Does creatine help build muscle?

Yes, when it is taken alongside resistance training. A meta-analysis of 61 trials found creatine with lifting added 3.1 lb (1.39 kg) of fat-free mass over lifting alone, and a meta-analysis of 12 randomized trials in adults under 50 found 2.5 lb (1.14 kg) of lean body mass. Both measures count the water that creatine draws into muscle. When ten trials scanned the muscle directly, the gain in thickness was very small, 0.04 to 0.06 in (0.10 to 0.16 cm).

Established. Creatine taken with resistance training increases lean mass and strength more than training alone. Several meta-analyses of randomized trials agree on the direction, including a 2026 analysis of 63 studies in 1,489 people. How much of the extra mass is new muscle tissue is the part still in question.

Extra kilograms of lean or fat-free mass from creatine, against training without it

Each bar is the pooled difference with its 95% confidence interval. Lean and fat-free mass are measured by body scans that count the water held in muscle, so these numbers are larger than the gain in muscle tissue itself. Sources: cards ev-crmg-02, ev-crmg-03, ev-crmg-06 and ev-crmg-07 below.

What the trials found

Mass on the scan

The largest pooling, a 2026 three-level meta-analysis of 63 studies in 1,489 people, compared resistance training plus creatine with resistance training alone. It found standardized gains of 0.30 for lean mass and 0.54 and 0.55 for upper and lower body strength. The trials often did not report diet or training background in full. In kilograms, the 61-trial analysis found 3.1 lb (1.39 kg) of fat-free mass (95% CI 1.07 to 1.70) and 2 lb (0.89 kg) of body weight, with no effect on fat mass. Trained lifters gained 4 lb (1.82 kg) and untrained lifters 2.7 lb (1.23 kg), and that difference was not significant. The 12-trial analysis in adults under 50 found 2.5 lb (1.14 kg) of lean body mass and 1.6 lb (0.73 kg) less fat mass, and 41% of its studies had some concerns about bias.

Muscle itself

A 2023 meta-analysis of 10 randomized trials in healthy adults training for at least six weeks used MRI, CT or ultrasound to measure the muscle rather than the whole lean compartment. The gain in muscle thickness was 0.04 to 0.06 in (0.10 to 0.16 cm), and the pooled standardized effect of 0.11 had a credible interval running from just below zero to 0.25. Read together with the scan results, much of the kilogram on a body composition scan may be water held in muscle rather than new tissue.

Strength

Across 23 studies in adults under 50, creatine with training added 9.8 lb (4.43 kg) to upper-body and 25 lb (11.35 kg) to lower-body strength against placebo. Those studies had 467 men and 49 women, and the women showed no significant gains. A network meta-analysis of 35 trials in 1211 trained athletes ranked creatine first among supplements for strength, with a standardized effect of 0.46, based partly on indirect comparisons.

Older adults and women

In older adults and people with chronic disease at risk of disability, 33 randomized trials in 1076 people found creatine added 2.4 lb (1.08 kg) of lean tissue, on evidence the reviewers rated low or very low because of bias. In postmenopausal women, 5 trials in 338 women found 0.82 lb (0.37 kg) more lean mass (95% CI 0.05 to 0.69). In that review the benefit appeared in trials using 5 g a day or more combined with resistance training, and trials at 3 g a day or less without training showed no effect.

Unsettled. The effect is not universal in older men. In a 12-month trial of 38 men aged 49 to 69 doing supervised whole-body training, those taking 0.1 g of creatine per kg a day ended with the same lean tissue, muscle thickness and strength as those on placebo. It is one small trial, and it sits against pooled results that favor creatine in older adults.

Who should be careful

The safety cards here are about kidneys, side effects in women and one hormone signal. We have no cards on pregnancy, children or interactions with medicines, so this page cannot speak to those groups. None of the cards here sets an upper safe daily dose either.

Creatine raises the blood creatinine reading. A 2025 meta-analysis found a slight, transient rise in serum creatinine with no significant change in kidney filtration rate, in mostly healthy people. That matters for anyone having kidney blood tests, because the lab result can look worse than kidney function is. The analysis says nothing about people who already have kidney disease.

In 29 studies of 951 women, adverse events were no more common on creatine, with a risk ratio of 1.24 and an interval from 0.51 to 2.98 that crosses no effect. Many of those trials reported side effects poorly.

Not for everyone. One small trial is behind the hair-loss worry. In a crossover trial of 20 college rugby players taking 25 g a day for 7 days and then 5 g a day, DHT, a hormone linked to hair loss, rose 56% after the loading week and stayed 40% above baseline after a further 14 days. Nobody measured hair, and the finding has not been repeated. If you already have kidney disease, creatine is a question for your doctor, because none of the safety data here covers you.

