Creatine in adult health and performance: A literature review

Authors

  • Marcin Migiel Private Health Care Facility in the Commune of Nowy Targ, 2 Podhalańska Street, 34-471 Ludźmierz, Poland https://orcid.org/0009-0003-3562-5051
  • Izabela Brynczka Ludwik Rydygier Specialist Hospital, 1 Złota Jesień Street, 31-826 Kraków, Poland https://orcid.org/0009-0002-1527-5659
  • Natalia Siuta Private Health Care Facility in the Commune of Nowy Targ, 2 Podhalańska Street, 34-471 Ludźmierz, Poland https://orcid.org/0000-0001-8441-5382
  • Joanna Rypel-Bośka Klara Helska Specialist Hospital of Lung Diseases „Odrodzenie”, 1 Gładkie Street, 34-500 Zakopane, Poland https://orcid.org/0009-0002-2380-571X
  • Jakub Miaśnikiewicz Central Teaching Hospital of the Medical University of Lodz, 251 Pomorska Street, 92-213 Łódź, Poland https://orcid.org/0009-0003-3186-010X
  • Klaudia Goleniewska University Clinical Hospital No. 2 of Medical University of Łódź, 113 Żeromskiego Street, 90-549 Łódź, Poland https://orcid.org/0009-0002-1597-9699
  • Aleksandra Stupecka University Clinical Hospital No. 1 named after Norbert Barlicki, 22 Dr. Stefama Kopcinskiego Street, 90-153 Łódź, Poland https://orcid.org/0009-0004-3585-9664
  • Wiktoria Cecuła Central Clinical Hospital of the Medical University of Łódź, 251 Pomorska Street, 92-213 Łódź, Poland https://orcid.org/0009-0005-8749-2312
  • Kamil Ciechomski Healthcare Service Center in Łowicz, 28 Ułańska Street, 99-400 Łowicz, Poland https://orcid.org/0009-0002-0049-2714

DOI:

https://doi.org/10.12775/QS.2025.47.66807

Keywords

creatine, performance, aging, cognitive function, depression

Abstract

Introduction and Purpose: Creatine is a naturally occurring compound widely used as a supplement to enhance high-intensity exercise performance and increase muscle mass. Beyond its muscular benefits, creatine plays a key role in cellular energy homeostasis. There is growing interest in its potential cognitive and therapeutic applications, but several misconceptions about its safety and effects persist.

Research Objective: The role of this article is to summarize current evidence on creatine supplementation in adults, focusing on its efficacy for physical performance, its safety profile and emerging roles in cognitive and other health domains.


 Materials and methods: A literature review of studies published from 2019–2024 in the PubMed database analyzed clinical trials, meta-analyses, and systematic reviews on the effects of PA, using the following keywords: „creatine” ; „performance” ; „aging” ; „cognitive function” ; „depression”.


 Conclusions: Creatine monohydrate is recognized as the most effective supplement for increasing muscle strength and muscle mass, with consistent benefits observed in both athletes and older adults. Long-term use of recommended doses is well-tolerated. Emerging evidence suggests creatine may also support cognitive function and brain health. Future research should prioritize human studies exploring neurological and mental health applications.

References

[1] Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017 Feb;14:18. doi:10.1186/s12970-017-0173-z. PMID: 28615996; PMCID: PMC5469049.

[2] Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021 Feb;18:13. doi:10.1186/s12970-021-00412-w. PMID: 33602135; PMCID: PMC7881130

[3] Roschel H, Gualano B, Ostojic SM, Rawson ES. Creatine supplementation and brain health. Nutrients. 2021 Feb;13(2):586. doi:10.3390/nu13020586. PMID: 33578876; PMCID: PMC7916590.

[4] Balestrino M. Role of creatine in the heart: health and disease. Nutrients. 2021 Apr;13(4):1215. doi:10.3390/nu13041215. PMID: 33924425; PMCID: PMC8069213.

