Creatine for Muscle Strength and Performance

Table of Contents

1. The ISSN 2017 Position Stand — What It States
2. The ATP-PCr Energy System (Why Creatine Is Studied for Short Bursts)
3. The Phosphocreatine Reservoir and Muscle Creatine Saturation
4. Loading (About 20 g/day for 5-7 Days) vs No-Loading Schedules in Studies
5. Strength Gains: What the Meta-Analyses Found
6. Power Output and Repeated Sprint Performance
7. Lean Mass Gains and Body Composition
8. Responders and Non-Responders: What Muscle Biopsy Studies Show
9. Creatine and Other Studied Ergogenic Aids (Caffeine, Beta-Alanine, Citrulline)
10. Combinations Studied With Creatine
11. The Endurance-Athlete Question
12. Doses and Schedules Used in the Research
13. Key Research Papers
14. Connections
15. Featured Videos

The ISSN 2017 Position Stand — What It States

The International Society of Sports Nutrition published an updated position stand on creatine in 2017 (Kreider et al., Journal of the International Society of Sports Nutrition). It is open access. Its authors are Richard Kreider, Douglas Kalman, Jose Antonio, Tim Ziegenfuss, Robert Wildman, Rick Collins, Darren Candow, Susan Kleiner, Anthony Almada and Hector Lopez. The competing-interests statement notes that the update was prepared at the request of a dietary-supplement trade association and the ISSN, and that several authors have received industry research funding or hold consulting or advisory roles with companies in the sports-nutrition field.

Among the conclusions the position stand lists as the official position of the Society (quoted from the paper):

• “Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training.”
• “Creatine monohydrate supplementation is not only safe, but has been reported to have a number of therapeutic benefits in healthy and diseased populations ranging from infants to the elderly.”
• “There is no compelling scientific evidence that the short- or long-term use of creatine monohydrate (up to 30 g/day for 5 years) has any detrimental effects on otherwise healthy individuals or among clinical populations who may benefit from creatine supplementation.”
• “If proper precautions and supervision are provided, creatine monohydrate supplementation in children and adolescent athletes is acceptable and may provide a nutritional alternative with a favorable safety profile to potentially dangerous anabolic androgenic drugs.”
• “The quickest method of increasing muscle creatine stores may be to consume ~0.3 g/kg/day of creatine monohydrate for 5–7-days followed by 3–5 g/day thereafter to maintain elevated stores. Initially, ingesting smaller amounts of creatine monohydrate (e.g., 3–5 g/day) will increase muscle creatine stores over a 3–4 week period, however, the initial performance effects of this method of supplementation are less supported.”

The position stand also states that the only consistently reported side effect in the literature has been weight gain. These are the Society’s stated positions; the trials and meta-analyses below give the measured effects.

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The ATP-PCr Energy System (Why Creatine Is Studied for Short Bursts)

Muscle cells run on adenosine triphosphate (ATP). When a muscle contracts, the actin-myosin cross-bridge cycle consumes ATP, producing ADP. The cell must regenerate ATP from ADP or contraction stops. Three energy systems do this, on different timescales:

1. ATP-PCr (phosphagen) system — the fastest, dominant in the first seconds of all-out effort. Phosphocreatine donates its phosphate to ADP via the creatine kinase reaction: PCr + ADP ↔ Cr + ATP. This is the system behind a maximal lift, a sprint start or a short heavy set.
2. Anaerobic glycolysis — slower than the phosphagen system but faster than oxidative phosphorylation; it carries more of the load as an intense effort continues past the first seconds and produces lactate.
3. Oxidative phosphorylation — the slowest but able to run for hours; it dominates longer, steadier exercise and burns carbohydrate and fat inside mitochondria.

The phosphagen system regenerates ATP fastest but has a small capacity. A review by Casey and Greenhaff (2000) describes fatigue during short, high-intensity exercise as linked to muscle’s inability to keep up a high rate of ATP production from phosphocreatine, and reports that after creatine loading, ATP loss during heavy exercise declined even though more work was done. The ISSN position stand states that supplementation raises muscle creatine and phosphocreatine by 20–40%.