What expert bodies say

The International Society of Sports Nutrition position stand from 2017 says the literature gives no support to the idea that creatine causes kidney dysfunction or long-term harm, and refutes claims about cramps, dehydration and gut upset. Some of its authors have industry ties, and it does not cover existing kidney disease.

The European Union authorizes creatine products to say that daily creatine can enhance the effect of resistance training on muscle strength in adults over 55. The approved wording is about strength and does not mention muscle size. The EU did not authorize a claim that creatine enhances physical working capacity at the fatigue threshold.

How we searched

Searched: a local copy of the PubMed 2026 baseline, queried for creatine with muscle, lean mass, fat-free mass, hypertrophy and strength (854 records), with muscle thickness and cross-sectional area (44), with kidney outcomes (155), and with safety, adverse events and hair loss (317). We also searched the EU register of health claims (13 creatine claims, 2 authorized, 11 rejected), the US drug interaction and supplement fact sheet sources (nothing found), the web for newer meta-analyses (nothing newer than the corpus), ClinicalTrials.gov for active trials, and Retraction Watch for every trial and review used, with no retractions found. Search run on 6 October 2026.

Included: seven meta-analyses of randomized trials on lean mass, muscle and strength, two randomized trials, two meta-analyses on safety, the ISSN position stand and the EU authorized claim.

Excluded: a review in young men that overlapped the larger syntheses, a 2019 kidney meta-analysis replaced by the 2025 one, a heat tolerance review about performance rather than muscle, and a trial comparing creatine forms.

What we read: the full text of the ISSN position stand. Abstracts for the rest.

What we could not get: there is no Cochrane review of creatine for muscle in healthy adults and no US government fact sheet on creatine. The dose conditions attached to the EU claim sit in a regulation annex that we did not quote. No trial has measured hair loss itself.

What would change this answer

Long trials that image muscle directly with MRI and separate muscle tissue from the water it holds. That would settle how much of the scan gain is muscle.
Results from NCT07463092, a recruiting trial of creatine with resistance training in 34 people with sarcopenia.
A second trial of creatine and DHT, ideally one that also measures hair.
More trials in women. The strength analysis had 49 of them.

More on creatine itself, including food sources and the brain claims: Creatine.

The food behind this question

Creatine: a real strength gain when it is paired with training — numbers, evidence and safety

The same question for other foods (muscle growth)