[5] Ribeiro F, Longobardi I, Perim P, Duarte B, Ferreira P, Gualano B, et al. Timing of creatine supplementation around exercise: a real concern? Nutrients. 2021 Aug;13(8):2844. doi:10.3390/nu13082844. PMID: 34444299; PMCID: PMC8402496.

[6] Poortmans JR, Auquier H, Renaut V, Durussel A, Saugy M, Brisson GR. Effect of short-term creatine supplementation on renal responses in men. Eur J Appl Physiol Occup Physiol. 1997;76(6):566-7. doi: 10.1007/s004210050291. PMID: 9404870.

[7] Persky AM, Rawson ES. Safety of creatine supplementation. Subcell Biochem. 2007;46:275-89. doi: 10.1007/978-1-4020-6486-9_14. PMID: 18652082.

[8] Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL. Bioavailability, efficacy, safety, and regulatory status of creatine and related compounds: a critical review. Nutrients. 2022 Feb;14(5):1035. doi:10.3390/nu14051035. PMID: 35268011; PMCID: PMC8912867.

[9] Jagim AR, Stecker RA, Harty PS, Erickson JL, Kerksick CM. Analysis of the efficacy, safety, and cost of alternative forms of creatine available for purchase on Amazon.com: are label claims supported by science? Nutrients. 2022 Dec;14(24):5192. doi:10.1016/j.heliyon.2022.e12113. PMID: 36544833; PMCID: PMC9761713.

[10] Fielding RA, Rivas D, Grosicki GJ, Ezzyat Y, Ceglia L, Price LL, Orhan C, Sahin K, Fowler K, White T, Durkee S, Kritsch K, Bellamine A. Effects of low doses of L-carnitine tartrate and lipid multi-particulate formulated creatine monohydrate on muscle protein synthesis in myoblasts and bioavailability in humans and rodents. Nutrients. 2021 Nov 9;13(11):3985. doi:10.3390/nu13113985. PMID: 34836240; PMCID: PMC8625796.

[11] Prokopidis K, Giannos P, Triantafyllidis KK, Kechagias KS, Forbes SC, Candow DG. Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2023 Mar;81(4):416–427. doi:10.1093/nutrit/nuac064. PMID:35984306; PMCID:PMC9999677.

[12] Snow WM, Cadonic C, Cortes-Perez C, Roy Chowdhury SK, Djordjevic J, Thomson E, Bernstein MJ, Suh M, Fernyhough P, Albensi BC. Chronic dietary creatine enhances hippocampal-dependent spatial memory, bioenergetics, and levels of plasticity-related proteins associated with NF-κB. Learn Mem. 2018 Jan 16;25(2):54-66. doi: 10.1101/lm.046284.117. PMID: 29339557; PMCID: PMC5772392.

[13] Gordji-Nejad A, Matusch A, Kleedörfer S, Patel J, Drzezga A, Elmenhorst D, Binkofski F, Bauer A. Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Sci Rep. 2024 Feb;14:4937. doi:10.1038/s41598-024-54249-9. PMID: 38418482; PMCID: PMC10902318.

[14] Genius J, Geiger J, Bender A, Möller HJ, Klopstock T, Rujescu D. Creatine protects against excitotoxicity in an in vitro model of neurodegeneration. PLoS One. 2012;7(2):e30554. doi:10.1371/journal.pone.0030554. PMID: 22347384; PMCID: PMC3275587.

[15] Stout AK, Raphael HM, Kanterewicz BI, Klann E, Reynolds IJ. Glutamate-induced neuron death requires mitochondrial calcium uptake. Nat Neurosci. 1998 Sep;1(5):366-73. doi: 10.1038/1577. PMID: 10196525.

[16] Chang H, Leem YH. The potential role of creatine supplementation in neurodegenerative diseases. Phys Act Nutr. 2023 Dec;27(4):48-54. doi: 10.20463/pan.2023.0037. Epub 2023 Dec 31. PMID: 38297476; PMCID: PMC10844727.