For the same reason the research focuses on heavy lifts, sprints and high-intensity intervals. In Branch’s 2003 meta-analysis of 100 placebo-controlled studies, effect sizes were greatest for repeated laboratory tasks of 30 seconds or less, and the author concluded that creatine “does not appear to be effective in improving running and swimming performance.”

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The Phosphocreatine Reservoir and Muscle Creatine Saturation

According to the ISSN position stand, about two thirds of the creatine in muscle is phosphocreatine and the rest is free creatine; the total averages about 120 mmol/kg of dry muscle in a 70 kg person, and the upper limit of storage appears to be about 160 mmol/kg in most people. The same paper states that with a normal diet containing 1–2 g/day of creatine (for example, a pound of uncooked beef or salmon provides about 1–2 g), muscle stores are about 60–80% saturated.

Two foundational biopsy studies established how quickly muscle fills. Harris, Söderlund and Hultman (Clinical Science 1992) gave 5 g of creatine monohydrate four or six times a day for 2 or more days to 17 subjects and found a significant rise in quadriceps total creatine. The rise was greatest in subjects who started with the lowest levels, and in some it was as much as 50%. Hultman et al. (J Appl Physiol 1996), in 31 men, then compared two routes to the same endpoint:

• Loading: 20 g/day for 6 days raised muscle total creatine by about 20%. Continuing at 2 g/day kept it there for a further 30 days; without that maintenance dose, levels drifted back to baseline over about 30 days.
• No loading: 3 g/day produced a similar, more gradual rise of about 20% over 28 days.

The authors concluded that 20 g/day for 6 days is a rapid way to load muscle and that 3 g/day is likely, in the long term, to be as effective at raising tissue levels. The ISSN position stand adds that the initial performance effects of the no-loading route are less supported than those of loading.

Not all of a large dose is retained. In Harris 1992, three subjects taking 6 × 5 g/day excreted 40, 61 and 68% of the dose in urine over the first 3 days. Casey and Greenhaff (2000) report no evidence that more than 20–30 g/day for 5–6 days increases uptake or performance further.

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Loading (About 20 g/day for 5-7 Days) vs No-Loading Schedules in Studies

Trials have generally used one of two schedules, both described in the Harris and Hultman work and in the ISSN position stand:

1. Loading, then maintenance: about 0.3 g/kg body weight per day (roughly 20 g/day, usually as four 5 g doses) for 5–7 days, followed by 3–5 g/day. The ISSN position stand notes that some studies indicate larger athletes may need 5–10 g/day to maintain stores.
2. No loading: 3–5 g/day from the start, which reaches similar muscle levels over 3–4 weeks (about 28 days at 3 g/day in Hultman 1996).

Digestive side effects appear to depend on how much is taken at once. In a 28-day trial in 59 soccer players, Ostojic and Ahmetovic (2008) found that diarrhoea was more common with a single 10 g dose than with two 5 g doses (55.6% vs 28.6%), and that two 5 g doses did not differ from placebo in overall digestive complaints.

Timing of the daily dose: in a 4-week study of 19 recreational male bodybuilders, Antonio and Ciccone (2013) compared 5 g taken immediately before or immediately after training. No statistically significant group differences were found; using magnitude-based inference, the authors concluded that post-workout intake appeared superior for fat-free mass and bench-press strength. The ISSN position stand reports that adding carbohydrate, or carbohydrate and protein, appears to increase muscle uptake of creatine, although the effect on performance may not be greater than creatine monohydrate alone.

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Strength Gains: What the Meta-Analyses Found

Placebo-controlled meta-analyses report a small but consistent strength advantage with creatine. Effect sizes below are standardized (the difference between groups divided by the spread of the data), with the 95% confidence interval in brackets.

• Lanhers et al., lower limb (Sports Medicine 2015) — 60 randomized placebo-controlled studies (646 people on creatine, 651 controls), strength measured in exercises lasting under 3 minutes. Global lower-limb effect size 0.235 (0.125–0.346); squat 0.336 (0.047–0.625); leg press 0.297 (0.098–0.496). Meta-regression found no link with population characteristics, training, dose or duration.
• Lanhers et al., upper limb (Sports Medicine 2017) — 53 studies (563 people on creatine, 575 controls). Global upper-limb effect size 0.317 (0.185–0.449); bench press 0.265 (0.132–0.398). Again, results did not vary with population characteristics, training protocol, dose or duration.
• Chilibeck et al., older adults (Open Access Journal of Sports Medicine 2017) — 22 studies, 721 participants with a mean age of 57–70 years, resistance training 2–3 days a week for 7–52 weeks. Chest press standardized mean difference 0.35 (0.16–0.53); leg press 0.24 (0.05–0.43).

