Tools for Practice Outils pour la pratique


#422 What’s the Scoop on Creatine? Effects on strength


CLINICAL QUESTION
QUESTION CLINIQUE
 How does creatine supplementation affect strength in adults?

BOTTOM LINE
RÉSULTAT FINAL
 Evidence supporting creatine is unreliable due to small, short trials, lack of blinding, and few intention-to-treat analyses. At best, over ~5 weeks, creatine may improve bench press (~1kg) and squat (~6kg) strength, but not leg press or hand-grip strength. In the largest and longest trials, no consistent improvements were observed. Adverse effects appear similar to placebo.


CFPCLearn Logo

Reading Tools for Practice Article can earn you MainPro+ Credits

La lecture d'articles d'outils de pratique peut vous permettre de gagner des crédits MainPro+

 Join Now S’inscrire maintenant

Already a CFPCLearn Member? Log in

Déjà abonné à CMFCApprendre? Ouvrir une session


EVIDENCE
DONNÉES PROBANTES
  • Results statistically different unless indicated. Creatine versus placebo. Focusing on systematic reviews from last ten years.1-3 Sport-specific reviews excluded: Limited generalizability.
  • Systematic review: 69 randomized controlled trials (RCTs), 1937 participants (range 8-237), mean ages 18-74. 60% RCTs with resistance training, 30% without.1 At ~5 weeks:
    • Bench press: +1.4kg over placebo.
    • Squat: +5.6kg over placebo.
    • Hand grip, leg press: No difference.
    • Without resistance training: Inconsistent effects.
  • Systematic review: 23 RCTs, 509 participants, age ≤50. Creatine with resistance training (2-5 times/week).2 At ~8 weeks:
    • Strength (one-rep max):
      • “Upper-body”: +4.4kg over placebo.
      • “Lower-body”: +11.3kg over placebo.
      • Limitation: Strength exercises undefined.
  • Other systematic review: Inconsistent reporting, unclear methods.3
  • RCTs (from systematic reviews above) with ≥6 month follow up:
    • 6 RCTs, 33-237 adults; >90% post-menopausal women.4-9
    • Largest RCTs (200-237 patients, 24 months follow-up):4-5 No benefit on squat strength, or leg press with4/without5 resistance training.
    • Limitations: Strength outcomes were secondary endpoints;4-6,9 low adherence (56%).4
  • Adverse events: Three systematic reviews, infrequently reported.10-13
    • No differences.10-11
    • Serum creatinine or glomerular filtration rate: No clinically meaningful differences.10
  • Limitations:
    • Over 80% of RCTs ≤3 months duration, over 90% had ≤50 participants; absence of blinding and intention-to-treat analysis.1
    • Author conflicts: Board advisors for creatine manufacturers.1-2
CONTEXT
CONTEXTE
  • Most studied formulation: Creatine monohydrate.1,2
  • Dosing: 5-10g/day; up to 20-25g/day if no loading dose.
  • Lean body mass may increase by ~1kg over placebo at 4 days-1 year, but no differences observed in largest and longest RCTs.4-5
  • Impurities found during commercial product testing. Consider products with third-party purity testing.14-16
  • Creatine on cognition: Largest RCT – no benefit.17

Latest Tools for Practice
Derniers outils pour la pratique
program image
September 25, 2026

#422 What’s the Scoop on Creatine? Effects on strength

How does creatine supplementation affect strength in adults?
Read Lire 0.25 credits available Crédits disponibles
program image
September 11, 2026

#421 Happiness is a Dry Bed: Desmopressin for pediatric nocturnal enuresis

Does desmopressin reduce bedwetting for children with nocturnal enuresis?
Read Lire 0.25 credits available Crédits disponibles
program image
August 28, 2026

#420 Scratching the Surface: What is the most effective treatment for scabies?

For adults and children with classic scabies, how effective are treatment options and what is the duration of treatment?
Read Lire 0.25 credits available Crédits disponibles
September 25, 2026

This content is certified for MainPro+ Credits, log in to access

Ce contenu est certifié pour les crédits MainPro+, Ouvrir une session
Author(s)
Auteur(s)
  • Justin Kennedy PharmD
  • Jessica Kirkwood MD CCFP (AM)
  • Samantha Moe PharmD

1. Kazeminasab F, Kerchi AB, Sharfifard F, et al. Nutrients. 2025;17: 2748.

2. Wang Z, Qiu B, Li R, et al. Nutrients. 2024;16: 3665.

3. Naddafha S, Antonio J, Kreider RB, et al. J Int Soc Sports Nutr. 2026;23: 1: 2668435.

4. Chilibeck PD, Candow DG, Gordon JJ, et al. Med Sci Sports Exerc. 2023;55(10): 1750-60.

5. Sales LP, Pinto AJ, Rodrigues SF, et al. J Gerontol A Biol Sci Med Sci. 2020;75(5): 931-38.

6. Alves CRR, Merege Filho CAA, Benatti FB, et al. PLoS ONE. 2013;8(10): e76301.

7. Gualano B, Macedo AR, Alves CRR, et al. Exp Gerontol. 2014;53: 7-15.

8. Candow DG, Chilibeck PD, Gordon J, et al. Nutr Health. 2021;27(2): 151-59.

9. Chilibeck PD, Candow DG, Landeryou T, et al. Med Sci Sports Exerc. 2015;47(8): 1587-95.

10. Naeini NK, Eskandari M, Mortazavi M, et al. BMC Nephrol. 2025;26: 662.

11. de Guingand DL, Palmer KR, Snow RJ, et al. Nutrients. 2020:12(6): 1780.

12. de Souza e Silva A, Pertille A, Barbosa CGR, et al. J Ren Nutr. 2019;29(6): 480-489.

13. Almedia D, Pereira R, Borges EQ, et al. J Sci Sport Exerc. 2022;4: 255-65.

14. Moret S, Prevarin A, Tubaro F. Food Chem. 2011;126(3): 1232-1238.

15. Feizi A, Hamidi S, Bakalam N et al. Talanta Open. 2022;6: 100157.

16. Oliveira TF, Santo GR, Jesus JC et al. Food Chem. 2025;484: 144282.

17. Sandkuhler JF, Kersting S, Faust A, et al. BMC Medicine. 2023;21: 440.

Authors have no conflicts of interest to declare.