31) J Int Soc Sports Nutr. 2021 Feb 8;18(1):13.

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

Jose Antonio ¹, Darren G Candow ², Scott C Forbes ³, Bruno Gualano ⁴, Andrew R Jagim ⁵, Richard B Kreider ⁶, Eric S Rawson ⁷, Abbie E Smith-Ryan ⁸, Trisha A VanDusseldorp ⁹, Darryn S Willoughby ¹⁰, Tim N Ziegenfuss ¹¹

Abstract

Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine ‘loading-phase’ required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.