[17] Leland KM, McDonald TL, Drescher KM. Effect of creatine, creatinine, and creatine ethyl ester on TLR expression in macrophages. Int Immunopharmacol. 2011 Sep;11(9):1341-7. doi: 10.1016/j.intimp.2011.04.018. Epub 2011 May 14. PMID: 21575742; PMCID: PMC3157573.

[18]Nomura A, Zhang M, Sakamoto T, Ishii Y, Morishima Y, Mochizuki M, Kimura T, Uchida Y, Sekizawa K. Anti-inflammatory activity of creatine supplementation in endothelial cells in vitro. Br J Pharmacol. 2003 Jun;139(4):715-20. doi: 10.1038/sj.bjp.0705316. PMID: 12812994; PMCID: PMC1573908.

[19] Candow DG, Forbes SC, Kirk B, Duque G. Current evidence and possible future applications of creatine supplementation for older adults. Nutrients. 2021;13(3):745. doi:10.3390/nu13030745.

[20] Harmon KK, Stout JR, Fukuda DH, Pabian PS, Rawson ES, Stock MS. The application of creatine supplementation in medical rehabilitation. Nutrients. 2021;13(6):1825. doi:10.3390/nu13061825.

[21] Forbes SC, Candow DG, Krentz JR, Roberts MD, Young KC. Changes in fat mass following creatine supplementation and resistance training in adults ≥50 years of age: a meta-analysis. J Funct Morphol Kinesiol. 2019;4(3):54. doi:10.3390/jfmk4030054.

[22] Candow DG, Vogt E, Johannsmeyer S, Forbes SC, Farthing JP. Strategic creatine supplementation and resistance training in healthy older adults. Appl Physiol Nutr Metab. 2015;40(7):689–694. doi:10.1139/apnm-2014-0498.

[23] Chrusch MJ, Chilibeck PD, Chad KE, Davison KS, Burke DG. Creatine supplementation combined with resistance training in older men. Med Sci Sports Exerc. 2001;33(12):2111–2117. doi:10.1097/00005768-200112000-00025.

[24] Eijnde BO, Van Leemputte M, Goris M, et al. Effects of creatine supplementation and exercise training on fitness in men 55–75 yr old. J Appl Physiol. 2003;95(2):818–828. doi:10.1152/japplphysiol.00910.2002.

[25] Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med. 2017;8:213–226. doi:10.2147/OAJSM.S123529.

[26] Candow DG, Forbes SC, Chilibeck PD, Cornish SM, Antonio J, Kreider RB. Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation. J Clin Med. 2019 Apr 11;8(4):488. doi: 10.3390/jcm8040488. PMID: 30978926; PMCID: PMC6518405.

[27] Bender A, Beckers J, Schneider I, Hölter SM, Haack T, Ruthsatz T, Vogt-Weisenhorn DM, Becker L, Genius J, Rujescu D, Irmler M, Mijalski T, Mader M, Quintanilla-Martinez L, Fuchs H, Gailus-Durner V, de Angelis MH, Wurst W, Schmidt J, Klopstock T. Creatine improves health and survival of mice. Neurobiol Aging. 2008 Sep;29(9):1404-11. doi: 10.1016/j.neurobiolaging.2007.03.001. Epub 2007 Apr 9. PMID: 17416441.

[28] Rizzoli R, Reginster JY, Arnal JF, et al. Quality of life in sarcopenia and frailty. Calcif Tissue Int. 2013;93(2):101–120. doi:10.1007/s00223-013-9758-y.

[29] Ogawa S, Yakabe M, Akishita M. Age-related sarcopenia and its pathophysiological bases. Inflamm Regen. 2016;36:17. doi:10.1186/s41232-016-0022-5.

[30] Forbes SC, Candow DG, Falk Neto JH, Kennedy MD, Forbes JL, Machado M, et al. Creatine supplementation and endurance performance: surges and sprints to win the race. J Int Soc Sports Nutr. 2023;20(1):2204071.

[31] Antonio J, Pereira F, Curtis J, Rojas J, Evans C. The top 5 can’t-miss sport supplements. Nutrients. 2024;16(19):3247.