Branch’s earlier meta-analysis (Int J Sport Nutr Exerc Metab 2003), covering 100 placebo-controlled studies, found small but significant effect sizes for body composition (0.17) and for exercise tasks of 30 seconds or less (0.24), larger effects for upper-body than lower-body exercise, no benefit for running and swimming, and no difference in effect between men and women or between trained and untrained subjects.

A trial example: in Volek et al. (Med Sci Sports Exerc 1999), 19 resistance-trained men followed 12 weeks of periodized heavy resistance training with creatine (25 g/day for 1 week, then 5 g/day) or placebo. Bench press rose 24% with creatine vs 16% with placebo, and squat 32% vs 24%.

The role of training: almost all of these trials paired creatine with resistance training. In the Delpino 2022 meta-analysis, creatine without an exercise programme did not significantly change lean body mass (mean difference 0.03 kg). A 2026 trial in sedentary adults aged 45 to 65 reported gains in lean tissue and bench-press strength with creatine alone; that study is covered on the Creatine Without Exercise page.

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Power Output and Repeated Sprint Performance

Several early studies found the clearest effects in repeated short, maximal efforts. In Greenhaff et al. (Clinical Science 1993), 12 subjects performed five bouts of 30 maximal isokinetic contractions separated by 1-minute rests, before and after 5 days of creatine (4 × 5 g/day) or placebo. After creatine, peak torque was greater during the final 10 contractions of bout 1, throughout bouts 2 and 3, and during part of the final bout; no change was seen after placebo. Vandenberghe et al. (1996) reported that 6 days of creatine increased dynamic torque by 10–23% in an intermittent maximal-contraction test, with the improvement most prominent right after the rest periods.

Kreider’s 2003 review of about 300 studies reports that about 70% found statistically significant results; it cites short-term improvements of 5–15% in maximal power and strength, 5–15% in work during sets of maximal-effort contractions, 1–5% in single-effort sprint performance and 5–15% in work during repeated sprints. No study in that review reported a statistically significant ergolytic (performance-reducing) effect.

Volek et al. (1999), the 12-week resistance-training trial, found that average volume lifted in the bench press during training was significantly greater with creatine during weeks 5–8, and the authors attributed the gains to “higher quality training sessions.”

For team sports, the ISSN position stand states that creatine has primarily been recommended for power and strength athletes and for athletes who sprint intermittently and recover during competition, such as in American football, soccer, basketball and tennis, and that after loading, high-intensity and repetitive exercise performance is generally increased by 10–20% depending on the rise in muscle phosphocreatine. The Wax et al. (Nutrients 2021) review reports consistent benefits for single and multiple bouts of short, high-intensity exercise, and contradictory findings for intermittent and continuous endurance-type exercise and for tasks in which extra body mass may hinder performance.

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Lean Mass Gains and Body Composition

Lean-mass findings from the meta-analyses:

• Delpino et al. (Nutrition 2022) — 35 randomized trials, 1,192 participants. Across all trials, creatine increased lean body mass by 0.68 kg (95% CI 0.26–1.11). Combined with resistance training: 1.10 kg (0.56–1.65), regardless of age. With mixed exercise: 0.74 kg (−3.89 to 5.36), not significant. Without exercise: 0.03 kg (−0.65 to 0.70), not significant. Men gained 1.46 kg (0.47–2.46); the 0.29 kg gain in women (−0.43 to 1.01) was not significant.
• Chilibeck et al. (2017), older adults — lean tissue mass 1.37 kg greater with creatine plus resistance training than with training plus placebo (95% CI 0.97–1.76).
• Burke et al. (Nutrients 2023) — 10 trials with direct imaging of muscle size (MRI, CT or ultrasound) over at least 6 weeks of resistance training. Pooled estimate 0.11 (95% credible interval −0.02 to 0.25), which the authors describe as “a very small effect” favouring creatine, with muscle-thickness gains of 0.10–0.16 cm in the upper and lower body. Several authors disclose advisory or research ties to companies that make or sell creatine.