Sources

ev-crmg-01 · Meta-analysis or systematic review · systematic review and three-level meta-analysis of controlled trials · n = 1,489
Compared with resistance training alone (RT), resistance training plus creatine (RT + CR) produced significant increases in upper-body strength (g = 0.54, p < 0.001), lower-body strength (g = 0.55, p < 0.001), lean mass (g = 0.30, p < 0.001), and body mass (g = 0.12, p = 0.04), and a significant reduction in body-fat percentage (g = -0.14, p = 0.02).
Who: adults in trials of resistance training plus creatine vs resistance training alone
Effect: lean mass g 0.30; upper-body strength g 0.54; lower-body strength g 0.55; fat mass g -0.10 (not significant)
Certainty: Standardized effects; diet and training backgrounds incompletely reported in trials.
J Int Soc Sports Nutr, 2026 · checked 2026-10-06 · we read the abstract
ev-crmg-02 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs, preregistered · n = 12 trials
Compared with resistance training (RT) alone, creatine supplementation increased LBM by 1.14 kg (95% CI 0.69 to 1.59), and reduced body fat percentage by -0.88% (95% CI -1.66 to -0.11) and body fat mass by -0.73 kg (95% CI -1.34 to -0.11).
Who: adults younger than 50 years doing resistance training
Effect: lean body mass +2.5 lb (95% CI 1.5 to 3.5; metric: 1.14 kg, 0.69 to 1.59); body fat -0.88% (-1.66 to -0.11); fat mass -1.6 lb (-3 to -0.24; metric: -0.73 kg, -1.34 to -0.11)
Certainty: Lean body mass by DXA or similar includes muscle water; 41% of studies had some concerns of bias.
J Strength Cond Res, 2024 · checked 2026-10-06 · we read the abstract
ev-crmg-03 · Meta-analysis or systematic review · systematic review and dose-response meta-analysis of controlled trials · n = 61 trials
A pooled analysis of 61 trials revealed that Cr supplementation significantly increased FFM (weighted mean difference [WMD]: 1.39 kg; 95% confidence intereval (CI): 1.07,1.70; p < 0.001) and body mass (WMD: 0.89 kg; 95% CI: 0.76,1.01; p < 0.001) without significant effects on FM, BMI, and BFP.
Who: trained and untrained adults doing resistance training with creatine or placebo
Effect: fat-free mass WMD +3.1 lb (95% CI 2.4 to 3.7; metric: 1.39 kg, 1.07 to 1.70); body mass +2 lb (1.7 to 2.2; metric: 0.89 kg, 0.76 to 1.01); trained 1.82 vs untrained 2.7 lb (1.23 kg), difference not significant
Certainty: Fat-free mass includes water; no effect on fat mass.
J Int Soc Sports Nutr, 2025 · checked 2026-10-06 · we read the abstract
ev-crmg-04 · Meta-analysis or systematic review · systematic review and Bayesian meta-analysis of RCTs · n = 10 trials
Multivariate analyses found similar small benefits for the combination of creatine supplementation and RT on changes in the upper and lower body muscle thickness (0.10-0.16 cm).
Who: healthy adults, at least 6 weeks of resistance training; MRI, CT or ultrasound measures of hypertrophy
Effect: pooled standardized effect 0.11 (95% CrI -0.02 to 0.25); muscle thickness +0.04 to 0.06 in (0.10 to 0.16 cm) upper and lower body
Certainty: Credible interval touches zero; shows that much of the lean-mass gain on DXA may not be new muscle tissue.
Nutrients, 2023 · checked 2026-10-06 · we read the abstract
ev-crmg-05 · Meta-analysis or systematic review · systematic review and meta-analysis of placebo-controlled trials · n = 23 studies
In comparison with a placebo, creatine supplementation combined with resistance training significantly increased upper-body (WMD = 4.43 kg, p < 0.001) and lower-body strength (WMD = 11.35 kg, p < 0.001).
Who: adults under 50 doing resistance training; 467 men and 49 women
Effect: upper-body strength WMD +9.8 lb (4.43 kg); lower-body strength WMD +25 lb (11.35 kg) vs placebo; women showed no significant gains
Certainty: Strength, not muscle size; few women studied.
Nutrients, 2024 · checked 2026-10-06 · we read the abstract
ev-crmg-06 · Meta-analysis or systematic review · systematic review and meta-analysis of randomized placebo-controlled trials with GRADE · n = 338
Lean mass (k = 5; n = 338) favored creatine: mean difference (MD) + 0.37 kg (95% CI + 0.05 to + 0.69; I² = 25%; τ² = 0.01; 95% PI -0.10 to + 0.84).
Who: postmenopausal women, mean age about 62 years; 12 to 104 weeks
Effect: lean mass MD +0.82 lb (95% CI 0.11 to 1.5; metric: 0.37 kg, 0.05 to 0.69); leg-press 1RM +17 lb (7.5 kg); no effect at 3 g/day or less without training
Certainty: Small, review not preregistered; renal indices unchanged.
J Int Soc Sports Nutr, 2026 · checked 2026-10-06 · we read the abstract
ev-crmg-07 · Meta-analysis or systematic review · systematic review and meta-analysis of RCTs · n = 1,076
Upper-body muscle strength (SMD: 0.25; 95% CI: 0.06-0.44; I2 = 0%; P = 0.01), handgrip strength (SMD 0.23; 95% CI: 0.01-0.45; I2 = 0%; P = 0.04), and lean tissue mass (MD 1.08 kg; 95% CI: 0.77-1.38; I2 = 26%; P < 0.01) improved with creatine supplementation.
Who: older adults and adults with chronic disease at risk of functional disability
Effect: lean tissue mass MD +2.4 lb (95% CI 1.7 to 3; metric: 1.08 kg, 0.77 to 1.38); sit-to-stand SMD 0.51 (0.01 to 1.00)
Certainty: Quality of evidence low or very low because of high risk of bias.
JPEN J Parenter Enteral Nutr, 2024 · checked 2026-10-06 · we read the abstract