[32] Amiri E, Sheikholeslami-Vatani D. The role of resistance training and creatine supplementation on oxidative stress, antioxidant defense, muscle strength, and quality of life in older adults. Front Public Health. 2023;11:1062832.

[33] Chilibeck PD, Candow DG, Gordon JJ, Duff WR, Mason R, Shaw K, et al. A 2-year randomized controlled trial on creatine supplementation during exercise for postmenopausal bone health. Med Sci Sports Exerc. 2023;55(10):1750-1760.

[34] Gordon AN, Moore SR, Patterson ND, Hostetter ME, Cabre HE, Hirsch KR, et al. The effects of creatine monohydrate loading on exercise recovery in active women throughout the menstrual cycle. Nutrients. 2023;15(16):3567.

[35] Turnagöl HH, Koşar ŞN, Güzel Y, Aktitiz S, Atakan MM. Nutritional considerations for injury prevention and recovery in combat sports. Nutrients. 2022;14(1):53.

[36] Bogdanis GC, Nevill ME, Aphamis G, Stavrinou PS, Jenkins DG, Giannaki CD, et al. Effects of oral creatine supplementation on power output during repeated treadmill sprinting. Nutrients. 2022;14(6):1140.

[37] Yamaguchi S, Inami T, Ishida H, Morito A, Yamada S, Nagata N, et al. The effect of prior creatine intake for 28 days on accelerated recovery from exercise-induced muscle damage: a double-blind, randomized, placebo-controlled trial. Nutrients. 2024;16(6):896.

[38] Furtado ETF, de Oliveira JPL, Pereira ISB, Veiga EP, da Silva SF, de Abreu WC. Short term creatine loading improves strength endurance even without changing maximal strength, RPE, fatigue index, and mood state. An Acad Bras Cienc. 2024;96(2):e20230559.

[39] Sherpa NN, De Giorgi R, Ostinelli EG, Choudhury A, Dolma T, Dorjee S. Efficacy and safety profile of oral creatine monohydrate in add-on to cognitive-behavioural therapy in depression: an 8-week pilot, double-blind, randomised, placebo-controlled feasibility and exploratory trial in an under-resourced area. Eur Neuropsychopharmacol. 2025;90:28–35.

[40] Aliomrani M, Mesripour A, Saleki Mehrjardi A. Creatine and alpha-lipoic acid antidepressant-like effect following cyclosporine A administration. Turk J Pharm Sci. 2022;19(2):196–201.

[41] Kanekar S, Ettaro R, Hoffman MD, Ombach HJ, Brown J, Lynch C, et al. Sex-based impact of creatine supplementation on depressive symptoms, brain serotonin and SSRI efficacy in an animal model of treatment-resistant depression. Int J Mol Sci. 2021;22(15):8195.

[42] Hellem TL, Sung YH, Shi XF, Pett MA, Latendresse G, Morgan J, et al. Creatine as a novel treatment for depression in females using methamphetamine: a pilot study. J Dual Diagn. 2015;11(3–4):189–202.

Quality in Sport

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Published

2025-11-30

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1.
MIGIEL, Marcin, BRYNCZKA, Izabela, SIUTA, Natalia, RYPEL-BOŚKA, Joanna, MIAŚNIKIEWICZ, Jakub, GOLENIEWSKA, Klaudia, STUPECKA, Aleksandra, CECUŁA, Wiktoria and CIECHOMSKI, Kamil. Creatine in adult health and performance: A literature review. Quality in Sport. Online. 30 November 2025. Vol. 47, p. 66807. [Accessed 10 December 2025]. DOI 10.12775/QS.2025.47.66807.

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Vol. 47 (2025)

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Medical Sciences

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Copyright (c) 2025 Marcin Migiel, Izabela Brynczka, Natalia Siuta, Joanna Rypel-Bośka, Jakub Miaśnikiewicz, Klaudia Goleniewska, Aleksandra Stupecka, Wiktoria Cecuła, Kamil Ciechomski

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