Two effects are discussed as contributing to the lean-mass result:

1. Water — creatine is osmotically active. The ISSN position stand reports that early studies found creatine loading produced short-term fluid retention of about 0.5–1.0 L, roughly proportional to the acute weight gain. The 2021 review by Antonio and colleagues states that water retention, mainly intracellular, is the most common effect in the first several days, but that several training studies of 5–10 weeks found no increase in total body water; it concludes that creatine supplementation “does not always lead to water retention.” A DXA scan counts this water as lean mass.
2. Muscle tissue — biopsy studies report fibre growth. In Volek et al. (1999), fibre cross-sectional area increased more with creatine than placebo in type I (35% vs 11%), type IIA (36% vs 15%) and type IIAB (35% vs 6%) fibres, and fat-free mass rose 6.3% vs 3.1%. In Burke et al. (2003), creatine produced greater increases in type II fibre area and whole-body lean tissue than placebo over 8 weeks of resistance training.

Cribb and Hayes (Med Sci Sports Exerc 2006) is a timing study rather than a creatine-versus-placebo trial: both groups of resistance-trained men took the same protein, creatine and glucose supplement for 10 weeks, either immediately before and after training or in the morning and late evening. The group that took it around training had greater gains in lean body mass, 1RM strength in two of three tests, type II fibre cross-sectional area and contractile protein content.

Water retention and body weight are covered in more detail on the Forms, Dosing & Safety page.

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Responders and Non-Responders: What Muscle Biopsy Studies Show

Muscle biopsy studies show that people differ in how much creatine their muscles take up. The best-known description is Syrotuik and Bell (2004): 11 healthy men loaded with 0.3 g/kg/day for 5 days fell into three groups by the rise in muscle total creatine — 3 responders (mean rise 29.5 mmol/kg dry weight), 5 quasi-responders (14.9 mmol/kg) and 3 non-responders (5.1 mmol/kg). Responders had the lowest starting creatine levels, the highest percentage of type II fibres, the largest fibre cross-sectional area and the most fat-free mass, and they improved leg-press 1RM; non-responders showed no improvement in 1RM strength. This was a small study, and the share of non-responders in larger populations has not been established.

Starting level is the factor most consistently linked to the size of the response:

• Low starting levels, larger response — in Harris 1992 the rise was greatest in subjects who started lowest. In Burke et al. (2003), vegetarians had lower baseline muscle total creatine than non-vegetarians (117 vs 130 mmol/kg) and, on creatine, had greater increases in total creatine, phosphocreatine, lean tissue and total work performance.
• High starting levels, little response — Casey and Greenhaff (2000) report that in individuals whose starting total creatine already approached 150 mmol/kg dry mass, neither creatine uptake nor an effect on phosphocreatine resynthesis or performance was found.

Findings on sex differ by measure. Branch 2003 found no difference in effect size between men and women. The Delpino 2022 lean-mass meta-analysis found a significant gain in men and a non-significant one in women. The 2021 review by Antonio and colleagues notes that women may have higher resting muscle creatine concentrations, which it suggests may help explain some research showing a smaller response in women.

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Creatine and Other Studied Ergogenic Aids (Caffeine, Beta-Alanine, Citrulline)

Several other supplements have their own research base for exercise performance, with different mechanisms and time windows:

• Caffeine — the 2021 ISSN position stand on caffeine reports that it has consistently improved exercise performance at 3–6 mg/kg body mass, with small to moderate benefits for muscular endurance, strength, sprinting and jumping, and the most consistent moderate-to-large benefits for aerobic endurance.
• Beta-alanine — a precursor of muscle carnosine, an intracellular pH buffer. The 2015 ISSN position stand reports that 4–6 g daily for at least 2–4 weeks improved exercise performance, with more pronounced effects in tasks lasting 1 to 4 minutes, and that the only reported side effect is tingling (paraesthesia).
• Citrulline — a precursor of arginine, thought to act by increasing nitric oxide production. A 2019 meta-analysis by Trexler and colleagues (12 studies, 198 participants, doses of at least 3 g) found a small benefit over placebo for high-intensity strength and power, a standardized mean difference of 0.20 (95% CI 0.01–0.39), with each individual study’s interval crossing the line of no effect.
• Sodium bicarbonate — an extracellular pH buffer; it is not covered by the sources cited on this page.

