Generally safe

Creatine might benefit athletes who need short bursts of speed or increased muscle strength, such as sprinters, weight lifters and team sport athletes.

While taking creatine might not help all athletes, evidence suggests that it generally won’t hurt if taken as directed.

Although an older case study suggested that creatine might worsen kidney dysfunction in people with kidney disorders, creatine doesn’t appear to affect kidney function in healthy people.

Safety and side effects

When used orally at appropriate doses, creatine is likely safe to take for up to five years. As with any dietary supplement, it’s important to choose a product that follows recommended manufacturing practices and subscribes to third-party testing to ensure the product’s quality.

Creatine can cause:

• Weight gain, generally as lean body mass

Creatine might be unsafe for people with preexisting kidney problems. However, further research is needed.

Interactions

Possible interactions include:

• Caffeine. Combining caffeine with creatine might decrease the efficacy of creatine. Use of creatine with a daily amount of caffeine greater than 300 milligrams might also worsen the progression of Parkinson’s disease. Further research is needed.