Is Creatine Supplementation Safe and Effective? – A Review

Abstract

Background:Creatine is one of the most widely used and extensively studied dietary supplements in sports nutrition. By supporting cellular energy metabolism and ATP resynthesis, it may improve exercise performance, muscle strength, and training adaptations. Growing attention is also being paid to its safety and potential applications beyond sports. Aim:This narrative review aimed to summarise current evidence on the efficacy and safety of creatine supplementation, with emphasis on muscle strength, body composition, physical performance, recovery, and potential clinical applications. Material and methods:A literature review was conducted using PubMed, Scopus, and Google Scholar, focusing mainly on studies published between 2015 and 2025. Clinical trials, systematic reviews, meta-analyses, and narrative reviews evaluating creatine supplementation in humans were considered. Results:Current evidence indicates that creatine supplementation improves muscle strength, increases lean body mass, and enhances performance during high-intensity and repeated exercise, particularly when combined with resistance training. Beneficial effects on post-exercise recovery have also been reported. Creatine monohydrate appears safe for healthy individuals when used at recommended doses, with no consistent evidence of adverse effects on renal or hepatic function. Emerging research suggests additional benefits in older adults, rehabilitation, cognitive function, and selected neurological conditions. Conclusions:Creatine monohydrate is an effective and well-established supplement for improving physical performance and supporting muscle adaptations. Available evidence confirms a favourable safety profile in healthy individuals. Although potential applications beyond sports are promising, further long-term clinical studies are required to establish their clinical relevance.