Caffeine and glucose dynamics are touched on in the CGM page.

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Combinations Studied With Creatine

• Caffeine — Vandenberghe et al. (J Appl Physiol 1996), in 9 healthy men, found that creatine alone for 6 days raised muscle phosphocreatine by 4–6% and dynamic torque by 10–23%, while creatine plus caffeine (5 mg/kg/day) raised phosphocreatine similarly but did not change torque; the authors wrote that the ergogenic effect was “completely eliminated by caffeine intake.” In a later 5-day loading trial in 54 active men (Trexler et al. 2016), neither creatine alone nor creatine with caffeine anhydrous or coffee significantly improved performance compared with placebo, and four subjects reported mild digestive discomfort with creatine plus caffeine. A 2015 review by Trexler and Smith-Ryan describes the research on concurrent use as scarce, notes that it has suggested caffeine may blunt creatine’s effect, and considers a pharmacokinetic interaction unlikely.
• Carbohydrate — Green et al. (Am J Physiol 1996) found that taking 93 g of simple carbohydrate 30 minutes after each 5 g creatine dose, four times a day for 5 days, produced a 60% greater rise in muscle total creatine than creatine alone, which appeared to be insulin-mediated. The ISSN position stand notes that the effect on performance may not be greater than with creatine monohydrate alone.
• Protein — the ISSN position stand reports that carbohydrate plus protein has been reported to promote creatine retention more consistently.
• Beta-alanine — acts on a different energy window (see above); the 2015 ISSN beta-alanine position stand states that combining it with other supplements may be advantageous when the beta-alanine dose and duration are sufficient.

Other points from the research:

• Other forms of creatine — the ISSN position stand states that clinical evidence has not shown creatine citrate, serum, ethyl ester, buffered creatine or nitrate to promote greater creatine retention than monohydrate. In Jagim et al. (2012), a buffered creatine product did not produce greater changes in muscle creatine, body composition, strength or anaerobic capacity than monohydrate, and did not have fewer side effects. See Forms, Dosing & Safety for each form.
• Hydration and heat — the 2021 review by Antonio and colleagues concludes that experimental and clinical research does not support the idea that creatine causes dehydration or muscle cramping.
• Kidneys — the ISSN position stand states there is no compelling evidence that creatine negatively affects renal function in healthy or clinical populations, while noting that some have suggested people with pre-existing kidney disease consult a physician first. Creatine raises blood creatinine, the marker used to estimate kidney function, which can complicate reading a routine kidney panel; this is covered on the Forms, Dosing & Safety page.

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The Endurance-Athlete Question

Most creatine research involves strength and sprint athletes, and the findings for endurance exercise are mixed.

• Aerobic capacity — a 2023 meta-analysis by Gras and colleagues (19 randomized trials, 424 people) found that VO2max rose in both groups but rose less with creatine than with placebo (effect size −0.32, 95% CI −0.51 to −0.12), and the authors concluded that creatine “has a negative effect on VO2max.”
• Running and swimming — Branch’s 2003 meta-analysis found field-based tasks such as running and swimming showed smaller effect sizes than laboratory tasks, and concluded creatine does not appear to improve running and swimming performance.
• Intermittent and continuous endurance exercise — the Wax 2021 review reports contradictory findings for intermittent and continuous endurance-type exercise.
• Body mass — weight gain is the side effect the ISSN position stand describes as consistently reported, and the Wax 2021 review notes contradictory findings in tasks where extra body mass may hinder performance.

The ISSN position stand also describes research on creatine for exercise in the heat, where loading increased intracellular water and reduced thermoregulatory and cardiovascular strain during prolonged exercise in one study.

