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Compound Profile
Creatine monohydrate has strong human evidence for selected high intensity exercise outcomes and can modestly support lean mass and strength, particularly alongside resistance training.
Use extra caution — Safety evidence: systematic review evidence shows a small serum creatinine increase without a significant decline in glomerular filtration in studied users. Details

Bottom line
Safety: Very well tolerated; stay hydrated. Discuss with a clinician if you have kidney disease.
On the evidence: Extensive evidence for physical performance; cognitive evidence is newer but growing.
Best for
Not ideal for
Why not higher
Why not lower
Practical takeaway: A very safe daily staple. Expect reliable training benefits; treat the cognitive upside — clearest when sleep-deprived — as a promising bonus.
Safety
Elevated caution
Caution level: Elevated. One caution category applies — read it before use.
Evidence in pre-existing kidney disease, pregnancy, breastfeeding, and long-term use remains limited; serum creatinine should be interpreted in context.
Early signal that needs stronger human replication before practical claims.
Human clinical evidence: Present in source signals
Mechanistic / preclinical: Mechanism mapped — Oxidative Stress Modulation · Mitochondrial Support · Neuroprotective Activity
Research maturity: Preliminary research — Early findings are not treated as established consumer benefit.
Safety boundary: Safety note available — Safety evidence: systematic review evidence shows a small serum creatinine increase without a significant decline in glomerular filtration in studied users.
This profile cites 4 human studies.
Confidence estimate based on the design quality and consistency of published clinical trials.
Creatine has a preliminary evidence rating.
Evaluation of methodological rigor, population reach, and evidence alignment.
Each grade reflects the strength and consistency of published human evidence — not marketing claims. Grades are based on study count, design quality, effect size, consistency, and recency.
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Showing 12 of 12 studies.
What the evidence actually shows
This table contains 12 structured sources, including 10 human evidence sources; 5 are human trials. Across 1 human evidence source with a reported sample size, the approximate participant total is 492; overlapping publications may include some of the same people.
| Study | Design | N | Dose | Duration | Population | Outcome | Result & magnitude | Source |
|---|---|---|---|---|---|---|---|---|
Xu et al. · Frontiers in Nutrition · 2024 Background | Systematic review Uses a predefined method to find and evaluate relevant studies, but may or may not pool their results statistically. | n=492 | — | — | — | — | — | PubMed → |
Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults Background | Systematic review Uses a predefined method to find and evaluate relevant studies, but may or may not pool their results statistically. | — | — | — | — | — | Five of six studies reported a positive creatine-cognition relationship, especially for memory/attention, but study quality was often weak. | Five of six studies reported a positive association between creatine and cognition, particularly memory and attention. | PubMed → |
Background | Systematic review Uses a predefined method to find and evaluate relevant studies, but may or may not pool their results statistically. | — | — | — | — | — | Some adult major-depression trials found adjunctive benefit, while adolescent depression and bipolar-depression augmentation findings were null. | Adult MDD trials showed promise for creatine augmentation of escitalopram (one trial, Cohen's d=1.13 at 8 weeks) and CBT; other trials, including female adolescents and bipolar depression, did not show a placebo difference. | PubMed → |
Background | Systematic review Uses a predefined method to find and evaluate relevant studies, but may or may not pool their results statistically. | — | — | — | — | — | Early studies show a possible cognitive-performance benefit during acute sleep deprivation, but effects vary by cognitive domain. | PubMed → |
Background | Systematic review Uses a predefined method to find and evaluate relevant studies, but may or may not pool their results statistically. | — | — | — | — | — | Creatine can increase brain creatine content, but cognitive effects were equivocal rather than consistently beneficial. | PubMed → |
Background | Randomized controlled trial Randomly assigns participants to interventions or controls, reducing many sources of bias when the trial is conducted well. | — | — | — | — | — | Creatine improved subjective sleep quality (d=0.81, p=0.009), digit-cancellation cognitive performance (d=0.77, p=0.013), high-intensity exercise output, and muscle soreness. | PubMed → |
Background | Randomized controlled trial Randomly assigns participants to interventions or controls, reducing many sources of bias when the trial is conducted well. | — | — | — | — | — | Creatine provided additional benefits in antioxidant/inflammatory markers and selected strength/function outcomes when combined with training; creatine alone reduced F2-isoprostanes and TNF-alpha and improved perceived health versus placebo. | PubMed → |
Background | Randomized controlled trial Randomly assigns participants to interventions or controls, reducing many sources of bias when the trial is conducted well. | — | — | — | — | — | The 1,500 mg/day creatine HCl group outperformed placebo for reaction-time improvement and increased frontal brain creatine; serum lipid profiles also improved. | PubMed → |
Cognitive effects of creatine ethyl ester supplementation PubMed · Behav Pharmacol · 2009 Background | Controlled trial Compares an intervention with a control group but may lack random assignment or other safeguards of a strong randomized trial. | — | — | — | — | — | — | PubMed → |
PubMed · Psychopharmacology (Berl) · 2006 Background | Controlled trial Compares an intervention with a control group but may lack random assignment or other safeguards of a strong randomized trial. | — | — | — | — | — | — | PubMed → |
PubMed · J Int Soc Sports Nutr · 2017 Background | Narrative review Summarizes selected literature without the full prespecified search and selection methods of a systematic review. | — | — | — | — | — | — | PubMed → |
Background | Narrative review Summarizes selected literature without the full prespecified search and selection methods of a systematic review. | — | — | — | — | — | Evidence did not support a general cognitive-function health claim; isolated acute working-memory findings at 20 g/day were not consistently reproduced at lower doses or longer use. | PubMed → |
Simplified mechanism pathway based on preclinical and pharmacological evidence. Does not confirm clinical efficacy.
Mechanism Pathway — How Creatine Works
Preclinical mechanism details from scientific profiles; these represent plausible pathways but do not guarantee clinical efficacy in humans.
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Safety first · Harm reduction
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