ev-crmg-08 · Randomized controlled trial(s) · randomized double-blind placebo-controlled trial · n = 38
After 12 months of training, both groups experienced similar changes in bone mineral density and geometry, bone speed of sound, lean tissue and fat mass, muscle thickness, and muscle strength.
Who: older males, creatine 0.1 g/kg/day (n 18) or placebo (n 20) with supervised whole-body resistance training
Effect: similar changes in lean tissue, muscle thickness and strength in both groups after 12 months
Certainty: Small; shows the effect is not universal in older men.
Nutr Health, 2021 · checked 2026-10-06 · we read the abstract
ev-crmg-09 · Observational data · systematic review and meta-analysis of controlled studies · n = 440
Creatine supplementation is associated with a modest, transient increase in serum creatinine levels, likely due to metabolic turnover rather than renal impairment.
Who: studies of creatine supplementation reporting kidney outcomes; 177 creatine and 263 control participants in the creatinine analysis
Effect: serum creatinine MD 0.07 (95% CI 0.01 to 0.12); no significant difference in GFR
Certainty: Mostly healthy people; says nothing about people with existing kidney disease.
BMC Nephrol, 2025 · checked 2026-10-06 · we read the abstract
ev-crmg-10 · Observational data · systematic review and meta-analysis · n = 951
There were no significant differences in total adverse events, (risk ratio (RR) 1.24 (95% CI 0.51, 2.98)), gastrointestinal events, (RR 1.09 (95% CI 0.53, 2.24)), or weight gain, (mean difference (MD) 1.24 kg pre-intervention, (95% CI -0.34, 2.82)) to 1.37 kg post-intervention (95% CI -0.50, 3.23)), in CrM supplemented females, when stratified by dosing regimen and subject to meta-analysis.
Who: female participants in creatine monohydrate studies that monitored adverse outcomes
Effect: total adverse events RR 1.24 (95% CI 0.51 to 2.98); weight gain MD 2.7 to 3 lb (1.24 to 1.37 kg), not significant
Certainty: Adverse events poorly reported in many trials.
Nutrients, 2020 · checked 2026-10-06 · we read the abstract
ev-crmg-11 · Randomized controlled trial(s) · double-blind placebo-controlled crossover trial · n = 20
However, levels of DHT increased by 56% after 7 days of creatine loading and remained 40% above baseline after 14 days maintenance (P < 0.001).
Who: college-aged male rugby players; 25 g/day creatine for 7 days then 5 g/day for 14 days
Effect: DHT +56% after 7 days, +40% after 21 days; DHT:T ratio +36%; testosterone unchanged
Certainty: Single small study, not replicated; no hair outcome was measured.
Clin J Sport Med, 2009 · checked 2026-10-06 · we read the abstract
ev-crmg-12 · Position of an expert body · society position stand · n = —
Nor has the literature provided any support that creatine promotes renal dysfunction [22, 51, 85, 114, 156, 172, 243–248] or has long-term detrimental effects [22, 23, 53, 155, 172].
Who: healthy people and athletes using creatine monohydrate
Effect: no consistent pattern of adverse events; refutes claims of injuries, dehydration, cramping, GI upset and renal dysfunction
Certainty: Sports nutrition society with some industry ties among authors; does not cover pre-existing kidney disease.
Journal of the International Society of Sports Nutrition, 2017, International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine · checked 2026-10-06 · we read the fulltext
ev-crmg-13 · Position of an expert body · EU Register on nutrition and health claims, claim POL-HC-8493, snapshot of 2026-09-21 · n = —
POL-HC-8493 Creatine Daily creatine consumption can enhance the effect of resistance training on muscle strength in adults over the age of 55. -/- Authorised
Who: foods and supplements sold in the EU; adults over 55
Effect: claim status: authorized
Certainty: Claim is about strength, not muscle size; conditions of use (dose) are in Regulation (EU) 432/2012 and not quoted here.
EU Register on nutrition and health claims, claim POL-HC-8493, snapshot 2026-09-21 · checked 2026-10-06 · we read the section
crtn-daily-r4-05 · Meta-analysis or systematic review · systematic review and network meta-analysis of RCTs · n = 1211
Creatine supplementation demonstrated superior effects for muscle strength (SMD = 0.46, 95% CI: 0.29 to 0.63, SUCRA = 82.4%)
Who: trained athletes with at least six months of structured training, 35 RCTs
Effect: strength SMD 0.46 (95% CI 0.29 to 0.63), SUCRA 82.4%
Certainty: indirect comparisons
Nutrients, 2026 · checked 2026-10-03 · we read the abstract
crtn-daily-r4-16 · Position of an expert body · regulatory decision · n = —
POL-HC-6993 Creatine Creatine can help enhance physical working capacity at fatigue threshold Non-authorised
Who: EU health claims register
Effect: status non-authorized
Certainty: reason for refusal is absent in the snapshot
EU Register on nutrition and health claims, claim POL-HC-6993, snapshot 2026-09-21 · checked 2026-10-03 · we read the dataset

How this page was made. Evidence was extracted from primary sources into cards, every number was re-checked against the source, and the text was written from those cards. Bioma Learn has no human medical reviewer at this time, and we say so rather than invent one. Methodology. This is information, not medical advice.