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Doses and Schedules Used in the Research

A summary of what the studies on this page used and reported:

1. Form — nearly all of the strength, power and lean-mass trials used creatine monohydrate, which the ISSN position stand calls the most extensively studied and clinically effective form.
2. Daily dose — 3–5 g/day is the maintenance range in the ISSN position stand; the 2021 review by Antonio and colleagues refers to 3–5 g/day or 0.1 g/kg of body mass/day as the recommended dosages, at which it reports creatine is relatively well tolerated.
3. Loading — about 20 g/day (four 5 g doses, or 0.3 g/kg/day) for 5–7 days raised muscle creatine faster; without loading, similar levels were reached in about 3–4 weeks (Hultman 1996).
4. Dose size — a single 10 g dose produced more diarrhoea than two 5 g doses (Ostojic 2008).
5. With food — carbohydrate, or carbohydrate and protein, increased muscle uptake (Green 1996; ISSN 2017).
6. In liquids — the 2021 review reports that creatine is stable as a dry powder but not in solution, where it converts to creatinine, especially at higher temperature and lower pH.
7. Training — the strength and lean-mass gains in the meta-analyses come mainly from trials that combined creatine with resistance training.

Safety is covered in detail on the Forms, Dosing & Safety page. Decisions about supplements belong with a clinician, particularly for people with kidney disease, as the ISSN position stand notes.

