Substrate ·evidence-based
interventions / Creatine

Creatine: what the evidence actually shows

settled  creatine — well-established; the public is catching up to the breadth of the evidence

Reviewed by Substrate editorial, Independent research collective ·

Evidence by outcome

strengthgrade Ahigh certainty— reliable improvement in strength/power with resistance training
cognitiongrade Bmoderate certainty— Meta-analysis of 16 RCTs (n≈492 adults): improved memory, attention, and processing speed; no significant effect on overall or executive function.
energy / fatiguegrade Clow certainty— may reduce mental fatigue, especially under sleep deprivation or stress
bone healthgrade Clow certainty— Favorable effects on bone in post-menopausal females when creatine is combined with resistance training.
strengthgrade Clow certainty— Post-menopausal females may experience benefits in skeletal muscle size and function with high-dose creatine.
moodgrade Clow certainty— emerging evidence as an adjunct for depressive symptoms; trials small
blood sugargrade Clow certainty— Systematic review and meta-analysis (9 studies): creatine supplementation had no significant overall effect on fasting blood glucose or insulin resistance. Some benefit appeared in the small number of studies in people with diabetes, so any effect is likely context-specific rather than general.
joint healthgrade Dvery-low certainty— Narrative review of creatine plus resistance training for knee osteoarthritis: available studies suggest positive effects with no significant adverse events, but sample sizes are very small and results vary between studies. Not enough evidence to establish a real effect yet.
heart healthstudied, no effectlow certainty— Meta-analysis of 8 RCTs: creatine supplementation showed no statistically significant effect on total cholesterol, LDL, HDL, or triglycerides versus control. Certainty of evidence was rated very low to low due to methodological limitations in the included trials.
inflammationstudied, no effectmoderate certainty— Meta-analysis: creatine supplementation did not significantly reduce inflammatory biomarkers (CRP, IL-6) in humans, either acutely or chronically. Certainty of evidence was rated moderate. The authors note some benefit was observed specifically under conditions of intense physical stress, but the general anti-inflammatory claim is not supported.

People say · Evidence shows

“Creatine only helps muscles, not the brain”

behindmodestfolk

What it probably doesn't do

Grade history

Re-review cadence: every 12 months (Grade A/B) · next scheduled by · methodology v1.

By outcome — the money pages

Compare

More

sources: PMID:28615996 · PMID:39070254 · PMID:21394604 · PMID:33800439 · PMID:39553021 · PMID:35063192 · PMID:41243927 · PMID:42180567 · PMID:41798953

Cite this page

Reuse under CC-BY 4.0 with attribution to evidencebased.info.

Plain-text citation
Substrate. Creatine: what the evidence actually shows. https://evidencebased.info/interventions/creatine. Updated 2026-07-16.
BibTeX
@misc{substrate_nterventionscreatine,
  author = {Substrate editorial},
  title  = {Creatine: what the evidence actually shows},
  year   = {2026},
  url    = {https://evidencebased.info/interventions/creatine},
  note   = {evidencebased.info}
}
Creatine: evidence, grades, doses & safety · Substrate