Creatine

WHAT IT DOES

• Increases muscle strength and power, Grade A evidence. The most reliable ergogenic supplement available. Works by replenishing ATP during high-intensity exercise.
• Increases lean body mass, Grade B evidence from 11 studies. Partly from water retention in muscles, partly from actual muscle growth over time with training.
• Improves anaerobic capacity, Grade B evidence from 8 studies. Better performance in sprints, HIIT, and explosive movements.
• Reduces exercise-induced oxidative stress, Grade A evidence. Protective effect against cellular damage from intense training.
• May support cognition, Emerging evidence suggests creatine can enhance short-term memory and reasoning, especially under sleep deprivation or stress.
• May improve depression symptoms, Grade B evidence, particularly as an adjunct to antidepressants.

OPTIMAL DOSAGE

DRUG INTERACTIONS

SAFETY PROFILE

Side Effects

• Common: Gastrointestinal discomfort (most common during loading phase and in older adults), weight gain (1-3 lbs from water retention in muscles, this is normal and expected)
• Rare (case reports only, not confirmed in controlled trials): Kidney dysfunction, lower leg compartment syndrome, rhabdomyolysis, stroke (one case with concurrent ephedra use), liver injury, atrial fibrillation
• Important context: The best evidence from controlled studies shows creatine side effects do not differ from placebo. The serious adverse events above are from case reports only, often with confounding factors.

Drug Interactions

Precautions

• Pregnancy: Caution. No reliable human evidence on safety during pregnancy. Preclinical evidence suggests low risk, but no clinical trials confirm this.
• Breastfeeding: Caution. No human evidence available.
• Children: Generally considered safe in adolescents at standard doses, but consult a healthcare provider.
• Established kidney disease: Use with caution. Case reports suggest kidney dysfunction in people with pre-existing kidney problems. Healthy kidneys handle creatine fine, the myth that creatine damages healthy kidneys is not supported by evidence.
• Parkinson's disease: Avoid combining creatine with high-dose caffeine (>300mg/day), evidence suggests faster disease progression.
• Surgery: No specific concerns, but disclosure to the surgical team is good practice.

WADA Status

Not Prohibited. Creatine is not on the 2026 WADA List of Prohibited Substances.

WHO SHOULD BE CAREFUL

HOW AVELOR SCORES THIS

CLINICAL REFERENCES

Reference identifiers on this page are being re-verified against PubMed. Some may not yet link to the paper named beside them.