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Key Research Papers

1. Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 14:18. — PubMed PMID: 28615996
2. Harris RC, Söderlund K, Hultman E (1992). Elevation of creatine in resting and exercised muscle of normal subjects by creatine supplementation. Clin Sci 83(3):367-374. — PubMed PMID: 1327657
3. Hultman E, Söderlund K, Timmons JA, Cederblad G, Greenhaff PL (1996). Muscle creatine loading in men. J Appl Physiol 81(1):232-237. — PubMed PMID: 8828669
4. Branch JD (2003). Effect of creatine supplementation on body composition and performance: a meta-analysis. Int J Sport Nutr Exerc Metab 13(2):198-226. — PubMed PMID: 12945830
5. Lanhers C, Pereira B, Naughton G, Trousselard M, Lesage FX, Dutheil F (2015). Creatine supplementation and lower limb strength performance: a systematic review and meta-analyses. Sports Med 45(9):1285-1294. — PubMed PMID: 25946994
6. Lanhers C, Pereira B, Naughton G, Trousselard M, Lesage FX, Dutheil F (2017). Creatine supplementation and upper limb strength performance: a systematic review and meta-analysis. Sports Med 47(1):163-173. — PubMed PMID: 27328852
7. Volek JS, Duncan ND, Mazzetti SA, Staron RS, Putukian M, Gómez AL, Pearson DR, Fink WJ, Kraemer WJ (1999). Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc 31(8):1147-1156. — PubMed PMID: 10449017
8. Cribb PJ, Hayes A (2006). Effects of supplement timing and resistance exercise on skeletal muscle hypertrophy. Med Sci Sports Exerc 38(11):1918-1925. — PubMed PMID: 17095924
9. Casey A, Greenhaff PL (2000). Does dietary creatine supplementation play a role in skeletal muscle metabolism and performance? Am J Clin Nutr 72(2 Suppl):607S-617S. — PubMed PMID: 10919967
10. Wax B, Kerksick CM, Jagim AR, Mayo JJ, Lyons BC, Kreider RB (2021). Creatine for exercise and sports performance, with recovery considerations for healthy populations. Nutrients 13(6):1915. — PubMed PMID: 34199588
11. Antonio J, Ciccone V (2013). The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. J Int Soc Sports Nutr 10:36. — PubMed PMID: 23919405
12. Greenhaff PL, Casey A, Short AH, Harris R, Soderlund K, Hultman E (1993). Influence of oral creatine supplementation of muscle torque during repeated bouts of maximal voluntary exercise in man. Clin Sci 84(5):565-571. — PubMed PMID: 8504634
13. Chilibeck PD, Kaviani M, Candow DG, Zello GA (2017). 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 8:213-226. — PubMed PMID: 29138605
14. Delpino FM, Figueiredo LM, Forbes SC, Candow DG, Santos HO (2022). Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: a systematic review and meta-analysis of randomized clinical trials. Nutrition 103-104:111791. — PubMed PMID: 35986981
15. Burke R, Piñero A, Coleman M, Mohan A, Sapuppo M, Augustin F, Aragon AA, Candow DG, Forbes SC, Swinton P, Schoenfeld BJ (2023). The effects of creatine supplementation combined with resistance training on regional measures of muscle hypertrophy: a systematic review with meta-analysis. Nutrients 15(9):2116. — PubMed PMID: 37432300
16. Kreider RB (2003). Effects of creatine supplementation on performance and training adaptations. Mol Cell Biochem 244(1-2):89-94. — PubMed PMID: 12701815
17. Syrotuik DG, Bell GJ (2004). Acute creatine monohydrate supplementation: a descriptive physiological profile of responders vs. nonresponders. J Strength Cond Res 18(3):610-617. — PubMed PMID: 15320650
18. Burke DG, Chilibeck PD, Parise G, Candow DG, Mahoney D, Tarnopolsky M (2003). Effect of creatine and weight training on muscle creatine and performance in vegetarians. Med Sci Sports Exerc 35(11):1946-1955. — PubMed PMID: 14600563
19. Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 18(1):13. — PubMed PMID: 33557850
20. Gras D, Lanhers C, Bagheri R, Ugbolue UC, Coudeyre E, Pereira B, Zak M, Bouillon-Minois JB, Dutheil F (2023). Creatine supplementation and VO2max: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 63(21):4855-4866. — PubMed PMID: 34859731
21. Vandenberghe K, Gillis N, Van Leemputte M, Van Hecke P, Vanstapel F, Hespel P (1996). Caffeine counteracts the ergogenic action of muscle creatine loading. J Appl Physiol 80(2):452-457. — PubMed PMID: 8929583
22. Trexler ET, Smith-Ryan AE, Roelofs EJ, Hirsch KR, Persky AM, Mock MG (2016). Effects of coffee and caffeine anhydrous intake during creatine loading. J Strength Cond Res 30(5):1438-1446. — PubMed PMID: 26439785
23. Trexler ET, Smith-Ryan AE (2015). Creatine and caffeine: considerations for concurrent supplementation. Int J Sport Nutr Exerc Metab 25(6):607-623. — PubMed PMID: 26219105
24. Green AL, Hultman E, Macdonald IA, Sewell DA, Greenhaff PL (1996). Carbohydrate ingestion augments skeletal muscle creatine accumulation during creatine supplementation in humans. Am J Physiol 271(5 Pt 1):E821-E826. — PubMed PMID: 8944667
25. Ostojic SM, Ahmetovic Z (2008). Gastrointestinal distress after creatine supplementation in athletes: are side effects dose dependent? Res Sports Med 16(1):15-22. — PubMed PMID: 18373286
26. Jagim AR, Oliver JM, Sanchez A, Galvan E, Fluckey J, Riechman S, Greenwood M, Kelly K, Meininger C, Rasmussen C, Kreider RB (2012). A buffered form of creatine does not promote greater changes in muscle creatine content, body composition, or training adaptations than creatine monohydrate. J Int Soc Sports Nutr 9(1):43. — PubMed PMID: 22971354
27. Trexler ET, Persky AM, Ryan ED, Schwartz TA, Stoner L, Smith-Ryan AE (2019). Acute effects of citrulline supplementation on high-intensity strength and power performance: a systematic review and meta-analysis. Sports Med 49(5):707-718. — PubMed PMID: 30895562
28. Guest NS, VanDusseldorp TA, Nelson MT, Grgic J, Schoenfeld BJ, Jenkins NDM, Arent SM, Antonio J, Stout JR, Trexler ET, Smith-Ryan AE, Goldstein ER, Kalman DS, Campbell BI (2021). International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr 18(1):1. — PubMed PMID: 33388079
29. Trexler ET, Smith-Ryan AE, Stout JR, Hoffman JR, Wilborn CD, Sale C, Kreider RB, Jäger R, Earnest CP, Bannock L, Campbell B, Kalman D, Ziegenfuss TN, Antonio J (2015). International society of sports nutrition position stand: Beta-Alanine. J Int Soc Sports Nutr 12:30. — PubMed PMID: 26175657

PubMed Topic Searches

1. PubMed: Creatine monohydrate & resistance training
2. PubMed: Creatine supplementation meta-analyses
3. PubMed: Loading kinetics & saturation
4. PubMed: Sprint & power output
5. PubMed: Lean mass & hypertrophy

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