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

Journal of the International Society of Sports Nutrition
December 1, 2025
Jose Antonio et al. (20 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate additional questions and misconceptions about creatine monohydrate (CrM), including its effects on muscle benefits without exercise, timing, interactions with other compounds, and safety in specific populations.

Results Summary

The study found that CrM is safe and effective for improving sport, exercise performance, and health across various populations, addressing misconceptions such as its impact on muscle protein synthesis, inflammation, recovery, and safety during pregnancy.

Population

Children, adolescents, biological females, older adults, and general populations.

Effective Dosage

Not specified in the abstract.

Duration

Not specified in the abstract.

Interactions

Mentions potential interaction with caffeine but does not specify the nature of the interaction.

Extracted Claims (31)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Creatine monohydrate supplementation (CrM)
increase
certain aspects of sport, exercise performance, and health
across the lifespan
-
is a safe and effective intervention for improving
#1
Creatine monohydrate supplementation (CrM)
increase
water retention
-
-
leads to
#2
Creatine monohydrate supplementation (CrM)
increase
fat accumulation
-
-
leads to
#3
Creatine monohydrate supplementation (CrM)
no change
a steroid
-
-
is
#4
Creatine monohydrate supplementation (CrM)
increase
hair loss
-
-
causes
#5
Creatine monohydrate supplementation (CrM)
increase
dehydration
-
-
causes
#6
Creatine monohydrate supplementation (CrM)
increase
muscle cramping
-
-
causes
#7
Creatine monohydrate supplementation (CrM)
decrease
renal function
-
-
adversely affects
#8
Creatine monohydrate supplementation (CrM)
decrease
liver function
-
-
adversely affects
#9
Creatine monohydrate supplementation (CrM)
no change
children
children
-
is safe and/or effective for
#10
Creatine monohydrate supplementation (CrM)
no change
adolescents
adolescents
-
is safe and/or effective for
#11
Creatine monohydrate supplementation (CrM)
no change
biological females
biological females
-
is safe and/or effective for
#12
Creatine monohydrate supplementation (CrM)
no change
older adults
older adults
-
is safe and/or effective for
#13
Creatine monohydrate supplementation (CrM)
increase
muscle benefits
-
-
provide
#14
Creatine monohydrate supplementation (CrM)
no change
timing
-
-
matter
#15
Creatine monohydrate supplementation (CrM)
increase
addition of other compounds
-
-
enhance its effectiveness
#16
Creatine monohydrate supplementation (CrM)
decrease
caffeine
-
-
oppose each other
#17
Creatine monohydrate supplementation (CrM)
increase
muscle protein synthesis
-
-
increase the rates of
#18
Creatine monohydrate supplementation (CrM)
increase
muscle protein breakdown
-
-
increase the rates of
#19
Creatine monohydrate supplementation (CrM)
no change
an anti-inflammatory intervention
-
-
is
#20
Creatine monohydrate supplementation (CrM)
increase
following injury, surgery, and/or immobilization
-
-
increase recovery
#21
Creatine monohydrate supplementation (CrM)
increase
cancer
-
-
cause
#22
Creatine monohydrate supplementation (CrM)
increase
urine production
-
-
increase
#23
Creatine monohydrate supplementation (CrM)
no change
blood pressure
-
-
influence
#24
Creatine monohydrate supplementation (CrM)
no change
pregnancy
pregnancy
-
is safe to consume during
#25
Creatine monohydrate supplementation (CrM)
increase
adolescents
adolescents
-
enhance performance in
#26
Creatine monohydrate supplementation (CrM)
decrease
male fertility
male
-
adversely affect
#27
Creatine monohydrate supplementation (CrM)
increase
brain
-
-
require a higher dose
#28
Creatine monohydrate supplementation (CrM)
decrease
symptoms of sleep deprivation
-
-
attenuate
#29
Creatine monohydrate supplementation (CrM)
decrease
traumatic brain injury
-
-
reduce the severity of
#30
Creatine monohydrate supplementation (CrM)
increase
traumatic brain injury
-
-
improve recovery from
#31
Abstract

Creatine monohydrate supplementation (CrM) is a safe and effective intervention for improving certain aspects of sport, exercise performance, and health across the lifespan. Despite its evidence-based pedigree, several questions and misconceptions about CrM remain. To initially address some of these concerns, our group published a narrative review in 2021 discussing the scientific evidence as to whether CrM leads to water retention and fat accumulation, is a steroid, causes hair loss, dehydration or muscle cramping, adversely affects renal and liver function, and if CrM is safe and/or effective for children, adolescents, biological females, and older adults. As a follow-up, the purpose of this paper is to evaluate additional questions and misconceptions about CrM. These include but are not limited to: 1. Can CrM provide muscle benefits without exercise? 2. Does the timing of CrM really matter? 3. Does the addition of other compounds with CrM enhance its effectiveness? 4. Does CrM and caffeine oppose each other? 5. Does CrM increase the rates of muscle protein synthesis or breakdown? 6. Is CrM an anti-inflammatory intervention? 7. Can CrM increase recovery following injury, surgery, and/or immobilization? 8. Does CrM cause cancer? 9. Will CrM increase urine production? 10. Does CrM influence blood pressure? 11. Is CrM safe to consume during pregnancy? 12. Does CrM enhance performance in adolescents? 13. Does CrM adversely affect male fertility? 14. Does the brain require a higher dose of CrM than skeletal muscle? 15. Can CrM attenuate symptoms of sleep deprivation? 16. Will CrM reduce the severity of and/or improve recovery from traumatic brain injury? Similar to our 2021 paper, an international team of creatine research experts was formed to perform a narrative review of the literature regarding CrM to formulate evidence-based responses to the aforementioned misconceptions involving CrM.

Medical Subject Headings (MeSH)
HumansCreatineDietary SupplementsMuscle, SkeletalSports Nutritional Physiological PhenomenaFemalePregnancy
Study Links
Quality Scores
Safety90
Efficacy85/10
Quality80/10
Citation Metrics
Total Citations6
Citations/Year6.0
Research Impact Scores
APT Score0.95
Weight Score3.11
Normalized Score0.86
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