Creatine Supplementation: A closer look at its effectiveness for Strength and Body Composition

Creatine is a naturally occurring compound that is partly synthesised in the body from the amino acids glycine, arginine, and methionine. Additional creatine can be obtained through dietary sources such as red meat and fish, where it is already present in animal muscle tissue. Around 95% of the body’s creatine stores are found in skeletal muscle, where it is stored as free creatine and phosphocreatine. (1)

Phosphocreatine helps rapidly regenerate ATP, the body’s immediate energy source, by donating a phosphate group to ADP during periods of high energy demand. This makes creatine particularly useful during short, intense activities such as sprinting or resistance training. By supporting training performance and workload over time, creatine supplementation may contribute to greater gains in lean body mass when combined with training. (1)

What does the evidence say?

Strength and Performance

• A systematic review from 2024 included 23 studies that looked at creatine supplementation in adults <50 and reported increased upper-and lower-body strength. These increases were noted largely in male participants, but female participants were underrepresented in the review. Additionally, there was a trend toward higher lower-body strength in men with a higher dose of creatine. (2)

• On the other hand, a systematic review and meta-analysis from 2025 found that although muscle strength was overall higher after creatine supplementation compared to placebo when assessing bench press, leg press and squat strength, better effects in muscle strength were noted in the low-to moderate dose group than the high-dose group. High-intensity training had a much greater effect than low-intensity training. (3)

• A 2025 meta-analysis of 69 randomised controlled trials on the effect of creatine supplementation on upper-and lower-body strength in adults ranging from 18 to 80 years, found that creatine improved several strength and power outcomes overall, but not every measure. The authors reported in a sub-analysis that benefits were more consistent in younger adults and in males. (4)

Body Composition

• A 2017 systematic review and meta-analysis looked at 22 studies comparing resistance training with creatine monohydrate (the most common supplement form of creatine) against resistance training with placebo in older adults. Participants consumed creatine or placebo for at least 5 weeks and completed resistance training at least twice a week. Results showed an increase in lean tissue mass of approximately +1.37kg and a statistically significant increase in upper-and lower-body strength, measured with chest press and leg press performance. (5)

• In a very recent review from 2026, 39 randomised controlled trials that included young males only aged 18-30years, the authors reported an increase in lean body mass of approximately 2.7kg in combination with resistance training and creatine supplementation. Outcomes were less reliable when creatine was taken without resistance training. (6)

• A similar conclusion was previously noted in another systematic review from 2024 that evaluated the effect of creatine on body composition with or without resistance training. Authors reported creatine supplementation increased fat-free mass by 0.82kg and therefore concluded that the effect is significantly more beneficial when creatine intake is combined with resistance training. (7)

What does this mean in practice?

• Creatine supplementation has been shown to likely increase muscle strength, although studies show mixed results of the effect in younger versus older populations.

• Additionally, creatine may increase lean body and fat-free mass, although it is important to note that creatine increases water uptake in the muscle cell, contributing to lean body mass measurements, particularly in the short-term. (6)

• There is lower evidence on creatine intake in females, with a positive effect in males being consistently reported, although this may partly reflect the lower number of female-only studies.

• The overall conclusion is that creatine alone will likely not substantially increase muscle strength and performance, or lean body mass by itself, but appears most effective when combined with resistance training, although some short-duration anaerobic performance benefits may still occur. (6)

• Lastly, some limitations of randomised controlled trials may include conflict of interest from supplement industry funding, inconsistencies in dose, body-mass-adjusted dose, and creatine loading vs no loading, which should be taken into account.

Key takeaway

Creatine is one of the most evidence-supported supplements for improving strength performance and supporting lean body mass, particularly when paired with regular resistance training. Its effects are generally modest rather than dramatic, but they appear reliable across many studies. For most individuals, creatine should be viewed as a useful supplement to support training, not a replacement for regular exercise and nutrition.

References:

1. Kreider RB, Stout JR. Creatine in health and disease. Nutrients. 2021;13(2):447. doi:10.3390/nu13020447.

2. Wang Z, Qiu B, Li R, Han Y, Petersen C, Liu S, et al. Effects of creatine supplementation and resistance training on muscle strength gains in adults <50 years of age: a systematic review and meta-analysis. Nutrients. 2024;16(21):3665. doi:10.3390/nu16213665.

3. Zhang H, Lan T, Yan X, Gu H, Li Y, He E. Effects of creatine supplementation on muscle strength gains: a meta-analysis and systematic review. PeerJ. 2025;13:e20380. doi:10.7717/peerj.20380.

4. Kazeminasab F, Kerchi AB, Sharafifard F, Zarreh M, Forbes SC, Camera DM, et al. The effects of creatine supplementation on upper- and lower-body strength and power: a systematic review and meta-analysis. Nutrients. 2025;17(17):2748. doi:10.3390/nu17172748.

5. 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.

6. Gu J, Li Y, Xiao J, Zhang Y. Creatine supplementation in young men under resistance versus non-resistance training: a systematic review and meta-analysis of strength, performance, and lean mass. Front Nutr. 2026;13:1800546. doi:10.3389/fnut.2026.1800546.

7. Pashayee-Khamene F, Heidari Z, Asbaghi O, Ashtary-Larky D, Goudarzi K, Forbes SC, et al. Creatine supplementation protocols with or without training interventions on body composition: a GRADE-assessed systematic review and dose-response meta-analysis. J Int Soc Sports Nutr. 2024;21(1):2380058. doi:10.1080/15502783.2024.2380058.

Disclaimer: This article is for educational purposes only and does not replace medical advice. Individual needs vary, and personalised guidance from a qualified healthcare professional is recommended for tailored support.